WorldWideScience

Sample records for dialysis develop strategies

  1. Patients in assisted automated peritoneal dialysis develop strategies for selfcare

    DEFF Research Database (Denmark)

    Holch, Kirsten

      Patients in Assisted Automated Peritoneal Dialysis develop strategies for self-care Background: Since 2000 a model for Assisted Automated Peritoneal Dialysis (AAPD) in the patients own home has been developed at Aarhus University Hospital, Skejby. The patient group consists of physically...

  2. Patients in assisted automated peritoneal dialysis develop strategies for self-care

    DEFF Research Database (Denmark)

    Holch, Kirsten

    2008-01-01

      Background Since 2000, a model for Assisted Automated Peritoneal Dialysis (aAPD) for patients in their own home needing chronic dialysis treatment has been developed at Aarhus University Hospital, Skejby, Denmark. The patient group consists of physically or mentally frail elderly who cannot...

  3. A simulation model to estimate the cost and effectiveness of alternative dialysis initiation strategies.

    Science.gov (United States)

    Lee, Chris P; Chertow, Glenn M; Zenios, Stefanos A

    2006-01-01

    Patients with end-stage renal disease (ESRD) require dialysis to maintain survival. The optimal timing of dialysis initiation in terms of cost-effectiveness has not been established. We developed a simulation model of individuals progressing towards ESRD and requiring dialysis. It can be used to analyze dialysis strategies and scenarios. It was embedded in an optimization frame worked to derive improved strategies. Actual (historical) and simulated survival curves and hospitalization rates were virtually indistinguishable. The model overestimated transplantation costs (10%) but it was related to confounding by Medicare coverage. To assess the model's robustness, we examined several dialysis strategies while input parameters were perturbed. Under all 38 scenarios, relative rankings remained unchanged. An improved policy for a hypothetical patient was derived using an optimization algorithm. The model produces reliable results and is robust. It enables the cost-effectiveness analysis of dialysis strategies.

  4. Educational strategies and challenges in peritoneal dialysis: a qualitative study of renal nurses' experiences.

    Science.gov (United States)

    Bergjan, Manuela; Schaepe, Christiane

    2016-06-01

    The aim of the study was to explore renal nurses' experiences, strategies and challenges with regard to the patient education process in peritoneal dialysis. Patient education in peritoneal dialysis is essential to developing a successful home-based peritoneal dialysis program. In this area research is scarce and there is a particular lack of focus on the perspective of the renal nurse. Qualitative design formed by thematic qualitative text analysis. Five group interviews (n = 20) were used to explore the challenges peritoneal dialysis nurses face and the training strategies they use. The interviews were analyzed with thematic qualitative content analysis using deductive and inductive subcategory application. The findings revealed the education barriers perceived by nurses that patients may face. They also showed that using assessment tools is important in peritoneal dialysis patient education, as is developing strategies to promote patient self-management. There is a need for a deeper understanding of affective learning objectives, and existing teaching activities and materials should be revised to incorporate the patient's perspective. Patients usually begin having questions about peritoneal dialysis when they return home and are described as feeling overwhelmed. Adapting existing conditions is considered a major challenge for patients and nurses. The results provided useful insights into the best approaches to educating peritoneal dialysis patients and served to raise awareness of challenges experienced by renal nurses. Findings underline the need for nosogogy - an approach of teaching adults (andragogy) with a chronic disease. Flexibility and cooperation are competencies that renal nurses must possess. Still psychomotor skills dominate peritoneal dialysis patient training, there is a need of both a deeper understanding of affective learning objectives and the accurate use of (self-)assessment tools, particularly for health literacy. © 2016 John Wiley & Sons

  5. Microbiological Surveillance and State of the Art Technological Strategies for the Prevention of Dialysis Water Pollution

    Directory of Open Access Journals (Sweden)

    Andrea Galfrè

    2012-08-01

    Full Text Available Methods: The present report attempts to illustrate the positive impact on the microbiological quality of dialysis patients over a 15-year period through the progressive implementation of state-of-the-art technological strategies and the optimization of microbiological surveillance procedures in five dialysis units in Sardinia. Results: Following on better microbiological, quality controls of dialysis water and improvement of procedures and equipment, a drastic improvement of microbiological water quality was observed in a total of 945 samples. The main aim was to introduce the use of microbiological culture methods as recommended by the most important guidelines. The microbiological results obtained have led to a progressive refining of controls and introduction of new materials and equipment, including two-stage osmosis and piping distribution rings featuring a greater capacity to prevent biofilm adhesion. The actions undertaken have resulted in unexpected quality improvements. Conclusions: Dialysis water should be viewed by the nephrologist as a medicinal product exerting a demonstrable positive impact on microinflammation in dialysis patients. A synergic effort between nephrologists and microbiologists undoubtedly constitutes the most effective means of preventing dialysis infections.

  6. Microbiological surveillance and state of the art technological strategies for the prevention of dialysis water pollution.

    Science.gov (United States)

    Bolasco, Piergiorgio; Contu, Antonio; Meloni, Patrizia; Vacca, Dorio; Galfrè, Andrea

    2012-08-01

    The present report attempts to illustrate the positive impact on the microbiological quality of dialysis patients over a 15-year period through the progressive implementation of state-of-the-art technological strategies and the optimization of microbiological surveillance procedures in five dialysis units in Sardinia. Following on better microbiological, quality controls of dialysis water and improvement of procedures and equipment, a drastic improvement of microbiological water quality was observed in a total of 945 samples. The main aim was to introduce the use of microbiological culture methods as recommended by the most important guidelines. The microbiological results obtained have led to a progressive refining of controls and introduction of new materials and equipment, including two-stage osmosis and piping distribution rings featuring a greater capacity to prevent biofilm adhesion. The actions undertaken have resulted in unexpected quality improvements. Dialysis water should be viewed by the nephrologist as a medicinal product exerting a demonstrable positive impact on microinflammation in dialysis patients. A synergic effort between nephrologists and microbiologists undoubtedly constitutes the most effective means of preventing dialysis infections.

  7. Dialysis and Quality of Dialysate in Southeast Asian Developing Countries

    Directory of Open Access Journals (Sweden)

    Tomotaka Naramura

    2014-04-01

    Full Text Available Background: The number of dialysis patients has been increasing in Southeast Asia, but statistical data about these patients and on the quality of dialysates in Southeast Asian dialysis facilities are still imprecise. For this study, dialysis-related statistical data were collected in Southeast Asia. Methods: A survey of the quality of dialysates was carried out at 4 dialysis facilities in Vietnam and Cambodia. The dialysis patient survey included the numbers of dialysis facilities and patients receiving dialysis, a ranking of underlying diseases causing the initiation of dialysis, the number of patients receiving hemodialysis (HD/on-line hemodiafiltration/continuous ambulatory peritoneal dialysis, the number of HD monitoring devices installed, the cost of each session of dialysis (in USD, the percentage of out-of-pocket payments, and the 1-year survival rates of the dialysis patients (in percent. The dialysate survey covered the endotoxin (ET level and bacterial count in tap water, in water filtered through a reverse osmosis system and in dialysate. Results: In each of the countries, the most frequent reason for the initiation of dialysis is diabetes mellitus. HD is usually carried out according to the ‘reuse' principle. The 1-year survival rates are 70% in Myanmar and about 90% in the Philippines and Malaysia. The ET levels in standard dialysates were satisfactory at 2 facilities. The bacterial counts in dialysates were not acceptable at any of the facilities investigated. Conclusion: There is an urgent need to teach medical workers involved in dialysis how to prepare sterile and ET-free dialysates.

  8. The stenting strategy of drug-eluting stents for coronary artery disease in patients on dialysis

    Directory of Open Access Journals (Sweden)

    Hiroshi Fujita

    2014-12-01

    Full Text Available Background: Reports regarding the relationship between the length and diameter of implanted drug-eluting stents and clinical and angiographic outcomes in dialysis patients are limited. Aim: We investigated the efficiency of drug-eluting stents for coronary artery disease in patients on dialysis from the viewpoint of stent sizing. Methods: Sirolimus-eluting stents were implanted in 88 lesions and bare metal stents were implanted in 43 lesions. We compared stenting strategy, major adverse cardiac events, and angiographic results between sirolimus-eluting stent and bare metal stent groups. Results: Stent diameter was smaller and stent length was longer in the sirolimus-eluting stent group than in the bare metal stent group in our routine practices. There was no significant between-group difference in late diameter loss. Rates of angiographic restenosis and target lesion revascularization were significantly higher in the sirolimus-eluting stent group than in the bare metal stent group. Although stent length was significantly longer and stent diameter was smaller in the sirolimus-eluting stent group, sirolimus-eluting stents did not improve the subsequent clinical and angiographic results compared with bare metal stents in dialysis patients. Conclusion: In dialysis patients, a longer length and/or smaller diameter sirolimus-eluting stent implantation was associated with high rates of restenosis and target lesion revascularization compared with bare metal stents.

  9. Blue Planet dialysis: novel water-sparing strategies for reducing dialysate flow.

    Science.gov (United States)

    Molano-Triviño, Alejandra; Wancjer, Benjamin; Neri, Mauro M; Karopadi, Akash N; Rosner, Mitchell; Ronco, Claudio

    2017-11-08

    Hemodialysis (HD) is an expensive therapy in economic and in ecological terms, owing to a high carbon footprint and significant consumption of natural sources, especially water. Our aim was to review strategies to diminish waste of water in maintenance dialysis, exploring previously described water reuse trends and less known strategies for reducing the dialysate flow. We conducted a systematic review of water-sparing strategies, including the reuse of reverse osmosis rejected water and the reduction of dialysate flux. We performed a search in Medline, Pubmed, Scielo, OVID and Biblioteca Redentor, using key words: Dialysate flow rate, Dialysate flux, and decrease; excluding: online, peritoneal, continuous, blood access, needle, hemodiafiltration, acute, pharmacokinetics, increase. We limited our search to adult humans or in vitro trials in English, Spanish, Italian and Portuguese, between January 1980 and June 2017. We found 816 trials. 37 articles were retrieved for review, and 11 articles were analyzed. Conservation of water in chronic HD should be considered an important responsibility of healthcare practitioners all over the world. We present a wider usage of dialysate flow rates, considering that it would lead to significant water conservation without much compromise on dialysis efficacy in small patients. We believe that further investigation into the utility of reduced dialysate flux in different populations is needed to broaden our understanding of how we can use these techniques in order to significantly reduce water consumption during chronic HD while still ensuring optimum efficacy and efficiency of the therapy.

  10. Development of a standardized transfusion ratio as a metric for evaluating dialysis facility anemia management practices.

    Science.gov (United States)

    Liu, Jiannong; Li, Suying; Gilbertson, David T; Monda, Keri L; Bradbury, Brian D; Collins, Allan J

    2014-10-01

    Because transfusion avoidance has been the cornerstone of anemia treatment for patients with kidney disease, direct measurement of red blood cell transfusion use to assess dialysis facility anemia management performance is reasonable. We aimed to explore methods for estimating facility-level standardized transfusion ratios (STfRs) to assess provider anemia treatment practices. Retrospective cohort study. Point prevalent US hemodialysis patients on January 1, 2009, with Medicare as primary payer and dialysis duration of 90 days or longer were included (n = 223,901). All dialysis facilities with eligible patients were included (n = 5,345). Dialysis facility assignment. Receiving a red blood cell transfusion in the inpatient or outpatient setting. We evaluated 3 approaches for estimating STfR: ratio of observed to expected numbers of transfusions (STfR(obs)), a Bayesian approach (STfR(Bayes)), and a modified version of the Bayesian approach (STfR(modBayes)). The overall national transfusion rate in 2009 was 23.2 per 100 patient-years. Our model for predicting the expected number of transfusions performed well. For large facilities, all 3 STfRs worked well. However, for small facilities, while the STfR(modBayes) worked well, STfR(obs) values demonstrated instability and the STfR(Bayes) may produce more bias. Administration of transfusions to dialysis patients reflects medical practice both within and outside the dialysis unit. Some transfusions may be deemed unavoidable and transfusion practices are subject to considerable regional variation. Development of an STfR metric is feasible and reasonable for assessing anemia treatment at dialysis facilities. The STfR(obs) is simple to calculate and works well for larger dialysis facilities. The STfR(modBayes) is more analytically complex, but facilitates comparisons across all dialysis facilities, including small facilities. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  11. Developing and pilot testing a shared decision-making intervention for dialysis choice.

    Science.gov (United States)

    Finderup, Jeanette; Jensen, Jens K D; Lomborg, Kirsten

    2018-04-17

    Evidence is inconclusive on how best to guide the patient in decision-making around haemodialysis and peritoneal dialysis choice. International guidelines recommend involvement of the patient in the decision to choose the dialysis modality most suitable for the individual patient. Nevertheless, studies have shown lack of involvement of the patient in decision-making. To develop and pilot test an intervention for shared decision-making targeting the choice of dialysis modality. This study reflects the first two phases of a complex intervention design: phase 1, the development process and phase 2, feasibility and piloting. Because decision aids were a part of the intervention, the International Patient Decision Aid Standards were considered. The pilot test included both the intervention and the feasibility of the validated shared decision-making questionnaire (SDM Q9) and the Decision Quality Measure (DQM) applied to evaluate the intervention. A total of 137 patients tested the intervention. After the intervention, 80% of the patients chose dialysis at home reflecting an increase of 23% in starting dialysis at home prior to the study. The SDM Q9 showed the majority of the patients experienced this intervention as shared decision-making. An intervention based on shared decision-making supported by decision aids seemed to increase the number of patients choosing home dialysis. The SDM Q9 and DQM were feasible evaluation tools. Further research is needed to gain insight into the patients' experiences of involvement and the implications for their choice of dialysis modality. © 2018 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  12. Critical Care Dialysis System

    Science.gov (United States)

    1992-01-01

    Organon Teknika Corporation's REDY 2000 dialysis machine employs technology originally developed under NASA contract by Marquardt Corporation. The chemical process developed during the project could be applied to removing toxic waste from used dialysis fluid. This discovery led to the development of a kidney dialysis machine using "sorbent" dialysis, a method of removing urea from human blood by treating a dialysate solution. The process saves electricity and, because the need for a continuous water supply is eliminated, the patient has greater freedom.

  13. Developing and pilot testing a shared decision-making intervention for dialysis choice

    DEFF Research Database (Denmark)

    Finderup, Jeanette; Jensen, Jens Dam; Lomborg, Kirsten

    2018-01-01

    . Nevertheless, studies have shown lack of involvement of the patient in decision-making. Objectives: To develop and pilot test an intervention for shared decision-making targeting the choice of dialysis modality. Methods: This study reflects the first two phases of a complex intervention design: phase 1......, the development process and phase 2, feasibility and piloting. Because decision aids were a part of the intervention, the International Patient Decision Aid Standards were considered. The pilot test included both the intervention and the feasibility of the validated shared decision-making questionnaire (SDM Q9......) and the Decision Quality Measure (DQM) applied to evaluate the intervention. Results: A total of 137 patients tested the intervention. After the intervention, 80% of the patients chose dialysis at home reflecting an increase of 23% in starting dialysis at home prior to the study. The SDM Q9 showed the majority...

  14. Development and psychometric evaluation of the Dialysis patient-perceived Exercise Benefits and Barriers Scale.

    Science.gov (United States)

    Zheng, Jing; You, Li-Ming; Lou, Tan-Qi; Chen, Nian-Chang; Lai, De-Yuan; Liang, Yan-Yi; Li, Ying-Na; Gu, Ying-Ming; Lv, Shao-Fen; Zhai, Cui-Qiu

    2010-02-01

    Perceptions of exercise benefits and barriers affect exercise behavior. Because of the clinical course and treatment, dialysis patients differ from the general population in their perceptions of exercise benefits and barriers, especially the latter. At present, no valid instruments for assessing perceived exercise benefits and barriers in dialysis patients are available. Our goal was to develop and test the psychometric properties of the Dialysis patient-perceived Exercise Benefits and Barriers Scale (DPEBBS). A literature review and two focus groups were conducted to generate the initial item pool. An expert panel examined the content validity. Then, 269 Chinese hemodialysis patients were recruited by convenience sampling. Exploratory and confirmatory factor analyses were used to test construct validity. Finally, internal consistency and test-retest reliability were assessed. The expert panel determined that the content validity index was satisfactory. The final 24-item scale consisted of six factors explaining 57% of the total variance in the data. Confirmative factor analysis supported the six-factor structure and a higher-order model. Cronbach's alpha was 0.87 for the total scale, and 0.84 for test-retest reliability. The DPEBBS was a valid and reliable instrument for evaluating dialysis patients' perceived benefits and barriers to exercise. The application value of this scale remains to be investigated by increasing the sample size and evaluating patients undergoing different dialysis modalities and coming from different regions and cultural backgrounds. Copyright 2009 Elsevier Ltd. All rights reserved.

  15. A Rare Case of Pediatric Nosocomial Liver Abscess Developing During Dialysis Therapy

    Directory of Open Access Journals (Sweden)

    Mittal

    2015-08-01

    Full Text Available Introduction Liver abscess developing during hospital stay in pediatric patients on dialysis for acute kidney injury has been previously unreported. Impaired immunity, prolonged use of antibiotics, diabetes and malnutrition predispose to liver abscess in chronic hemodialysis patients. Case Presentation We reported a case of liver abscess developing in a 6-year-old boy admitted with sepsis and multiorgan dysfunction syndrome including acute kidney injury. He received peritoneal and subsequently hemodialysis, as he did not improve on peritoneal dialysis. He developed fever while on hemodialysis, which was due to a liver abscess developing during the course of hospital stay. The abscess was in the right lobe of the liver with a volume of 40 mL. Staphylococcus aureus is the leading cause of pyogenic liver abscesses in children and infection acquired from hospital. The patient received vancomycin and responded well with complete resolution and did not require any drainage procedure. He may have acquired bacteremia during dialysis with subsequent hepatic seeding. Conclusions Though rare, liver abscess may develop even in patients undergoing short-term dialysis therapy. Liver abscess is a medical emergency and if not treated promptly may lead to significant mortality. Invasive therapeutic procedures, like drainage is associated with further risk of complications. Therefore, a high index of suspicion should be kept when evaluating a patient who develops unexplained fever while being on hemodialysis. Early medical intervention through appropriate antibiotics can significantly reduce the morbidity and mortality. Strict infection control policies should be followed to prevent such nosocomial infections.

  16. 30 years of peritoneal dialysis development: the past and the future

    NARCIS (Netherlands)

    Krediet, Raymond T.

    2007-01-01

    A review is given of 30 years of development in peritoneal dialysis (PD). After a short description of the first 20 years, the main emphasis is put on the last 10 years. Subjects discussed are the increasing use of PD in high-risk populations, peritonitis and other catheter-related problems,

  17. Low GDP Solution and Glucose-Sparing Strategies for Peritoneal Dialysis.

    Science.gov (United States)

    Szeto, Cheuk Chun; Johnson, David W

    2017-01-01

    Long-term exposure to a high glucose concentration in conventional peritoneal dialysis (PD) solution has a number of direct and indirect (via glucose degradation products [GDP]) detrimental effects on the peritoneal membrane, as well as systemic metabolism. Glucose- or GDP-sparing strategies often are hypothesized to confer clinical benefits to PD patients. Icodextrin (glucose polymer) solution improves peritoneal ultrafiltration and reduces the risk of fluid overload, but these beneficial effects are probably the result of better fluid removal rather than being glucose sparing. Although frequently used for glucose sparing, the role of amino acid-based solution in this regard has not been tested thoroughly. When glucose-free solutions are used in a combination regimen, published studies showed that glycemic control was improved significantly in diabetic PD patients, and there probably are beneficial effects on peritoneal function. However, the long-term effects of glucose-free solutions, used either alone or as a combination regimen, require further studies. On the other hand, neutral pH-low GDP fluids have been shown convincingly to preserve residual renal function and urine volume. The cost effectiveness of these solutions supports the regular use of neutral pH-low GDP solutions. Nevertheless, further studies are required to determine whether neutral pH-low GDP solutions exert beneficial effects on patient-level outcomes, such as peritonitis, technique survival, and patient survival. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Strategy Development in Organisations

    DEFF Research Database (Denmark)

    Sørensen, Lene

    1999-01-01

    There exist certain ambiguities with the converging fields of information technology and organisational strategy development. The term "IT strategy" has evolved and reflects in some respects this confusion. This paper discusses some of the ambiguities and difficulties of the term "IT strategy......" as used in practice and literature. Emphasis is put on how the term is related to the problem, the organisation, the strategy process and the practical way of methodologically developing the strategy. Finally, alternative strategy developing perspectives are presented....

  19. Creativity and Strategy Development

    DEFF Research Database (Denmark)

    Sørensen, Lene Tolstrup; Vidal, Rene Victor Valqui

    This paper focus on how creative thinking, processes and methods can support the strategy development and planning process in organisations. First, several fundamental concepts related to both strategy development and planning are stipulated. In addition, the concept of living organisation...... will be discussed as well as the interaction between strategy and creativity. Then, methodological ideas to support the strategy making process are presented enhancing the use of creative methods and tools. Finally, a case study related to the development of a strategy for organisational development using...... creativity tools is discussed....

  20. Dialysis Provision and Implications of Health Economics on Peritoneal Dialysis Utilization: A Review from a Malaysian Perspective.

    Science.gov (United States)

    Abdul Manaf, Mohd Rizal; Surendra, Naren Kumar; Abdul Gafor, Abdul Halim; Seong Hooi, Lai; Bavanandan, Sunita

    2017-01-01

    End-stage renal disease (ESRD) is managed by either lifesaving hemodialysis (HD) and peritoneal dialysis (PD) or a kidney transplant. In Malaysia, the prevalence of dialysis-treated ESRD patients has shown an exponential growth from 504 per million population (pmp) in 2005 to 1155 pmp in 2014. There were 1046 pmp patients on HD and 109 pmp patients on PD in 2014. Kidney transplants are limited due to lack of donors. Malaysia adopts public-private financing model for dialysis. Majority of HD patients were treated in the private sector but almost all PD patients were treated in government facilities. Inequality in access to dialysis is visible within geographical regions where majority of HD centres are scattered around developed areas. The expenditure on dialysis has been escalating in recent years but economic evaluations of dialysis modalities are scarce. Evidence shows that health policies and reimbursement strategies influence dialysis provision. Increased uptake of PD can produce significant economic benefits and improve patients' access to dialysis. As a result, some countries implemented a PD-First or Favored Policy to expand PD use. Thus, a current comparative costs analysis of dialysis is strongly recommended to assist decision-makers to establish a more equitable and economically sustainable dialysis provision in the future.

  1. Dialysis Provision and Implications of Health Economics on Peritoneal Dialysis Utilization: A Review from a Malaysian Perspective

    Directory of Open Access Journals (Sweden)

    Mohd Rizal Abdul Manaf

    2017-01-01

    Full Text Available End-stage renal disease (ESRD is managed by either lifesaving hemodialysis (HD and peritoneal dialysis (PD or a kidney transplant. In Malaysia, the prevalence of dialysis-treated ESRD patients has shown an exponential growth from 504 per million population (pmp in 2005 to 1155 pmp in 2014. There were 1046 pmp patients on HD and 109 pmp patients on PD in 2014. Kidney transplants are limited due to lack of donors. Malaysia adopts public-private financing model for dialysis. Majority of HD patients were treated in the private sector but almost all PD patients were treated in government facilities. Inequality in access to dialysis is visible within geographical regions where majority of HD centres are scattered around developed areas. The expenditure on dialysis has been escalating in recent years but economic evaluations of dialysis modalities are scarce. Evidence shows that health policies and reimbursement strategies influence dialysis provision. Increased uptake of PD can produce significant economic benefits and improve patients’ access to dialysis. As a result, some countries implemented a PD-First or Favored Policy to expand PD use. Thus, a current comparative costs analysis of dialysis is strongly recommended to assist decision-makers to establish a more equitable and economically sustainable dialysis provision in the future.

  2. Patterns of strategy development

    OpenAIRE

    Bailey, Andy; Johnson, Gerry

    1996-01-01

    This paper builds on a multidimensional framework of strategy development to more clearly understand the processes by which strategy develops within organisations. It reports on a survey based research project which employs senior executives’ perceptions of the strategy development process in their organisations to examine how context specific configurations of dimensions explaining such processes can advance our understanding of strategic management. Six configurations are ide...

  3. POSITIONING STRATEGIES DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Shakhshir Ghassan

    2014-07-01

    Full Text Available The positioning strategy has suffered serious changes in the last few decades, being influenced by the rapid development of competition and the growing focus on specific traits belonging to the market, to the consumer or to the product. The purpose of this paper is to present the developments of theoretical positioning strategies and the orientation from more simple, product oriented strategies, to ones more oriented towards the client and with a briefer period of time. The world is moving in a much faster pace than in the past, thanks to communication development so companies are obliged to adopt more specific strategies in order for them to be effective. This essay represents a literary review presenting a documentary research within the scientific articles and strategy and positioning books. The paper begins with the analysis of company strategies and the marketing strategies in general. The first author to group the product positioning strategies is Porter with his three generic strategies. Following the development of brands and because of the lack of competitiveness in the simple generic positioning strategies, this paper has also presented the newer positioning strategies proposed by Kotler, Treacy & Wiersema, and also more complex ones such as Bowman's Strategy Clock and Blankson and Kalafatis positioning strategy based on the type of the consumer. The fast expansion of local brands in all categories has led to mistakes in positioning strategies, categories also presented in the current essay. The results of this study show that new positioning strategies are more and more based on the consumer and market segments and on the product specification - which have also evolved in the last decades. Adaptability to fast changes in the competitive market will represent the future positioning strategies.

  4. Heparin free dialysis in critically sick children using sustained low efficiency dialysis (SLEDD-f: A new hybrid therapy for dialysis in developing world.

    Directory of Open Access Journals (Sweden)

    Sidharth Kumar Sethi

    Full Text Available In critically sick adults, sustained low efficiency dialysis [SLED] appears to be better tolerated hemodynamically and outcomes seem to be comparable to CRRT. However, there is paucity of data in critically sick children. In children, two recent studies from Taiwan (n = 11 and India (n = 68 showed benefits of SLED in critically sick children.The objective of the study was to look at the feasibility and tolerability of sustained low efficiency daily dialysis-filtration [SLEDD-f] in critically sick pediatric patients.Design: Retrospective study Inclusion criteria: All pediatric patients who had undergone heparin free SLEDD-f from January 2012 to October 2017. Measurements: Data collected included demographic details, vital signs, PRISM III at admission, ventilator parameters (where applicable, number of inotropes, blood gas and electrolytes before, during, and on conclusion of SLED therapy. Technical information was gathered regarding SLEDD-f prescription and complications.Between 2012-2017, a total of 242 sessions of SLEDD-f were performed on 70 patients, out of which 40 children survived. The median age of patients in years was 12 (range 0.8-17 years, and the median weight was 39 kg (range 8.5-66 kg. The mean PRISM score at admission was 8.77±7.22. SLEDD-f sessions were well tolerated, with marked improvement in fluid status and acidosis. Premature terminations had to be done in 23 (9.5% of the sessions. There were 21 sessions (8.6% terminated due to hypotension and 2 sessions (0.8% terminated due to circuit clotting. Post- SLEDD-f hypocalcemia occurred in 15 sessions (6.2%, post- SLEDD-f hypophosphatemia occurred in 1 session (0.4%, and post- SLEDD-f hypokalemia occurred in 17 sessions (7.0%.This study is the largest compiled data on pediatric SLEDD-f use in critically ill patients. Our study confirms the feasibility of heparin free SLEDD-f in a larger pediatric population, and even in children weighing <20 kg on inotropic support.

  5. Treatment of AKI in developing and developed countries: An international survey of pediatric dialysis modalities.

    Directory of Open Access Journals (Sweden)

    Rupesh Raina

    Full Text Available Acute kidney injury (AKI is a common cause of morbidity and mortality worldwide, with a pediatric incidence ranging from 19.3% to 24.1%. Treatment of pediatric AKI is a source of debate in varying geographical regions. Currently CRRT is the treatment for pediatric AKI, but limitations due to cost and accessibility force use of adult equipment and other therapeutic options such as peritoneal dialysis (PD and hemodialysis (HD. It was hypothesized that more cost-effective measures would likely be used in developing countries due to lesser resource availability.A 26-question internet-based survey was distributed to 650 pediatric Nephrologists. There was a response rate of 34.3% (223 responses. The survey was distributed via pedneph and pcrrt email servers, inquiring about demographics, technology, resources, pediatric-specific supplies, and preference in renal replacement therapy (RRT in pediatric AKI. The main method of analysis was to compare responses about treatments between nephrologists in developed countries and nephrologists in developing countries using difference-of-proportions tests.PD was available in all centers surveyed, while HD was available in 85.1% and 54.1% (p = 0.00, CRRT was available in 60% and 33.3% (p = 0.001, and SLED was available in 20% and 25% (p = 0.45 centers of developed and developing world respectively. In developing countries, 68.5% (p = 0.000 of physicians preferred PD to costlier therapies, while in developed countries it was found that physicians favored HD (72%, p = 0.00 or CRRT (24%, p = 0.041 in infants.Lack of availability of resources, trained physicians and funds often preclude standards of care in developing countries, and there is much development needed in terms of meeting higher global standards for treating pediatric AKI patients. PD remains the main modality of choice for treatment of AKI in infants in developing world.

  6. POSITIONING STRATEGIES DEVELOPMENT

    OpenAIRE

    Shakhshir Ghassan

    2014-01-01

    The positioning strategy has suffered serious changes in the last few decades, being influenced by the rapid development of competition and the growing focus on specific traits belonging to the market, to the consumer or to the product. The purpose of this paper is to present the developments of theoretical positioning strategies and the orientation from more simple, product oriented strategies, to ones more oriented towards the client and with a briefer period of time. The world is moving in...

  7. Peritoneal Dialysis

    Science.gov (United States)

    ... include: Infections. An infection of the abdominal lining (peritonitis) is a common complication of peritoneal dialysis. An ... day. You might have a lower risk of peritonitis because you connect and disconnect to the dialysis ...

  8. Newly Developed Neutralized pH Icodextrin Dialysis Fluid: Nonclinical Evaluation.

    Science.gov (United States)

    Yamaguchi, Naoya; Miyamoto, Keiichi; Murata, Tomohiro; Ishikawa, Eiji; Horiuchi, Takashi

    2016-08-01

    A two-compartment system (NICOPELIQ; NICO, Terumo Co., Tokyo, Japan) has recently been developed to neutralize icodextrin peritoneal dialysis fluid (PDF). In this study, a nonclinical evaluation of NICO was carried out to evaluate biocompatibility as well as water transport ability. Glucose degradation products (GDPs) in the icodextrin PDFs were analyzed via high-performance liquid chromatography (HPLC). The cell viability of human peritoneal mesothelial cells derived from peritoneal dialysis effluent (PDE-HPMCs) was evaluated as well as the amount of lactate dehydrogenase (LDH) released after exposure to different PDFs (NICO and EXTRANEAL [EX, Baxter Healthcare Corp., Chicago, IL, USA]) and neutralized pH glucose PDF MIDPELIQ 250 (M250, Terumo). The water transport ability of NICO, EX, and M250 was tested using dialysis tube membranes with various pore sizes: 1, 2, 6-8, and 12-16 kDa. Although cell viability decreased by 30% after 30 min exposure to NICO, it was maintained for 6 h while a significant decrease was observed after 6 h exposure to EX. However, following adjustment of the pH to the same pre-exposure pH value, there was no significant difference in cell viability within the same pH group despite a doubling of the difference in the total amount of GDPs (44.6 ± 8.6 µM in NICO and 91.9 ± 9.5 µM in EX, respectively). In contrast, a significant decrease in cell viability was observed when the pH decreased to less than pH 6. Levels of released LDH, a cytotoxic marker, were within 5% after a 6-h exposure of NICO to PDE-HPMCs. There was no significant difference in water transport ability represented as overall osmotic gradients between NICO and EX. In conclusion, neutralization of icodextrin PDF is beneficial for maintaining cell viability and minimizing LDH release while water transport ability is comparable to the conventional icodextrin PDF. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  9. Development and validation of the Consumer Quality index instrument to measure the experience and priority of chronic dialysis patients

    NARCIS (Netherlands)

    van der Veer, Sabine N.; Jager, Kitty J.; Visserman, Ella; Beekman, Robert J.; Boeschoten, Els W.; de Keizer, Nicolette F.; Heuveling, Lara; Stronks, Karien; Arah, Onyebuchi A.

    2012-01-01

    Patient experience is an established indicator of quality of care. Validated tools that measure both experiences and priorities are lacking for chronic dialysis care, hampering identification of negative experiences that patients actually rate important. We developed two Consumer Quality (CQ) index

  10. Amyloidosis associated with dialysis

    International Nuclear Information System (INIS)

    Schadmand, S.; Klose, K.J.; Wandel, E.

    1991-01-01

    Amongst the complications of dialysis, amyloid osteopathy is getting increasingly significant. It is due to deposition of β2-microglobulin. To determine the incidence and time of development of this complication, the skeletal radiographs of 185 patients undergoing dialysis, some for up to ten years, were analysed retrospectively. In about 10% of patients, the presence of β2-microglobulin osteopathy may be expected. The radiological features, sites of predilection and differential diagnosis of amyloid osteopathy and of other skeletal changes due to dialysis are discussed. (orig.) [de

  11. Equilibrium Dialysis

    African Journals Online (AJOL)

    context of antimicrobial therapy in malnutrition. Dialysis has in the past presented technical problems, being complicated and time-consuming. A new dialysis system based on the equilibrium technique has now become available, and it is the principles and practical application of this apparatus (Kontron Diapack; Kontron.

  12. Development and Psychometric Properties of the Dialysis Module of the WHOQOL-BREF Taiwan Version

    Directory of Open Access Journals (Sweden)

    Shu-Chang Yang

    2006-01-01

    Conclusion: Besides broader coverage than the core WHOQOL-BREF(TW, the dialysis module of the WHOQOL-BREF(TW is a valid, reliable and sensitive QOL instrument for the assessment of HD patients in Taiwan.

  13. Development and validation of the Consumer Quality index instrument to measure the experience and priority of chronic dialysis patients.

    Science.gov (United States)

    van der Veer, Sabine N; Jager, Kitty J; Visserman, Ella; Beekman, Robert J; Boeschoten, Els W; de Keizer, Nicolette F; Heuveling, Lara; Stronks, Karien; Arah, Onyebuchi A

    2012-08-01

    Patient experience is an established indicator of quality of care. Validated tools that measure both experiences and priorities are lacking for chronic dialysis care, hampering identification of negative experiences that patients actually rate important. We developed two Consumer Quality (CQ) index questionnaires, one for in-centre haemodialysis (CHD) and the other for peritoneal dialysis and home haemodialysis (PHHD) care. The instruments were validated using exploratory factor analyses, reliability analysis of identified scales and assessing the association between reliable scales and global ratings. We investigated opportunities for improvement by combining suboptimal experience with patient priority. Sixteen dialysis centres participated in our study. The pilot CQ index for CHD care consisted of 71 questions. Based on data of 592 respondents, we identified 42 core experience items in 10 scales with Cronbach's α ranging from 0.38 to 0.88; five were reliable (α ≥ 0.70). The instrument identified information on centres' fire procedures as the aspect of care exhibiting the biggest opportunity for improvement. The pilot CQ index PHHD comprised 56 questions. The response of 248 patients yielded 31 core experience items in nine scales with Cronbach's α ranging between 0.53 and 0.85; six were reliable. Information on kidney transplantation during pre-dialysis showed most room for improvement. However, for both types of care, opportunities for improvement were mostly limited. The CQ index reliably and validly captures dialysis patient experience. Overall, most care aspects showed limited room for improvement, mainly because patients participating in our study rated their experience to be optimal. To evaluate items with high priority, but with which relatively few patients have experience, more qualitative instruments should be considered.

  14. Telemedicine: Development of a distance care system for pre-dialysis chronic kidney disease patients.

    Science.gov (United States)

    Fernandes, Natália Maria da Silva; Bastos, Marcus Gomes; Oliveira, Nivalda A C de; Costa, Alex do Vale; Bernardino, Heder Soares

    2015-01-01

    The focus in the treatment of CKD is to prevent its progression through optimal medical control. The large number of patients with CKD has pressed nephrologists to assess more patients into ever-smaller periods of consultation. The use of light technologies as a promising form of health care. The internet offers the opportunity to manipulate the doctor in his professional contact with the user. To develop a web system to attend the patients with CKD not on dialysis and clinically stable stages at distance. Developed a system using the Java language, MySQL database and PrimeFaces framework; available on a Glassfish application server. The initial access is performed by the nephrologist, which registers the patients with their personal information and access data. After being registered, the patient (or family doctor) can enter the data of your query and these will be following, passed on to the nephrologist for evaluation. The form with the data of interest is pre-determined, but there is possibility to add free-form information. The system enables, in addition, there is exchange of messages between doctors and patients. In addition, users receive messages via e-mail alerting them of their duties. Confidentiality is guaranteed by individual passwords for doctors and patients. This tool will enable to increase the coverage area of nephrologists, reduce costs and bring the patient to the primary care physician, using the Family Health Program as an interface between the patient and the nephrology secondary care.

  15. Peritoneal Dialysis in Asia.

    Science.gov (United States)

    Kwong, Vickie Wai-Ki; Li, Philip Kam-Tao

    2015-12-01

    There is a growing demand of dialysis in Asia for end-stage renal failure patients. Diabetes mellitus is the leading cause of end-stage renal failure in many countries in Asia. The growth of peritoneal dialysis (PD) in Asia is significant and seeing a good trend. With the enhanced practices of PD, the quality of care in PD in Asia is also improved. Overall, PD and hemodialysis (HD) are comparable in clinical outcome. There is a global trend in the reduction of peritonitis rates and Asian countries also witness such improvement. The socio-economic benefits of PD for end-stage renal failure patients in both urban and rural areas in the developed and developing regions of Asia are an important consideration. This can help to reduce the financial burden of renal failure in addressing the growing demand of patients on dialysis. Initiatives should be considered to further drive down the cost of PD in Asia. Growing demand for dialysis by an increasing number of end-stage renal failure patients requires the use of a cost-effective quality dialysis modality. PD is found to be comparable to HD in outcome and quality. In most countries in Asia, PD should be more cost-effective than HD. A 'PD-first' or a 'PD as first considered therapy' policy can be an overall strategy in many countries in Asia in managing renal failure patients, taking the examples of Hong Kong and Thailand. (1) PD is cheaper than HD and provides a better quality of life worldwide, but its prevalence is significantly lower than that of HD in all countries, with the exception of Hong Kong. Allowing reimbursement of PD but not HD has permitted to increase the use of PD over HD in many Asian countries like Hong Kong, Vietnam, Taiwan, Thailand, as well as in New Zealand and Australia over the last years. In the Western world, however, HD is still promoted, and the proportion of patients treated with PD decreases. Japan remains an exception in Asia where PD penetration is very low. Lack of adequate education of

  16. Supervisory Control Strategy Development

    International Nuclear Information System (INIS)

    Gary D Storrick; Bojan Petrovic

    2007-01-01

    Task 4 of this collaborative effort between ORNL, Brazil, and Westinghouse for the International Nuclear Energy Research Initiative entitled 'Development of Advanced Instrumentation and Control for an Integrated Primary System Reactor' focused on the design of the hierarchical supervisory control for multiple-module units. The state of the IRIS plant design--specifically, the lack of a detailed secondary system design--made developing a detailed hierarchical control difficult at this time. However, other simultaneous and ongoing efforts have contributed to providing the needed information. This report summarizes the results achieved under Task 4 of this Financial Assistance Award. Section 1.2 describes the scope of this effort. Section 2 discusses the IRIS control functions. Next, it briefly reviews the current control concepts, and then reviews the maneuvering requirements for the IRIS plant. It closes by noting the benefits that automated sequences have in reducing operator workload. Section 3 examines reactor loading in the frequency domain to establish some guidelines for module operation, paying particular attention to strategies for using process steam for desalination and/or district heating. The final subsection discusses the implications for reactor control, and argues that using the envisioned percentage (up to 10%) of the NSSS thermal output for these purposes should not significantly affect the NSSS control strategies. Section 4 uses some very general economic assumptions to suggest how one should approach multi-module operation. It concludes that the well-known algorithms used for economic dispatching could be used to help manage a multi-unit IRIS site. Section 5 addresses the human performance factors of multi-module operation. Section 6 summarizes our conclusions

  17. Development of a risk-prediction model for Middle East respiratory syndrome coronavirus infection in dialysis patients.

    Science.gov (United States)

    Ahmed, Anwar E; Alshukairi, Abeer N; Al-Jahdali, Hamdan; Alaqeel, Mody; Siddiq, Salma S; Alsaab, Hanan A; Sakr, Ezzeldin A; Alyahya, Hamed A; Alandonisi, Munzir M; Subedar, Alaa T; Aloudah, Nouf M; Baharoon, Salim; Alsalamah, Majid A; Al Johani, Sameera; Alghamdi, Mohammed G

    2018-04-14

    Introduction The Middle East respiratory syndrome coronavirus (MERS-CoV) infection can cause transmission clusters and high mortality in hemodialysis facilities. We attempted to develop a risk-prediction model to assess the early risk of MERS-CoV infection in dialysis patients. Methods This two-center retrospective cohort study included 104 dialysis patients who were suspected of MERS-CoV infection and diagnosed with rRT-PCR between September 2012 and June 2016 at King Fahd General Hospital in Jeddah and King Abdulaziz Medical City in Riyadh. We retrieved data on demographic, clinical, and radiological findings, and laboratory indices of each patient. Findings A risk-prediction model to assess early risk for MERS-CoV in dialysis patients has been developed. Independent predictors of MERS-CoV infection were identified, including chest pain (OR = 24.194; P = 0.011), leukopenia (OR = 6.080; P = 0.049), and elevated aspartate aminotransferase (AST) (OR = 11.179; P = 0.013). The adequacy of this prediction model was good (P = 0.728), with a high predictive utility (area under curve [AUC] = 76.99%; 95% CI: 67.05% to 86.38%). The prediction of the model had optimism-corrected bootstrap resampling AUC of 71.79%. The Youden index yielded a value of 0.439 or greater as the best cut-off for high risk of MERS infection. Discussion This risk-prediction model in dialysis patients appears to depend markedly on chest pain, leukopenia, and elevated AST. The model accurately predicts the high risk of MERS-CoV infection in dialysis patients. This could be clinically useful in applying timely intervention and control measures to prevent clusters of infections in dialysis facilities or other health care settings. The predictive utility of the model warrants further validation in external samples and prospective studies. © 2018 International Society for Hemodialysis.

  18. Strategies for Sustainable Energy Development

    DEFF Research Database (Denmark)

    Meyer, Niels I

    2009-01-01

    The paper analyses international strategies for establishing a sustainable energy development. Proposals are given for mitigation of global warming.......The paper analyses international strategies for establishing a sustainable energy development. Proposals are given for mitigation of global warming....

  19. Strategy development marketing commercial enterprise

    OpenAIRE

    Shatalov D. S.; Hamidova O. M.

    2016-01-01

    in the scientific article the necessity of development and implementation of marketing strategies in the activity of any commercial enterprise, we give a meaningful description of the concept of «marketing strategy» and develop requirements for the selection strategy of trade enterprise.

  20. The processes of strategy development

    OpenAIRE

    Bailey, Andy; Johnson, Gerry

    1995-01-01

    This paper is concerned with the processes by which strategy is developed within organisations. It builds on research into the nature of strategy development being undertaken within the Centre for Strategic Management and Organisational Change at Cranfield School of Management. Initially the process of strategy development is discussed, a number of explanations of the process are presented and an integrated framework is developed. This framework is subsequently used to illustra...

  1. Osteoarthropathy in dialysis amyloidosis

    International Nuclear Information System (INIS)

    Baldrati, L.; Feletti, C.; Capponcini, C.; Docci, D.; Rocchi, A.; Balbi, B.; Bonsanto, R.; Mughetti, M.; Pasini, A.

    1991-01-01

    Many long-term (>60 months) hemodialysis patients develop a severe osteoarticular disease, called 'dialysis arthropathy', which is characterized by the deposition in bone and synovia of a new type of amyloid made mainly of β 2 -microglobulin. In the present study, 31 patients (17 males, 14 females; age 54.1±13 years) undergoing chronic hemodialysis arthropathy by means of clinics and of radiological investigations (conventional radiography and computed tomography). Sixteen patients (51.6%) had radiographic evidence of dialysis arthropathy: geodes (shoulders, 12 cases; wrists, 11; hips, 2; knees, 2) and/or destructive arthropathies (cervical spine, 13 cases; dorsolumbar spine, 2; hands, 2; hips, 1). Within 24 months, these lesions were found to progress slowly in the majoriry of cases. In the diagnostic process, CT should be employed in the study of spine, shoulders and hips when the lesions have not been sufficiently demonstrated by conventional radiography in the presence of evident clinical signs. Patients with dialysis arthropathy had undergone dialysis for longer periods than those without it (p<0.005) and showed a significantly higher incidence of both carpal tunnel syndrome (p<0.0005) and shoulder pain (p<0.005). Our findings confirm the high incidence and clinical importance of dialysis arthropathy in long-term hemodialysis patients end the value of diagnostic imaging in screening such patients for those lesions

  2. Developing a glocalisation strategy

    DEFF Research Database (Denmark)

    Hollensen, Svend; Schimmelpfennig, Christian

    2015-01-01

    while exploiting the benefits of global integration. The challenge is to balance the local knowledge with global reach. In the case of Persil Abaya Shampoo (for the Middle East market) and Persil Black Gel (for the European market), Henkel chose a strategy that successfully benefitted from...... markets and used Persil Abayas’ particular significance in the Arab world to its advantage. The results document that it has been possible for Henkel’s Persil to gain competitive advantages in terms of higher market shares, with the ‘glocalisation strategy’ in the (Middle East) liquid detergent market.......The glocalisation strategy strives to achieve the slogan, ‘think globally but act locally’, through dynamic interdependence between headquarters and subsidiaries and/or local intermediaries around the world. Companies following such a strategy coordinate their efforts, ensuring local flexibility...

  3. REGIONAL DEVELOPMENT STRATEGY

    Directory of Open Access Journals (Sweden)

    Vaduva Maria

    2011-01-01

    Full Text Available Regional development policies in the EU Member States have included tools whoseimportance varied from one country to another. Can be identified by negative incentives forregional development policy towards location in crowded areas or control over the location,the reallocation of economic activities in national territory, creation of adequateinfrastructure, measures to enhance development, financial incentives granted toenterprises. Sustainable business development, rehabilitation of social infrastructure,including social housing and improved social services. Improved regional and localtransportation are key areas of intervention rehabilitation and upgrading of county roads,city streets, including road construction and rehabilitation of belt.

  4. Long-Term Outcome of Liver Transplant Recipients After the Development of Renal Failure Requiring Dialysis: A Study Using the National Health Insurance Database in Taiwan.

    Science.gov (United States)

    Wang, T-J; Lin, C-H; Chang, S-N; Cheng, S-B; Chou, C-W; Chen, C-H; Shu, K-H; Wu, M-J

    2016-05-01

    The aims of this study were to identify the incidence of renal failure requiring dialysis and to investigate the long-term outcome after renal failure in liver transplantation (LT) patients. The primary database used was the Taiwan National Health Insurance Research Database. Subjects with LT from 1997 to 2009 were included. Patients were grouped into the dialysis cohort if they once received hemodialysis owing to any pattern of renal failure during peri-transplantation periods or after LT. Otherwise, they were categorized into the nondialysis cohort. We conducted a retrospective observational study on the correlation of renal failure requiring dialysis and its effect on LT recipients. The analysis included data of 1,771 LT recipients with a mean follow-up time of 3.8 ± 2.9 years. The mean age was 43.2 ± 19.3 years, and 69.4% were male. Overall patient survival was 86.2% at 1 year, 82.2% at 3 years, and 80.5% at 5 years. Renal failure requiring dialysis had developed in the 323 patients (18.2%). Among them, 26 individuals (1.5%) had progressed to end-stage renal disease without renal recovery after perioperative hemodialysis. Individuals who developed renal failure requiring dialysis had a higher mortality compared with LT recipients never requiring dialysis (hazard ratio, 8.75; 95% confidence interval, 7.0-10.9). Renal failure requiring dialysis development after LT is common and carries high mortality in Chinese liver allograft recipients. Recognizing risk factors permits the timely institution of proper treatment, which is the key to reducing untoward outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. An IFE development strategy

    International Nuclear Information System (INIS)

    Hogan, W.J.; Storm, E.; Lindl, J.D.

    1991-01-01

    The development of inertial fusion as a power source will require achieving four principal milestones: ignition and propagating burn; high gain at low drive energy for the reactor driver; pulse repetition rates of a few Hz; and long-term reliability and economics of a reactor. To keep development time and costs to a minimum, these should be accomplished with as few major facilities as possible. A viable scenario for the Inertial Fusion Energy (IFE) Program would include establishing the first milestone in a Nova Upgrade for ignition and gain and the latter three in an upgradable, low-power Engineering Test Facility (ETF)/Demonstration Power Plant (DPP), i.e. two major facilities. To be successful in as short a time as possible operations at the major facilities would have to be supported by off-line reactor driver and other reactor technology development efforts. These efforts would evaluate and prioritize the myriad of options available at present for power plant and subsystem concepts. This paper describes the elements of such a program that could make the first commercial power available in the decade of the 2020s and estimates the resources needed. This program would be carried out in phases with major go/no-go decision points before each large funding change. It is estimated that an IFE evaluation phase in the early 1990s would cost $100--150 M, a concept development phase in the latter 1990s would cost $500--850 M, and an engineering test and demonstration phase after the year 2000 would cost $6--8 over 20 years

  6. Dialysis centers - what to expect

    Science.gov (United States)

    ... kidneys - dialysis centers; Dialysis - what to expect; Renal replacement therapy - dialysis centers; End-stage renal disease - dialysis ... to a tube that connects to the dialysis machine. Your blood will flow through the tube, into ...

  7. Design and development of an impedimetric-based system for the remote monitoring of home-based dialysis patients.

    Science.gov (United States)

    Montalibet, Amalric; Arkouche, Walid; Bogónez Franco, Paco; Bonnet, Stéphane; Clarion, Antoine; Delhomme, Georges; Géhin, Claudine; Gharbi, Sadok; Guillemaud, Régis; Jallon, Pierre; Massot, Bertrand; Pham, Pascale; Ribbe-Cornet, Eva; McAdams, Eric

    2016-01-01

    A key clinical challenge is to determine the desired 'dry weight' of a patient in order to terminate the dialysis procedure at the optimal moment and thus avoid the effects of over- and under-hydration. It has been found that the effects of haemodialysis on patients can be conveniently monitored using whole-body bioimpedance measurements. The identified need of assessing the hydrational status of patients undergoing haemodialysis at home gave rise to the present Dialydom (DIALYse à DOMicile) project. The aim of the project is to develop a convenient miniaturised impedance monitoring device for localised measurements (on the calf) in order to estimate an impedimetric hydrational index of the home-based patient, and to transmit this and other parameters to a remote clinical site. Many challenges must be overcome to develop a robust and valid home-based device. Some of these are presented in the paper.

  8. Maldives Low Carbon Development Strategy

    DEFF Research Database (Denmark)

    Fenhann, Jørgen Villy; Ramlau, Marianne

    This report presents the findings of a study for low carbon development strategy for Maldives. The study was implemented under the Memorandum of Understanding between the Ministry of Environment and Energy (MEE), Maldives and URC and was financed by Danida, Denmark’s development aid agency under...

  9. Virtual laboratory strategies for development

    International Nuclear Information System (INIS)

    Canessa, Enrique; Fonda, Carlo; Radicella, Sandro M.

    2001-08-01

    We present an overview of the VL approach to promote research and education in developing countries and to help reduce the technology gap of the digital divide. We discuss software tools for instrument control, data sharing and e-collaboration with special attention on low-bandwidth networks. We analyse the VL tentative costs involved and the skills needed for the VL administration. We conclude by identifying some VL strategies for development. (author)

  10. Development Strategy for Slovak society

    International Nuclear Information System (INIS)

    Sikula, V.

    2010-01-01

    In this book authors analyse the present state of economy as well as strategy of perspectives of development of Slovak society. A key issue in the next 5 to 10 years in the energy sector will mainly address energy security, diversification of energy sources, renewable energy sources and energy savings. The strategic goal is to transform energy into a form that will ensure long competition-capable and reliable supply of all forms of energy, taking into account sustainable development, security of supply and technical security. The strategy of energy security of Slovakia in 2030 is to achieve a competitive energy industry, ensuring safe, reliable and efficient supply of all forms of energy at affordable prices with regard to consumer protection, environmental protection, sustainable development, security of supply and technical security.

  11. Clostridium difficile-associated diarrhea in dialysis patients

    Directory of Open Access Journals (Sweden)

    Sook Eui Oh

    2013-03-01

    Conclusion: Our data indicate that dialysis patients might be at a greater risk of developing CDAD, which suggests that particular attention should be provided to CDAD when antibiotic treatment is administered to dialysis patients.

  12. Dialysis Facility Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Dialysis Facility Compare helps you find detailed information about Medicare-certified dialysis facilities. You can compare the services and the quality of care that...

  13. Skills Development and Transfer Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Mutshena, M.T.; Nkuna, K.K. [Pebble Bed Modular Reactor Pty (Ltd), P O Box 9394, Centurion, 0046 (South Africa); South African Young Nuclear Professionals Society (South Africa); Thugwane, S.J. [South African Young Nuclear Professionals Society (South Africa); Rasweswe, M.A. [South African Young Nuclear Professionals Society (South Africa); Nuclear Energy Cooperation of South Africa, P O Box 582, PRETORIA 0001 (South Africa)

    2008-07-01

    South Africa as a developing country is faced with numerous challenges amongst them is the shortage of skills in the working environment. Skills shortage has been aggravated by the retirement of the ageing skilled workforce and emigration of most experienced professionals to first world countries. Some professionals once they acquire the experience they opt out for a consultative business. This leaves a gap or void in the industries which can results into poor performance and quality, lessening of business standards and loosing competition. This challenge need to be attended to, because it will lead to hiring of consultants in most jobs or having many young and less experienced professionals and new graduates filling these gaps. The South African Young Nuclear Professionals Society (SAYNPS) has developed a strategic plan to serve as a guideline on how these challenges mentioned above can be addressed [1]. The proposed strategy will be aligned with skills development in the line of work and should get support from the nuclear Industry. Young professionals and recent graduates are the most affected people who lack skills and shall benefit from these programmes. In order for skill development and transfer to be accomplished there should be a Skill Development and Transfer Strategy and procedures to be followed. (authors)

  14. Skills Development and Transfer Strategy

    International Nuclear Information System (INIS)

    Mutshena, M.T.; Nkuna, K.K.; Thugwane, S.J.; Rasweswe, M.A.

    2008-01-01

    South Africa as a developing country is faced with numerous challenges amongst them is the shortage of skills in the working environment. Skills shortage has been aggravated by the retirement of the ageing skilled workforce and emigration of most experienced professionals to first world countries. Some professionals once they acquire the experience they opt out for a consultative business. This leaves a gap or void in the industries which can results into poor performance and quality, lessening of business standards and loosing competition. This challenge need to be attended to, because it will lead to hiring of consultants in most jobs or having many young and less experienced professionals and new graduates filling these gaps. The South African Young Nuclear Professionals Society (SAYNPS) has developed a strategic plan to serve as a guideline on how these challenges mentioned above can be addressed [1]. The proposed strategy will be aligned with skills development in the line of work and should get support from the nuclear Industry. Young professionals and recent graduates are the most affected people who lack skills and shall benefit from these programmes. In order for skill development and transfer to be accomplished there should be a Skill Development and Transfer Strategy and procedures to be followed. (authors)

  15. Myths in peritoneal dialysis.

    Science.gov (United States)

    Lee, Martin B; Bargman, Joanne M

    2016-11-01

    To clarify misconceptions about the feasibility and risks of peritoneal dialysis that unnecessarily limit peritoneal dialysis uptake or continuation in patients for whom peritoneal dialysis is the preferred dialysis modality. The inappropriate choice of haemodialysis as a result of these misconceptions contributes to low peritoneal dialysis penetrance, increases transfer from peritoneal dialysis to haemodialysis, increases expenditure on haemodialysis and compromises quality of life for these patients. Peritoneal dialysis is an excellent renal replacement modality that is simple, cost-effective and provides comparable clinical outcomes to conventional in-centre haemodialysis. Unfortunately, many patients are deemed unsuitable to start or continue peritoneal dialysis because of false or inaccurate beliefs about peritoneal dialysis. Here, we examine some of these 'myths' and critically review the evidence for and against each of them. We review the feasibility and risk of peritoneal dialysis in patients with prior surgery, ostomies, obesity and mesh hernia repairs. We examine the fear of mediastinitis with peritoneal dialysis after coronary artery bypass graft surgery and the belief that the use of hypertonic glucose dialysate causes peritoneal membrane failure. By clarifying common myths about peritoneal dialysis, we hope to reduce overly cautious practices surrounding this therapy.

  16. Sustainable development strategy : moving forward

    International Nuclear Information System (INIS)

    2004-01-01

    This publication demonstrates the steps that Natural Resources Canada has taken to optimize the contribution of natural resources to sustainable development. Canada's forestry, minerals, metals and energy sectors are key components to Canada's overall economy and society. The Sustainable Development Strategy (SDS) focuses on the development and use of Canada's resources in a responsible manner that will maintain the integrity of natural ecosystems and safeguard the quality of life for Canadians. All decision-making takes into account economic, environmental and social considerations. The challenges facing the natural resources sector include the management of forests, the development of clean energy options, and the recycling and reuse of minerals and metals resources. This publication outlines the specific goals and objectives set by Natural Resources Canada that will make the SDS possible through programs, policies, legislation, technology utilization and operations. It also describes Canada's progress in meeting the following 4 commitments: (1) Canadians make better decisions that advance sustainable development, (2) Canadians are taking action to reduce greenhouse gas emissions and adapt to the effects of climate change, (3) Canada is recognized globally as a responsible steward of natural resources and a leader in advancing sustainable development, and (4) Natural Resources Canada demonstrates its commitment to sustainable development in its operations. tabs

  17. Inertial fusion energy development strategy

    International Nuclear Information System (INIS)

    Coutant, J.; Hogan, W.J.; Nakai, S.; Rozanov, V.B.; Velarde, G.

    1995-01-01

    The research and development strategy for inertial fusion energy (IFE) is delineated. The development strategy must indicate how commercial IFE power can be made available in the first part of the next century, by which is meant that a Demonstration Power Plant (DPP) will have shown that in commercial operation IFE power plants can satisfy the requirements of public and employee safety, acceptably low impact on the environment, technical performance, reliability, maintainability and economic competitiveness. The technical issues associated with the various required demonstrations for each of the subsystems of the power plant (target, driver, reaction chamber, and remainder of plant (ROP) where the tritium for future targets is extracted and thermal energy is converted into electricity) are listed. The many developments required to make IFE commercially available can be oriented towards a few major demonstrations. These demonstrations do not necessarily each need separate facilities. The goals of these demonstrations are: (i) ignition demonstration, to show ignition and thermonuclear burn in an ICF target and determine the minimum required driver conditions; (ii) high gain demonstration, to show adequate driver efficiency-gain product; (iii) engineering demonstrations, to show high pulse rate operations in an integrated system and to choose the best designs of the various reactor systems; (iv) commercial demonstrations, to prove safe, environmentally benign, reliable, economic, near-commercial operation. In this document the present status of major inertial confinement research activities is summarized including a table of the major operating or planned facilities. The aspects involved in each of the required demonstrations are discussed. Also, for each of the subsystems mentioned above the technical developments that are needed are discussed. The document ends with a discussion of the two existing detailed IFE development plans, by the United States and Japan. 9

  18. TOURISM - AS A DEVELOPMENT STRATEGY

    Directory of Open Access Journals (Sweden)

    Borma Afrodita

    2012-12-01

    Full Text Available Third year PhD candidate at the University of Oradea, under the guidance of Professor Mrs. Alina Bădulescu in the doctoral research project entitled: "Doctoral studies and Ph.D. candidates for competitive research on a knowledge based society", a co-financed project by the European Social Fund through the Sectoral Operational Program for Human Resources Development 2007 - 2013, Priority Axis 1. "Education and training in support for growth and development of a knowledge based society" I chose to present this subject in order to demonstrate the connection that exists between tourism and development. Having as research topic "Tourism and development in the Euro regional context” I dedicated a subchapter of this thesis in presenting tourism as a development strategy. Thus we have analysed a series of specialised papers encountered at national and international level in order to achieve a synthesis about the addressed topic. Authors like Sharpley and Telfer (2002 found that the specialised literature in the tourism domain contains few articles on the relationship between tourism and development despite the fact that tourism remains an important area of the economic policy regarding development in most regions of the world. Writings on tourism, that debate development, are often written in terms of the impact of tourism on the environment in which it unfolds. Following statistical data collected on Faits saillants OMT du tourisme, 2011 Edition I found that indeed tourism is an important element in the development strategies. The research methodology that was used consisted in documentation from the specialised literature and the site http://mkt.unwto.org/sites/all/files/docpdf/unwtohighlights11frhr.pdf in order to gather representative data on the evolution of international tourism for the 1950-2010 period, also highlighting the potential success of tourism in the economic development. For this study to be more representative I

  19. Developing a stakeholder engagement strategy

    International Nuclear Information System (INIS)

    Nixon, J.A.

    2004-01-01

    Shell Canada's social performance plan was outlined in this presentation. Stakeholder engagement is a key strategy in the company's response to the concerns and broader priorities of different groups and individuals affected by their operations. A review of the business and societal values of stakeholder engagement was presented. Key benefits include greater profitability; protection of the environment; effective resource management; community benefits; and the delivery of value to customers. It was suggested that a continuous engagement process helps companies to assess impacts and work on strategies to avoid and mitigate negative impacts. A framework for social performance management was presented. It was noted that accountability and transparency are key components of Shell's progress towards sustainable development, and their direct and indirect contributions to the communities and societies where they operate. The social impact of core business operations is now a focus of the company. Key concerns of the social performance plan include environmental and health impacts; land use and changes in local economies; cultural concerns; and infrastructure impacts. An outline of Shell's Listening and Responding Program was also provided. refs., tabs., figs

  20. Developing a stakeholder engagement strategy

    Energy Technology Data Exchange (ETDEWEB)

    Nixon, J.A. [Shell Canada Ltd., Calgary, AB (Canada)

    2004-07-01

    Shell Canada's social performance plan was outlined in this presentation. Stakeholder engagement is a key strategy in the company's response to the concerns and broader priorities of different groups and individuals affected by their operations. A review of the business and societal values of stakeholder engagement was presented. Key benefits include greater profitability; protection of the environment; effective resource management; community benefits; and the delivery of value to customers. It was suggested that a continuous engagement process helps companies to assess impacts and work on strategies to avoid and mitigate negative impacts. A framework for social performance management was presented. It was noted that accountability and transparency are key components of Shell's progress towards sustainable development, and their direct and indirect contributions to the communities and societies where they operate. The social impact of core business operations is now a focus of the company. Key concerns of the social performance plan include environmental and health impacts; land use and changes in local economies; cultural concerns; and infrastructure impacts. An outline of Shell's Listening and Responding Program was also provided. refs., tabs., figs.

  1. Strategies for Cancer Vaccine Development

    Directory of Open Access Journals (Sweden)

    Matteo Vergati

    2010-01-01

    Full Text Available Treating cancer with vaccines has been a challenging field of investigation since the 1950s. Over the years, the lack of effective active immunotherapies has led to the development of numerous novel strategies. However, the use of therapeutic cancer vaccines may be on the verge of becoming an effective modality. Recent phase II/III clinical trials have achieved hopeful results in terms of overall survival. Yet despite these encouraging successes, in general, very little is known about the basic immunological mechanisms involved in vaccine immunotherapy. Gaining a better understanding of the mechanisms that govern the specific immune responses (i.e., cytotoxic T lymphocytes, CD4 T helper cells, T regulatory cells, cells of innate immunity, tumor escape mechanisms elicited by each of the various vaccine platforms should be a concern of cancer vaccine clinical trials, along with clinical benefits. This review focuses on current strategies employed by recent clinical trials of therapeutic cancer vaccines and analyzes them both clinically and immunologically.

  2. The EM technology development strategy

    International Nuclear Information System (INIS)

    Frank, C.W.; Barainca, M.; Kubo, A.S.

    1992-01-01

    The Office of Technology Development (TD) supports research and development of technologies that will lower cost, reduce risk, improve safety, and accelerate cleanup of the Nuclear Weapons Complex and provide solutions to currently untractable environmental problems. The TD strategic plan outlines Applied Research, Development, Demonstration, Testing, and Evaluation (RDDT and E) that will provide needed technology products to be used by Environmental Restoration and Waste Management operations (i.e., our customers). The TD strategic plan is derived from EM Goals, Objectives, and Strategy and is incorporated into DOE'S Five-Year Plan for Environmental Restoration and Waste Management. The TD strategic plan is developed based on integrating customer requirements, and is complemented by a top-down, bottom-up analysis of Site Specific Technology Needs and environmental problems. The execution of TD's strategic plan is implemented largely through Integrated Programs (IP) and Integrated Demonstrations (ID). IDs have proven to be a cost-effective method of managing technology development, testing and evaluation, and implementation of successful technology systems into the DOE Environmental Restoration and Waste Management Programs. The Savannah River ID for Volatile Organic Compounds (VOCs) in Saturated Soils resulted in a 51 percent cost savings over stand-alone demonstrations, saving over $8 million. The IPs and IDs are selected based on customer needs, technical complexity, and complex-wide regulatory and compliance agreements. New technology systems are selected for incorporation into an IP or ID from offerings of the DOE laboratories, industry, and the universities. A major TD initiative was announced in August 1991, with the release of a Program Research and Development Announcement (PRDA) requesting industry and universities to propose innovative new technologies to clean up the Weapons Complex. (author)

  3. Australian consumer perspectives on dialysis: first national census.

    Science.gov (United States)

    Ludlow, Marie J; Lauder, Lydia A; Mathew, Timothy H; Hawley, Carmel M; Fortnum, Debbie

    2012-11-01

    The percentage of people in Australia who undertake home dialysis has steadily decreased over the past 40 years and varies within Australia. Consumer factors related to this decline have not previously been determined. A 78-question survey was developed and piloted in 2008 and 2009. Survey forms were distributed to all adult routine dialysis patients in all Australian states and territories (except Northern Territory) between 2009 and 2010. Of 9223 distributed surveys, 3250 were completed and returned. 49% of respondents indicated they had no choice in the type of dialysis and 48% had no choice in dialysis location. Respondents were twice as likely to receive information about haemodialysis (85%) than APD (39%) or CAPD (41%). The provision of education regarding home modalities differed significantly between states, and decreased with increasing patient age. Additional nursing support and reimbursement of expenses increased the proportion of those willing to commence dialysis at home, from 13% to 34%. State differences in the willingness to consider home dialysis, the degree of choice in dialysis location, the desire to change current dialysis type and/or location, and the provision of information about dialysis were identified. The delivery of pre-dialysis education is variable, and does not support all options of dialysis for all individuals. State variances indicate that local policy and health professional teams significantly influence the operation of dialysis programs. © 2012 The Authors. Nephrology © 2012 Asian Pacific Society of Nephrology.

  4. Effectiveness of peritonaeal dialysis

    Directory of Open Access Journals (Sweden)

    Jovanović Nataša

    2005-01-01

    Full Text Available Introduction. In the last few years, an increasing number of patients suffering from terminal renal disease of various leading causes was treated with renal replacement therapy. Peritonaeal dialysis involves an exchange of water and solutes between blood in the peritonaeal capillaries and dialysate in the peritonaeal cavum throughout the peritonaeum. Effective dialysis treatment should provide good quality of life, decrease the number of physical complaints, and bring the incidence of morbidity and mortality closer to the incidence of morbidity and mortality in the healthy population. Aim. The aim of this study was the evaluation of peritonaeal transport characteristics and dialysis effectiveness in 58 patients affected by terminal renal disease who underwent peritonaeal dialysis treatment during August 2003 at the Clinic of Nephrology of the Clinical Centre of Serbia. Method. We examined 30 male and 28 female patients, with an average age of 52 years (range 26 to 78 years. The average duration of peritoneal dialysis treatment was 20 months (ranging from 2 to 66 months, and the end-stage renal failure was caused by different leading disease in our patients. We applied different dialysis modalities: continuous ambulatory peritonaeal dialysis (CAPD with three to five 2- or 3-litre exchanges daily, cyclic peritonaeal dialysis (CCPD, intermittent peritonaeal dialysis (IPD, or automatic peritonaeal dialysis (APD, according to the transport characteristics of the peritonaeal membrane, the residual renal function (RRF, and the clinical status of the patients, in order to perform adequate depuration as suggested by the new international criteria. A peritonaeal equilibrium test (PET was performed according to the new international advice; urea and creatinine clearances (Kt/V and Ccr as well as RRF were calculated using the internationally suggested formulas. Results. Most of our patients received effective dialysis treatment, thanks to the modulation of

  5. Reorienting development: towards and engendered employment strategy

    OpenAIRE

    Selim Jahan

    2005-01-01

    Development strategies, in the name of gender-neutral, are gender-blind. The gender blindness of development strategies are derived from the gender-insensitiveness of dominant development paradigms, which, in the name of work, do not make any distinction between productive and reproductive work and does not differentiate, in the name of household, the asymmetries faced by its different members on the basis of sex. Given the nature of gender blindness of development strategies, it is clear tha...

  6. Clusters and strategy in regional economic development

    OpenAIRE

    Feser, Edward

    2009-01-01

    Many economic development practitioners view cluster theory and analysis as constituting a general approach to strategy making in economic development, which may lead them to prioritize policy and planning interventions that cannot address the actual development challenges in their cities and regions. This paper discusses the distinction between strategy formation and strategic planning, where the latter is the programming of development strategies that are identified through a blend of exper...

  7. Sustainable development strategy formation for business corporations

    Directory of Open Access Journals (Sweden)

    L. A. Zaporozhtseva

    2016-01-01

    Full Text Available The article explains the concept of the company sustainable development strategy based on its economic security level, which includes the economic security concept loss threat control; and the concept of company sustainable development based on the fact, that the company in a developed market should not only "defend", but also ensure its development. After it implementation of decomposition is applied to the system of strategic economic security through a balanced scorecard, which allows translating the mission and vision into a set of operational goals and targets. The main components of strategic economic security provision are: business processes, finance, contractors and staff; based on the state which economic security level is determined as: high, normal, low or critical. After that, the strategic prospects are set, i.e. transition from the lowest to the highest economic security level takes place, passing the economic security fields. In order to do this, certain company development strategy is selected, the mechanism for its implementation is being worked out. At the same time, company sustainable development strategy is identified in the case of a growth strategy use, which implies a transition from endogenous development strategy to introductive or introspective development strategy with further access to multi-integral development strategy. If there is inverse relationship, one can not speak of any sustainable development strategy. Besides, development, implementation and use of monitoring for the design process of the company's development strategy taking into account its economic security level acquires great importance.

  8. Advances in peritoneal dialysis

    NARCIS (Netherlands)

    Krediet, R. T.

    2007-01-01

    New peritoneal dialysis (PD) patients have a better survival than new haemodialysis (HD) patients in the first years on dialysis. During long-term treatment, this changes into a survival advantage for HD. The superior initial survival on PD is related to a better preservation of residual renal

  9. Peritoneal Dialysis in Western Countries.

    Science.gov (United States)

    Struijk, Dirk G

    2015-12-01

    Peritoneal dialysis (PD) for the treatment of end-stage renal failure was introduced in the 1960s. Nowadays it has evolved to an established therapy that is complementary to hemodialysis (HD), representing 11% of all patients treated worldwide with dialysis. Despite good clinical outcomes and similar results in patient survival between PD and HD, the penetration of PD is decreasing in the Western world. First the major events in the history of the development of PD are described. Then important insights into the physiology of peritoneal transport are discussed and linked to the changes in time observed in biopsies of the peritoneal membrane. Furthermore, the developments in peritoneal access, more biocompatible dialysate solutions, automated PD at home, the establishment of parameters for dialysis adequacy and strategies to prevent infectious complications are mentioned. Finally non-medical issues responsible for the declining penetration in the Western world are analyzed. Only after introduction of the concept of continuous ambulatory PD by Moncrief and Popovich has this treatment evolved in time to a renal replacement therapy. Of all structures present in the peritoneal membrane, the capillary endothelium offers the rate-limiting hindrance for solute and water transport for the diffusive and convective transport of solutes and osmosis. The functional and anatomical changes in the peritoneal membrane in time can be monitored by the peritoneal equilibrium test. Peritonitis incidence decreased by introduction of the Y-set and prophylaxis using mupirocin on the exit site. The decrease in the proportion of patients treated with PD in the Western world can be explained by non-medical issues such as inadequate predialysis patient education, physician experience and training, ease of HD initiation, overcapacity of in-center HD, lack of adequate infrastructure for PD treatment, costs and reimbursement issues of the treatment. (1) PD is cheaper than HD and provides a

  10. New Product Development and Business Strategy of Research and Development

    International Nuclear Information System (INIS)

    Lee, Sun Cheol

    1998-05-01

    The contents of this book are new product development strategy of the top business, commercialization and new product development, development case analysis and framework of new product development, investigation strategy for idea of new product development, case analysis of research as development and goal of new product development, case analysis and planning and management for new product development, innovative item development and technical management against confusion, the map for determination procedure of development, strategy of market and goods and development strategy cases in leading company.

  11. Medical nutrition therapy in chronic kidney disease; from dialysis to transplant: A case report

    Directory of Open Access Journals (Sweden)

    Gabriela Leal-Escobar

    2016-01-01

    Full Text Available Chronic kidney disease has direct implications in nutritional status, causing anorexia and muscular catabolism. These situations are frequent in kidney renal replacement therapy in which nutritional disorders and inflammatory mechanisms associated with therapy often lead to the development of protein-energy wasting. Nutrition therapy has shown an adequate therapeutic strategy to prevent and treat metabolic alterations, reducing surgical and nutritional complication risks in kidney transplantation patients. The current case reports nutritional intervention on a continuous ambulatory peritoneal dialysis patient who was subsequently prescribed to automatic peritoneal dialysis and, finally, kidney transplant from a living donor.

  12. Developing Action Plans Based on Strategy

    DEFF Research Database (Denmark)

    Carstensen, Peter H.; Vinter, Otto

    2018-01-01

    The authors have performed a thorough study of the change strategy literature that is the foundation for the 10 overall change strategies defined in ISO/IEC 33014. Then the authors identified eight aspects that should be considered when developing the concrete actions for executing the strategy....

  13. Routine development of objectively derived search strategies

    Directory of Open Access Journals (Sweden)

    Hausner Elke

    2012-02-01

    Full Text Available Abstract Background Over the past few years, information retrieval has become more and more professionalized, and information specialists are considered full members of a research team conducting systematic reviews. Research groups preparing systematic reviews and clinical practice guidelines have been the driving force in the development of search strategies, but open questions remain regarding the transparency of the development process and the available resources. An empirically guided approach to the development of a search strategy provides a way to increase transparency and efficiency. Methods Our aim in this paper is to describe the empirically guided development process for search strategies as applied by the German Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, or "IQWiG". This strategy consists of the following steps: generation of a test set, as well as the development, validation and standardized documentation of the search strategy. Results We illustrate our approach by means of an example, that is, a search for literature on brachytherapy in patients with prostate cancer. For this purpose, a test set was generated, including a total of 38 references from 3 systematic reviews. The development set for the generation of the strategy included 25 references. After application of textual analytic procedures, a strategy was developed that included all references in the development set. To test the search strategy on an independent set of references, the remaining 13 references in the test set (the validation set were used. The validation set was also completely identified. Discussion Our conclusion is that an objectively derived approach similar to that used in search filter development is a feasible way to develop and validate reliable search strategies. Besides creating high-quality strategies, the widespread application of this approach will result in a

  14. Self-management support for peritoneal dialysis patients.

    Science.gov (United States)

    Sarian, Mari; Brault, Diane; Perreault, Nathalie

    2012-01-01

    The increasing prevalence of chronic illnesses and kidney disease, in particular, makes it necessary to adopt new approaches towards their management (Wagner, 1998). Evidence suggests that promoting self-management improves the health status of peritoneal dialysis (PD) patients, as they manage upwards of 90% of their own care. Patients who are unable to self-manage suffer from various complications. This project proposes an intervention aimed at improving self-management skills among PD patients. To promote self-management in peritoneal dialysis patients. This is achieved through the following objectives: (a) develop an algorithm that can improve patients' ability to solve the specific problem of fluid balance maintenance, (b) develop an educational session for patients on how to use the algorithm, and (c) develop an implementation strategy in collaboration with the PD nurse. Three measures evaluate the effectiveness of the intervention. First, a telephone call log shows that participating patients call the clinic less to inquire about fluid balance maintenance. Next, a pre- and post-intervention knowledge test measures definite knowledge increase. Finally, a Patient Satisfaction Questionnaire reveals overall satisfaction with the intervention. This project, which proved beneficial to our patient population, could be duplicated in other clinics. The algorithm "How do I choose a dialysis bag" and the slides of the educational sessions can be shared with PD nurses across the country for the benefit of PD patients.

  15. Summary: analysis of alternative FBR development strategies

    International Nuclear Information System (INIS)

    Burnham, J.B.

    1981-12-01

    This report summarizes the comparative evaluation of alternative strategies for the development of the commercial fast breeder reactor (FBR) in the United States. For planning purposes, a range of possible FBR development paths called strategies were selected for evaluation. These strategies, designed to be technically and economically feasible, were expressed in terms of the timing and nature of facilities/research and development programs required to reach full power operation of the first commercial FBR. Four of the seven strategies resulted in a large (1457 MWe) FBR as an end point, the other three in a 1000-MWe plant. Probability distributions were calculated for total strategy costs and time to completion. For the seven strategies analyzed, the costs (discounted 1980 dollars) ranged from $1.8 billion to $4.9 billion; the completion times ranged from 24 to 55 years

  16. ASSESSMENT BASIS OF INNOVATIVE DEVELOPMENT STRATEGY

    Directory of Open Access Journals (Sweden)

    Alexander O. Bebris

    2014-01-01

    Full Text Available The article provides a brief description of modern concept of strategic management and provides the effectiveness principles for the strategy of modern ventures innovative development. The article refers to the management of ventures strategic development.

  17. A call to arms: economic barriers to optimal dialysis care.

    Science.gov (United States)

    McFarlane, P A; Mendelssohn, D C

    2000-01-01

    Epidemic growth rates and the enormous cost of dialysis pressure end-stage renal disease (ESRD) delivery systems around the world. Payers of dialysis services can constrain costs through (1) limiting access to dialysis, (2) reducing the quality of dialysis, and (3) placing constraints on modality distribution. In order to secure the necessary resources for ESRD care, we propose that the nephrology community consider the following suggestions: First, future leaders in dialysis should acquire additional advanced training in innovative pathways such as health care economics, business and health care administration, and health care policy. Second, the international nephrology community must strongly engage in ongoing advocacy for accessible, high quality, cost-effective care.Third, efforts should be made to better define and then implement optimal dialysis modality distributions that maximize patient outcomes but limit unnecessary costs. Fourth, industry should be encouraged to lower the unit cost of dialysis, allowing for improved access to dialysis, especially in developing countries. Fifth, research should be encouraged that seeks to identify measures that will reduce dialysis costs but will not impair quality of care. Finally, early referral of patients with progressive renal disease to nephrology clinics, empowerment of informed patient choice of dialysis modality, and proper and timely access creation should be encouraged and can be expected to help limit overall expenditures. Ongoing efforts in these areas by the nephrology community will be essential if we are to overcome the challenges of ESRD growth in this new decade.

  18. Labor development strategy in the bag industry

    Directory of Open Access Journals (Sweden)

    Dyah Maya Nihayah

    2016-04-01

    Full Text Available The research aims to formulate strategies for improving the labor competencies in the bag industry in Kudus Regency. The data comprise business players, which will be analyzed using the Strength, Weaknesses, Opportunities, and Threats (SWOT analysis. The results reveal that the proper strategy for improving employment in the bag industry is growth and build strategy. Growth and development strategy are intensive actions undertaken through the development of labor competencies to improve the quality of output. It can be made with creating learning resources by designing methods and trainings refer to the Competency Based Training (CBT.

  19. Strategies for developing competency models.

    Science.gov (United States)

    Marrelli, Anne F; Tondora, Janis; Hoge, Michael A

    2005-01-01

    There is an emerging trend within healthcare to introduce competency-based approaches in the training, assessment, and development of the workforce. The trend is evident in various disciplines and specialty areas within the field of behavioral health. This article is designed to inform those efforts by presenting a step-by-step process for developing a competency model. An introductory overview of competencies, competency models, and the legal implications of competency development is followed by a description of the seven steps involved in creating a competency model for a specific function, role, or position. This modeling process is drawn from advanced work on competencies in business and industry.

  20. How to the development strategy of Serbia?

    Directory of Open Access Journals (Sweden)

    Popov Đorđe

    2014-01-01

    Full Text Available Experiences, especially those countries that in their development have achieved results above average confirmed the need for preparing and implementation the development strategy for Serbia. Preparation of strategy requires an intellectual effort. It requires the collection, analysis and evaluation of a series of data and trends in the country and in the world. Before starting work on the strategy there is a need to formulate what can be considered as a strategy. Serbia has a total of 120 strategies. It could not be just each document, regardless of title ,is a strategy. Development of the strategy must be delegated to the experts who are not compromised with actively participation in the destruction of the Serbian economy in the past decade. The strategy should clearly define the desired model of the economy. The strategy must be focused on the primary goal: growing production and employment. Serbia must redeveloped the industry. Foreign investments are important, but they can not substitute investments from domestic sources. Quality education, production and quality and uncorrupted public administration are the basic prerequisites for the successful economic development.

  1. Peritoneal Dialysis in Children*

    African Journals Online (AJOL)

    1971-06-02

    Jun 2, 1971 ... efficiency due to vasodilatation of the peritoneal vessels.' DIALYSIS ... osmotic load in the face of a decreasing blood urea and may thus help ... infection, heart failure, sodium and volume de- depletion; ..... around the catheter.

  2. Dialysis Extraction for Chromatography

    Science.gov (United States)

    Jahnsen, V. J.

    1985-01-01

    Chromatographic-sample pretreatment by dialysis detects traces of organic contaminants in water samples analyzed in field with minimal analysis equipment and minimal quantities of solvent. Technique also of value wherever aqueous sample and solvent must not make direct contact.

  3. Dialysis Facility Compare Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — These are the official datasets used on the Medicare.gov Dialysis Facility Compare Website provided by the Centers for Medicare and Medicaid Services. These data...

  4. Your Dialysis Care Team

    Science.gov (United States)

    ... A to Z Health Guide Your Dialysis Care Team Tweet Share Print Email Good health care is ... dialyzers (artificial kidneys) for reuse. Vascular Access Care Team If you are a hemodialysis patient, another group ...

  5. Developing Strategies for Networked Education.

    Science.gov (United States)

    Peregoy, Richard; Kroder, Stanley

    2000-01-01

    Assesses the strengths, weaknesses, opportunities and threats (SWOT) of the distance learning approach to education, and discusses how one institution, the University of Dallas Graduate School of Management, has developed a progressively expanding networked distance education program. Includes quotes from three students that suggest the quality of…

  6. Success rates for product development strategies in new drug development.

    Science.gov (United States)

    Dahlin, E; Nelson, G M; Haynes, M; Sargeant, F

    2016-04-01

    While research has examined the likelihood that drugs progress across phases of clinical trials, no research to date has examined the types of product development strategies that are the most likely to be successful in clinical trials. This research seeks to identify the strategies that are most likely to reach the market-those generated using a novel product development strategy or strategies that combine a company's expertise with both drugs and indications, which we call combined experience strategies. We evaluate the success of product development strategies in the drug development process for a sample of 2562 clinical trials completed by 406 US pharmaceutical companies. To identify product development strategies, we coded each clinical trial according to whether it consisted of an indication or a drug that was new to the firm. Accordingly, a clinical trial that consists of both an indication and a drug that were both new to the firm represents a novel product development strategy; indication experience is a product development strategy that consists of an indication that a firm had tested previously in a clinical trial, but with a drug that was new to the firm; drug experience is a product development strategy that consists of a drug that the firm had prior experience testing in clinical trials, but with an indication that was new to the firm; combined experience consists of both a drug and an indication that the firm had experience testing in clinical trials. Success rates for product development strategies across clinical phases were calculated for the clinical trials in our sample. Combined experience strategies had the highest success rate. More than three and a half percent (0·036) of the trials that combined experience with drugs and indications eventually reached the market. The next most successful strategy is drug experience (0·025) with novel strategies trailing closely (0·024). Indication experience strategies are the least successful (0·008

  7. Energy strategy in the national strategy of economy development

    International Nuclear Information System (INIS)

    Pop-Jordanov, Jordan; Boshevski, Tome; Hadzi-Mishev, Dimitar

    1997-01-01

    This paper is based on the sectorial study on energy, prepared by authors within the project 'National Strategy of Economic Development of Republic of Macedonia', carried out by the Macedonian Academy of Sciences and Arts. The aim is to define the basic lines for the development of energy sector in Macedonia until 2020. The main topics discussed comprise: fuel resources, thermal energy, electric power, price policy, forms of ownership and the environmental impacts. (author)

  8. Dialysis and contrast media

    International Nuclear Information System (INIS)

    Morcos, Sameh K.; Thomsen, Henrik S.; Webb, Judith A.W.

    2002-01-01

    In a previous survey we revealed uncertainty among responders about (a) whether or not to perform hemodialysis in patients with severely reduced renal function who had received contrast medium; and (b) when to perform hemodialysis in patients on regular treatment with hemodialysis or continuous ambulatory dialysis who received contrast medium. Therefore, the Contrast Media Safety Committee of The European Society of Urogenital Radiology decided to review the literature and to issue guidelines. The committee performed a Medline search. Based on this, a report and guidelines were prepared. The report was discussed at the Ninth European Symposium on Urogenital Radiology in Genoa, Italy. Hemodialysis and peritoneal dialysis safely remove both iodinated and gadolinium-based contrast media. The effectiveness of hemodialysis depends on many factors including blood and dialysate flow rate, permeability of dialysis membrane, duration of hemodialysis and molecular size, protein binding, hydrophilicity, and electrical charge of the contrast medium. Generally, several hemodialysis sessions are needed to removal all contrast medium, whereas it takes 3 weeks for continuous ambulatory dialysis to remove the agent completely. There is no need to schedule the dialysis in relation to the injection of iodinated or MR contrast media or the injection of contrast agent in relation to the dialysis program. Hemodialysis does not protect poorly functioning kidneys against contrast-medium-induced nephrotoxicity. Simple guidelines are given. (orig.)

  9. Predictors of chain acquisition among independent dialysis facilities.

    Science.gov (United States)

    Pozniak, Alyssa S; Hirth, Richard A; Banaszak-Holl, Jane; Wheeler, John R C

    2010-04-01

    To determine the predictors of chain acquisition among independent dialysis providers. Retrospective facility-level data combined from CMS Cost Reports, Medical Evidence Forms, Annual Facility Surveys, and claims for 1996-2003. Independent dialysis facilities' probability of acquisition by a dialysis chain (overall and by chain size) was estimated using a discrete time hazard rate model, controlling for financial and clinical performance, practice patterns, market factors, and other facility characteristics. The sample includes all U.S. freestanding dialysis facilities that report not being chain affiliated for at least 1 year between 1997 and 2003. Above-average costs and better quality outcomes are significant determinants of dialysis chain acquisition. Facilities in larger markets were more likely to be acquired by a chain. Furthermore, small dialysis chains have different acquisition strategies than large chains. Dialysis chains appear to employ a mix of turn-around and cream-skimming strategies. Poor financial health is a predictor of chain acquisition as in other health care sectors, but the increased likelihood of chain acquisition among higher quality facilities is unique to the dialysis industry. Significant differences among predictors of acquisition by small and large chains reinforce the importance of using a richer classification for chain status.

  10. Learning Strategies at Work and Professional Development

    Science.gov (United States)

    Haemer, Hannah Deborah; Borges-Andrade, Jairo Eduardo; Cassiano, Simone Kelli

    2017-01-01

    Purpose: This paper aims to investigate the prediction of current and evolutionary perceptions of professional development through five learning strategies at work and through training and how individual and job characteristics predict those strategies. Design/methodology/approach: Variables were measured in a cross-sectional survey, with 962…

  11. International strategies for breeder development

    International Nuclear Information System (INIS)

    Zaleski, C.P.; Zebroski, E.L.

    1992-01-01

    This paper studies the perspectives of breeder reactors development. The near term context has led some experts to the conclusion that breeder reactor technology is too far ahead of its time. Some have compared breeders to the supersonic airplane, Concorde: good technical performance but failure in its economic dimensions. In this paper, the author points out the major shortcomings of such an assessment which may be valid in the short time. However, with a short-term market-dominated perspective that uses an 8% discount rate, one can neglect every thing that is going to happen in 50 years. 6 refs., 11 figs

  12. Acute hydrothorax from peritoneal dialysis successfully treated with new dialysis regime

    International Nuclear Information System (INIS)

    Lim, C.T.S.; Thong, K.M.

    2015-01-01

    Hydrothorax is a rare and often unrecognized complication associated with peritoneal dialysis (PD). This is usually due to the presence of pleuroperitoneal fistula. Most nephrologist will choose to cease the peritoneal dialysis and rest the peritoneum. More than often surgical interventions include pleurodesis or thoracotomy will be required. In this report, we reported a patient who developed pleural effusion after starting continuous ambulatory peritoneal dialysis. She was successfully managed by the use of low volume exchange during daytime with avoidance of conversion to haemodialysis or any surgical intervention. (author)

  13. Strategy for Developing Local Chicken

    Directory of Open Access Journals (Sweden)

    Sofjan Iskandar

    2006-12-01

    Full Text Available Chicken industry in Indonesia offer jobs for people in the village areas . The balance in development industry of selected and local chicken has to be anticipated as there has been threat of reducing importation of grand parent stock of selected chicken due to global avian influenza . In the mean time, high appreciation to the local chicken has been shown by the existence of local chicken farms in the size of business scale . For local chicken business, the government has been built programs, projects, and infrastructures, although the programs and projects were dropped scattered in to several institutions, which were end up with less significant impact to the people. Therefore, it is the time that the government should put more efforts to integrate various sources . focusing in enhancing local chicken industry .

  14. Prodrug Strategy in Drug Development

    Directory of Open Access Journals (Sweden)

    Hajnal Kelemen

    2016-09-01

    Full Text Available Prodrugs are chemically modified derivatives introduced in therapy due to their advantageous physico-chemical properties (greater stability, improved solubility, increased permeability, used in inactive form. Biological effect is exerted by the active derivatives formed in organism through chemical transformation (biotransformation. Currently, 10% of pharmaceutical products are used as prodrugs, nearly half of them being converted to active form by hydrolysis, mainly by ester hydrolysis. The use of prodrugs aims to improve the bioavailability of compounds in order to resolve some unfavorable characteristics and to reduce first-pass metabolism. Other objectives are to increase drug absorption, to extend duration of action or to achieve a better tissue/organ selective transport in case of non-oral drug delivery forms. Prodrugs can be characterized by chemical structure, activation mechanism or through the presence of certain functional groups suitable for their preparation. Currently we distinguish in therapy traditional prodrugs prepared by chemical derivatisation, bioprecursors and targeted delivery systems. The present article is a review regarding the introduction and applications of prodrug design in various areas of drug development.

  15. HUMAN CAPITAL DEVELOPMENT: A STRATEGY FOR MOVING ...

    African Journals Online (AJOL)

    economy” but also “Knowledge economy” via human capital development. She has not been serious with her ... economy, Human capital, Strategy. Introduction. The world is now controlled by the revolution of Information and Communication.

  16. Systems strategies for developing industrial microbial strains

    DEFF Research Database (Denmark)

    Lee, Sang Yup; Kim, Hyun Uk

    2015-01-01

    Industrial strain development requires system-wide engineering and optimization of cellular metabolism while considering industrially relevant fermentation and recovery processes. It can be conceptualized as several strategies, which may be implemented in an iterative fashion and in different...

  17. Dialysis access, infections, and hospitalisations in unplanned dialysis start patients

    DEFF Research Database (Denmark)

    Machowska, Anna; Alscher, Mark Dominik; Vanga, Satyanarayana Reddy

    2017-01-01

    Introduction: Unplanned dialysis start (UPS) associates with worse clinical outcomes, higher utilisation of healthcare resources, lower chances to select dialysis modality and UPS patients typically commenced in-centre haemodialysis (HD) with central venous catheter (CVC). We evaluated patient ou...

  18. Appalachia: Goals, Objectives and Development Strategies

    Science.gov (United States)

    Appalachian Regional Commission, Washington, DC.

    Goals, objectives, and strategies for development in the 13 states involved in the Appalachian Regional Commission (ARC) are detailed in this document adopted by ARC in 1977. The regional development plan incorporates earlier evaluation and program design efforts, discussion from an issues report, state comments and development plans, and public…

  19. Determinants of Adherence to Living on Dialysis for Mexican Americans

    Directory of Open Access Journals (Sweden)

    Shirley A. Wells

    2015-03-01

    Full Text Available This study explores perceptions that affect adherence behaviors among Mexican Americans living with dialysis. In-depth narrative interviews were conducted with 15 Mexican Americans with end-stage renal disease (ESRD living on dialysis, 15 family members, and 6 health care personnel who provided care to them. Four themes emerged: (a positive influences to adherence, (b obstacles to adherence, (c daily activity losses, and (d fears about living with dialysis. From the findings, the perceptions given for non-adherence with the dialysis regimen ranged from denial of the condition, lack of pre-education, to cultural factors. Those given for adherence included prolonged life, family, and hope of getting a transplant. Health care providers were the reminder to adhere. Several cultural factors influenced their adherence perceptions. Strategies to enhance adherence behaviors should focus on knowledge about dialysis, use of the collective efficacy of the family, and the inclusion of cultural values.

  20. An animal study of a newly developed skin-penetrating pad and covering material for catheters to prevent exit-site infection in continuous ambulatory peritoneal dialysis.

    Science.gov (United States)

    Aoyama, Masato; Mizuno, Toshihide; Tatsumi, Eisuke; Taenaka, Yoshiyuki; Nemoto, Yasushi; Okamoto, Yoshihiro; Takemoto, Yoshiaki; Naganuma, Toshihide; Nakatani, Tatsuya

    2009-12-01

    Because currently available peritoneal dialysis catheters are not sufficiently biocompatible with the skin and subcutaneous tissue at the site of penetration, exit-site infection due to pericatheter pocket formation caused by epidermal downgrowth over a long period of time has increasingly become a problem. We developed a new, biocompatible, segmented polyurethane porous material and devised a novel skin-penetrating pad, the form and material of which we optimized for application in peritoneal dialysis catheters. For the extent of tissue ingrowth into this porous material to be examined, test materials with different pore diameters were inserted into hollow silicone tubes and implanted in the subcutaneous tissue of a goat. Four weeks later, the tubes were extracted, and, after the extent of granulation tissue ingrowth was measured, histopathological evaluation was made. Our novel skin-penetrating pad has three disklike layers of the segmented polyurethane material with different pore sizes, into the center of which a polyurethane catheter is inserted. These pads were implanted in the skin of a goat and clinically observed over a 2-year period, after which they were extracted and histopathologically analyzed. In accordance with actual clinical procedures, a commercial CAPD catheter equipped with our skin-penetrating pad was left indwelling in a goat for 4 months, and the performance of the pad was evaluated after repeated periodic infusion and drainage of the dialysate in and out of the abdominal cavity. There was no inflammation of the ingrown tissue in the pores of the segmented polyurethane material as well as the surrounding tissue, which indicated favorable tissue biocompatibility. The extent of tissue ingrowth was greater as the pore size of the material was larger, and the tissue tended to be mature, mainly consisting of collagenous fibers. The skin-penetrating pad using the porous material, of which tissue ingrowth was thus optimized, tightly adhered to the

  1. Phosphate control in dialysis

    Directory of Open Access Journals (Sweden)

    Cupisti A

    2013-10-01

    Full Text Available Adamasco Cupisti,1 Maurizio Gallieni,2 Maria Antonietta Rizzo,2 Stefania Caria,3 Mario Meola,4 Piergiorgio Bolasco31Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 2Nephrology and Dialysis Unit, San Carlo Borromeo Hospital, Milan, Italy; 3Territorial Department of Nephrology and Dialysis, ASL Cagliari, Italy; 4Sant'Anna School of Advanced Studies, University of Pisa, Pisa, ItalyAbstract: Prevention and correction of hyperphosphatemia is a major goal of chronic kidney disease–mineral and bone disorder (CKD–MBD management, achievable through avoidance of a positive phosphate balance. To this aim, optimal dialysis removal, careful use of phosphate binders, and dietary phosphate control are needed to optimize the control of phosphate balance in well-nourished patients on a standard three-times-a-week hemodialysis schedule. Using a mixed diffusive–convective hemodialysis tecniques, and increasing the number and/or the duration of dialysis tecniques are all measures able to enhance phosphorus (P mass removal through dialysis. However, dialytic removal does not equal the high P intake linked to the high dietary protein requirement of dialysis patients; hence, the use of intestinal P binders is mandatory to reduce P net intestinal absorption. Unfortunately, even a large dose of P binders is able to bind approximately 200–300 mg of P on a daily basis, so it is evident that their efficacy is limited in the case of an uncontrolled dietary P load. Hence, limitation of dietary P intake is needed to reach the goal of neutral phosphate balance in dialysis, coupled to an adequate protein intake. To this aim, patients should be informed and educated to avoid foods that are naturally rich in phosphate and also processed food with P-containing preservatives. In addition, patients should preferentially choose food with a low P-to-protein ratio. For example, patients could choose egg white or protein from a vegetable source

  2. Students’ Learning Strategies for Developing Speaking Ability

    Directory of Open Access Journals (Sweden)

    Sofyan A. Gani

    2015-03-01

    Full Text Available This study was done to study the learning strategies used by both low and high performance speaking students in developing their speaking skills as well as the differences between the learning strategies used by both groups of learners. The reason for conducting this research was the fact that the competency of many students in speaking English was still considered unsatisfactory in Banda Aceh. We postulated that one aspect involved in the process of developing speaking skills was the learning strategies used by the learners. In this study, the data was collected through field research by means of documents, questionnaires, and interviews. The result of this study indicated that high performance speaking students had better balance in using all kinds of learning strategies (memory, cognitive, compensatory, metacognitive, affective, and social for enhancing their speaking skills; the same could not be found with low performance speaking students. Besides, the high performance students employed more learning strategies consciously and appropriately compared to the low performance students. Based on the research results, it is suggested that students should be trained to be more aware of their own speaking learning strategies. They should use appropriate language learning strategies more consciously, purposefully, and frequently to be more successful in developing their speaking skills.

  3. Performance measures for a dialysis setting.

    Science.gov (United States)

    Gu, Xiuzhu; Itoh, Kenji

    2018-03-01

    This study from Japan extracted performance measures for dialysis unit management and investigated their characteristics from professional views. Two surveys were conducted using self-administered questionnaires, in which dialysis managers/staff were asked to rate the usefulness of 44 performance indicators. A total of 255 managers and 2,097 staff responded. Eight performance measures were elicited from dialysis manager and staff responses: these were safety, operational efficiency, quality of working life, financial effectiveness, employee development, mortality, patient/employee satisfaction and patient-centred health care. These performance measures were almost compatible with those extracted in overall healthcare settings in a previous study. Internal reliability, content and construct validity of the performance measures for the dialysis setting were ensured to some extent. As a general trend, both dialysis managers and staff perceived performance measures as highly useful, especially for safety, mortality, operational efficiency and patient/employee satisfaction, but showed relatively low concerns for patient-centred health care and employee development. However, dialysis managers' usefulness perceptions were significantly higher than staff. Important guidelines for designing a holistic hospital/clinic management system were yielded. Performance measures must be balanced for outcomes and performance shaping factors (PSF); a common set of performance measures could be applied to all the healthcare settings, although performance indicators of each measure should be composed based on the application field and setting; in addition, sound causal relationships between PSF and outcome measures/indicators should be explored for further improvement. © 2017 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  4. Peritoneal dialysis-related peritonitis: challenges and solutions

    Science.gov (United States)

    Salzer, William L

    2018-01-01

    Peritoneal dialysis is an effective treatment modality for patients with end-stage renal disease. The relative use of peritoneal dialysis versus hemodialysis varies widely by country. Data from a 2004 survey reports the percentage of patients with end-stage renal disease treated with peritoneal dialysis to be 5%–10% in economically developed regions like the US and Western Europe to as much as 75% in Mexico. This disparity is probably related to the availability and access to hemodialysis, or in some cases patient preference for peritoneal over hemodialysis. Peritoneal dialysis-related peritonitis remains the major complication and primary challenge to the long-term success of peritoneal dialysis. Fifty years ago, with the advent of the Tenckhoff catheter, patients averaged six episodes of peritonitis per year on peritoneal dialysis. In 2016, the International Society for Peritoneal Dialysis proposed a benchmark of 0.5 episodes of peritonitis per year or one episode every 2 years. Despite the marked reduction in peritonitis over time, peritonitis for the individual patient is problematic. The mortality for an episode of peritonitis is 5% and is a cofactor for mortality in another 16% of affected patients. Prevention of peritonitis and prompt and appropriate management of peritonitis is essential for the long-term success of peritoneal dialysis in all patients. In this review, challenges and solutions are addressed regarding the pathogenesis, clinical features, diagnosis, treatment, and prevention of peritoneal dialysis-related peritonitis from the viewpoint of an infectious disease physician.

  5. Filtering Dialysis Myths from Facts

    Science.gov (United States)

    ... to work. Fact: Many dialysis patients continue to work, go to school, or volunteer . Some take time off when they first start dialysis treatment and back to work or school after they have gotten used to ...

  6. Strategy community development based on local resources

    Science.gov (United States)

    Meirinawati; Prabawati, I.; Pradana, G. W.

    2018-01-01

    The problem of progressing regions is not far from economic problems and is often caused by the inability of the regions in response to changes in economic conditions that occur, so the need for community development programs implemented to solve various problems. Improved community effort required with the real conditions and needs of each region. Community development based on local resources process is very important, because it is an increase in human resource capability in the optimal utilization of local resource potential. In this case a strategy is needed in community development based on local resources. The community development strategy are as follows:(1) “Eight Line Equalization Plus” which explains the urgency of rural industrialization, (2) the construction of the village will be more successful when combining strategies are tailored to regional conditions, (3) the escort are positioning themselves as the Planner, supervisor, information giver, motivator, facilitator, connecting at once evaluators.

  7. Draft Guidance for Protective Action Strategies Development

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sang Hyun; Jeong, Seung Young; Kim, Wanjoo [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2016-10-15

    National nuclear emergency preparedness and response (EPR) framework has been improved since the Fukushima accident in 2011. There are still many needs to be amended and improved in regulatory requirements and technical criteria to warrant efficacy of the EPR framework. As an important part of the framework, protective actions have to be implemented with optimized and justified manner during whole emergency phases. In this study, to enhance protective action strategies in response to severe accident or general emergency, existing procedures were reviewed. And generic guidance to develop protective action recommendations (PARs) was proposed considering revised EPZ and recent technical information on protective action strategies. The generic guidance for PARs based on facility status was introduced. Revision of EPZ and some recent information on protective action strategies, such as staged evacuation, specific approach for rapidly progressing accident were considered. It would be employed as a basis to develop site-specific strategies of PARs and regulatory guidance for emergency plan by nuclear licensee. It was focused on an early phase of nuclear emergency. Further efforts to develop site specific strategies of PARs and strategies which cover full range of nuclear emergency would be followed by several stake holders.

  8. Developing people: a strategy for competitive advantage.

    Science.gov (United States)

    King, S

    1995-05-01

    This article will provide vital insights, acquired in a recent study with eight manufacturing companies, to guide the development of a human resource development strategy. This study was a pilot for a larger study, planned for the fall of 1995 with 50 manufacturing companies randomly chosen from the Directory of Massachusetts High Technology Companies.

  9. Development Strategy 0f Local Food Diversification

    Directory of Open Access Journals (Sweden)

    Imelda Imelda

    2017-03-01

    Full Text Available The purpose of this research is to develop strategies that can be applied in the development of local food diversification in West Kalimantan. The data used are primary data and secondary data. Variables examined included internal factors (strengths and weaknesses and external factors (opportunities and threats in the development of local food diversification in West Kalimantan. Data analysis were conducted in qualitative descriptive to describe the pattern of food consumption in West Kalimantan and continued with a SWOT analysis to carry out the development strategy of the local food diversification in West Kalimantan. The analysis result showed that the strategy for the development of local food diversification in West Kalimantan is SO strategy (Strengths - Opportunities those are: 1 the increase in synergy between the government and the micro, small and medium enterprises for the development of local food products, 2 the utilization of communications and market information system in improving the marketing of local food products on micro, small and medium enterprises, and 3 the utilization of unutilized agricultural land to improve the quality and quantity of local food products.

  10. National strategy for sustainable development: 5. report

    International Nuclear Information System (INIS)

    2009-01-01

    After an introduction on the assessment and perspectives of the French national strategy for a sustainable development, this report presents actions which are associated with different themes: social dimension of the sustainable development, the citizen as an actor of sustainable development, territories, economic activities, companies and consumers, climate change and energy, transports, agriculture and fishery, prevention of risks, pollutions and other hazards for health and the environment, an exemplary State, research and innovation, international action

  11. Strategy development management of Multimodal Transport Network

    Directory of Open Access Journals (Sweden)

    Nesterova Natalia S.

    2016-01-01

    Full Text Available The article gives a brief overview of works on the development of transport infrastructure for multimodal transportation and integration of Russian transport system into the international transport corridors. The technology for control of the strategy, that changes shape and capacity of Multi-modal Transport Network (MTN, is considered as part of the methodology for designing and development of MTN. This technology allows to carry out strategic and operational management of the strategy implementation based on the use of the balanced scorecard.

  12. Organisational IT Strategy Development using GDSS

    DEFF Research Database (Denmark)

    Sørensen, Lene

    1999-01-01

    development. This paper discusses the features of GDSSs in terms of a broad definition, and a focus on how it supports and makes impact on group decision making. For illustrating reasons, an existing GDSS is presented: the Strategic ADvisor, STRAD. STRAD is presented and it is showed how this GDSs can be used......IT strategy development in organisations is a complex task for which there is an immediate need for methodological support to be able to make satisfying decisions. Group Decision Support Systems (GDSS) is one line of supporting the process of group decision making and supporting IT strategy...

  13. Evaluation of alternative MGDS development strategies

    International Nuclear Information System (INIS)

    Roberds, W.; Miller, I.; Caldwell, D.

    1991-01-01

    A methodology has been developed to explicitly and quantitatively evaluate acceptable alternative repository development strategies, in terms of the degree to which they are likely to satisfy a specified set of system objectives (e.g., minimizing overall costs through closure, time to initial waste receipt and long-term health effects). An open-quotes acceptableclose quotes strategy is one which has a high likelihood of satisfying specified system functions and requirements. Simple but comprehensive system models have been developed to estimate the relevant consequences of any strategy, explicitly considering system uncertainties and contingencies, including the possibility of finding the site to be unsuitable and having to develop a repository elsewhere. Such open-quotes technical assessments,close quotes which are appropriately developed by technical experts, can then be combined with separate open-quotes value judgementsclose quotes regarding preferences and tradeoffs among the consequences, which are appropriately determined by the decision makers/stake holders (rather than by the technical experts) in order to explicitly determine preferences among the acceptable strategies. Implementation of the methodology has been demonstrated by example

  14. Peritoneal Dialysis in Children*

    African Journals Online (AJOL)

    1971-06-02

    Jun 2, 1971 ... cellular fluid' into the peritoneal cavity allows both the removal of excess fluid ... occur. In adults the maximum peritoneal urea clearance is ob- tained with a dialysis ..... and Records. Pulse and respiration rates, temperature and blood .... diffusion of urea out of the brain cells, with consequent movement of ...

  15. Strategies for successful software development risk management

    Directory of Open Access Journals (Sweden)

    Marija Boban

    2003-01-01

    Full Text Available Nowadays, software is becoming a major part of enterprise business. Software development is activity connected with advanced technology and high level of knowledge. Risks on software development projects must be successfully mitigated to produce successful software systems. Lack of a defined approach to risk management is one of the common causes for project failures. To improve project chances for success, this work investigates common risk impact areas to perceive a foundation that can be used to define a common approach to software risk management. Based on typical risk impact areas on software development projects, we propose three risk management strategies suitable for a broad area of enterprises and software development projects with different amounts of connected risks. Proposed strategies define activities that should be performed for successful risk management, the one that will enable software development projects to perceive risks as soon as possible and to solve problems connected with risk materialization. We also propose a risk-based approach to software development planning and risk management as attempts to address and retire the highest impact risks as early as possible in the development process. Proposed strategies should improve risk management on software development projects and help create a successful software solution.

  16. Renewable energy strategies for sustainable development

    DEFF Research Database (Denmark)

    Lund, Henrik

    2005-01-01

    This paper discusses the perspective of renewable energy (wind, solar, wave and biomass) in the making of strategies for a sustainable development. Such strategies typically involve three major technological changes: energy savings on the demand side, efficiency improvements in the energy...... production, and replacement of fossil fuels by various sources of renewable energy. Consequently, large-scale renewable energy implementation plans must include strategies of how to integrate the renewable sources in coherent energy systems influenced by energy savings and efficiency measures. Based...... on the case of Denmark, this paper discusses the problems and perspectives of converting present energy systems into a 100 percent renewable energy system. The conclusion is that such development will be possible. The necessary renewable energy sources are present, if further technological improvements...

  17. Strategies of Integrated Rural Development Adopted by ...

    African Journals Online (AJOL)

    forward and the basic idea was that it is a development process embracing the efforts of individuals, self help groups, non-governmental and governmental organisations, collective thinking, collective action and participation. ... These were represented in a schema as stated in figs 1 and 2. The application of these strategies ...

  18. Development Strategy of Lanting Small Industry

    Directory of Open Access Journals (Sweden)

    Atika Tri Puspitasari

    2015-12-01

    Full Text Available This research aims to describe and analyze the strategy of production, marketing, human resources (labor, and capital. The technique of collecting data used observation, interviews, documentation, questionnaires, and triangulation. The technique of sampling was purposive sampling. Findings show that the strategy of production, marketing strategies by the way of increased order coupled with the trademark shows as well as various flavors of innovation development, adjustment of the selling price with the price of raw materials production, the cooperation of manufacturers and suppliers in the distribution of lanting, promotional activities by means of cooperation with the agency and related service trade off products online. The strategy of human resources is with the formation groups of industry in the village of Lemahduwur (but not running smoothly. Strategy capital with the initial capital comes from its own capital and profit as capital accumulation, additional capital when many party and by feast day; increased access to capital, financial administration and against accounting in a simple and routine. The advice given is the government and manufacturers improve HR, technology development, marketing and capital. Manufacturer improves collaboration with suppliers of raw materials, maintaining the typical features and making a trademark.

  19. Wearable impedance monitoring system for dialysis patients.

    Science.gov (United States)

    Bonnet, S; Bourgerette, A; Gharbi, S; Rubeck, C; Arkouche, W; Massot, B; McAdams, E; Montalibet, A; Jallon, P

    2016-08-01

    This paper describes the development and the validation of a prototype wearable miniaturized impedance monitoring system for remote monitoring in home-based dialysis patients. This device is intended to assess the hydration status of dialysis patients using calf impedance measurements. The system is based on the low-power AD8302 component. The impedance calibration procedure is described together with the Cole parameter estimation and the hydric volume estimation. Results are given on a test cell to validate the design and on preliminary calf measurements showing Cole parameter variations during hemodialysis.

  20. Sustainable development strategy 2001-2003

    International Nuclear Information System (INIS)

    2001-01-01

    The planned strategies and actions that Environment Canada (EC) will take to promote sustainable development with the goal to preserve and enhance the quality of the natural environment and its renewable resources were described. EC's challenge regarding sustainable development is to integrate environmental, economic and social considerations into their federal environmental policies and programs. This report described how EC plans to implement their agenda based on four major themes which include: (1) knowledge for decision making, (2) incentives, (3) partnerships and sustainable communities, and (4) managing for sustainable development. A federal framework on sustainable communities will be developed jointly with other government departments and partners with the objective of developing action plans. EC will measure and report on its performance in implementing its sustainable development strategy on an annual basis to identify any corrective measures during the three year period of the strategy. This report also included an issue scan, a consultation summary, and a review of the department's long term results against performance indicators. tab., figs

  1. Research requirements for alternative reactor development strategies

    International Nuclear Information System (INIS)

    1979-06-01

    The purpose of this paper is to estimate and compare resource requirements and other fuel cycle quantities for alternative reactor deployment strategies. The paper examines from global and national perspectives the interaction of various fuel cycle alternatives described in the previous U.S. submissions to Working Groups 4, 5, 8 and Subgroup 1A/2A. Nuclear energy forecasts of Subgroup 1A/2A are used in the calculation of uranium demand for each strategy. These uranium demands are then compared to U.S. estimates of annual uranium producibility. Annual rather than cumulative producibility was selected because it does not assume preplanned stockpiling, and is therefore more conservative. The strategies attempt to span a range of nuclear power mixes which could evolve if appropriate commercial and governmental climates develop

  2. Developing marketing strategies for university teaching hospitals.

    Science.gov (United States)

    Fink, D J

    1980-07-01

    University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, a rising tide of consumerism, and in many cases a declining urban population base. These problems, which may threaten the teaching hospital's ability to continue tertiary care, teaching, and research functions, may be solved with the aid of new marketing strategies. In developing its marketing strategy, a hospital must assess its strengths and weaknesses, specify its goals in measurable terms, implement tactics to achieve these goals, and evaluate its marketing program. The strategies should be directed toward achieving better relationships with institutions, practitioners, and surrounding communities and increasing patient, visitor, and employee satisfaction. A wide variety of programs can be used to reach these goals and to help teaching hospitals meet the competitive challenges of this decade.

  3. STRATEGY FORMULATION FOR DEVELOPING BATIK TULIS

    Directory of Open Access Journals (Sweden)

    Indah Eko Suryani

    2015-01-01

    Full Text Available The objective of this study was to formulate a development strategy in order to maintain the existence of Batik Tulis Rolla Junior. The study used a case study approach with Rumah Batik Tulis Rolla Junior as the research object. The data were analyzed by a value chain approach to determine the internal and external conditions influencing the existence of the Batik Tulis Rolla Junior. Furthermore, this study also used the analysis of Internal Factor Evaluation (IFE, External Factor Evaluation (EFE, Internal-External (IE Matrix, SWOT, dan Quantitative Strategic Planning Matrix (QSPM to create the development strategy. The results show that the strategies that can be recommended to Rolla Junior include 1 increasing the capital by Kredit Usaha Rakyat (KUR program, 2 conductiong expansions to other regencies, 3 creating a website/blog  to promote and perform business transactions, 4 increasing the frequency in joining exhibitions or EXPO both in regional and national levels, 5 conducting researches to solve the problem of coloring which requires sun rays, 6 conducting cooperations with raw material suppliers (backward integration, and 7 finding alternative suppliers of raw materials especially from the areas closer to Jember district.Keywords: development strategy, batik tulis Rolla Junior, SWOT, QSPMABSTRAKPenelitian ini bertujuan merumuskan strategi pengembangan sehingga dapat menjaga eksistensi Batik Tulis Rolla Junior. Penelitian menggunakan pendekatan studi kasus dengan Rolla Junior sebagai objek penelitiannya. Data dianalisis dengan pendekatan rantai nilai untuk mengetahui kondisi internal dan eksternal yang berpengaruh terhadap Batik Tulis kemudian menggunakan analisis Internal Factor Evaluation (IFE, External Factor Evaluation (EFE, Internal-External (IE Matrix, SWOT, dan Quantitative Strategic Planning Matrix (QSPM untuk menyusun strategi pengembangan Batik Tulis Rolla Junior. Hasil penelitian menunjukkan bahwa strategi-straegi prioritas

  4. Psychosocial adjustment and adherence to dialysis treatment regimes.

    Science.gov (United States)

    Brownbridge, G; Fielding, D M

    1994-12-01

    Sixty children and adolescents in end-stage renal failure who were undergoing either haemodialysis or continuous ambulatory peritoneal dialysis at one of five United Kingdom dialysis centres were assessed on psychosocial adjustment and adherence to their fluid intake, diet and medication regimes. Parental adjustment was also measured and data on sociodemographic and treatment history variables collected. A structured family interview and standardised questionnaire measures of anxiety, depression and behavioural disturbance were used. Multiple measures of treatment adherence were obtained, utilising children's and parents' self-reports, weight gain between dialysis, blood pressure, serum potassium level, blood urea level, dietitians' surveys and consultants' ratings. Correlational analyses showed that low treatment adherence was associated with poor adjustment to diagnosis and dialysis by children and parents (P adherence than younger children, P dialysis (P treatment of this group of children. Future research should develop and evaluate psychosocial interventions aimed at improving treatment adherence.

  5. Development strategy and targets of CGNPG

    International Nuclear Information System (INIS)

    Zan Yunlong

    2002-01-01

    The development of nuclear power industry in Guangdong results from the steady implementation of a catch-up strategy aimed at the advanced world level in the nuclear power industry. China Guangdong Nuclear Power (Holding) Co., Ltd. (CGNPC) started from Daya Bay Nuclear Power Station (GNPS). In the form of joint venture, GNPS has obtained sophisticated technology, management expertise and human resources both at home and abroad, and has successfully completed the learning curve from importing, digesting, absorbing to innovating and self-improving. Under the principle of maintaining continuous nuclear power development by reinvesting the returns on the operating nuclear power stations, the second nuclear power project, Ling Ao Nuclear Power Station (LNPS) is progressing well and preparation for the third nuclear power project is now in full swing. With a rolling-on development mechanism being established, Daya Bay has become the cradle for nuclear power development in Guangdong. In the 21 st century, CGNPC is facing new challenges and opportunity. CGNPC will uphold the principle of maintaining continuous nuclear power development by reinvesting the returns on the operating nuclear power stations, brace itself for the market competition and explore sustained development of nuclear power in China by pursuing constant innovation in technology, management, system and concept. The strategy framework for future development of CGNPC is defined as follows: - to establish three-dimension strategic targets; - to pursue two-step development with the year 2015 as the dividing point; - to promote concerted development of nuclear power, associated industries and supporting services

  6. Using Sustainable Development as a Competitive Strategy

    Science.gov (United States)

    Spearman, Pat

    Sustainable development reduces construction waste by 43%, generating 50% cost savings. Residential construction executives lacking adequate knowledge regarding the benefits of sustainable development practices are at a competitive disadvantage. Drawing from the diffusion of innovation theory, the purpose of this qualitative case study was to explore knowledge acquisition within the bounds of sustainable residential construction. The purposive sample size of 11 executive decision makers fulfilled the sample size requirements and enabled the extraction of meaningful data. Participants were members of the National Home Builders Association and had experience of a minimum of 5 years in residential construction. The research question addressed how to improve knowledge acquisition relating to the cost benefits of building green homes and increase the adoption rate of sustainable development among residential builders. Data were collected via semistructured telephone interviews, field observation, and document analysis. Transcribed data were validated via respondent validation, coded into 5 initial categories aligned to the focus of the research, then reduced to 3 interlocking themes of environment, competitive advantage, and marketing. Recommendations include developing comprehensive public policies, horizontal and vertical communications networks, and green banks to capitalize sustainable development programs to improve the diffusion of green innovation as a competitive advantage strategy. Business leaders could benefit from this data by integrating sustainable development practices into their business processes. Sustainable development reduces operational costs, increases competitive advantage for builders, and reduces greenhouse gas emissions. Implications for social change increase energy independence through conservation and developing a legislative policy template for comprehensive energy strategies. A comprehensive energy strategy promotes economic development

  7. Ketoanalogues supplementation decreases dialysis and mortality risk in patients with anemic advanced chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Che-Hsiung Wu

    Full Text Available The benefit of alpha-Ketoanalogues (KA supplementation for chronic kidney disease (CKD patients that followed low-protein diet (LPD remains undetermined.We extracted longitudinal data for all CKD patients in the Taiwan National Health Insurance from January 1, 2000 through December 31, 2010. A total of 1483 patients with anemic advanced CKD treated with LPD, who started KA supplementation, were enrolled in this study. We analyzed the risks of end stage renal disease and all-cause mortality using Cox proportional hazard models with influential drugs as time-dependent variables.A total of 1113 events of initiating long-term dialysis and 1228 events of the composite outcome of long-term dialysis or death occurred in patients with advanced CKD after a mean follow-up of 1.57 years. Data analysis suggests KA supplementation is associated with a lower risk for long-term dialysis and the composite outcome when daily dosage is more than 5.5 tablets. The beneficial effect was consistent in subgroup analysis, independent of age, sex, and comorbidities.Among advanced CKD patients that followed LPD, KA supplementation at an appropriate dosage may substantially reduce the risk of initiating long-term dialysis or of developing the composite outcome. KA supplementation represents an additional therapeutic strategy to slow the progression of CKD.

  8. Green energy strategies for sustainable development

    International Nuclear Information System (INIS)

    Midilli, Adnan; Dincer, Ibrahim; Ay, Murat

    2006-01-01

    In this study we propose some green energy strategies for sustainable development. In this regard, seven green energy strategies are taken into consideration to determine the sectoral, technological, and application impact ratios. Based on these ratios, we derive a new parameter as the green energy impact ratio. In addition, the green energy-based sustainability ratio is obtained by depending upon the green energy impact ratio, and the green energy utilization ratio that is calculated using actual energy data taken from literature. In order to verify these parameters, three cases are considered. Consequently, it can be considered that the sectoral impact ratio is more important and should be kept constant as much as possible in a green energy policy implementation. Moreover, the green energy-based sustainability ratio increases with an increase of technological, sectoral, and application impact ratios. This means that all negative effects on the industrial, technological, sectoral and social developments partially and/or completely decrease throughout the transition and utilization to and of green energy and technologies when possible sustainable energy strategies are preferred and applied. Thus, the sustainable energy strategies can make an important contribution to the economies of the countries where green energy (e.g., wind, solar, tidal, biomass) is abundantly produced. Therefore, the investment in green energy supply and progress should be encouraged by governments and other authorities for a green energy replacement of fossil fuels for more environmentally benign and sustainable future

  9. DEVELOPING A STRATEGY CONCEPT ON MICRO LEVELS

    Directory of Open Access Journals (Sweden)

    S. P. Burlankov

    2014-01-01

    Full Text Available Relevance of the topic of the study is that the conflicting tendencies of economic development, the need to consider a variety of factors internal and external environment in a changing operating environment in the paramount problem of providing concept enterprises as concept distributed in time. Variety of factors that influence the activity of enterprises, the ambiguity estimates of their effect, often lack the possibility of their accounting and forecasting, the complication of the problem to identify the interdependence of external and internal parameters of management lead to serious negative consequences, and often to the destruction of production and the economic system. This raises the need to develop new approaches and management techniques the intra interaction, based on the use of tools of market relations and the transformation of the elements of the market at the enterprise level. Insufficiently complete theoretical study concept issues, lack of models, diagrams, algorithms for the formation mechanism of industrial relations on the principles of intra-enterprise, ensuring longevity economic enterprises by integrating and mobilizing intra-building, deter-mined the choice of the research topic. Strategy - an integrated model of action designed to achieve the objectives of the enterprise. Content of the strategy is a set of decision rules used to determine the main directions of activity. In the literature on strategic planning, there are two opposing views on the understanding of the strategy. In the first case the strategy - it is a concrete long-term plan to achieve a certain goal, and develop a strategy - it is the process of finding a purpose and making long-term plan. This approach is based on the fact that all the emerging changes are predictable, occur-ring in the environment of the processes are deterministic and amenable to complete control and management. At the same time, both within the organization and outside it there

  10. The Manchester contribution to peritoneal dialysis

    NARCIS (Netherlands)

    Krediet, Raymond T.

    2011-01-01

    Two names emerge when considering the contribution of Manchester in the development of peritoneal dialysis (PD). The first is Ram Gokal; the second is icodextrin. As there will be a separate article on icodextrin, this one will focus more on other aspects of the activities performed by the Renal

  11. Strategies of development of reactor types

    International Nuclear Information System (INIS)

    Bacher, P.

    2004-01-01

    The development of nuclear energy in the coming decades will depend on the goals followed, on the available technologies and on the strategies implemented in the world in agreement with public acceptation. This article is limited to the technical aspects of the strategies of development of reactor types: 1 - objectives; 2 - common constraints to all reactor types: safety and terrorism risks, wastes, non-proliferation, economics; 3 - different reactor types: general considerations, proven technologies (PWR, BWR, Candu), non-proven technologies but having an important experience, technologies at the design stage; 4 - energy systems and 'Generation IV forum': systems based on thermal neutron reactors and low enrichment, systems for the valorization of 238 U, systems for Pu burning, systems allowing the destruction of minor actinides, thorium-based systems, the Gen IV international forum; 5 - conclusion. (J.S.)

  12. Central station market development strategies for photovoltaics

    Science.gov (United States)

    1980-01-01

    Federal market development strategies designed to accelerate the market penetration of central station applications of photovoltaic energy system are analyzed. Since no specific goals were set for the commercialization of central station applications, strategic principles are explored which, when coupled with specific objectives for central stations, can produce a market development implementation plan. The study includes (1) background information on the National Photovoltaic Program, photovoltaic technology, and central stations; (2) a brief market assessment; (3) a discussion of the viewpoints of the electric utility industry with respect to solar energy; (4) a discussion of commercialization issues; and (5) strategy principles. It is recommended that a set of specific goals and objectives be defined for the photovoltaic central station program, and that these goals and objectives evolve into an implementation plan that identifies the appropriate federal role.

  13. Strategy of Energy Development Until 2015

    International Nuclear Information System (INIS)

    Vilemas, J.; Miskinis, V.; Galinis, V.; Zukauskas, V.; Valentukevicius, V.

    2002-01-01

    In the introductory part of the strategy for the development of energy until 2015 the specifications of the present-day energy sector are given: strengths and weaknesses, opportunities for further development, which are expedient to be used, and threats, which are necessary to be reduced as much as possible. A vision of the energy sector and State mission, i.e., the main provisions and trends of State activities, which would allow the implementation of the desirable development of energy, are also formulated. The main strategic goals are identified with the consideration taken of essential requirements and provisions of the European Association Agreement, the Energy Charter Agreement, and other international agreements in the field of energy. Special attention in the strategy is devoted to the identification of the main trends in the development of the energy sector. A number of factors, both external and internal, will have an effect on the development of Lithuania's economy in the future. In preparing this strategy three scenarios of economic growth will be possible: 1) fast economic growth scenario (5.7 percent per year, on the average, in 2000-2015); 2) the main scenario (4.1 percent); 3) slow economic growth scenario (2.3 percent). Forecasts for the needs of energy for the said economic scenarios are prepared with the application of the MAED model, taking into consideration the expected structural changes in the GDP, energy intensity changes, the development of social indices, and other factors, having an effect on the changes in the consumption of energy. The duration of exploitation of the Ignalina NPP will have an essential effect on the development of the electric energy system. On the basis of optimisation calculations, performed with the use of the WASP-4 model, the strategy presents a detailed analysis of different scenarios for the shutdown of the nuclear power plant and expenses of its replacement by other electric power plants. Seeking to ensure the

  14. Strategies of the future technological development

    International Nuclear Information System (INIS)

    Lelek, V.

    2011-01-01

    Attempt to formulate strategies of the future development are formulated based on raw materials for energy needs, which will be in our disposal for the interval up to the start of nuclear fast breeder reactors. Main tendencies should be broader nuclear energy use and nonelectric application. As an externally given boundary condition it is supposed that world society model will be kept as a continuity of mankind history. There are recommendation of the demands for the development of new technologies to substitute decreasing external fossil energy resources and generally growing demand for living standard. Most of the considerations are growing from the INPRO studies published in IAEA Vienna. (Author)

  15. Developing IEC strategies for population programmes.

    Science.gov (United States)

    Cohen, S I

    1993-01-01

    The thrust of this article is to define terms of IEC, IEC strategies, the stepwise planning process for IEC, data requirements, the ideational change process, and the need for situational and institutional analysis. A chart provided an at-a-glance perspective on the 11 steps in IEC strategic planning for as many specific target groups as needed. The steps are to state the goals, select and prioritize the target audience, describe the target audience,, determine the IEC activities, outline appropriate messages, identify communication channels, identify managerial and organizational strategies, calculate the amount of resources required, identify a realistic time frame, and evaluate critical factors and obstacles. IEC goals are to contribute to solving a problem or supporting an issue, which involved attitudinal and/or behavioral changes. Many strategies are possible. The common weaknesses are the lack of priorities, the view of targets as a mass audience, a lack in support for population strategies, a lack of integration with family planning or specific population sectors, a lack of integration of up-to-data research findings on population programs, vague or difficult-to-measure objectives, reliance on printed media, and sporadic assessment of personnel needs. THe levels of strategy are identified as follows: 1) national and multisectoral, 2) national and sectoral specific, and 3) project specific. Traditional sociocultural research and KAP surveys are not sufficient to provide an understanding of the target audience. There must be an understanding of the stages of individual change: unaware, aware, concerned, information seeking, learning, motivated to change, initial behavior change, sustained behavior change, and adoption or refusal of behavior change. Beliefs must be distinguished from attitudes in measurement. Changes in beliefs may involve correction of misinformation; attitude change requires a motivational approach. Behavior may be determined by other

  16. BUSINESS DEVELOPMENT STRATEGY FOR SPECIALTY COFFEE

    Directory of Open Access Journals (Sweden)

    Vharessa Aknesia

    2015-01-01

    Full Text Available Specialty coffee is a coffee of premium quality that has been made through various stages of post-harvest processing and strictly controlled to produce distinctive taste of origins. PT Sinar Mayang Lestari is one of the companies that currently produce and develop specialty coffee type, Arabica Java Preanger. The objectives of the study are to examine competitive advantages and develop an alternative strategy that need to be done by PT Sinar Mayang Lestari for their business development. The research methods used are value chain analysis and VRIO framework to explore competitive advantage owned by the company. The result shows the company currently has a temporary competitive advantage of the technological resources and reputation. By using SWOT-AHP technique, the alternative strategies that can be done by company are as follows: 1 increasing the production of natural and honey coffee  type; 2 building coffee center in plantation site for sharing knowledge and innovation media to the farmers; 3 improving the competency of human resource in plantation, post harvest, and promoting area; 4 building management system gradually 5 forwarding integration by building roast and ground coffee business; and 6 maximizing the ability of the land and human resources through research and development.Keywords: competitive advantage, specialty coffee, SWOT-AHP, value chain, VRIOABSTRAKKopi special merupakan kopi dengan kualitas premium yang sudah melalui berbagai tahapan pengolahan pascapanen yang diawasi dengan ketat sehingga menghasilkan cita rasa yang khas sesuai dengan daerah asalnya. PT Sinar Mayang Lestari adalah salah satu perusahaan yang saatini memproduksi dan mengembangkan kopi spesial jenis Arabika Java Preanger. Tujuan dari penelitian ini adalah menganalisis keunggulan bersaing yang dimiliki dan mengembangkan alternative strategi yang perlu dilakukanoleh PT Sinar Mayang Lestari untuk pengembangan usahanya. Penelitian ini menggunakan analisis rantai

  17. Nuclear Fuel Cycle Strategy For Developing Countries

    International Nuclear Information System (INIS)

    Kim, Chang Hyo

    1987-01-01

    The world's uranium market is very uncertain at the moment while other front-end fuel cycle services including enrichment show a surplus of supply. Therefore, a current concern of developing countries is how to assure a long-term stable supply of uranium, so far as front-end fuel cycle operation is concerned. So, as for the front-end fuel cycle strategy, I would like to comment only on uranium procurement strategy. I imagine that you are familiar with, yet let me begin my talk by having a look at, the nuclear power development program and current status of fuel cycle technology of developing countries. It is a nice thing to achieve the full domestic control of fuel cycle operation. The surest way to do so is localization of related technology. Nevertheless, developing at a time due to enormous capital requirements, not to mention the non-proliferation restrictions. Therefore, the important which technology to localize prior to other technology and how to implement. The non-proliferation restriction excludes the enrichment and reprocessing technology for the time being. As for the remaining technology the balance between the capital costs and benefits must dictate the determination of the priority as mentioned previously. As a means to reduce the commercial risk and heavy financial burdens, the multi-national joint venture of concerned countries is desirable in implementing the localization projects

  18. Developing A Strategy to Enact Lean

    Directory of Open Access Journals (Sweden)

    Nicola Morrey

    2013-01-01

    Full Text Available This paper explains the strategy employed by a case study company to implement lean across the business, and to reflect on the success of this approach so other companies may consider this learning and how it might be useful to them. The strategy to enact lean in the case study company was based on creating a number of standard tools/ways of working. These tools can be considered to be standardised work for key aspects of the construction process that the company undertakes. The aim of the tools was to ensure that critical tasks would be carried out to the correct standard (quality, time, cost, health and safety every time, across the business. Achievement of this is expected to lead to improved performance and elimination of variation (waste. To implement this strategy of using standardised work to eliminate variation and lead to improved performance, a step-by-step process was developed to create the tools/standardised work. The paper describes the process that was undertaken and how it aimed to not only produce a number of tools/standardised work, but also to involve people and managers from across the business such that lean philosophy and thinking might also begin to become embedded. The paper will firstly explain, with reference to the relevant literature, how and why the strategy to implement standardised work was chosen, the process that was defined to develop the standardised work, and what happened when that process was put into practice. The findings of the paper show that whilst the completed tools delivered business benefits, the development of the tools did not follow the planned process. The paper discusses how people within the business responded to this strategy and how the process had to be continuously adapted to cope with the current business environment and path dependencies, further evidencing that lean implementations need to be tailored to suit the needs of the individual firm, rather than there being a one size fits all

  19. Klotho G-395A gene polymorphism: impact on progression of end-stage renal disease and development of cardiovascular complications in children on dialysis.

    Science.gov (United States)

    Elghoroury, Eman A; Fadel, Fatina I; Elshamaa, Manal F; Kandil, Dina; Salah, Doaa M; El-Sonbaty, Marwa M; Farouk, Hebatallah; Raafat, Mona; Nasr, Soha

    2018-06-01

    Klotho G-395-A gene polymorphism may impact children with end-stage renal disease (ESRD). We investigated the relevance of Klotho G-395-A on ESRD development and progression, and its relationship with evolution of cardiovascular complications in pediatric dialysis patients. Fifty-five children with chronic kidney disease (CKD) and seventy healthy children were genotyped for Klotho G-395A. Incidence of GA/AA genotypes and A allele were higher in ESRD patients compared with controls (54.5 vs. 7.1%, P < 0.001; 30.9 vs. 13.6%, P = 0.001, respectively). Also, children with GA/AA genotypes were 15.6 times more likely to develop ESRD than with GG genotype (95% CI 5.4-44.7, P < 0.001). A allele carriers have 2.8 times higher risk of developing ESRD than those with G allele (95% CI 1.5-5.35, P = 0.001). Also, the A allele could be considered a predictor of cardiovascular disease (CVD), as carriers have 161 times higher risk of cardiovascular complications than non-carriers (95% CI 21-1233, P < 0.001). All ESRD patients with CVD presented with left ventricular hypertrophy (LVH) and the frequency of A allele was significantly higher among ESRD children with LVH, whereas G allele frequency was significantly higher among ESRD children without LVH. The A allele of the G-395A Klotho gene polymorphism shows a significantly higher frequency among children with CKD and those with CVD and LVH. This mutant allele could be used as a risk marker for the development of ESRD as well as a predictor of CVD in these children.

  20. The role of OR in strategy development

    Directory of Open Access Journals (Sweden)

    T.J. Ormerod

    2003-12-01

    Full Text Available Reflecting on the experiences of applying OR approaches in a variety of contexts, the paper draws attention to some of the ways that OR can be brought to bear on strategic issues. Perhaps most frequently the strategic contribution derives from projects aimed at operational issues which have strategic implications. The paper argues that OR practitioners cannot expect to be given a role in strategy questions as of right, nor is there an "OR solution" to strategic questions. However, many OR scientists do have the skills, approaches and methods that can be usefully deployed, if they develop the confidence to do so.

  1. Strategies for developing and implementing specialized training

    International Nuclear Information System (INIS)

    Pate, M.C.

    1991-01-01

    Numerous strategies can be used to develop and implement specialized training. In order to achieve effective specialized training, however, two items are especially critical: use of a systematic approach and sensitiwity towards a good needs analysis. Sensitivity towards these items includes involving representatives of the target population in all phases of training, identifying student characteristics and their impact on training setting and delivery, preparing a scope document that addresses the terminal and enabling objectives of training in terms understandable to the customer, and emphasizing flexibility in the use of alternative training delivery methods and training resources. Increasing sensitivity towards these factors will increase participant satisfaction and the ultimate use of the training provided

  2. The elderly on dialysis: some considerations in compliance.

    Science.gov (United States)

    McKevitt, P M; Jones, J F; Lane, D A; Marion, R R

    1990-10-01

    Compliance with scheduled treatments, dietary and fluid restrictions, and multiple medications is an important component in the care and well-being of end-stage renal disease (ESRD) patients. Given the rigorus and complex demands of dialysis, it is important to examine the issue of compliance, focusing on a large and ever-increasing segment of our patient population, the elderly. The ESRD literature reflects efforts to define and measure levels of compliance, identify factors that influence and predict compliance, and develop intervention strategies to improve adherence to treatment regimens. While limited attention has been focused specifically on the elderly, there are studies suggesting that age may be a factor associated with improved adherence and that social support may be a significant contributor to compliance in this patient group. In an effort to examine the current status and needs of the dialysis elderly, research is in progress at Chromalloy American Kidney Center, Washington University, which replicates a study of 5 years ago. Eighty-four patients age 60 and over, on dialysis for a minimum of 6 months, were identified. Sociodemographic, treatment, compliance, and functional capacity data were collected; additional mental and psychological testing was completed on patients willing and able to participate. Preliminary data suggest the current elderly population is larger and significantly older than that of 5 years ago. Other sociodemographic data indicate the population is increasingly female, black, and more socioeconomically disadvantaged. In regard to compliance, the vast majority of elderly demonstrate good compliance as measured by serum potassium, fair to good compliance with phosphorus, and fair to poor compliance with fluid restrictions.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. The diagnosis of tuberculosis in dialysis patients

    Directory of Open Access Journals (Sweden)

    Hela Jebali

    2017-01-01

    Full Text Available The incidence of tuberculosis (TB is high in patients undergoing chronic dialysis than it is in the general population. The diagnosis of TB is often difficult and extrapulmonary involvement is predominant. This study investigates the spectrum of clinical presentations and outcome in dialysis patients during a nine-year period. TB was diagnosed in 41 patients. Anti-TB drugs, adverse effects of therapy, and outcome were noted. Thirty-eight patients (92.6% were on hemodialysis and three were on peritoneal dialysis (7.3%. The mean age at diagnosis was 50.8 years and the male/female ratio was 1.16. Four patients had a history of pulmonary TB. Extrapulmonary involvement was observed in 32 (78 % patients. The bacteriological confirmation was made in 41.46% and histological confirmation was made in 26.83%, and in the rest, the diagnosis was retained on the criterion presumption. Nineteen patients (46.34% developed adverse effects of antitubercular drugs. Eight patients (19.51% died during the study from TB or adverse effects of treatment. Low urea reduction ratio and female sex were associated with poor prognosis in our study. The clinical manifestations of TB in patients on dialysis are quite nonspecific, making timely diagnosis difficult, and delaying the initiation of curative treatment, which is a major determinant of the outcome.

  4. Amyloidosis associated with dialysis. Dialyseassoziierte Amyloidosteopathie - radiologische Aspekte

    Energy Technology Data Exchange (ETDEWEB)

    Schadmand, S.; Klose, K.J. (Mainz Univ. (Germany, F.R.). Inst. fuer Klinische Strahlenkunde); Wandel, E. (Mainz Univ. (Germany, F.R.). 1. Medizinische Klinik und Poliklinik)

    1991-06-01

    Amongst the complications of dialysis, amyloid osteopathy is getting increasingly significant. It is due to deposition of {beta}2-microglobulin. To determine the incidence and time of development of this complication, the skeletal radiographs of 185 patients undergoing dialysis, some for up to ten years, were analysed retrospectively. In about 10% of patients, the presence of {beta}2-microglobulin osteopathy may be expected. The radiological features, sites of predilection and differential diagnosis of amyloid osteopathy and of other skeletal changes due to dialysis are discussed. (orig.).

  5. Bioorthogonal chemistry: strategies and recent development

    Science.gov (United States)

    Ramil, Carlo P.; Lin, Qing

    2013-01-01

    The use of covalent chemistry to track biomolecules in their native environment—a focus of bioorthogonal chemistry—has received considerable interests recently among chemical biologists and organic chemists alike. To facilitate wider adoption of bioorthogonal chemistry in biomedical research, a central effort in the last few years has been focused on the optimization of a few known bioorthogonal reactions, particularly with respective to reaction kinetics improvement, novel genetic encoding systems, and fluorogenic reactions for bioimaging. During these optimizations, three strategies have emerged, including the use of ring strain for substrate activation in the cycloaddition reactions, the discovery of new ligands and privileged substrates for accelerated metal-catalysed reactions, and the design of substrates with pre-fluorophore structures for rapid “turn-on” fluorescence after selective bioorthogonal reactions. In addition, new bioorthogonal reactions based on either modified or completely unprecedented reactant pairs have been reported. Finally, increasing attention has been directed toward the development of mutually exclusive bioorthogonal reactions and their applications in multiple labeling of a biomolecule in cell culture. In this feature article, we wish to present the recent progress in bioorthogonal reactions through the selected examples that highlight the above-mentioned strategies. Considering increasing sophistication in bioorthogonal chemistry development, we strive to project several exciting opportunities where bioorthogonal chemistry can make a unique contribution to biology in near future. PMID:24145483

  6. Peritoneal Dialysis Dose and Adequacy

    Science.gov (United States)

    ... infused dialysis solution and how much urea and creatinine have entered into the solution during a 4-hour dwell. The peritoneal transport rate varies from person to person. People who have a high rate of transport absorb dextrose from the dialysis ...

  7. Peritoneal Dialysis in Western Countries

    NARCIS (Netherlands)

    Struijk, Dirk G.

    2015-01-01

    Peritoneal dialysis (PD) for the treatment of end-stage renal failure was introduced in the 1960s. Nowadays it has evolved to an established therapy that is complementary to hemodialysis (HD), representing 11% of all patients treated worldwide with dialysis. Despite good clinical outcomes and

  8. Metabolic alterations in dialysis patients

    NARCIS (Netherlands)

    Drechsler, Christiane

    2010-01-01

    Assessing metabolic risk in dialysis patients, three main aspects are important: a) the pathophysiologic effects of metabolic disturbances as known from the general population are unlikely to completely reverse once patients reach dialysis. b) Specific additional problems related to chronic kidney

  9. Service-oriented product development strategies

    DEFF Research Database (Denmark)

    Tan, Adrian Ronald

    Manufacturing companies have traditionally focused their efforts on designing, developing and producing physical products for the market. Today, global competition, outsourcing and legislation commend that companies take greater responsibility of their products. This is driving some manufacturers...... to shift their business strategies from selling products (e.g. photocopying machines) to the provision of services (e.g. document services). Instead of the product itself, the activity and knowledge associated with the use of the product is perceived to be of more value to customers. In the research...... community, service-oriented approaches that embrace this change of business focus from individual products to total integrated customer solutions are termed Product/Service-Systems (PSS). The research in this thesis addresses the systematic design and development of PSS solutions in manufacturing firms...

  10. Mexico's development strategy for the 1980s

    Energy Technology Data Exchange (ETDEWEB)

    Hardy, C

    1982-06-01

    In examining the problems and prospects of the Mexican economy in the 1980s, the main concern of this paper is whether Mexico will use its new found wealth to correct some of the major deficiences of past policies or whether the development of the energy sector will further increase the dualism between the modern and traditional sectors. This paper surveys the major problems now facing the economy (poverty and unemployment, declining agricultural production, a weak industrial base, inflation) and then discusses the framework in which Mexico proposes to deal with these problems, in particular the priority allocated to development of oil and gas. The policies are then compared briefly with the experience of Japan and Iran. The conclusion takes a critical view of current Mexican policies and suggests that a more equity-oriented and efficient growth strategy is required. 18 references, 2 tables.

  11. Power Generation Strategy Development in Croatia

    International Nuclear Information System (INIS)

    Curkovic, A.; Androcec, I.; Tarnik, T.

    2010-01-01

    Electricity generation as an economic sector contributes to the national GDP through increasing investments and exports. In the period from 2000 to 2008 the annual growth rate of final electricity demand was 3,8% which was higher than for any other energy form. Almost 1200 MW of thermal power plants will go out of system due to lifetime (more than 30 years). Energy Strategy is a basic document of the Energy Act with the purpose to define energy policy and future plans for energy development of the Republic of Croatia till 2020. Based on the adopted strategy the Government will create the Energy Strategy Implementation Programme for the four-year period. Croatian's energy development should be based on best available technologies as well as on energy-related, economic and environmental assessment of all available energy options. Energy strategy of Croatia (NN 130/09) puts up next goals: 300 MW hydro power plants (bigger than 10 MW), 1200 MW gas-fired thermal power plants (including 300 MW of cogeneration), 1200 MW of coal-fired thermal power plants, and 35% of renewable (including hydro). The market, i.e. a competitive generation, is the driving force in the construction of new power plants. The main stimulus for the construction is the possibility of definite return of invested capital as well as earning of reasonable profit for investors. Choose of location, environmental impact and competitiveness are main criteria for decision making. Technological and financial terms of new power plant is under influence of the law of supply and demand, so short marginal costs are in the first view - power plant life is at least 30 years - how to deal with this conditions, who will invest in long-term projects with condition of short pay-back period. Climate change and greenhouse gas emissions have become a priority development issue. The main challenge is a long-term development of economy with decreased emission of carbon dioxide. Kyoto protocol obligations, Copenhagen Accord

  12. Strategies for environmentally sound economic development

    International Nuclear Information System (INIS)

    Duchin, F.; Lange, G.M.

    1991-01-01

    This paper reports that it has been estimated that the burning of fossil fuels and the clearing of forests account for 6-7 billion tons of carbon emissions each year. Combustion also results in significant emissions of sulfur oxides and nitrogen oxides. While the growth in the use of fuels has slowed considerably in the developed regions of North America, western Europe, and Japan over the past decade, pressure for increased energy use and the clearing of forests can be expected with even moderate economic and population growth in the developing regions of Asia, Africa, and Latin America. Researchers at the Institute for Economic Analysis have begun the formulation and analysis of alternative scenarios describing environmentally sound economic development over the next 50 years. These scenarios include activities aimed at improving the standards of living in developing countries while reducing emissions of the aforementioned gases or removing carbon from the atmosphere. Specific alternatives include tropical forestation; the adoption of relatively clean and efficient boilers, especially for the production of electricity in developing countries, as well as greater use of cogeneration systems and hydroelectricity; alternative transportation strategies; and conservation of energy in households of rich and middle-income countries (e.g., efficient lighting fixtures, appliances, and cooling equipment)

  13. Vision and strategy development of Slovak society. Development Strategy for Slovak society (basis for public adversary)

    International Nuclear Information System (INIS)

    Sikula, V.; Peknik, M.; Tirpak, I.; Bucek, M.

    2010-02-01

    This analytical study analyses the present state as well as strategy of perspectives of development of Slovak society. This strategy of development of Slovak society is scientific testimony of the authors, the manner and extent of its use will determine political representation. Future economic growth and development of Slovak's regions will mainly depend on the availability of raw materials, energy resources, water, food processes and improving the environment. A key issue in the next 5 to 10 years in the energy sector will address energy security, diversification of energy sources, utilization of domestic raw materials and renewable energy and energy savings. The energy security strategy is to achieve a competitive energy industry for reliable and efficient supply of all forms of energy at affordable prices, with a view to protection of the customer and the environment.

  14. Pregnancy in chronic dialysis, late diagnosis, and other problems

    Science.gov (United States)

    Ramadani, S.; Nasution, A. T.; Nasution, S.; Lubis, H. R.

    2018-03-01

    The incidence of pregnancy in patients with chronic kidney disease (CKD) undergoing hemodialysis is rare. Forpregnant patients with CKD undergoing regular hemodialysis, the effects of renal disease on the fetus should be noted and require specific strategies. A 30-year-old woman had no menstruation for 4 months. Abdominal ultrasound showed single fetus within 16 weeks of pregnancy. She had previously been in regular hemodialysis twice a week since 2015, then the frequency of hemodialysis was increased to thrice a week for 4 hours/dialysis. During pregnancy, she was given erythropoiesis stimulating agent, controlled protein nutrition (0.6-1.5g/kg/day) and routine pregnancy controls to an obstetrician. After 31-32 weeks gestation, thebaby was born alive with low birth weight (1800g). Maintaining pregnancy in women with regular hemodialysis is still challenging and difficult. Prolonged/intensive dialysis during pregnancy results in longer gestational periods, higher fetal weights, and a higher likelihood of survival. Based on a dialysis guideline for pregnancy in CKD, hemodialysis is performed at least 20 hours/week to maintain pre-dialysis of BUN≤50mg/dl hemoglobin should be at least 10-11g/dL. We reported a case of pregnancy in dialysis CKD patient undergoing hemodialysis thricea week (4 hours/dialysis). The baby was born alive with low birth weight (1800 g).

  15. Conservation strategies, sustainable development and climate change

    International Nuclear Information System (INIS)

    Manning, E.; Rizzo, B.; Wiken, E.

    1990-01-01

    The relationship between conservation strategies, sustainable development and climatic change is discussed. A broad conceptual model of environment-economy relationships is introduced, which can aid in understanding the sources of the stresses put on the environment and the ability of the environment to respond. The supply side of the model introduces the concept of the environment as a source of environmental functions, each distinguishable part of which can be described in terms of a range of biological or physical variables. These functions have the potential to produce an extensive range of goods, services, values, etc. The demand side of the model is population powered and anthropocentric. Transformation functions occur to alter the supply to satisfy the demand, and may range from picking an apple to combinations of transport, combination, distillation and packaging of many different substances. Climate change can be viewed as one of the most significant feedbacks from our demands on the resource base, most particularly from the transformation functions used. Conservation strategies are a means to try to address concerns with all areas of the system embodied in the model. 36 refs., 4 figs

  16. THE ESSENCE OF STRATEGY DEVELOPMENT COMPANY IN THE INTEGRATED STRUCTURE

    Directory of Open Access Journals (Sweden)

    A. I. Khorev

    2014-01-01

    Full Text Available Summary. In the beginning of the article is defined a rational sequence of the consideration of the nature of the strategy of a company development, included into an integrated structure. Further the article describes the following items separately: "a strategy", "a development of a company", and "an integrational structure", applying them to companies included to the integrated structure; separating them from a strategy of development of an autonomous company. The article defines functions which such strategy must define, taking into consideration the nature of the strategy of the company development, included into an integrated structure. Next, the article defines six steps which describe a sequence of development of the strategy of the company development, included into an integrated structure. The analysis which is defined in the article allows determining a complete definition of essence of the strategy of the company development, included into an integrated structure. The article also defines a place of the strategy of development into the hierarchical structure of the strategies. The strategy of the company development, included into an integrated structure (as well as the strategy of development of an autonomous company -- is a competition strategy, and it separates "strategy of leadership for costs", “differentiation strategy”, and “strategy of focusing for costs”. Also authors are analyzed the strategy of the cost optimization. According to the complex definition of the strategy, and the strategy's place inside the hierarchical structure, the article defines functions which corporate, competitive, and functional strategies execute during the management of companies inside an integrational structure. The article presents characteristics of applied strategic decisions at different levels of all three types of strategies. The article's researches allow companies included to the integrated structure define their place inside the

  17. Strategies for Developing China's Software Industry

    Directory of Open Access Journals (Sweden)

    Mingzhi Li

    2003-01-01

    Full Text Available The software industry is deemed an ideal target for a developing country to integrate into the world information and communications technology (ICT market. On the one hand the industry is labor intensive, and the developing countries have a large labor surplus; on the other hand, it is a worldwide trend for developed countries to outsource a vast amount of low-end, software-related tasks to the low-cost countries and regions, which fits into some developing countries’ caliber nicely. India has often been cited as the role model for a developing country to tap into the world software market for its continuous success in the software export sector. In comparison, China’s software industry is still negligible in the world despite its sustained high economic growth rate since the economic reform took off in the late 1970s.This paper aims at examining strategies for developing China’s software industry. We use India as a reference because of the similarities of the two countries’ stages of economic development and the clear divergence in their ICT structures and development paths. Although the language barrier has often been singled out as the major obstacle for China’s software exports, we believe the major reasons for its underdevelopment can be ascribed to the following factors. On the national level, the government attention has been skewed toward the hardware sector in the ICT industry, and there is no clear national vision for the strategic direction for the software industry.On the industry and ªrm level, software development has been regarded as the art of individual creativity rather than an engineering process. As a result, the importance of quality and standards, the two important critical factors in software development, have been largely neglected. Perhaps an even more fundamental factor lies in the deeply rooted notion that software is an attachment to the hardware and should be a free product. The lack of intellectual

  18. Myanmar strategy for forest resource development

    Energy Technology Data Exchange (ETDEWEB)

    Wint, Sein Maung

    1993-10-01

    Myanmar strategy for forest resource development is presented under sub-headings of (1) Myanmar experience; (2) control against over-exploitation; (3) impact of population pressure; (4) forest plantation system on commercial plantation, industrial plantation, firewood plantation and watershed plantation; (5) people`s participation; (6) shifting cultivation. The forest resources of Myanmar have been changed for the past 136 years (1856-1992) successfully on sustained yield basis. Through proclamation of Forest Law (1992), active forestry and forest products research, upgrading of forestry educational institutions, modernization of forest inventory system and encouragement of downstream processing wood-based industries for value-added products, it was expected by the author that the forestry sector would be able to contribute more for the well-being of the people of Myanmar

  19. Myanmar strategy for forest resource development

    International Nuclear Information System (INIS)

    Sein Maung Wint

    1993-01-01

    Myanmar strategy for forest resource development is presented under sub-headings of (1) Myanmar experience; (2) control against over-exploitation; (3) impact of population pressure; (4) forest plantation system on commercial plantation, industrial plantation, firewood plantation and watershed plantation; (5) people's participation; (6) shifting cultivation. The forest resources of Myanmar have been changed for the past 136 years (1856-1992) successfully on sustained yield basis. Through proclamation of Forest Law (1992), active forestry and forest products research, upgrading of forestry educational institutions, modernization of forest inventory system and encouragement of downstream processing wood-based industries for value-added products, it was expected by the author that the forestry sector would be able to contribute more for the well-being of the people of Myanmar

  20. Strategies for Local Low-Carbon Development

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Nan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Price, Lynn [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fridley, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ohshita, Stephanie [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Khanna, Nina [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Min, Hu [Energy Foundation China, Beijing (China); Xiulian, Hu [Energy Research Inst., Beijing (China)

    2012-11-14

    Cities around the world are implementing policies and programs with the goal to reduce greenhouse gas emissions, as well as save energy, reduce costs, and protect the local, regional, and global environment. In China, low-carbon development is a key element of the 12th Five Year Plan. Pilot low-carbon development zones have been initiated in five provinces and eight cities and many other locations around China also want to pursue a low-carbon development pathway. This booklet provides information for government officials, policy makers, program designers and implementers, provincial and city planners, and others who want an overview of the key options available for low-carbon development at local level. These Strategies for Local Low-Carbon Development draw from successful experiences from around the world. Information is provided for low-carbon actions that can be taken in the sectors of (1) Industry, (2) Buildings and Appliances, (3) Electric Power, (4) Consumption and Waste Management, (5) Transportation and Urban Form, and (6) Agriculture and Forestry. A description of each policy is provided along with information on the stakeholders involved in implementation, the conditions for successful implementation, the expected energy and carbon savings, and the policy cost-effectiveness. Case studies show how each policy has been implemented somewhere around the world. While there are many low-carbon options available for local implementation, this booklet aims to provide guidance on those that have been most successful, that have the largest impact, and that are cost-effective in order to support low-carbon development efforts in Chinese cities.

  1. Development Strategies in Papua Economic Democracy

    Directory of Open Access Journals (Sweden)

    Muhamad Ismail

    2015-09-01

    Full Text Available Based economic development aims to increase community participation in various development activities, especially in the economic field. Populist both economic development by exploiting the potential of Micro Small Medium Enterprises has not made a significant impact to the welfare of society. The purpose of the study to see how far the populist economic development in Papua, and formulate a strategy based economic development in the province of Papua. Using SWOT the analysis, using primary and secondary data. The results showed populist economic development in Papua province could not be implemented to the fullest because it is affected by several drawbacks and other technical constraints such as shortage of working capital, equipment is still modest, the quality and quantity of the product is low, the difficulty of access to markets and weak entrepreneurial spirit, especially for community / indigenous people of Papua economic actors. Based economic development can be done by utilizing the role of micro and medium-sized businesses and cooperatives / KUD because people could easily be involved in both the economic container. Based economic development can be done by: Increasing the quality and quantity of local products to compete with regional and international markets, giving stimulant fund for venture capital for the economic actors of the people by utilizing funds OTSUS, and the state budget, Improved HR agriculture through private sector support (partners’ business and capital of banking institutions. To overcome the weaknesses in the development of community economy, it can be done through: Boosting qualities SDM economic actors people through non-formal education / training, education and ongoing training for facilitators, provision of venture capital and agricultural equipment by utilizing appropriate technology (TTG, increasing the role of Micro, Small and Medium Enterprises and co-operatives to all districts / cities, utilization of

  2. Strategies for developing knowledge economy in Romania

    Directory of Open Access Journals (Sweden)

    Hadad Shahrazad

    2017-09-01

    Full Text Available The present paper delves into the specifics of knowledge economy with a particular focus on Romania. In the first part, it identifies knowledge economy characteristics and pillars and it analyses them as compared to levels exhibited by countries in the European Union. In the second part it argues for the strategies that could be used for enhancing knowledge economy in Romania. In order to do so we used the Delphi method and we identified 25 experts in the knowledge economy/management field coming from internationally renowned companies, universities and ministries located in Romania, to whom we sent invitations for participating in our Delphi survey that lasted one month. Out of the 25 experts, 10 answered positively and during the research we had an attrition rate of 90%. The experts delivered their opinions on the measures to be adopted in order to increase education and learning, ICT and innovation as building blocks of knowledge economy. Findings reveals that knowledge economy can be developed by adopting measures such as: devising a governmental program that will sustain the development of knowledge repositories at the level of technological clusters, industry associations and other professional organizations by providing financial assistance for hardware acquisition and software development in order to facilitate knowledge transfer; Governmental program for the financial support of schools’ investments in hardware and educational software and the training of staff for the use of ITC in teaching and learning, etc.

  3. Ormen Lange subsea development strategy and execution

    Energy Technology Data Exchange (ETDEWEB)

    Hogmoen, K. [Norsk Hydro, Oslo (Norway)

    2007-07-01

    Ormen Lange is the largest natural gas field in development on the Norwegian continental shelf. This paper discussed Norsk Hydro's Ormen Lange development strategy and execution. Several illustrations of the Ormen Lange project were presented, including the field layout and the main challenges of working in deep water. Other challenges involve environmental conditions; long distance control; and hydrate prevention. Several components of the project were presented, including the xmas tree handling system; choke module; control system; large bore tie-in system; in-line tee system; and free spans in pipeline design. Other topics that were presented and illustrated included the feasibility of pipeline design; design optimization with installation contractors; design optimization between intervention methods; positioning; dredging with spiders; excavation with jetprops; ploughing; rock installation; and trenching. The installation of thirty inch pipelines and umbilical lines in shallow and deep water were also discussed and illustrated. The presentation concluded with a discussion of lessons learned subsea. These included early definition of operational requirements; close monitoring of interface work between contractors; professional change management; and thorough testing onshore prior to installation. Securing vessel capacity and timely start-up were among the lessons learned for marine operations. figs.

  4. Peritoneal dialysis in Asia.

    Science.gov (United States)

    Cheng, I K

    1996-01-01

    The socioeconomic status of Asian countries is diverse, and government reimbursement policies for treatment of patients suffering from end-stage renal disease (ESRD) vary greatly from one country to another. Both of these factors have a major impact not only on the choice of treatment for ESRD but also on the utilization of peritoneal dialysis (PD) in this region. Based on the data collected from 11 representative Asian countries, several observations can be made. First, the treatment rates for ESRD in these countries correlated closely with their gross domestic product (GDP) per capita income. Second, the PD utilization rate appeared to have a biphasic relationship with the GDP per capita income and treatment rate, in that countries with the highest and the lowest treatment rates tended to have lower PD utilization rates, whereas countries with modest treatment rates tended to have higher PD utilization rates. The reason for low PD utilization in countries with the highest treatment rates differs from that in countries with low treatment rates. In the former, because of full government reimbursement, there is little physician incentive to introduce PD as an alternative form of ESRD treatment to in-center hemodialysis (HD), whereas in the latter, the complete lack of government reimbursement prevents the introduction of PD as a form of treatment. This pattern is likely to change in the future because, of the 11 countries surveyed, all except Thailand have recorded a growth rate which is higher for PD than HD over the last three years. The rate of utilization of different PD systems varies greatly among different Asian countries. Automated PD has yet to gain popularity in Asia. Conventional straight-line systems remain the dominant PD systems in use in Hong Kong, Korea, Thailand, and the Philippines, while in Malaysia and Singapore UV germicidal connection devices are most popular. However, in all these countries there has been a progressive shift over the last

  5. Developing an information systems strategy for nursing.

    Science.gov (United States)

    Callanan, K M; Hughes, S J

    1995-01-01

    With the rapidly changing health care environment and information technology advances, organizations need to engage in strategic, planned change in order to allocate limited resources, achieve the organization's goals, and fulfill its mission [1]. One of the most important aspects of the organization's planned strategies for change concerns the information systems. The involvement of the nursing department in this process is critical. This poster presentation will communicate how nurses can develop an information systems strategic plan that will enable them to play an active role as contributors and vital participants in the strategic and business planning processes for information systems. This information systems strategy for nursing will: a) provide direction and purpose, b) guide nursing in identifying the kinds of information technology needed, c) assist in timely implementation of a system that supports nursing, and d) identify desired outcomes and benefits of an information system. The nursing information systems plan must be built on, and support, the organization's mission and business plan and integrate into the over-all information systems plans [2]. Components of the nursing strategic plan include the nursing mission statement and vision, an assessment of the current environment to identify supporting technology needed to achieve the nursing vision, expectations/anticipated outcomes, environmental considerations, and special staffing/expertise considerations. The nursing vision and mission statement is an articulation of the overall direction and purpose of the nursing organization. An assessment of the nursing organization, problem areas, opportunities for growth, the physical environment, existing systems, communications requirements, and resources is carried out to help identify areas where new technologies and automated methods of managing information could be applied. Special staffing and expertise not currently available in the organization, but

  6. Single Pass Albumin Dialysis in Hepatorenal Syndrome

    Directory of Open Access Journals (Sweden)

    Rahman Ebadur

    2008-01-01

    Full Text Available Hepatorenal syndrome (HRS is the most appalling complication of acute or chronic liver disease with 90% mortality rate. Single pass albumin dialysis (SPAD can be considered as a noble liver support technique in HRS. Here, we present a case of a young healthy patient who developed hyperacute fulminant liver failure that progressed to HRS. The patient was offered SPAD as a bridge to liver transplantation, however, it resulted in an excellent recovery.

  7. Counter-flow dialysis for microvolume desalting

    OpenAIRE

    Kalikavunkal, Prameen Chacko

    2015-01-01

    Some analytical techniques are not compatible with physiological salt concentrations. An array of desalting approaches exists, but the conventional implementation requires large sample volumes, which is not compatible with fingerprick blood samples for molecular diagnostics. With dialysis being identified as the most suitable method for on-chip microvolume desalting, the aim of this work was to develop a microvolume dialyser that can desalt biological samples to any required salt concentratio...

  8. Population and Strategy Development in Buffaloes

    Directory of Open Access Journals (Sweden)

    Lisa Praharani

    2010-09-01

    Full Text Available Buffalo is a potential large ruminant that its contribution in national program on beef self sufficiency has been unrecognized in Indonesia. In rural community, buffalo has similar functions as cattle, it is used as draught animal, meat (beef producer, saving, milk producer, sacrificial ritual animal to social status. The peak of buffalo population was on 1925, 3.227 million heads in Java and 1.10 million in outside Java. The centers of cattle production sites for national program of self sufficiency on beef were formly as noted the centers of buffalo production. The introduction of Bali cattle to those former buffalo centers particularly in outside of Java depressed buffalo population and then dominated by Bali cattle. Then Bali cattle were noted to be the major beef animal supplier beside buffalo to the centers of consumers for domestic and export. This article aims to discuss the depleting buffalo population and to formulate development strategy. Historical approaches system and critical evaluation population, SWOT (strength, weaknesses, opportunity and threat analysis were used as tools for analyzing. Two case studies on herd survival from Banten indicated depleting population of buffalo. Despite low reproductive profile, strategic diseases and farmers’ institution needed to be optimized on services. Understanding criticizing on ecological habitats in the potential regions, the need of spatial planning for its development, zoning program for strategic diseases free, reproductive problems and village institution are the important areas of improvement for buffalo development in supporting beef self sufficiency and the welfare of rural people with their buffalo in sustainable beef production.

  9. A study on the information-motivation-behavioural skills model among Chinese adults with peritoneal dialysis.

    Science.gov (United States)

    Chang, Tian-Ying; Zhang, Yi-Lin; Shan, Yan; Liu, Sai-Sai; Song, Xiao-Yue; Li, Zheng-Yan; Du, Li-Ping; Li, Yan-Yan; Gao, Douqing

    2018-05-01

    To examine whether the information-motivation-behavioural skills model could predict self-care behaviour among Chinese peritoneal dialysis patients. Peritoneal dialysis is a treatment performed by patients or their caregivers in their own home. It is important to implement theory-based projects to increase the self-care of patients with peritoneal dialysis. The information-motivation-behavioural model has been verified in diverse populations as a comprehensive, effective model to guide the design, implementation and evaluation of self-care programmes. A cross-sectional, observational study. A total of 201 adults with peritoneal dialysis were recruited at a 3A grade hospital in China. Participant data were collected on demographics, self-care information (knowledge), social support (social motivation), self-care attitude (personal motivation), self-efficacy (behaviour skills) and self-care behaviour. We also collected data on whether the recruited patients had peritoneal dialysis-associated peritonitis from electronic medical records. Measured variable path analysis was performed using mplus 7.4 to identify the information-motivation-behavioural model. Self-efficacy, information and social motivation predict peritoneal dialysis self-care behaviour directly. Information and personal support affect self-care behaviour through self-efficacy, whereas peritoneal dialysis self-care behaviour has a direct effect on the prevention of peritoneal dialysis-associated peritonitis. The information-motivation-behavioural model is an appropriate and applicable model to explain and predict the self-care behaviour of Chinese peritoneal dialysis patients. Poor self-care behaviour among peritoneal dialysis patients results in peritoneal dialysis-associated peritonitis. The findings suggest that self-care education programmes for peritoneal dialysis patients should include strategies based on the information-motivation-behavioural model to enhance knowledge, motivation and behaviour

  10. Biofeedback-driven dialysis: where are we?

    Science.gov (United States)

    Santoro, Antonio; Ferramosca, Emiliana; Mancini, Elena

    2008-01-01

    interactions between the actuators and the controlled variable. In these cases, more sophisticated control systems are needed, which must be capable of identifying the behavior of the process, and continuously update information data while the control is on. These complex systems are called adaptive controllers. In dialysis, over the last few years, it has been relatively easy to realize some biofeedback systems since a series of sensors have been developed for online monitoring. Three biofeedback devices are routinely used with the aim of improving the cardiovascular instability, one of the main problems limiting the tolerance to treatment by the patient and the quality of HD in itself - the first is the biofeedback control of blood volume, the second is the biofeedback control of thermal balance, and the third is the biofeedback control of blood pressure.

  11. Petroleum industry: Development strategies to year 2000

    International Nuclear Information System (INIS)

    Curcio, E.

    1993-01-01

    During the last two years, the petroleum industry has undergone a period of modest demand increase on the international market, normal consumption rates by consuming countries and, faced with a growing supply base, a progressive per barrel unit price depreciation. In the refinery sector, margins have been reduced due to strong petroleum products price reductions. New anti-pollution laws have necessitated substantial investment in the development of cleaner fuels and pollution control technologies. The reorganization of the former USSR petroleum and gas sector should give rise to technology transfer opportunities for Western nations and spur gradual production increases especially in natural gas. Petroleum and gas demand increases are expected due to the modernization of China's industries. While it is clear that for the next decade their won't be any shortages in supply, forecasting petroleum prices to the year 2000 will remain clouded with uncertainty until such time as the national European petroleum industries decide to go ahead with their long awaited privatization and adjustments are made to current government and private sector energy strategies

  12. Developing strategies for detection of gene doping.

    Science.gov (United States)

    Baoutina, Anna; Alexander, Ian E; Rasko, John E J; Emslie, Kerry R

    2008-01-01

    It is feared that the use of gene transfer technology to enhance athletic performance, the practice that has received the term 'gene doping', may soon become a real threat to the world of sport. As recognised by the anti-doping community, gene doping, like doping in any form, undermines principles of fair play in sport and most importantly, involves major health risks to athletes who partake in gene doping. One attraction of gene doping for such athletes and their entourage lies in the apparent difficulty of detecting its use. Since the realisation of the threat of gene doping to sport in 2001, the anti-doping community and scientists from different disciplines concerned with potential misuse of gene therapy technologies for performance enhancement have focused extensive efforts on developing robust methods for gene doping detection which could be used by the World Anti-Doping Agency to monitor athletes and would meet the requirements of a legally defensible test. Here we review the approaches and technologies which are being evaluated for the detection of gene doping, as well as for monitoring the efficacy of legitimate gene therapy, in relation to the detection target, the type of sample required for analysis and detection methods. We examine the accumulated knowledge on responses of the body, at both cellular and systemic levels, to gene transfer and evaluate strategies for gene doping detection based on current knowledge of gene technology, immunology, transcriptomics, proteomics, biochemistry and physiology. (c) 2008 John Wiley & Sons, Ltd.

  13. What's the Deal with Dialysis?

    Science.gov (United States)

    ... Dialysis Work? Other Options Print Don't you love swimming in a cool, blue pool? Splashing around ... dialysate cleanses the blood and rebalances the blood's chemistry. After about an hour, the machine drains the ...

  14. Harnessing biomechanics to develop cartilage regeneration strategies.

    Science.gov (United States)

    Athanasiou, Kyriacos A; Responte, Donald J; Brown, Wendy E; Hu, Jerry C

    2015-02-01

    As this review was prepared specifically for the American Society of Mechanical Engineers H.R. Lissner Medal, it primarily discusses work toward cartilage regeneration performed in Dr. Kyriacos A. Athanasiou's laboratory over the past 25 years. The prevalence and severity of degeneration of articular cartilage, a tissue whose main function is largely biomechanical, have motivated the development of cartilage tissue engineering approaches informed by biomechanics. This article provides a review of important steps toward regeneration of articular cartilage with suitable biomechanical properties. As a first step, biomechanical and biochemical characterization studies at the tissue level were used to provide design criteria for engineering neotissues. Extending this work to the single cell and subcellular levels has helped to develop biochemical and mechanical stimuli for tissue engineering studies. This strong mechanobiological foundation guided studies on regenerating hyaline articular cartilage, the knee meniscus, and temporomandibular joint (TMJ) fibrocartilage. Initial tissue engineering efforts centered on developing biodegradable scaffolds for cartilage regeneration. After many years of studying scaffold-based cartilage engineering, scaffoldless approaches were developed to address deficiencies of scaffold-based systems, resulting in the self-assembling process. This process was further improved by employing exogenous stimuli, such as hydrostatic pressure, growth factors, and matrix-modifying and catabolic agents, both singly and in synergistic combination to enhance neocartilage functional properties. Due to the high cell needs for tissue engineering and the limited supply of native articular chondrocytes, costochondral cells are emerging as a suitable cell source. Looking forward, additional cell sources are investigated to render these technologies more translatable. For example, dermis isolated adult stem (DIAS) cells show potential as a source of

  15. Toward dialysis "a la carte".

    Science.gov (United States)

    Funck-Brentano, J L

    1987-12-01

    From the very beginning, the artificial kidney postponed the death of patients with end-stage renal failure. For years, owing to the performance of the machine, the patient was obliged to follow a severe diet in order to maintain good humoral and circulatory status. Now technological improvements allow "dialysis à la carte," whereby each individual achieves a better clinical status. The next step will be automation of the procedure to improve its security, mainly for dialysis performed at home.

  16. [Customization of hemodialysis therapy: dialysis is not a washing machine].

    Science.gov (United States)

    Santoro, Antonio

    2018-02-01

    In recent years, the population of chronic dialysis has grown in number but also in age and frequency of co-morbidies such as cardiac diseases, vascular pathologies, diabetes, etc. The majority of patients on chronic hemodialysis are over 70 years and, given the high number of comorbidities, they often exhibit poor tolerance to dialysis treatments. A non-tolerated dialytic treatment can have side-effects that would require an intensification of the dialysis sessions and many hospitalizations. Consequently, the problematic dialysis treatments, as well as harmful for the patient, become economically more detrimental than other treatments apparently more expensive but more tolerated ones In the current days we have, thanks to the huge developments in dialysis technology, powerful weapons to ensure effective and scarcely symptomatic dialysis treatments to the majority of the HD patients. New, highly biocompatible membranes with defined and modular cut-off and / or absorption capacity may allow us to provide adequate purification. Moreover the monitoring and biofeedback systems such as blood volume tracking, body temperature monitoring (BTM) and blood pressure (BPM) can be very useful in reducing the risk of intra-dialytic hypotension and symptoms. Therefore, the dialytic therapy, as well as all the pharmacological therapies for the chronic patient, must consider the specificity of the patient, basing on his metabolic problems, cardiovascular tolerance, residual renal function and on his dietary and general compliance. The central aim of the nephrologist is to formulate the better prescription for the individual patient, considering the dialysis modalities, the membrane type, the dry weight (ideal post-dialysis body weight), the frequency and the duration of the weekly sessions and the technological tools that can optimize the treatment. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  17. Arthritis associated with calcium oxalate crystals in an anephric patient treated with peritoneal dialysis

    International Nuclear Information System (INIS)

    Rosenthal, A.; Ryan, L.M.; McCarty, D.J.

    1988-01-01

    The authors report a case of calcium oxalate arthropathy in a woman undergoing intermittent peritoneal dialysis who was not receiving pharmacologic doses of ascorbic acid. She developed acute arthritis, with calcium oxalate crystals in Heberden's and Bouchard's nodes, a phenomenon previously described in gout. Intermittent peritoneal dialysis may be less efficient than hemodialysis in clearing oxalate, and physicians should now consider calcium oxalate-associated arthritis in patients undergoing peritoneal dialysis who are not receiving large doses of ascorbic acid

  18. Developing Children's Language Learner Strategies at Primary School

    Science.gov (United States)

    Kirsch, Claudine

    2012-01-01

    This article discusses the strategy repertoires and strategy development of six English children who learned foreign languages at primary school. My study differs from mainstream research, in that it focuses on young children and on the development of their strategies, draws on sociocultural theory and uses ethnographic methods. My findings show…

  19. Decreasing dialysis catheter rates by creating a multidisciplinary dialysis access program.

    Science.gov (United States)

    Rosenberry, Patricia M; Niederhaus, Silke V; Schweitzer, Eugene J; Leeser, David B

    2018-03-01

    Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have 45%. A multidisciplinary program was established with goals of decreasing catheter rates in order to decrease central line-associated bloodstream infections, decrease mortality associated with central line-associated bloodstream infection, decrease hospital days, and provide savings to the healthcare system. We collected the catheter rates within three dialysis centers served over a 5-year period. Using published data surrounding the incidence and related costs of central line-associated bloodstream infection and mortality per catheter day, the number of central line-associated bloodstream infection events, the costs, and the related mortality could be determined prior to and after the initiation of the dialysis access program. An organized dialysis access program resulted in a 82% decrease in the number of central venous catheter days which lead to a concurrent reduction in central line-associated bloodstream infection and deaths. As a result of creating an access program, central venous catheter rates decreased from an average rate of 45% to 8%. The cost savings related to the program was calculated to be over US$5 million. The decrease in the number of mortalities is estimated to be between 13 and 27 patients. We conclude that a formalized access program decreases catheter rates, central line-associated bloodstream infection, and the resultant hospitalizations, mortality, and costs. Areas with high hemodialysis catheter rates should develop access programs to better serve their patient population.

  20. Gaming: a creative strategy for staff education.

    Science.gov (United States)

    Swartzendruber, D

    1994-02-01

    Providing staff development in a stimulating, innovative manner is the challenge of all nurse educators. This article discusses gaming, a creative teaching strategy that can help meet these needs. Games designed specifically for the education of dialysis staff will be reviewed. Advantages of the various games will also be examined.

  1. Developments in weather responsive traffic management strategies.

    Science.gov (United States)

    2011-06-01

    This report provides a comprehensive overview of weather-responsive traffic management practices. It focuses on what WRTM strategies exist, where they have been used, the benefits realized, what improvements are needed, and how to implement and evalu...

  2. Decommissioning Challenges, strategy and programme development

    Energy Technology Data Exchange (ETDEWEB)

    Potier, J.M.; Laraie, M.; Dinner, P. [Waste Technology Section, Dept. of Nuclear Energy, International Atomic Energy Agency (IAEA), Vienna (Austria); Pescatore, C.; O' Sullivan [Organisation for Economic Co-Operation and Development, Nuclear Energy Agency, 75 - Paris (France); Dupuis, M.C. [Agence Nationale pour la Gestion des Dechets Radioactifs (ANDRA), 92 - Chatenay Malabry (France); Szilagyi, A.; Collazo, Y.; Negin, Ch. [U.S. Department of Energy, Washington, DC (United States)

    2008-11-15

    This document gathers 4 short articles. The first one presents the IAEA decommissioning activities. These activities include: -) the development and implementation of the international action on decommissioning, -) the provision of experts and equipment to assist member states, -) networking activities such as training or exchange of knowledge and experience. The second article presents the work program of the Nea (nuclear energy agency) in the field of decommissioning and reports on the lessons that have been learnt. Among these lessons we can quote: -) selecting a strategy for decommissioning and funding it adequately, -) regulating the decommissioning of nuclear activities, -) thinking of the future in terms of reusing materials, buildings and sites, -) involving local and regional actors in the decommissioning process from decision-making to dismantling work itself, and -) increasing transparency in decision-making in order to build trust. The third article presents the management of radioactive wastes in France. This management is based on the categorization of wastes in 6 categories according to both the activity level and the radioactive half-life T: 1) very low activity, 2) low activity and T < 31 years, 3) low activity and T > 31 years, 4) intermediate activity and T < 31 years, 5) intermediate activity and T > 31 years, and 6) high activity. For categories 1, 2, 3 and 5, the waste treatment process and the disposal places have been operating for a long time while for categories 4 and 6, the disposal places are still being studied: low-depth repository and deep geological repository respectively. The last article presents the action of the US Department of energy in decommissioning activities and environmental remediation, the example of the work done at the ancient nuclear site of Rocky Flats gives an idea of the magnitude and complexity of the operations made. (A.C.)

  3. Water-Permeable Dialysis Membranes for Multi-Layered Micro Dialysis System

    Directory of Open Access Journals (Sweden)

    Naoya eTo

    2015-06-01

    Full Text Available This paper presents the development of water-permeable dialysis membranes that are suitable for an implantable microdialysis system that does not use dialysis fluid. We developed a microdialysis system integrating microfluidic channels and nanoporous filtering membranes made of polyethersulfone (PES, aiming at a fully implantable system that drastically improves the quality of life of patients. Simplicity of the total system is crucial for the implantable dialysis system, where the pumps and storage tanks for the dialysis fluid pose problems. Hence, we focus on hemofiltration, which does not require the dialysis fluid but water-permeable membranes. We investigated the water-permeability of the PES membrane with respect to the concentrations of the PES, the additives, and the solvents in the casting solution. Sufficiently water-permeable membranes were found through in vitro experiments using whole bovine blood. The filtrate was verified to have the concentrations of low-molecular-weight molecules, such as sodium, potassium, urea, and creatinine, while proteins, such as albumin, were successfully blocked by the membrane. We conducted in vivo experiments using rats, where the system was connected to the femoral artery and jugular vein. The filtrate was successfully collected without any leakage of blood inside the system and it did not contain albumin but low-molecular-weight molecules whose concentrations were identical to those of the blood. The rat model with renal failure showed 100% increase of creatinine in 5 h, while rats connected to the system showed only a 7.4% increase, which verified the effectiveness of the proposed microdialysis system.

  4. Dialysis facility staff perceptions of racial, gender, and age disparities in access to renal transplantation.

    Science.gov (United States)

    Lipford, Kristie J; McPherson, Laura; Hamoda, Reem; Browne, Teri; Gander, Jennifer C; Pastan, Stephen O; Patzer, Rachel E

    2018-01-10

    Racial/ethnic, gender, and age disparities in access to renal transplantation among end-stage renal disease (ESRD) patients have been well documented, but few studies have explored health care staff attitudes towards these inequalities. Staff perceptions can influence patient care and outcomes, and identifying staff perceptions on disparities could aid in the development of potential interventions to address these health inequities. The objective of this study was to investigate dialysis staff (n = 509), primarily social workers and nurse managers, perceptions of renal transplant disparities in the Southeastern United States. This is a mixed methods study that uses both deductive and inductive qualitative analysis of a dialysis staff survey conducted in 2012 using three open-ended questions that asked staff to discuss their perceptions of factors that may contribute to transplant disparities among African American, female, and elderly patients. Study results suggested that the majority of staff (n = 255, 28%) perceived patients' low socioeconomic status as the primary theme related to why renal transplant disparities exist between African Americans and non-Hispanic whites. Staff cited patient perception of old age as a primary contributor (n = 188, 23%) to the disparity between young and elderly patients. The dialysis staff responses on gender transplant disparities suggested that staff were unaware of differences due to limited experience and observation (n = 76, 14.7%) of gender disparities. These findings suggest that dialysis facilities should educate staff on existing renal transplantation disparities, particularly gender disparities, and collaboratively work with transplant facilities to develop strategies to actively address modifiable patient barriers for transplant.

  5. Development strategies and regional income disparities in China

    OpenAIRE

    Lin, Justin Yifu; Liu, Peilin

    2006-01-01

    This paper argues that the regional income gap of China is endogenously determined by its long-term economic development strategy. Development strategies can be broadly divided into two mutually exclusive groups: (i) the comparative advantage-defying (CAD) strategy, which attempts to encourage firms to deviate from the economy’s existing comparative advantages in their entry into an industry or choice of technology; and (ii) the comparative advantage-following (CAF) strategy, which attempts t...

  6. Entropy of uremia and dialysis technology.

    Science.gov (United States)

    Ronco, Claudio

    2013-01-01

    The second law of thermodynamics applies with local exceptions to patient history and therapy interventions. Living things preserve their low level of entropy throughout time because they receive energy from their surroundings in the form of food. They gain their order at the expense of disordering the nutrients they consume. Death is the thermodynamically favored state: it represents a large increase in entropy as molecular structure yields to chaos. The kidney is an organ dissipating large amounts of energy to maintain the level of entropy of the organism as low as possible. Diseases, and in particular uremia, represent conditions of rapid increase in entropy. Therapeutic strategies are oriented towards a reduction in entropy or at least a decrease in the speed of entropy increase. Uremia is a process accelerating the trend towards randomness and disorder (increase in entropy). Dialysis is a factor external to the patient that tends to reduce the level of entropy caused by kidney disease. Since entropy can only increase in closed systems, energy and work must be spent to limit the entropy of uremia. This energy should be adapted to the system (patient) and be specifically oriented and personalized. This includes a multidimensional effort to achieve an adequate dialysis that goes beyond small molecular weight solute clearance. It includes a biological plan for recovery of homeostasis and a strategy towards long-term rehabilitation of the patient. Such objectives can be achieved with a combination of technology and innovation to answer specific questions that are still present after 60 years of dialysis history. This change in the individual bioentropy may represent a local exception to natural trends as the patient could be considered an isolated universe responding to the classic laws of thermodynamics. Copyright © 2013 S. Karger AG, Basel.

  7. Satisfaction with care in peritoneal dialysis patients.

    Science.gov (United States)

    Kirchgessner, J; Perera-Chang, M; Klinkner, G; Soley, I; Marcelli, D; Arkossy, O; Stopper, A; Kimmel, P L

    2006-10-01

    Patient satisfaction is an important aspect of dialysis care, only recently evaluated in clinical studies. We developed a tool to assess peritoneal dialysis (PD) customer satisfaction, and sought to evaluate and validate the Customer Satisfaction Questionnaire (CSQ), quantifying PD patient satisfaction. The CSQ included questions regarding administrative issues, Delivery Service, PD Training, Handling Requests, and transportation. The study was performed using interviews in all Hungarian Fresenius Medical Care dialysis centers offering PD. CSQ results were compared with psychosocial measures to identify if patient satisfaction was associated with perception of social support and illness burden, or depression. We assessed CSQ internal consistency and validity. Factor analysis explored potential underlying dimensions of the CSQ. One hundred and thirty-three patients treated with PD for end-stage renal disease for more than 3 months were interviewed. The CSQ had high internal consistency. There was high patient satisfaction with customer service. PD patient satisfaction scores correlated with quality of life (QOL) and social support measures, but not with medical or demographic factors, or depressive affect. The CSQ is a reliable tool to assess PD customer satisfaction. PD patient satisfaction is associated with perception of QOL. Efforts to improve customer satisfaction may improve PD patients' quantity as well as QOL.

  8. Disruptive technological advances in vascular access for dialysis: an overview.

    Science.gov (United States)

    Yeo, Wee-Song; Ng, Qin Xiang

    2017-11-29

    End-stage kidney disease (ESKD), one of the most prevalent diseases in the world and with increasing incidence, is associated with significant morbidity and mortality. Current available modes of renal replacement therapy (RRT) include dialysis and renal transplantation. Though renal transplantation is the preferred and ideal mode of RRT, this modality may not be available to all patients with ESKD. Moreover, renal transplant recipients are constantly at risk of complications associated with immunosuppression and immunosuppressant use, and posttransplant lymphoproliferative disorder. Dialysis may be the only available modality in certain patients. However, dialysis has its limitations, which include issues associated with lack of vascular access, risks of infections and vascular thrombosis, decreased quality of life, and absence of biosynthetic functions of the kidney. In particular, the creation and maintenance of hemodialysis vascular access in children poses a unique set of challenges to the pediatric nephrologist owing to the smaller vessel diameters and vascular hyperreactivity compared with adult patients. Vascular access issues continue to be one of the major limiting factors prohibiting the delivery of adequate dialysis in ESKD patients and is the Achilles' heel of hemodialysis. This review aims to provide a critical overview of disruptive technological advances and innovations for vascular access. Novel strategies in preventing neointimal hyperplasia, novel bioengineered products, grafts and devices for vascular access will be discussed. The potential impact of these solutions on improving the morbidity encountered by dialysis patients will also be examined.

  9. Investigating product development strategy in beverage industry using factor analysis

    Directory of Open Access Journals (Sweden)

    Naser Azad

    2013-03-01

    Full Text Available Selecting a product development strategy that is associated with the company's current service or product innovation, based on customers’ needs and changing environment, plays an important role in increasing demand, increasing market share, increasing sales and profits. Therefore, it is important to extract effective variables associated with product development to improve performance measurement of firms. This paper investigates important factors influencing product development strategies using factor analysis. The proposed model of this paper investigates 36 factors and, using factor analysis, we extract six most influential factors including information sharing, intelligence information, exposure strategy, differentiation, research and development strategy and market survey. The first strategy, partnership, includes five sub-factor including product development partnership, partnership with foreign firms, customers’ perception from competitors’ products, Customer involvement in product development, inter-agency coordination, customer-oriented approach to innovation and transmission of product development change where inter-agency coordination has been considered the most important factor. Internal strengths are the most influential factors impacting the second strategy, intelligence information. The third factor, introducing strategy, introducing strategy, includes four sub criteria and consumer buying behavior is the most influencing factor. Differentiation is the next important factor with five components where knowledge and expertise in product innovation is the most important one. Research and development strategy with four sub-criteria where reducing product development cycle plays the most influential factor and finally, market survey strategy is the last important factor with three factors and finding new market plays the most important role.

  10. Nuclear power development: global challenges and strategies

    International Nuclear Information System (INIS)

    Mourogov, Victor M.; )

    1997-01-01

    This article highlights key factors that will determine today and tomorrow's optimal energy strategies. It addresses methods to utilize the high potential energy content of uranium. Plutonium used as fuel in a nuclear reactors is discussed as is the future potential of a thorium fuel cycle. Various strategies to increase the economic viability of nuclear power are brought out. Technological means to further minimize environmental impacts and to enhance safety are covered as they are a major factor in public acceptance. Also covered are advances anticipated by mid-century in nuclear reactor and fuel cycle technologies

  11. Development of an integrated tobacco endgame strategy.

    Science.gov (United States)

    van der Eijk, Yvette

    2015-07-01

    In recent years, various tobacco 'endgame' strategies have been suggested as a means to phase out tobacco consumption. Using country examples, this paper discusses three potential strategies: replacing cigarettes with alternative products (harm reduction), denying tobacco sales to people born after a certain year (the tobacco-free generation proposal), and further implementing measures based on the WHO Framework Convention for Tobacco Control (FCTC) treaty. It is argued that all strategies have potential issues that could be avoided by combining them into an integrated, sequential endgame that, first, using measures recommended in the WHO FCTC, creates a climate that facilitates the phasing out of cigarettes; second, implements a generational phase out of cigarette sales; and third, simultaneously permits the regulated use of alternative nicotine products. Thus, integrating ideas from various endgame strategies will result in a more effective, resilient tobacco endgame policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Analyst, Policy and Strategy | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Working under the supervision of the Director, and with guidance from the Senior Analyst, the Analyst provides research, analysis, and advice on matters of policy and strategy for the Centre and its Board. He or she contributes to strategic and operational planning, corporate reporting, trend monitoring, and engagement with ...

  13. Views of Canadian patients on or nearing dialysis and their caregivers: a thematic analysis.

    Science.gov (United States)

    Barnieh, Lianne; King-Shier, Kathryn; Hemmelgarn, Brenda; Laupacis, Andreas; Manns, Liam; Manns, Braden

    2014-01-01

    Quality of life of patients receiving dialysis has been rated as poor. To synthesize the views of Canadian patients on or nearing dialysis, and those who care for them. Secondary analysis of a survey, distributed through dialysis centres, social media and the Kidney Foundation of Canada. Pan-Canadian convenience sample. Patients, their caregivers and health-care providers. Text responses to open-ended questions on topics relevant to end-stage renal disease. Statements related to needs, beliefs or feelings were identified, and were analysed by thematic content analysis. A total of 544 relevant statements from 189 respondents were included for the thematic content analysis. Four descriptive themes were identified through the content analysis: gaining knowledge, maintaining quality of life, sustaining psychosocial wellbeing and ensuring appropriate care. Respondents primarily identified a need for more information, better communication, increased psychosocial and financial support for patients and their families and a strong desire to maintain their previous lifestyle. Convenience sample; questions were originally asked with a different intent (to identify patient-important research issues). Patients on or nearing dialysis and their caregivers identified four major themes, gaining knowledge, maintaining quality of life, sustaining psychosocial wellbeing and ensuring appropriate care, several of which could be addressed by the health care system without requiring significant resources. These include the development of patient materials and resources, or sharing of existing resources across Canadian renal programs, along with adopting better communication strategies. Other concerns, such as the need for increased psychosocial and financial support, require consideration by health care funders.

  14. The dialysis catheter and infectious peritonitis in intermittent peritoneal dialysis

    DEFF Research Database (Denmark)

    Kolmos, Hans Jørn; Hemmeløff Andersen, Karl Erik; Hansen, Lise

    1984-01-01

    118 episodes of infectious peritonitis registered among 156 patients treated with intermittent peritoneal dialysis over a 5-yr period were analysed with special reference to potential routes of infection associated with the dialysis catheter. Peritonitis was randomly distributed among the patients......, and the change of keeping free of peritonitis declined exponentially with time. The main factor determining the individual number of episodes was the total space of time, in which a patient had been wearing a dialysis catheter, whereas the number of catheter disconnections played no significant role. A relative...... preponderance of cases due to Enterobacteriaceae was noted within the first week after catheter implantation. In contrast with this, peritonitis with skin microorganisms was not associated with the implantation of catheters....

  15. A classification of strategies for the development of product configurators

    DEFF Research Database (Denmark)

    Haug, Anders; Hvam, Lars; Mortensen, Niels Henrik

    2009-01-01

    the right strategy. However, the literature does not discuss different strategic alternatives in a detailed manner, but only provides generalised recommendations of single strategies. To deal with this issue, this paper defines three main and four additional strategies for the development of product...... configurators. The strategies are defined based on literature, seven named case studies, and other case experiences of the authors. The paper deduces the advantages and disadvantages of the individual strategies, and gives a general recommendation of which type of strategy to pursue in different types...

  16. Nature-Inspired Design : Strategies for Sustainable Product Development

    NARCIS (Netherlands)

    De Pauw, I.C.

    2015-01-01

    Product designers can apply different strategies, methods, and tools for sustainable product development. Nature-Inspired Design Strategies (NIDS) offer designers a distinct class of strategies that use ‘nature’ as a guiding source of knowledge and inspiration for addressing sustainability.

  17. Nuclear power development strategy through 2020 in China

    International Nuclear Information System (INIS)

    Wang Yongping; Zhao Shoufeng; Yuan Yujun; Rao Shuang; Liu Qun; Ding Ruijie

    2005-10-01

    Through the analysis of the nuclear power situation of China, it is emphasized that the nuclear power development strategy is an important part of electric power development strategy and national energy security strategy in China, but nuclear power development in accelerant way will face greater challenge. The uranium demand and supply, the treatment and disposal of radioactive wastes, and other primary problems through 2020 in China are discussed. The nuclear power development strategy till 2020 are described. The relevant measures and recommendations are proposed. (authors)

  18. Development and implementation of public relations strategy

    International Nuclear Information System (INIS)

    Kukovica, T.; Mele, I.; Stritar, A.; Isteni, R.

    1995-01-01

    Following the strong public opposition after the announcement of the results of possible site selections for the final low and intermediate waste repository in Slovenia in 1993, the Agency for Radwaste Management has completely revised its public information strategy. The information and education programs, that should lead to greater public acceptance, are described. At present the bulletin, leaflets, booklet, permanent exhibition and lectures in the Nuclear Training Centre are applied. (author)

  19. Dialysis: Reducing Infections and Changing Culture

    Centers for Disease Control (CDC) Podcasts

    This podcast is an account from an infection preventionist about the challenges and successes with engaging dialysis care teams to focus on "Zero Preventable Infections" in outpatient dialysis facilities.

  20. Treatment Methods for Kidney Failure: Peritoneal Dialysis

    Science.gov (United States)

    ... connect the bags of dialysis solution place the drain tube If you choose automated peritoneal dialysis, you also ... from the new bag of solution into the drain bag. Clamp the tube that goes to the drain bag. Open or ...

  1. A CO2-strategy for BTC [Belgian Development Agency

    Energy Technology Data Exchange (ETDEWEB)

    Bailly, J. [Prospect C and S, Brussels (Belgium); Hanekamp, E. [Partners for Innovation, Amsterdam (Netherlands)

    2008-09-15

    The CO2 footprint is determined the CO2 strategy is developed for the Belgian Technical Cooperation (BTC). BTC is the Belgian agency for development cooperation, and finances development projects in 23 partner countries. The CO2 footprint covered BTC's activities in 2007 in all their offices worldwide. Footprint and strategy were finalised and adopted by the Executive Board at the end of 2008. Meanwhile, the BTC began with the introduction of the proposed strategy. Partners for Innovation and Prospect were asked to support the introduction of the strategy and to determine the CO2 footprint of 2008.

  2. (HIV) seropositive Nigerian patients undergoing dialysis

    African Journals Online (AJOL)

    Most dialysis centres in Nigeria currently do not accept HIV positive patients for dialysis therapy for many reasons. The prevailing high level of stigmatization of HIV positive patients and the lack of job security for infected staff are two major reasons for the non-acceptance of HIV infected patients for dialysis by these centres.

  3. Nuclear Cryogenic Propulsion Stage Affordable Development Strategy

    Science.gov (United States)

    Doughty, Glen E.; Gerrish, H. P.; Kenny, R. J.

    2014-01-01

    The development of nuclear power for space use in nuclear thermal propulsion (NTP) systems will involve significant expenditures of funds and require major technology development efforts. The development effort must be economically viable yet sufficient to validate the systems designed. Efforts are underway within the National Aeronautics and Space Administration's (NASA) Nuclear Cryogenic Propulsion Stage Project (NCPS) to study what a viable program would entail. The study will produce an integrated schedule, cost estimate and technology development plan. This will include the evaluation of various options for test facilities, types of testing and use of the engine, components, and technology developed. A "Human Rating" approach will also be developed and factored into the schedule, budget and technology development approach.

  4. Developing green supply chain management strategies: A taxonomic approach

    Directory of Open Access Journals (Sweden)

    Michael Mutingi

    2013-06-01

    Full Text Available Purpose: The objective of this research is to explore the empirical green supply chain activities found in literature, and to develop a taxonomic framework that can be used for formulating appropriate strategies for green supply chains, based on characteristic dimensions for the green supply chain. Design/methodology/approach: The taxonomic framework is developed through (i analysis of green supply chain activities found in existing empirical work or case studies recorded in literature, (ii identification of key dimensions that influence green supply chain management strategies, and (iii development of a taxonomic scheme for selecting or developing green strategies. Findings: The paper finds that this study yielded: a set of three characteristic dimensions that influence strategic green supply chain management, and a guided structured approach selecting appropriate green strategies, providing managerial insights. Research limitations/implications: This paper shows that future work includes development of specific performance management indices according to the taxonomy of green strategies developed in this study. Practical implications: This research provided a practical guided approach that enhances appropriate formulation of green strategies for green supply chain management, while providing sound managerial insights for the supply chain decision maker. The choice of supply chain strategy directly impacts the overall environmental, economic and operations performance of the supply chain. Originality/value: This study presents to supply chain decision makers a new taxonomic framework that simplifies and enhances the formulation of green strategies, and to researchers a comparative understanding of various strategies applicable to green supply chains.

  5. A strategy for teacher involvement in curriculum development ...

    African Journals Online (AJOL)

    Hence this study focuses on an effective strategy for teacher involvement in curriculum development. The strength of the strategy is that it involves formal teacher training with semesterised courses. There is phased- in implementation of the different phases of the curriculum development process. This formal training course ...

  6. Understanding MBA Consumer Needs and the Development of Marketing Strategy

    Science.gov (United States)

    Dailey, Lynn; Anderson, Murphy; Ingenito, Cristina; Duffy, David; Krimm, Paul; Thomson, Scott

    2006-01-01

    The need to develop marketing strategies in higher education is evident. In order to develop effective strategies, marketers must understand the basic needs that their product fulfills. Exploratory research was utilized to identify and better understand the needs that motivate consumers to pursue an MBA degree. This paper emphasizes the importance…

  7. Developing strategies for HIV-1 eradication

    Science.gov (United States)

    Durand, Christine M.; Blankson, Joel N.; Siliciano, Robert F.

    2014-01-01

    Highly active antiretroviral therapy (HAART) suppresses HIV-1 replication, transforming the outlook for infected patients. However, reservoirs of replication-competent forms of the virus persist during HAART, and when treatment is stopped, high rates of HIV-1 replication return. Recent insights into HIV-1 latency, as well as a report that HIV-1 infection was eradicated in one individual, have renewed interest in finding a cure for HIV-1 infection. Strategies for HIV-1 eradication include gene therapy and hematopoietic stem cell transplantation, stimulating host immunity to control HIV-1 replication, and targeting latent HIV-1 in resting memory CD4+ T cells. Future efforts should aim to provide better understanding of how to reconstitute the CD4+ T cell compartment with genetically engineered cells, exert immune control over HIV-1 replication, and identify and eliminate all viral reservoirs. PMID:22867874

  8. Strategies of development of European power producers

    International Nuclear Information System (INIS)

    Heddebaut, D.

    2007-12-01

    This economical study answers the following questions: what is the dynamics of European power markets? What is the relative competitiveness of the different power production means? What are the determining factors of electricity wholesale prices? Who are the operators the most threatened by the rise of wholesale prices? To what extend power producers are impacted by the CO 2 constrain? Who are the most efficient producers? The analysis is based on 18 of the most representative groups of the European electric utilities. The first volume of the study presents the strategic perspectives of European power producers: dynamics and basic characteristics of European power markets, strategic options of European operators, typology and financial results of European power producers, scenarios of market reorganization according to Eurostaf (possible mega-mergers in the future, competition). Volume 2 makes a detailed analysis of the positioning and perspectives of the 18 selected groups: key figures, sourcing strategies, production means management, Eurostaf's diagnosis. (J.S.)

  9. Strategies for Developing China's Software Industry

    OpenAIRE

    Mingzhi Li; Ming Gao

    2003-01-01

    The software industry is deemed an ideal target for a developing country to integrate into the world information and communications technology (ICT) market. On the one hand the industry is labor intensive, and the developing countries have a large labor surplus; on the other hand, it is a worldwide trend for developed countries to outsource a vast amount of low-end, software-related tasks to the low-cost countries and regions, which fits into some developing countries’ caliber nicely. India h...

  10. A Mobile Application Development Strategy-Finding Model

    OpenAIRE

    MBAYEN MBAYEN, GHISLAIN EDGARD

    2013-01-01

    Nowadays there are several different types of ways to build a mobile application, through web technologies, or through mobile manufacturers’ languages. Thus, in this study we focus on the three major mobile application development strategies: Native, Hybrid, and Web to Native. This plurality of solutions renders the selection of a mobile application development strategy complex. Hence, this study aims at understanding how developers deal with the selection of a mobile development approach. Th...

  11. Developing inspection strategies to support local activities

    DEFF Research Database (Denmark)

    Jensen, Per Langå

    2003-01-01

    An analysis of the Danish development in regulatory praxsis within occupational health and safety with a detailed description of Adapted Inspection.......An analysis of the Danish development in regulatory praxsis within occupational health and safety with a detailed description of Adapted Inspection....

  12. Developing Business School Strategies: A Practitioner-Oriented Conceptualization

    Directory of Open Access Journals (Sweden)

    Daniel Seelhofer

    2016-03-01

    Full Text Available This conceptual paper examines the rationale for strategic planning in business schools and outlines an applied strategy development and controlling process that has been in use at a major Swiss business school for several years, contributing to a significant strengthening of the school's strategic position. It explains the strategy hierarchy and the strategy planning cycle, describes how to conduct a consistent strategic situation analysis, and details how to develop and manage a coherent strategy at all levels (normative, strategic, tactical, and operational, including type, nature, and structure of the corresponding documents.

  13. Intermittent Oral Versus Intravenous Alfacalcidol in Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Mitwalli Ahmed

    2000-01-01

    Full Text Available Patients with end-stage renal failure (ESRF on maintenance dialysis, commonly develop secondary hyperparathyroidism and renal osteodystrophy (ROD. Alfacalcidol, taken orally or administered intravenously, is known to reverse these complications. In this study, 19 ESRF patients, who were on dialysis (13 on hemodialysis and six on peritoneal dialysis for longer than six months and having serum parathormone levels at least four times normal and serum calcium less than 2.1 mmol/L, were randomly allocated to treatment with oral or intravenous (i.v. alfacalcidol for a period of 12 months. There were six patients on hemodialysis (HD and three on peritoneal dialysis (PD in the oral treatment group while in the i.v. group there were seven patients on HD and three on PD. Clinical and serial biochemical assessments showed no statistically significant difference between the orally- and i.v.-treated patients in terms of suppressing secondary hyperparathyroidism and osteodystrophy. However, patients with features of mild ROD on bone histology, had more satisfactory changes in biochemistry when compared to others. Our results further support the use of intermittent oral alfacalcidol in ESRF patients because of its cost effectiveness, ease of administration and convenience, especially for peritoneal dialysis patients.

  14. Alloy development for irradiation performance: program strategy

    International Nuclear Information System (INIS)

    Bloom, E.E.; Stiegler, J.O.; Wiffen, F.W.; Dalder, E.N.C.; Reuther, T.C.; Gold, R.E.; Holmes, J.J.; Kummer, D.L.; Nolfi, F.V.

    1978-01-01

    The objective of the Alloy Development for Irradiation Performance Program is the development of structural materials for use in the first wall and blanket region of fusion reactors. The goal of the program is a material that will survive an exposure of 40 MWyr/m 2 at a temperature which will allow use of a liquid-H 2 O heat transport system. Although the ultimate aim of the program is development of materials for commercial reactors by the end of this century, activities are organized to provide materials data for the relatively low performance interim machines that will precede commercial reactors

  15. Innovation Strategies for a Global Economy: Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-10-01

    Oct 1, 2010 ... This path-breaking book integrates theory, case studies, data and policy ... their development, implementation, measurement and management. Following the global economic crisis, people are asking: what went wrong? Here ...

  16. Transportation strategy development under economic uncertainty.

    Science.gov (United States)

    2013-05-01

    The interests of the researchers here were to understand various modes for developing long term : that is strategic plans with particular concern for the economic uncertainties one invariably : faces in such a planning environment. Often resou...

  17. Cheyenne-Laramie County Economic Development Strategy

    Science.gov (United States)

    1986-06-01

    Chamber of Commerce John Etchepare Warren Livestock Co. Shirley Francis Laramie County Commissioner Nancy Gire Economic Development Planner, Cheyenne...County Unamounoed 13 Industrial Development Association of Cheyenne- justifloatio Laramie County (IDAC-LC) Greater Cheyenne Chamber of Commerce (GCCC...February 10-21, 1986, in the Greater Cheyenne Chamber of Commerce offices. With a few excep- tions, BBC project team leaders met with each person

  18. Differences in care burden of patients undergoing dialysis in different centres in the netherlands.

    Science.gov (United States)

    de Kleijn, Ria; Uyl-de Groot, Carin; Hagen, Chris; Diepenbroek, Adry; Pasker-de Jong, Pieternel; Ter Wee, Piet

    2017-06-01

    A classification model was developed to simplify planning of personnel at dialysis centres. This model predicted the care burden based on dialysis characteristics. However, patient characteristics and different dialysis centre categories might also influence the amount of care time required. To determine if there is a difference in care burden between different categories of dialysis centres and if specific patient characteristics predict nursing time needed for patient treatment. An observational study. Two hundred and forty-two patients from 12 dialysis centres. In 12 dialysis centres, nurses filled out the classification list per patient and completed a form with patient characteristics. Nephrologists filled out the Charlson Comorbidity Index. Independent observers clocked the time nurses spent on separate steps of the dialysis for each patient. Dialysis centres were categorised into four types. Data were analysed using regression models. In contrast to other dialysis centres, academic centres needed 14 minutes more care time per patient per dialysis treatment than predicted in the classification model. No patient characteristics were found that influenced this difference. The only patient characteristic that predicted the time required was gender, with more time required to treat women. Gender did not affect the difference between measured and predicted care time. Differences in care burden were observed between academic and other centres, with more time required for treatment in academic centres. Contribution of patient characteristics to the time difference was minimal. The only patient characteristics that predicted care time were previous transplantation, which reduced the time required, and gender, with women requiring more care time. © 2017 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  19. Transportation energy strategy: Project {number_sign}5 of the Hawaii Energy Strategy Development Program

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    This study was prepared for the State Department of Business, Economic Development and Tourism (DBEDT) as part of the Hawaii Energy Strategy program. Authority and responsibility for energy planning activities, such as the Hawaii Energy Strategy, rests with the State Energy Resources Coordinator, who is the Director of DBEDT. Hawaii Energy Strategy Study No. 5, Transportation Energy Strategy Development, was prepared to: collect and synthesize information on the present and future use of energy in Hawaii`s transportation sector, examine the potential of energy conservation to affect future energy demand; analyze the possibility of satisfying a portion of the state`s future transportation energy demand through alternative fuels; and recommend a program targeting energy use in the state`s transportation sector to help achieve state goals. The analyses and conclusions of this report should be assessed in relation to the other Hawaii Energy Strategy Studies in developing a comprehensive state energy program. 56 figs., 87 tabs.

  20. Fusion instrumentation and control: a development strategy

    International Nuclear Information System (INIS)

    Hsu, P.Y.; Greninger, R.C.; Longhurst, G.R.; Madden, P.

    1981-01-01

    We have examined requirements for a fusion instrumentation and control development program to determine where emphasis is needed. The complex, fast, and closely coupled system dynamics of fusion reactors reveal a need for a rigorous approach to the development of instrumentation and control systems. A framework for such a development program should concentrate on three principal need areas: the operator-machine interface, the data and control system architecture, and fusion compatible instruments and sensors. System dynamics characterization of the whole fusion reactor system is also needed to facilitate the implementation process in each of these areas. Finally, the future need to make the instrumentation and control system compatible with the requirements of a commercial plant is met by applying transition technology. These needs form the basis for the program tasks suggested

  1. National Strategies for Public Library Development

    DEFF Research Database (Denmark)

    Kann-Christensen, Nanna

    2010-01-01

    policies on the local level are discussed. according to the national goals and cultural policies for libraries. This is done in order to point towards a possible relationship between the political means and ends regarding library development. The two models to be discussed are the systems practiced...... by The Danish Agency for Libraries and Media, and The Swedish Arts Council, who both administer development grants to public libraries. The paper identifies both differences and similarities in both the means to (the political agendas) and the objectives of governmental influence in the libraries.......The economic rationale of New Public Management (NPM) is used in both Sweden and Denmark in order to employ the national cultural policies in local development projects. The paper discusses two different organizational models that are used in order for the national level to be able to exercise...

  2. Characterization of alternative FBR development strategies

    International Nuclear Information System (INIS)

    Boegel, A.J.; Clausen, M.J.

    1981-08-01

    Near-term decisions regarding the nature and place of the FBR development program must be made. This study is part of a larger program designed to provide the Department of Energy (DOE) with imformation that can be used to make strategic programmatic decisions. The focus of this report is the description of alternative approaches for developing the FBR and the quantification of the duration and cost of each alternative. The time frames of the alternative approaches are investigated in companion reports (White 1981 and Fraley 1981). The results of these analyses will be described in a summary report

  3. Product development capability and marketing strategy for new durable products

    OpenAIRE

    Banerjee, Sumitro; Soberman, David A.

    2013-01-01

    Our objective is to understand how a firm’s product development capability (PDC) affects the launch strategy for a durable product that is sequentially improved over time in a market where consumers have heterogeneous valuations for quality. We show that the launch strategy of firms is affected by the degree to which consumers think ahead. However, only the strategy of firms with high PDC is affected by the observability of quality. When consumers are myopic and quality is observable, both hi...

  4. Conditions for developing a successful Talent Management Strategy

    OpenAIRE

    Naulleau , Mickaël

    2015-01-01

    International audience; The literature on Talent Management (TM) presupposes an exclusive alignment of TM with the organization's strategy, and the ability of any organization to engage a TM strategy. This article examines these principles by exploring the organizational contingency factors involved in the process of creation / development of TM strategy. We carried out a one-year Action-Research with the business leaders of a French medium-sized company (3 000 employees). We propose a comple...

  5. Reproductive strategy, sexual development and attraction to facial characteristics

    OpenAIRE

    Cornwell, R. Elisabeth; Law Smith, Miriam J; Boothroyd, Lynda G; Moore, Fhionna R; Davis, Hasker P; Stirrat, Michael; Tiddeman, Bernard; Perrett, David I

    2006-01-01

    Sexual reproduction strategies vary both between and within species in the level of investment in offspring. Life-history theories suggest that the rate of sexual maturation is critically linked to reproductive strategy, with high investment being associated with few offspring and delayed maturation. For humans, age of puberty and age of first sex are two developmental milestones that have been associated with reproductive strategies. Stress during early development can retard or accelerate s...

  6. Orphan drug: Development trends and strategies

    Directory of Open Access Journals (Sweden)

    Aarti Sharma

    2010-01-01

    Full Text Available The growth of pharma industries has slowed in recent years because of various reasons such as patent expiries, generic competition, drying pipelines, and increasingly stringent regulatory guidelines. Many blockbuster drugs will loose their exclusivity in next 5 years. Therefore, the current economic situation plus the huge generic competition shifted the focus of pharmaceutical companies from the essential medicines to the new business model - niche busters, also called orphan drugs. Orphan drugs may help pharma companies to reduce the impact of revenue loss caused by patent expiries of blockbuster drugs. The new business model of orphan drugs could offer an integrated healthcare solution that enables pharma companies to develop newer areas of therapeutics, diagnosis, treatment, monitoring, and patient support. Incentives for drug development provided by governments, as well as support from the FDA and EU Commission in special protocols, are a further boost for the companies developing orphan drugs. Although there may still be challenges ahead for the pharmaceutical industry, orphan drugs seem to offer the key to recovery and stability within the market. In our study, we have compared the policies and orphan drug incentives worldwide alongwith the challenges faced by the pharmaceutical companies. Recent developments are seen in orphan drug approval, the various drugs in orphan drug pipeline, and the future prospectives for orphan drugs and diseases.

  7. STRATEGIES FOR THE DEVELOPMENT OF TOURISM AND ...

    African Journals Online (AJOL)

    Rivers State Perspective ... A well-developed tourism industry can house a theatre to enhance the beauty of tourism. ... Tourism, as a concept of travelling from one destination to another by a .... economic policies education, health, industrial activities, transport, .... facilities that will ensure sustainability of the human industry”.

  8. Competitive Manufacturing: New Strategies for Regional Development.

    Science.gov (United States)

    Rosenfeld, Stuart A.

    In the past, economic development in the rural United States, particularly in the rural South, relied principally on the attractiveness of a low-wage work force to mass-production manufacturing industries. Now however, the viability of the traditional mass-production economy's organizational structure and operating procedures has been eroded by…

  9. Strategies of Integrated Rural Development Adopted by ...

    African Journals Online (AJOL)

    unique firstlady

    organization of self-help and co-operative effort on the part of the community, but ..... which urban and rural areas are considered as an integral part of the ... through these approaches or models, rural development could be attained, but it is ...

  10. Stakeholder participation in planning rural development strategies

    NARCIS (Netherlands)

    Sisto, Roberta; Lopolito, Antonio; Vliet, van Mathijs

    2018-01-01

    In advanced countries, rural areas are a complex web of social, political and historical factors. In addition, several kinds of uncertainties are usually present. As a consequence, frequent mismatches arise in practise between measures and rural development goals and priorities. To overcome this

  11. Conflict when making decisions about dialysis modality.

    Science.gov (United States)

    Chen, Nien-Hsin; Lin, Yu-Ping; Liang, Shu-Yuan; Tung, Heng-Hsin; Tsay, Shiow-Luan; Wang, Tsae-Jyy

    2018-01-01

    To explore decisional conflict and its influencing factors on choosing dialysis modality in patients with end-stage renal diseases. The influencing factors investigated include demographics, predialysis education, dialysis knowledge, decision self-efficacy and social support. Making dialysis modality decisions can be challenging for patients with end-stage renal diseases; there are pros and cons to both haemodialysis and peritoneal dialysis. Patients are often uncertain as to which one will be the best alternative for them. This decisional conflict increases the likelihood of making a decision that is not based on the patient's values or preferences and may result in undesirable postdecisional consequences. Addressing factors predisposing patients to decisional conflict helps to facilitate informed decision-making and then to improve healthcare quality. A predictive correlational cross-sectional study design was used. Seventy patients were recruited from the outpatient dialysis clinics of two general hospitals in Taiwan. Data were collected with study questionnaires, including questions on demographics, dialysis modality and predialysis education, the Dialysis Knowledge Scale, the Decision Self-Efficacy scale, the Social Support Scale, and the Decisional Conflict Scale. The mean score on the Decisional Conflict Scale was 29.26 (SD = 22.18). Decision self-efficacy, dialysis modality, predialysis education, professional support and dialysis knowledge together explained 76.4% of the variance in decisional conflict. Individuals who had lower decision self-efficacy, did not receive predialysis education on both haemodialysis and peritoneal dialysis, had lower dialysis knowledge and perceived lower professional support reported higher decisional conflict on choosing dialysis modality. When providing decisional support to predialysis stage patients, practitioners need to increase patients' decision self-efficacy, provide both haemodialysis and peritoneal dialysis

  12. Strategy of Gurgyan-Deniz field development

    International Nuclear Information System (INIS)

    Javadova, Rena A.; Gumbatov, Bahruz Y.

    2002-01-01

    Full text : It is known that during long suspension of oil-gas production process due to some reasons of technical and geological character through their further involvement into development one can observe restoration of productive characteristics of layers. it can be associated with redistribution of hydrodynamic flows, stratal pressure, segregation and other. Analysis of conducted geological, commercial-geophysical, geochemical results allowed to say about significant amount of residual reserves on the field. According to the obtained data distribution of residual oil reserves along horizons is presented in this article. In 2001 well which operates by gas lift method and gives production 25 ton/per day. In order to increase temp of selection and of course ratio of oil recovery after restoration of grid one should provide application of new methods of development.

  13. Management Strategies and Economic Development in Ghana

    DEFF Research Database (Denmark)

    Kuada, John

    2014-01-01

    as number 2 on the World Bank’s world economic growth list. It has also scored high on measures of civil liberty, political rights and political stability among other nations on the West African sub-continent. But Ghana still faces serious economic and social challenges and is, therefore, in search of new......Ghana has experienced a tumultuous political and economic history since its independence in 1957. But today it is among the handful of African nations that showcase the dreams and aspirations of Sub-Sahara Africa. In 2011 it achieved an impressive economic growth rate of 14.6 per cent and ranked...... to provides illustrations of the usefulness of the human capability development framework presented in volume one as a foundation for sustainable and inclusive economic development in SSA. It also highlights the challenges that the country continues to grapple with and provides some directions for further...

  14. Sustainable development: downwards and upwards strategies

    International Nuclear Information System (INIS)

    Claval, Paul

    2006-01-01

    The idea of sustainable development, which was officialised by the Brundtland Report in 1987, was born from the will to reconcile the defence of ecological equilibria with the necessity to offer better conditions of life to the developing countries. It was supported from the start by the most important ecological NGOs. Following Solow, economists showed that, under specific conditions, economic growth was not conducive to environmental degradation. In 1992, the Rio de Janeiro Conference transformed sustainable growth into a political obligation for political authorities, whatever their scale. Because of the urgency created by climatic change, targets were fixed at the top level, and then applied to every State. Other procedures, which give more initiative to the local and national levels, are also used

  15. Networking - The Urban and Regional Development Strategy?

    OpenAIRE

    Maria Nowicka-Skowron; Piotr Pachura

    2008-01-01

    It has become more and more common to claim that the concept of innovations embraces everything that is connected with creation and application of new knowledge in order to win competitive advantage. In this respect innovations concern as well, apart from technology, economy, society and culture. A traditional approach applied by organizational and management sciences is not enough to explain and manage the development of enterprises as well as that of cities, regions and countries. Simultane...

  16. NETWORKING - THE URBAN AND REGIONAL DEVELOPMENT STRATEGY?

    OpenAIRE

    MARIA NOWICKA-SKOWRON; DEJAN ERIĆ; IVONNE GRABARA; IOAN COSMESCU

    2011-01-01

    The concept of innovations embraces everything that is connected with creation and application of new knowledge in order to win competitive advantage. A traditional approach applied by organizational and management sciences are not enough to explain and manage the development of enterprises as well as that of cities, regions and countries. According to a new approach to innovativeness, creation of innovations depends on a complex/system approach. A phenomenon of particular importance is the a...

  17. The national strategy for a sustainable development 2009-2013

    International Nuclear Information System (INIS)

    2010-01-01

    This document first presents the content of the French national strategy for a sustainable development, and notably its nine strategic challenges: climate change and energy, sustainable transport and mobility, sustainable consumption and production, sustainable management of biodiversity and natural resources, public health, prevention and risk management, international challenges in terms of sustainable development and struggle against poverty, knowledge society, and governance. While discussing these challenges, the report outlines the need to make this strategy more constraining for public authorities, to structure this strategy about transitions towards a sustainable development, and to give room to dialogue

  18. Principles and framework for eHealth strategy development.

    Science.gov (United States)

    Scott, Richard E; Mars, Maurice

    2013-07-30

    Significant investment in eHealth solutions is being made in nearly every country of the world. How do we know that these investments and the foregone opportunity costs are the correct ones? Absent, poor, or vague eHealth strategy is a significant barrier to effective investment in, and implementation of, sustainable eHealth solutions and establishment of an eHealth favorable policy environment. Strategy is the driving force, the first essential ingredient, that can place countries in charge of their own eHealth destiny and inform them of the policy necessary to achieve it. In the last 2 years, there has been renewed interest in eHealth strategy from the World Health Organization (WHO), International Telecommunications Union (ITU), Pan American Health Organization (PAHO), the African Union, and the Commonwealth; yet overall, the literature lacks clear guidance to inform countries why and how to develop their own complementary but locally specific eHealth strategy. To address this gap, this paper further develops an eHealth Strategy Development Framework, basing it upon a conceptual framework and relevant theories of strategy and complex system analysis available from the literature. We present here the rationale, theories, and final eHealth strategy development framework by which a systematic and methodical approach can be applied by institutions, subnational regions, and countries to create holistic, needs- and evidence-based, and defensible eHealth strategy and to ensure wise investment in eHealth.

  19. Self-Regulated Strategy Development. What Works Clearinghouse Intervention Report

    Science.gov (United States)

    What Works Clearinghouse, 2017

    2017-01-01

    "Self-Regulated Strategy Development" ("SRSD") is an intervention designed to improve students' academic skills through a six-step process that teaches students specific academic strategies and self-regulation skills. The practice is especially appropriate for students with learning disabilities, the focal population of the…

  20. Development of a resistance management strategy for ixodid ticks ...

    African Journals Online (AJOL)

    The strategy developed for managing resistance in ticks with the acaricidal products on the market was based on mode of action of the active ingredients. The strategy requires the rotaional use of the acaricidal products in ways that reduces the selection pressure of active ingredients of same chemistry on the target-site in ...

  1. Peritoneal dialysis: a primary care perspective.

    Science.gov (United States)

    Saxena, Ramesh; West, Cheryl

    2006-01-01

    As the population of chronic kidney disease (CKD) and end-stage renal disease (ESRD) grows at an alarming rate, primary care physicians will increasingly be involved in the management of these patients. Early recognition of CKD and timely referral to a nephrologist when glomerular filtration rate approaches 30 mL/min/1.73 m(2) is extremely important to improve ESRD outcome and appropriate selection of dialysis modality. Peritoneal dialysis (PD) remains a viable treatment option for ESRD patients. PD is less expensive dialysis modality and may provide a survival advantages over hemodialysis in first 2 to 4 years of treatment. Preserving residual renal function (RRF) is of paramount importance to prolong the survival outcomes in PD patients. Thus preservation of RRF is an important goal in the management of PD patients. Every effort should be made to avoid nephrotoxic drugs like aminoglycosides and nonsteroidal anti-inflammatory drugs, and limit the use of radiocontrast agents in PD patients with RRF. Judicious use of prophylactic antibiotics to prevent peritonitis would further help to reduce morbidity from PD. Protecting peritoneal membrane from long-term toxic and metabolic effects of the conventional glucose-based solutions is another objective to further improve PD outcome. Development of new, more biocompatible PD solutions holds promise for the future. One such solution, icodextrin, is now approved for use in the United States. Although extremely safe to use, it is associated with unique metabolic effects that may concern primary care physicians. They include false elevation of blood glucose, a reversible increase in serum alkaline phosphatase and a false decline in serum amylase. Monitoring of glycemia by assays that use glucose dehydrogenase pyrroloquinoline quinone enzymes should be avoided and serum amylase alone should not be relied on in diagnosing pancreatitis in patients on icodextrin.

  2. Development of a new risk model for predicting cardiovascular events among hemodialysis patients: Population-based hemodialysis patients from the Japan Dialysis Outcome and Practice Patterns Study (J-DOPPS.

    Directory of Open Access Journals (Sweden)

    Yukiko Matsubara

    Full Text Available Cardiovascular (CV events are the primary cause of death and becoming bedridden among hemodialysis (HD patients. The Framingham risk score (FRS is useful for predicting incidence of CV events in the general population, but is considerd to be unsuitable for the prediction of the incidence of CV events in HD patients, given their characteristics due to atypical relationships between conventional risk factors and outcomes. We therefore aimed to develop a new prognostic prediction model for prevention and early detection of CV events among hemodialysis patients.We enrolled 3,601 maintenance HD patients based on their data from the Japan Dialysis Outcomes and Practice Patterns Study (J-DOPPS, phases 3 and 4. We longitudinaly assessed the association between several potential candidate predictors and composite CV events in the year after study initiation. Potential candidate predictors included the component factors of FRS and other HD-specific risk factors. We used multivariable logistic regression with backward stepwise selection to develop our new prediction model and generated a calibration plot. Additinially, we performed bootstrapping to assess the internal validity.We observed 328 composite CV events during 1-year follow-up. The final prediction model contained six variables: age, diabetes status, history of CV events, dialysis time per session, and serum phosphorus and albumin levels. The new model showed significantly better discrimination than the FRS, in both men (c-statistics: 0.76 for new model, 0.64 for FRS and women (c-statistics: 0.77 for new model, 0.60 for FRS. Additionally, we confirmed the consistency between the observed results and predicted results using the calibration plot. Further, we found similar discrimination and calibration to the derivation model in the bootstrapping cohort.We developed a new risk model consisting of only six predictors. Our new model predicted CV events more accurately than the FRS.

  3. DEVELOPING A VIRTUAL ORGANIZATION: SERENDIPITY OR STRATEGY?

    Directory of Open Access Journals (Sweden)

    Shirley Gregor

    2002-01-01

    Full Text Available This paper addresses the question of how virtual organizations that yield strategic advantage are formed. The study uses grounded theory to investigate the organizational processes and structure that facilitate the formation of a successful virtual organization. We present a case study of one virtual organization, a university in Australia, which has gained strategic advantage from alliances supported by information and communication technologies (ICT. The university is now the fastest growing university in Australia in terms of international student enrolments. The case study suggests that this commercial success is based on responsiveness to environmental conditions and organizational factors that include a long history as a distance education provider (an early form of virtualization, sophisticated information communication technologies, and a culture of innovation and risk-taking. The development processes observed included evolutionary growth, decisive actions and management leadership at opportune moments, and examples of technological and entrepreneurial innovations led by individuals. Significant decision making occurred outside formal strategic planning processes.

  4. IANGV strategy and NGV market development

    International Nuclear Information System (INIS)

    Mobers, L.P.H.

    1997-01-01

    The mission statement of IANGV is to facilitate the development and commercialization of NGVs world wide by providing leadership and a forum for information exchange in all contries where NG can provide economic and environmental benefits as an alternative transport fuel. IANGV is the industry association which represents all parts of the NGV industry at the international level. The objective of IANGV is to bring about the increase in use of gas as a transport fuel. There are approximately one million NGVs of all types around the world. While this is small compared with the total number of vehicles in the world it is nevertheless a substantial industry which has had more than 50 years of fully commercial and technical experience. (au)

  5. NETWORKING - THE URBAN AND REGIONAL DEVELOPMENT STRATEGY?

    Directory of Open Access Journals (Sweden)

    PIOTR PACHURA

    2008-01-01

    Full Text Available It has become more and more common to claim that the concept of innovations embraces everything that is connected with creation and application of new knowledge in order to win competitive advantage. In this respect innovations concern as well, apart from technology, economy, society and culture. A traditional approach applied by organizational and management sciences is not enough to explain and manage the development of enterprises as well as that of cities, regions and countries. Simultaneously, according to a new approach to innovativeness, creation of innovations depends on a complex/system approach. The word complex is vital since this approach should embrace the complexity of innovative networks as well as complexity of relations of cooperation and the whole network environment together with social context.

  6. DENGUE VACCINE, CHALLENGES, DEVELOPMENT AND STRATEGIES

    Directory of Open Access Journals (Sweden)

    Dewi Marbawati

    2014-08-01

    Full Text Available ABSTRAKPenyakit demam Dengue endemik di lebih dari 100 negara di dunia. Obat anti virus Dengue efektif belum ditemukan danpengendalian vektor dinilai kurang efektif, sehingga diperlukan upaya pencegahan dengan vaksinasi. Vaksin Dengue yangideal adalah murah, mencakup 4 serotipe, efektif dalam memberikan kekebalan, cukup diberikan sekali seumur hidup, aman,memberi kekebalan jangka panjang, stabil dalam penyimpanan dan stabil secara genetis (tidak bermutasi. Beberapakandidat vaksin yang telah dan sedang dikembangkan oleh para peneliti di seluruh dunia adalah tetravalent live attenuatedvaccine, vaksin Chimera (ChimeriVax, vaksin subunit dan vaksin DNA. Vaksin Dengue dipandang sebagai pendekatan yangefektif dan berkesinambungan dalam mengendalikan penyakit Dengue. Tahun 2003 telah terbentuk Pediatric DengueVaccine Initiative (PDVI, yaitu sebuah konsorsium internasional yang bergerak dalam advokasi untuk meyakinkanmasyarakat internasional akan penting dan mendesaknya vaksin Dengue. Konsorsium vaksin Dengue Indonesia saat iniberupaya mengembangkan vaksin Dengue dengan menggunakan strain virus lokal.Kata kunci: Dengue, virus, vaksinABSTRACTDengue fever is endemic in more than 100 countries in the world. The effective dengue antiviral drug has not been found yet,and vector control is considered less effective. Prevention program by vaccination is needed. An ideal dengue vaccine shouldbe inexpensive, covering four serotypes (tetravalent, effective in providing immunity, given once a lifetime, safe, stable instorage and genetically. Several vaccine candidates have been and are being developed included attenuated tetravalentvaccine, ChimeriVax, sub- unit vaccines and DNA vaccines. Dengue vaccine is seen as an effective and sustainable approachto controll Dengue infection. In 2003, Pediatric Dengue Vaccine Initiative (PDVI has been formed as an internationalconsortium involved in advocacy to convince the international community about the essence and urgency

  7. Sustainable development strategy 2001-2003

    International Nuclear Information System (INIS)

    2001-01-01

    This report defines what Transport Canada can do to incorporate environmental considerations into its mandate. While governments are faced with more pressures to finance and expand transportation infrastructure to meet the growth in transportation, environmental pressures are also increasing to make efficient use of land and natural resources, preserve vital habitats and maintain biodiversity. A greater use of non-renewable resources and new technologies such as fuel cells for automobiles will play an important role in addressing these environmental challenges related to the transportation sector. In addition, the transportation infrastructure will have to evolve to promote less polluting modes of travel and to better integrate different modes to make the system more efficient. This report presented the following 7 strategic challenges facing the transportation sector in Canada: (1) improving education and awareness of sustainable transportation, (2) developing tools for better decision-making, (3) promoting the adoption of sustainable transportation technology, (4) improving environmental management for Transport Canada operations and lands, (5) reducing air emissions, (6) reducing water pollution, and (7) promoting efficient transportation. For each challenge, the department has defined specific commitments for action, with a total of 29 commitments. tabs., figs

  8. NETWORKING - THE URBAN AND REGIONAL DEVELOPMENT STRATEGY?

    Directory of Open Access Journals (Sweden)

    MARIA NOWICKA-SKOWRON

    2011-01-01

    Full Text Available The concept of innovations embraces everything that is connected with creation and application of new knowledge in order to win competitive advantage. A traditional approach applied by organizational and management sciences are not enough to explain and manage the development of enterprises as well as that of cities, regions and countries. According to a new approach to innovativeness, creation of innovations depends on a complex/system approach. A phenomenon of particular importance is the approach to network pro-innovation structures from the urban and regional point of view. What makes a network work is a mutual relation between actors who have same rights to access and participate in the network. The whole system must be perceived by every actor. Simultaneously, every actor is partially responsible for the whole. The nature of networking can be understood as a differentiated system of relations (particularly personal ones inside the network. Tolerance and trust are other foundations of information flow and information return.

  9. Framework for Creating a Smart Growth Economic Development Strategy

    Science.gov (United States)

    This step-by-step guide can help small and mid-sized cities, particularly those that have limited population growth, areas of disinvestment, and/or a struggling economy, build a place-based economic development strategy.

  10. Development of stable marker-free nuclear transformation strategy ...

    African Journals Online (AJOL)

    Development of stable marker-free nuclear transformation strategy in the green microalga Chlorella vulgaris. ... into Chlorella by electroporation has very low stability and it is hard to screen the transformants without antibiotic marker genes.

  11. Developing online research strategies for library users at Sokoine ...

    African Journals Online (AJOL)

    Wanyenda

    SNAL develop effective online search strategies that help them make effective use of ... “trained in the application of information resources of their work”. ... However, the library has now migrated to an integrated web-based library automation.

  12. MARKETING STRATEGIES FOR DEVELOPING AGROTOURISM IN JEMBER REGENCY

    Directory of Open Access Journals (Sweden)

    Tantri Wijayanti

    2015-09-01

    Full Text Available This research was aimed to identify the agrotourism potential in Jember Regency, to identify the condition of internal and external environment of Sukorambi Botanic Garden. The research used the Importance Performance Analysis (IPA method to find out the level of the visitors’ interest and satisfaction. For the internal and external analyses, the Internal Factor Evaluation (IFE method, the External Factor Evaluation (EFE method,  Strength Weakness Opportunity and Threat (SWOT and the Analytic Hierarchy Process (AHP were used to determine the strategies for marketing Sukorambi Botanic Garden. Three resource persons were used by purposive sampling technique. Thirty respondents were used for analytical level of interest by distributing questionnaires to visitors. The results of the research showed that the priorities of marketing Sukorambi Botanic Garden were 1 the strategy to maximize the concept of recreation while studying  such as crop cultivation and animal farming, 2 the strategy to increase the number of outbound games, 3 the strategy to coordinate intensively with stakeholders for improvement and sustainable development, 4 the strategy to get a loan from  a financial institution to increase capital, 5 the strategy to optimize promotion activities, (6  the strategy to improve the quality of community services through improved performance and transportation facilities, 7 the strategy to improve the quality of services through trainings for the employees to improve the company’s management system, 8 the strategy to realize facility development on the remainder of the land  accompanied by improvement of existing facilities, and 9 the strategy to optimize online promotion activities.    Keywords: Agrotourism, marketing development strategy, Sukorambi Botanic Garden, AHP, SWOT

  13. Strategy of plant concept development in Hitachi

    International Nuclear Information System (INIS)

    Kumiaki, Moriya

    2007-01-01

    Hitachi contributes to the society in various fields of nuclear power such as the Light Water Reactor field, the Fast Breeder Reactor, the fuel cycle, and the medical treatment. Since the beginning of a first commercial operation of a BWR in Japan, Hitachi has constructed 20 units of BWR. Hitachi continues its efforts in achieving high reliability and large-scale output, and in 1996, it completed Advanced Boiling Water Reactor (ABWR) in cooperation with various BWR utilities, General Electric Company, and Toshiba Corporation. Hitachi has enhanced the ABWR technology further based on the above enough experience. The latest technologies were reflected in Hamaoka unit 5 and Shika unit 2 as the latest ABWR plants. The further upgrade technologies would been reflected in Shimane-3, Ohma-1 and Higashidori-1 as ABWR plants under planning. Hitachi obtains the chance to construct the nuclear power plant continuously. For the next generation, Hitachi is working on developing nuclear power plants that take diversified needs and global characteristics into account. As one of the approaches, the output series formation of BWR is extended as the following. ABWR-II and ESBWR (Economic and Simplified BWR) as a large-scale centralized power supply emphasizing cost efficiency, Medium size ABWR and natural circulation type BWR as medium and small-scale distributed power supply that features flexibility to various market needs, such as minimized capital risks, timely return on a capital investment, etc. As another approach, Hitachi tries to extend the Light Water Reactor technology. RBWR (Resource-Renewable BWR ) that achieves a high conversion ratio over 1.0 based on the BWR technology will make the fuel cycle flexible. Hitachi will continue the challenge for the next ABWR and the future with the enough experience of BWR construction. (author)

  14. The grown-up patient. The new customer in dialysis or--how to handle the demanding and emancipated dialysis patient.

    Science.gov (United States)

    Hippold, I

    2001-01-01

    The treatment of dialysis patients is under pressure. As a result of strict budgeting and increased administrative work, enhancement and the further development of the dialysis health care system is needed. An essential element of that development is a radical change in the patient/nurse relationship. Customer relationship management assumes that the patient is seen as a client, is encouraged to make decisions on their treatment and also emphasises the professionalism of nursing.

  15. The development strategy of financial and innovative technologies

    OpenAIRE

    R.V. Lavrov

    2013-01-01

    The aim of the article. The aim of the article is to define and to estimate the forming of expediency of the development strategy of financial and innovative technologies in the context of modern economic space realities.The results of the analysis. The growing importance of the financial sector in the contemporary economic space, as well as rapid changes in it, generates a need for financial innovative technologies. Development strategy of financial and innovative technologies is always asso...

  16. Cybersecurity Strategy in Developing Nations: A Jamaica Case Study

    Science.gov (United States)

    Newmeyer, Kevin Patrick

    2014-01-01

    Developing nations have been slow to develop and implement cybersecurity strategies despite a growing threat to governance and public security arising from an increased dependency on Internet-connected systems in the developing world and rising cybercrime. Using a neorealist theoretical framework that draws from Gilpin and Waltz, this qualitative…

  17. Children of home dialysis patients.

    Science.gov (United States)

    Tsaltas, M O

    1976-12-13

    Fifteen children of six families in which one parent was undergoing home dialysis were examined by the Minnesota Multiphasic Personality Inventory, human figure drawings, and family interviews. All the children were found to be clinically depressed, and two thirds had a history of being referred by teachers to school counselors and psychiatrists for behavioral problems in school. Of these referred children, all showed disorders of psychomotor activity and reduced academic achievement. There was no clear-cut evidence that these children were depressed because of exposure to home dialysis per se. The most disturbed children seemed to be responding to depressed parents or to partial object loss. A controlled, prospective study is planned to clarify this question.

  18. SUSTAINABILITY AS A STRATEGY OF RESPONSIBLE AND COMPETITIVE DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    José G. Vargas-Hernández

    2012-12-01

    Full Text Available The aim of this paper is to analyze a competitiveness strategy based on sustainability to lead the way to a model of responsible and competitive development. The analysis takes as its starting point the assumption that the maturity of a sustainable business strategy positively affects competitiveness. The used method is the critical analysis. Among other results of this analysis concludes that the current business strategy seeks a system ecologically appropriate, economically viable and socially fair to reach sustainable equilibrium. This strategy based on sustainability must be promoted by the institutions and strengthened by the capabilities and resources that each company counts on to develop advantages to foster the overall development and achieve the maximization of benefits from the tangible and intangible perspectives

  19. Nutrition and the dialysis prescription.

    Science.gov (United States)

    Chertow, G M; Bullard, A; Lazarus, J M

    1996-01-01

    Malnutrition is common among patients with acute and chronic renal failure. The efficiency of modern dialytic techniques has allowed for more liberal administration of nutrients to patients with renal failure, particularly with regard to protein and amino acids. Protein restriction is not indicated for patients on dialysis, and should be employed cautiously, if at all, in patients with renal insufficiency. The 'nutrition prescription' should be considered a vital part of the comprehensive medical, surgical, and dialytic care provided to patients with renal disease.

  20. Anxiety disorders in dialysis patients

    OpenAIRE

    Novaković Milan

    2007-01-01

    Introduction. Anxiety, as a primary symptom, includes all conditions of indefinite fear and psychic disorders dominated by fear. All dialysis patients suffer from anxiety as an independent phenomenon, or as part of another disease. Material and Methods. This study included 753 patients on chronic hemodialysis in Bosnia and Herzegovina (B&H) in the period 1999-2004. The patients were divided into two groups: the first group included 348 patients with Balkan Endemic Nephropathy (BEN), and t...

  1. Prophylactic dialysis in non-dialysis-dependent patients with renal failure after CABG

    Directory of Open Access Journals (Sweden)

    Roghayyeh Borji

    2014-03-01

    Conclusion: According the results of this study, prophylactic dialysis, before conduct-ing CABG, does not have any significant effect on mortality and other complications. The only exception is lung complications in non-dialysis-dependent patients with renal failure.

  2. Development Strategy for Mobilecommunications Market in Chinese Rural Area

    Science.gov (United States)

    Zhang, Liwei; Zhang, Yanjun; Xu, Liying; Li, Daoliang

    Based on full analysis of rural mobile communication market, in order to explore mobile operators in rural areas of information services for sustainable development model, this paper presents three different aspects, including rural mobile communications market demand, the rural market for mobile communications business model and development strategies for rural mobile communications market research business. It supplies some valuable references for operators to develop rural users rapidly, develop the rural market effectively and to get access to develop a broad space.

  3. Rationale for a home dialysis virtual ward: design and implementation.

    Science.gov (United States)

    Schachter, Michael E; Bargman, Joanne M; Copland, Michael; Hladunewich, Michelle; Tennankore, Karthik K; Levin, Adeera; Oliver, Matthew; Pauly, Robert P; Perl, Jeffrey; Zimmerman, Deborah; Chan, Christopher T

    2014-02-14

    Home-based renal replacement therapy (RRT) [peritoneal dialysis (PD) and home hemodialysis (HHD)] offers independent quality of life and clinical advantages compared to conventional in-center hemodialysis. However, follow-up may be less complete for home dialysis patients following a change in care settings such as post hospitalization. We aim to implement a Home Dialysis Virtual Ward (HDVW) strategy, which is targeted to minimize gaps of care. The HDVW Pilot Study will enroll consecutive PD and HHD patients who fulfilled any one of our inclusion criteria: 1. following discharge from hospital, 2. after interventional procedure(s), 3. prescription of anti-microbial agents, or 4. following completion of home dialysis training. Clinician-led telephone interviews are performed weekly for 2 weeks until VW discharge. Case-mix (modified Charlson Comorbidity Index), symptoms (the modified Edmonton Symptom Assessment Scale) and patient satisfaction are assessed serially. The number of VW interventions relating to eight pre-specified domains will be measured. Adverse events such as re-hospitalization and health-services utilization will be ascertained through telephone follow-up after discharge from the VW at 2, 4, 12 weeks. The VW re-hospitalization rate will be compared with a contemporary cohort (matched for age, gender, renal replacement therapy and co-morbidities). Our protocol has been approved by research ethics board (UHN: 12-5397-AE). Written informed consent for participation in the study will be obtained from participants. This report serves as a blueprint for the design and implementation of a novel health service delivery model for home dialysis patients. The major goal of the HDVW initiative is to provide appropriate and effective supports to medically complex patients in a targeted window of vulnerability. (NCT01912001).

  4. Indications for vancomycin in dialysis patients.

    Science.gov (United States)

    Golper, T A; Schulman, G; D'Agata, E M

    2000-01-01

    Resistance to vancomycin has emerged among Staphylococcus aureus, coagulase-negative staphylococci (CNS), and enterococci, and this emergence has particular prevalence in dialysis units. It has therefore become imperative that physicians use vancomycin judiciously. General recommendations regarding the appropriate use of vancomycin have been developed. Although in theory implementation of these guidelines should not be difficult, the medical community may be unable or unwilling to make the necessary adjustments in practice. The onslaught of cost constraints and bureaucratic encumbrance has occurred simultaneously with the increase in vancomycin resistance among pathogens commonly isolated among the dialysis population. When a patient responds to empiric antibiotic therapy and susceptibility data indicate that an antibiotic other than vancomycin would be appropriate, the clinician far too often does not make the change to this alternative. Previously there was no biological imperative to change the antibiotic. That complacency has infected an entire generation of physicians, and especially nephrologists. Furthermore, there is an active movement against change, driven by concerns such as malpractice accusations and frank errors in the interpretation of medical facts.

  5. Biocompatible Peritoneal Dialysis Fluids: Clinical Outcomes

    Directory of Open Access Journals (Sweden)

    Yeoungjee Cho

    2012-01-01

    Full Text Available Peritoneal dialysis (PD is a preferred home dialysis modality and has a number of added advantages including improved initial patient survival and cost effectiveness over haemodialysis. Despite these benefits, uptake of PD remains relatively low, especially in developed countries. Wider implementation of PD is compromised by higher technique failure from infections (e.g., PD peritonitis and ultrafiltration failure. These are inevitable consequences of peritoneal injury, which is thought to result primarily from continuous exposure to PD fluids that are characterised by their “unphysiologic” composition. In order to overcome these barriers, a number of more biocompatible PD fluids, with neutral pH, low glucose degradation product content, and bicarbonate buffer have been manufactured over the past two decades. Several preclinical studies have demonstrated their benefit in terms of improvement in host cell defence, peritoneal membrane integrity, and cytokine profile. This paper aims to review randomised controlled trials assessing the use of biocompatible PD fluids and their effect on clinical outcomes.

  6. Model strategy for village development in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Ladislav ROLÍNEK

    2015-03-01

    Full Text Available The model strategies discussed in this article represent different ways of possible village development in the Czech Republic. We used typologies of strategies from business strategic management for their definition. Twenty municipalities, where structured interviews were carried out with their mayors, were chosen randomly from among 100 villages where a questionnaire survey was conducted in 2012 (Faltová Leitmanová, et al., 2012. Based on the qualitative analysis of the structured interview summaries, eight model strategies were ascertained. These include integration strategy, service differentiation, spending cuts, usage of municipal property, stabilization of village population, business support, fundraising, and identification of the inhabitants with the village (village pride. The most commonly applied model strategy is integration, followed by village population stabilization.

  7. Features of the Development Strategy Customer Relationship Management

    Directory of Open Access Journals (Sweden)

    I. M. Gurova

    2017-01-01

    Full Text Available Purpose: in the current economic situation one of the main conditions of competitiveness of the company is its customer focus. In this regard, the most promising strategy for strengthening the stability of the organization is the management of customer relationships.The presented article explores the process of developing a customer relationship management strategy. This is a crucial, fundamental stage, from the very outcome of which the very possibility of achieving the organization's global goal depends to a large extent. Therefore, the development of a strategy requires deep reflection and qualitative elaboration. The aim of this work is to identify specific features of development of strategy of customer relationship management through the systematization of theoretical and methodological framework and a detailed consideration of the algorithm of this process. Methods: the methodology of the study is based on the application of universal scientific methods of analysis and synthesis, analogy and modeling. In the process of collecting and collating data used content analysis, comparative analysis, methods of induction and deduction, system approach. Functional, strategic and economic analysis, methods of formalization, forecasting and expert assessments are used to generalize information and solve assigned tasks. Results: in the process of the study, a common algorithm for creating a customer relationship management strategy was developed. In particular, its main stages have been identified; the processes of solving the most important problems have been singled out and studied in detail. In addition, the article substantiates the basic theoretical and methodological guidelines, as well as the practical aspects of development of this type of strategy. Conclusions and Relevance: the main feature of development of the strategy of customer relationship management is the focus on the value characteristics of the analyzed elements. This is due to

  8. Cognitive Impairment in Non-Dialysis-Dependent CKD and the Transition to Dialysis: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.

    Science.gov (United States)

    Harhay, Meera N; Xie, Dawei; Zhang, Xiaoming; Hsu, Chi-Yuan; Vittinghoff, Eric; Go, Alan S; Sozio, Stephen M; Blumenthal, Jacob; Seliger, Stephen; Chen, Jing; Deo, Rajat; Dobre, Mirela; Akkina, Sanjeev; Reese, Peter P; Lash, James P; Yaffe, Kristine; Tamura, Manjula Kurella

    2018-05-02

    initiation. Future studies may consider addressing cognitive function when testing strategies to improve patient transitions to dialysis therapy. Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  9. Testosterone deficiency in dialysis patients: Differences according to the dialysis techniques

    Directory of Open Access Journals (Sweden)

    Secundino Cigarrán

    2017-09-01

    Conclusions: Circulating testosterone levels in men on dialysis were independently associated with HD technique. It can be concluded that a new factor—namely the dialysis technique—may be associated with falling testosterone levels and the associated loss of muscle mass and inflammation. Further studies are needed to establish whether the dialysis technique itself triggers testosterone elimination.

  10. Protein binding studies with radiolabeled compounds containing radiochemical impurities. Equilibrium dialysis versus dialysis rate determination

    DEFF Research Database (Denmark)

    Honoré, B

    1987-01-01

    The influence of radiochemical impurities in dialysis experiments with high-affinity ligands is investigated. Albumin binding of labeled decanoate (97% pure) is studied by two dialysis techniques. It is shown that equilibrium dialysis is very sensitive to the presence of impurities resulting...

  11. Development and face validation of strategies for improving consultation skills.

    Science.gov (United States)

    Lefroy, Janet; Thomas, Adam; Harrison, Chris; Williams, Stephen; O'Mahony, Fidelma; Gay, Simon; Kinston, Ruth; McKinley, R K

    2014-12-01

    While formative workplace based assessment can improve learners' skills, it often does not because the procedures used do not facilitate feedback which is sufficiently specific to scaffold improvement. Provision of pre-formulated strategies to address predicted learning needs has potential to improve the quality and automate the provision of written feedback. To systematically develop, validate and maximise the utility of a comprehensive list of strategies for improvement of consultation skills through a process involving both medical students and their clinical primary and secondary care tutors. Modified Delphi study with tutors, modified nominal group study with students with moderation of outputs by consensus round table discussion by the authors. 35 hospital and 21 GP tutors participated in the Delphi study and contributed 153 new or modified strategies. After review of these and the 205 original strategies, 265 strategies entered the nominal group study to which 46 year four and five students contributed, resulting in the final list of 249 validated strategies. We have developed a valid and comprehensive set of strategies which are considered useful by medical students. This list can be immediately applied by any school which uses the Calgary Cambridge Framework to inform the content of formative feedback on consultation skills. We consider that the list could also be mapped to alternative skills frameworks and so be utilised by schools which do not use the Calgary Cambridge Framework.

  12. Human Resource Development Issues in the Implementation of the Western China Development Strategy

    Science.gov (United States)

    Xiao, Mingzheng

    2007-01-01

    This paper systematically illustrates the value and role of human resource development in the implementation of the Western China development strategy. It analyzes in details some current human resource issues constraining the implementation of the Western China development strategy and those on the sustainable development process of economic…

  13. Strategies for Designing and Developing Services for Manufacturing Firms

    DEFF Research Database (Denmark)

    Tan, Adrian; Matzen, Detlef; McAloone, Tim C.

    2009-01-01

    Product/service-systems (PSS) are in effect an approach to designing integrated products and services with a focus on both customer activities and product life cycle considerations. Literature offers a range of serviceoriented design strategies from product-oriented DfX approaches to more customer......-oriented approaches such as integrated solutions and service design. These design strategies are mapped out in relation to how applicable they are to different types of services. Case studies from two industrial companies are used to confront the existing literature in order to begin to understand how manufacturing...... companies may align their business strategies with their product and service development activities....

  14. Strategies for Designing and Developing Services for Manufacturing Firms

    DEFF Research Database (Denmark)

    Tan, Adrian Ronald; Matzen, Detlef; McAloone, Tim C.

    2010-01-01

    Product/service-systems (PSS) are in effect an approach to designing integrated products and services with a focus on both customer- and product life cycleactivities . Literature offers a range of service-oriented design strategies from product-oriented DfX approaches to more customer...... manufacturing companies may align their product and service development activities with their business strategies.......-oriented approaches such as integrated solutions and service design. These design strategies are mapped out in relation to how applicable they are to different types of services. Case studies from two industrial companies are used to confront the existing literature in order to improve understanding of how...

  15. Development and face validation of strategies for improving consultation skills

    OpenAIRE

    Lefroy, J; Thomas, A; Harrison, C; Williams, S; O'Mahony, F; Gay, S; Kinston, R; McKinley, RK

    2014-01-01

    While formative workplace based assessment can improve learners' skills, it often does not because the procedures used do not facilitate feedback which is sufficiently specific to scaffold improvement. Provision of pre-formulated strategies to address predicted learning needs has potential to improve the quality and automate the provision of written feedback. To systematically develop, validate and maximise the utility of a comprehensive list of strategies for improvement of consultation skil...

  16. Developing a promotional strategy: important questions for social marketing.

    Science.gov (United States)

    Thackeray, Rosemary; Neiger, Brad L; Hanson, Carl L

    2007-10-01

    Health practitioners often use the terms marketing and promotion interchangeably. Yet, promotion is just one element of an overall marketing strategy. To realize the greatest impact there must be a combination of all the marketing components, including product, price, place, and promotion. The purpose of this article is to clarify the role of promotion and describe key elements of developing a promotional strategy within the broader context of a social marketing initiative.

  17. MARKETING STRATEGIES IN THE DEVELOPMENT AND IMPLEMENTATION OF THE PROJECT

    Directory of Open Access Journals (Sweden)

    Дмитрий Георгиевич БЕЗУГЛЫЙ

    2015-05-01

    Full Text Available The article is devoted to marketing in project management, as the scope of activities aimed at improving the quality characteristics of the project for its further effective market promotion in an increasingly competitive environment. Particular attention is paid to marketing strategies during the development and subsequent sale of the project to the investor. The problem of effective combination of marketing strategies and project management process is being solved.

  18. An Analytic Framework to Support E.Learning Strategy Development

    Science.gov (United States)

    Marshall, Stephen J.

    2012-01-01

    Purpose: The purpose of this paper is to discuss and demonstrate the relevance of a new conceptual framework for leading and managing the development of learning and teaching to e.learning strategy development. Design/methodology/approach: After reviewing and discussing the research literature on e.learning in higher education institutions from…

  19. Staff Development Strategies for School Library and Media Centres ...

    African Journals Online (AJOL)

    Staff Development is a sine-qua non to the provision of efficient library services at any level. The study sets to investigate staff development strategies in school libraries and Information centres in Owerri, Imo State Nigeria. Selfdesigned questionnaires were used in eliciting data for the study. Ten schools were used with 10 ...

  20. Development Options as Strategies for Conflict Reduction in ...

    African Journals Online (AJOL)

    This paper explores development options as effective strategies for conflict reduction in the Cross River National Park, Nigeria. It also discusses the tensions that result from the different development and conservation priorities that confront such humaninhabited protected areas as the Cross River National Park. The success ...

  1. Strategies in development of advanced fuels for LMFBR

    International Nuclear Information System (INIS)

    Handa, Muneo

    1976-12-01

    Overseas strategies in development of advanced fuels for LMFBR are reviewed. Recent irradiation experiment and out-of-pile test data of the fuels are given in detail. The present status of development of oxide fueled LMFBR is also treated. (auth.)

  2. Staff development strategies for school library media centres: a case ...

    African Journals Online (AJOL)

    Staff development is a sine-qua non to the provision of efficient library services at any level. The study sets to investigate staff development strategies in school libraries and Information centres in Owerri, Imo State Nigeria. Self-designed questionnaires were used in eliciting data for the study. Ten schools were used with 10 ...

  3. Reimbursement and economic factors influencing dialysis modality choice around the world

    Science.gov (United States)

    Just, Paul M.; de Charro, Frank Th.; Tschosik, Elizabeth A.; Noe, Les L.; Bhattacharyya, Samir K.; Riella, Miguel C.

    2008-01-01

    The worldwide incidence of kidney failure is on the rise and treatment is costly; thus, the global burden of illness is growing. Kidney failure patients require either a kidney transplant or dialysis to maintain life. This review focuses on the economics of dialysis. Alternative dialysis modalities are haemodialysis (HD) and peritoneal dialysis (PD). Important economic factors influencing dialysis modality selection include financing, reimbursement and resource availability. In general, where there is little or no facility or physician reimbursement or payment for PD, the share of PD is very low. Regarding resource availability, when centre HD capacity is high, there is an incentive to use that capacity rather than place patients on home dialysis. In certain countries, there is interest in revising the reimbursement structure to favour home-based therapies, including PD and home HD. Modality selection is influenced by employment status, with an association between being employed and PD as the modality choice. Cost drivers differ for PD and HD. PD is driven mainly by variable costs such as solutions and tubing, while HD is driven mainly by fixed costs of facility space and staff. Many cost comparisons of dialysis modalities have been conducted. A key factor to consider in reviewing cost comparisons is the perspective of the analysis because different costs are relevant for different perspectives. In developed countries, HD is generally more expensive than PD to the payer. Additional research is needed in the developing world before conclusive statements may be made regarding the relative costs of HD and PD. PMID:18234844

  4. Mangrove area development strategy wonorejo as ecotourism in surabaya

    Science.gov (United States)

    Murtini, S.; Kuspriyanto; Kurniawati, A.

    2018-01-01

    Wonorejo mangrove ecotourism is a natural attraction that is increasingly in demand by the community. From year to year, this mangrove ecotourism shows an increase in the number of visitors so it is necessary to know the carrying capacity and development strategy to keep visitors comfortable in the location of tourism. The purpose of this research is to determine development strategies undertaken by the government. The research approach is descriptive quantitative by using survey method. The subject of research is the management of ecotourism area while the object of research includes mangrove, biota object and wide of an area. Sources of data obtained from interviews with parties related to the management of mangrove eco-tourism Wonorejo. Development strategy by using SWOT analysis. The results showed that the collation of the I-EFAS value indicates the position of P (2,35: 2,61) in quadrant I or growth, it’s the right strategy for the development of Wonorejo mangrove eco-tourism area is an aggressive strategy.

  5. A pyruvate-buffered dialysis fluid induces less peritoneal angiogenesis and fibrosis than a conventional solution

    NARCIS (Netherlands)

    van Westrhenen, Roos; Zweers, Machteld M.; Kunne, Cindy; de Waart, Dirk R.; van der Wal, Allard C.; Krediet, Raymond T.

    2008-01-01

    BACKGROUND: Conventional lactate-buffered peritoneal dialysis (PD) fluids containing glucose and glucose degradation products are believed to contribute to the development of fibrosis and angiogenesis in the dialyzed peritoneum. To reduce potential negative effects of lactate, pyruvate was

  6. [Patients' opinions and expectations about the dialysis care process].

    Science.gov (United States)

    Prieto, M A; Escudero, M J; Suess, A; March, J C; Ruiz, A; Danet, A

    2011-01-01

    To determine the experiences and needs of patients on dialysis, in order to identify critical points of the care process and develop proposals for improvement. Qualitative study using semistructured interviews with 22 patients on hemodialysis and peritoneal dialysis, from the Andalusian Health Service. Discourse analysis, using the SERVQUAL model. Triangulation of results. The diagnostic stage is described as the hardest moment as it requires acceptance of the disease. During hemodialysis, we see both positive adaptation and the perception of a diminished quality of life. The technique of peritoneal dialysis is evaluated positively, enabling greater independence, despite requiring more responsibility for self care. The contact with patients' organizations or the provision of a counseling service are valued as an aid in the process. With respect to different dimensions of the SERVQUAL model, human treatment and professional competence are valued. The critical points are lack of coordination, malfunctioning of transportation and lack of transparency in the management of waiting lists. Shortcomings in dealing with informal caregivers and the level of knowledge of professionals from areas other than Nephrology, also appear as deficiencies. The main proposals for improving the dialysis process are: attention to psychosocial aspects, the improvement of organizational aspects such as transport, and greater attention to informal caregivers.

  7. Preparing emergency personnel in dialysis: a just-in-time training program for additional staffing during disasters.

    Science.gov (United States)

    Stoler, Genevieve B; Johnston, James R; Stevenson, Judy A; Suyama, Joe

    2013-06-01

    There are 341 000 patients in the United States who are dependent on routine dialysis for survival. Recent large-scale disasters have emphasized the importance of disaster preparedness, including supporting dialysis units, for people with chronic disease. Contingency plans for staffing are important for providing continuity of care for a technically challenging procedure such as dialysis. PReparing Emergency Personnel in Dialysis (PREP-D) is a just-in-time training program designed to train individuals having minimum familiarity with the basic steps of dialysis to support routine dialysis staff during a disaster. A 5-module educational program was developed through a collaborative, multidisciplinary effort. A pilot study testing the program was performed using 20 nontechnician dialysis facility employees and 20 clinical-year medical students as subjects. When comparing pretest and posttest scores, the entire study population showed a mean improvement of 28.9%, with dialysis facility employees and medical students showing improvements of 21.8% and 36.4%, respectively (P just-in-time training format. The knowledge gained by using the PREP-D program during a staffing shortage may allow for continuity of care for critical services such as dialysis during a disaster.

  8. Conditions and strategies for integrating ergonomics into product development

    DEFF Research Database (Denmark)

    Broberg, Ole

    1996-01-01

    Ergonomics considerations at the stage of product development in industry is a major strategy for prevention of work-related injuries and illnesses among employees at the time of manufacture of new products. This study elucidates some important conditions and possibilities for integrating...... such considerations during the product development process. Special attention is paid to the role of design and production engineers. Based on different understandings of the product development process four approaches to integration of ergonomics are outlined....

  9. New Technological Platform for the National Nuclear Energy Strategy Development

    Science.gov (United States)

    Adamov, E. O.; Rachkov, V. I.

    2017-12-01

    The paper considers the need to update the development strategy of Russia's nuclear power industry and various approaches to the large-scale nuclear power development. Problems of making decisions on fast neutron reactors and closed nuclear fuel cycle (NFC) arrangement are discussed. The current state of the development of fast neutron reactors and closed NFC technologies in Russia is considered and major problems are highlighted.

  10. Lipofection strategy for the study of Xenopus retinal development.

    Science.gov (United States)

    Ohnuma, Shin-ichi; Mann, Fanny; Boy, Sébastien; Perron, Muriel; Harris, William A

    2002-12-01

    The analysis of gene function during retinal development can be addressed by perturbing gene expression either by inhibition or by overexpression in desired regions and at defined stages of development. An in vivo lipofection strategy has been applied for stage-specific and region-specific expression of genes in Xenopus retina. Due to colipofection efficiency, this strategy enables us to study functional interaction of genes by lipofecting multiple expression constructs. This lipofection technique also allows us to transfect morpholino oligonucleotides into retinoblasts to block gene function. We present here various aspects of this technique, including recent improvements and modifications.

  11. Increasing loyalty to breastfeeding: investigating a product development strategy.

    Science.gov (United States)

    Parkinson, Joy; Russell-Bennett, Rebekah; Previte, Josephine

    2012-01-01

    This article demonstrates how social marketing insights were used to influence women's loyalty to breastfeeding. The article reports on a social marketing campaign undertaken by the Australian Breastfeeding Association and a government health department, which used a product development strategy in order to increase breastfeeding loyalty. Seeking new approaches to support breastfeeding behaviors is critical and timely, because while initiation rates of breastfeeding are high in developed countries such as the United Kingdom, Australia, Canada, and the United States, duration rates are significantly lower. Results indicate that a product- focused strategy influences pregnant women's loyalty to exclusively breastfeeding.

  12. Economic strategies to maximize profits from satellite field developments

    International Nuclear Information System (INIS)

    Antia, D.D.J.

    1994-01-01

    The main strategies that can be used to maximize profits from integrated satellite field developments are: (1) restructuring the cost, production and revenue profile of the satellite field; and (2) increasing the volume of oil/gas processed, and available for future use, by the central processing and distribution facility through: (a) using a combined strategy of low tariffs, volume discount, and netback agreements; (b) using reusable facilities, shared facilities, extended reach wells, contractor finance, partnering agreements, netback agreements, oil/gas price swaps; and (c) improving development, discovery and exploration efficiency

  13. Making of Croatian Low-Emission Development Strategy

    International Nuclear Information System (INIS)

    Bartle, B.; Herencic, L.; Kordic, Z.; Pasicko, R.; Vlasic, S.

    2012-01-01

    A Low-Emission Development Strategy (LEDS) is a national, high-level, comprehensive, long-term strategy, developed by domestic stakeholders, which aims at decoupling economic growth and social development from greenhouse gas (GHG) emissions growth. Croatia has begun to join the growing list of countries in the world that have already developed a long-term strategy for low-emissions development and thereby take the road of sustainable development. The 16th Conference of the Parties'' (COP), held in Cancun in December 2010, adopted the Cancun Agreements - a historic set of decisions laying the foundation to tackle climate change through a new post-2012 regime. The Cancun Agreements ''encourages governments to prepare low-carbon development strategies in the context of sustainable development.'' and ''realizes that addressing climate change requires a paradigm shift towards building a low-carbon society that offers substantial opportunities and ensures continued high growth and sustainable development''. Recently the European Commission adopted a Roadmap for transforming the European Union into a competitive low carbon economy by 2050. The Roadmap describes the cost-effective pathway to reach the EU's objective of cutting greenhouse gas emissions by 80-95% of 1990 levels by 2050. On the domestic level, the LEDS is a country-driven policy instrument for national decision making. The LEDS supports sector transformation through a national, economy-wide approach. On the international level, LEDS support the global goal of GHG emission reduction. The Croatian Ministry of Environmental and Nature Protection in cooperation with United Nations Development Programme (UNDP) Croatia will design and implement the Low-Emissions Development Strategy (LEDS) under project titled ''Supporting RBEC countries transition to low-emission development''. The LEDS merges climate change action with national sustainable development and helps to identify and prioritize nationally appropriate

  14. STRATEGIES FOR DEVELOPING SUSTAINABLE AND COMPETITIVE CLUSTER FOR SHRIMP INDUSTRY

    Directory of Open Access Journals (Sweden)

    Anas M. Fauzi

    2012-09-01

    Full Text Available Kampung Vannamei as shrimp cluster is being developed since 2004 by PT CP Prima, tbk Surabaya through Shrimp Culture Health Management transformation technology to several traditional farmers in Gresik, Lamongan, Tuban, and Madura areas. The research objectives aims to identify and mapping of stakeholder, to analyze interaction of stakeholders, to formulate strategy from internal and external environment factors and to set priority on strategy to develop sustainable and competitive shrimp cluster in the Kampung vannamei. Primary data was collected through stakeholders’ discussion forums, questionnaires, and interviews with relevant actors. Observations to the business unit also performed to determine the production and business conditions, particularly in capturing information about the threat and challenges. While the secondary data is used in policy documents national and local area statistics, and relevant literature. Analyses were performed by using the SRI International cluster pyramid, diamond porter’s analysis, SWOT and Matrix TOWS analysis, and analytical hierarchy process. Analyses were performed by the methods discussed in qualitative and descriptive. There are 7 strategies could be implemented to develop sustainable and competitive shrimp cluster. However, it is recommended to implement the strategy base on priority, which the first priority is strategy to improve linkages between businesses in the upstream and downstream industries into multi stakeholders’ platform in shrimp industry.Keywords: Shrimp, Cluster, Competitiveness, Diamond Porter, SWOT Analysis, AHP

  15. Effect of water deionisers on 'fracturing osteodystrophy' and dialysis encephalopathy in Plymouth.

    Science.gov (United States)

    Leather, H M; Lewin, I G; Calder, E; Braybrooke, J; Cox, R R

    1981-01-01

    In the Plymouth area, 95 patients with end-stage renal failure have undergone haemodialysis for 6 months or longer. Of the 47 patients beginning dialysis between 1967 and 1973, when water deionisers were not used routinely, a bone disease with multiple fractures, 'fracturing osteodystrophy', occurred in 18 patients and dialysis encephalopathy in 10. Of the 48 patients first dialysing between 1974 and 1979, when water deionisers used commonly, fracturing osteodystrophy occurred in only one and dialysis encephalopathy also in only one. Duration of dialysis without a water deioniser appeared to be the most important factor in the development of these two conditions. The use of water deionisers usually led to healing of fractures in patients with fracturing osteodystrophy and also led to improvement in 4 of the 11 patients with dialysis encephalopathy. Neither condition has occurred in any patient using a water deioniser from the first dialysis. Water deionisers, therefore, appeared to be effective in both the treatment and prevention of fracturing osteodystrophy and dialysis encephalopathy.

  16. Clinical Causes of Inflammation in Peritoneal Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Yeoungjee Cho

    2014-01-01

    Full Text Available Inflammation at both systemic and local intraperitoneal levels commonly affects peritoneal dialysis (PD patients. Interest in inflammatory markers as targets of therapeutic intervention has been considerable as they are recognised as predictors of poor clinical outcomes. However, prior to embarking on strategies to reduce inflammatory burden, it is of paramount importance to define the underlying processes that drive the chronic active inflammatory status. The present review aims to comprehensively describe clinical causes of inflammation in PD patients to which potential future strategies may be targeted.

  17. THE DEVELOPMENT OF BIOLOGY MATERIAL RESOURCES BY METACOGNITIVE STRATEGY

    Directory of Open Access Journals (Sweden)

    Endang Susantini

    2016-02-01

    Full Text Available The Development of Biology Material Resources by Metacognitive Strategy The study was aimed at finding out the suitability of Biology Materials using the metacognitive strategy. The materials were textbooks, self-understanding Evaluation Sheet and the key, lesson plan, and tests including the answer key. The criteria of appropriateness included the relevance of the resources with the content validity, face va­lidity and the language. This research and development study was carried out employing a 3D model, namely define, design and develop. At the define stage, three topics were selected for analysis, they were virus, Endocrine System, and Genetic material. During the design phase, the physical appearance of the materials was suited with the Metacognitive Strategy. At the develop phase, the material resources were examined and validated by two Biology experts and senior teachers of Biology. The results showed that the Biology material Resources using Metacognitive Strategy developed in the study has fell into the category of very good ( score > 3.31 and was therefore considered suitable.

  18. Dialysis: Reducing Infections and Changing Culture

    Centers for Disease Control (CDC) Podcasts

    2018-03-19

    This podcast is an account from an infection preventionist about the challenges and successes with engaging dialysis care teams to focus on “Zero Preventable Infections” in outpatient dialysis facilities.  Created: 3/19/2018 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 3/19/2018.

  19. The development and implementation of a waste management strategy

    International Nuclear Information System (INIS)

    Fairhall, G.A.; Vickery, P.; Edmiston, L.

    1999-01-01

    Over the past forty years BNFL has operated 4 nuclear sites in the UK. Commercial operations on these sites span the full nuclear fuel cycle from enrichment, fuel fabrication, electricity generation, reprocessing, waste management, and decommissioning. Through the recent merger with Magnox Electric BNFL has acquired a further 8 Magnox reactor sites in the UK. Prior to 1980 BNFL adopted a policy of storing wastes generated by its activities in an unconditioned state in purpose built stores. This paper shows how BNFL's waste management strategy has developed to ensure how volume reduction technologies have been implemented for low level waste. Whilst immobilisation technologies have been implemented for high and intermediate level wastes. The paper describes how continual review of the strategy ensures waste management processes are continually monitored against progress and optimised to ensure all waste arisings are conditioned for final disposal. Finally the paper will show how the strategy can be used to develop waste management plans for customer sites. (author)

  20. Optimum strategies for nuclear energy system development (method of synthesis)

    International Nuclear Information System (INIS)

    Belenky, V.Z.

    1983-01-01

    The problem of optimum long-term development of the nuclear energy system is considered. The optimum strategies (i.e. minimum total uranium consumption) for the transition phase leading to a stationary regime of development are found. For this purpose the author has elaborated a new method of solving linear problems of optimal control which can include jumps in trajectories. The method gives a possibility to fulfil a total synthesis of optimum strategies. A key characteristic of the problem is the productivity function of the nuclear energy system which connects technological system parameters with its growth rate. There are only two types of optimum strategies, according to an increasing or decreasing productivity function. Both cases are illustrated with numerical examples. (orig.) [de

  1. Development of Strategy Generator for PWRs Core Maneuver

    International Nuclear Information System (INIS)

    Deswandri

    2003-01-01

    Generally, nuclear power plants are utilized for base-load operation. However, if the nuclear capacity constitutes a large fraction of the total electric capacity in a country, the ability of nuclear power plants to perform load following operation is inevitable. In the load following operation, the reactor power is adjusted based on the fluctuation of electric power demand in the grid. That changes of power level can cause unbalance in the reactor, therefore, the control actions should be done during the power maneuvering. In order that the control actions could be effective and efficient, guidance for the reactor operators is needed. Strategy generator refers to a tool which provides guidance for operators as to control actions to be taken. This work developed the strategy generator based on the three concepts of control strategy. By numerical simulation, performance of these three strategies was tested and compared. The simulation result shows the unique characteristic for each strategy and discussion was provided to evaluate the abilities of each strategy in achieving the control targets. (author)

  2. Update on dialysis economics in the UK.

    Science.gov (United States)

    Sharif, Adnan; Baboolal, Keshwar

    2011-03-01

    The burgeoning population of patients requiring renal replacement therapy contributes a disproportionate strain on National Health Service resources. Although renal transplantation is the preferred treatment modality for patients with established renal failure, achieving both clinical and financial advantages, limitations to organ donation and clinical comorbidities will leave a significant proportion of patients with established renal failure requiring expensive dialysis therapy in the form of either hemodialysis or peritoneal dialysis. An understanding of dialysis economics is essential for both healthcare providers and clinical leaders to establish clinically efficient and cost-effective treatment modalities that maximize service provision. In light of changes to the provision of healthcare funds in the form of "Payment by Results," it is imperative for UK renal units to adopt clinically effective and financially accountable dialysis programs. This article explores the role of dialysis economics and implications for UK renal replacement therapy programs.

  3. Problem Analysis: Application in Developing Marketing Strategies for Colleges.

    Science.gov (United States)

    Martin, John; Moore, Thomas

    1991-01-01

    The problem analysis technique can help colleges understand students' salient needs in a competitive market. A preliminary study demonstrates the usefulness of the approach for developing strategies aimed at maintaining student loyalty and improving word-of-mouth promotion to other prospective students. (Author/MSE)

  4. The development of a strategy for the facilitation of income ...

    African Journals Online (AJOL)

    The development of a strategy for the facilitation of income-generating projects in rural communities: an insider account. ... helpful Frequently Asked Questions about PDFs. Alternatively, you can download the PDF file directly to your computer, from where it can be opened using a PDF reader. To download the PDF, click the ...

  5. A Study on Developing Learning Strategies in Violin Education

    Science.gov (United States)

    Afacan, Senol; Cilden, Seyda

    2018-01-01

    This study was conducted for the purpose of developing a valid and reliable learning strategies scale for students receiving violin education in Departments of Music at Fine Arts High Schools. The scale was applied to 391 violin students receiving education in the 11th and 12th grades in Departments of Music at Fine Arts High Schools in the…

  6. Exploring the Relationship between Listening Development and Strategy Use

    Science.gov (United States)

    Graham, Suzanne; Santos, Denise; Vanderplank, Robert

    2011-01-01

    This article reports on an investigation into the development of the listening proficiency and strategic behaviour of 15 lower-intermediate learners of French in England. We consider whether listeners remain in the same listening proficiency group after six months, and whether changes in strategy use are related to movement or non-movement between…

  7. State Sector Strategies: The New Workforce Development in the USA

    Science.gov (United States)

    Lakes, Richard D.

    2012-01-01

    Neoliberal governments consider global business competitiveness to be thwarted by costly bureaucratic regulation and programme duplication. In an effort to downsize the costs of operating a state, the governors now streamline job training functions via a coordinated workforce and economic development effort known as sector strategies, with…

  8. Modeling Coherent Strategies for the Sustainable Development Goals

    Science.gov (United States)

    Walsh, B.; Obersteiner, M.; Herrero, M.; Riahi, K.; Fritz, S.; van Vuuren, D.; Havlik, P.

    2016-12-01

    The Sustainable Development Goals (SDGs) call for a comprehensive new approach to development rooted in planetary boundaries, equity and inclusivity. Societies have largely responded to this call with siloed strategies capable of making progress on selected subsets of these goals. However, agendas crafted specifically to alleviate poverty, hunger, deforestation, biodiversity loss, or other ills may doom the SDG agenda, as policies and strategies designed to accomplish one or several goals can impede and in some cases reverse progress toward others at national, regional, and global levels. We adopt a comprehensive modeling approach to understand the basis for tradeoffs among environmental conservation initiatives (goals 13-15) and food prices (goal 2). We show that such tradeoffs are manifestations of policy-driven pressure in land (i.e. agricultural and environmental) systems. By reducing total land system pressure, Sustainable Consumption and Production (SCP, goal 12) policies minimize tradeoffs and should therefore be regarded as necessary conditions for achieving multiple SDGs. SDG strategies constructed around SCP policies escape problem-shifting, which has long placed global development and conservation agendas at odds. We expect that this and future systems analyses will allow policymakers to negotiate tradeoffs and exploit synergies as they assemble sustainable development strategies equal in scope to the ambition of the SDGs.

  9. The development strategies of the european electric power companies

    International Nuclear Information System (INIS)

    Heddebaud, D.

    2005-01-01

    This study takes stock on the european market of the electric power and of its development perspectives. It details the strategy and the place of the main operators and shows their forces and weaknesses. It provides a comparison of the financial performances of 28 companies (growth, margins, profitability, debt and war chest). (A.L.B.)

  10. User Studies: Developing Learning Strategy Tool Software for Children.

    Science.gov (United States)

    Fitzgerald, Gail E.; Koury, Kevin A.; Peng, Hsinyi

    This paper is a report of user studies for developing learning strategy tool software for children. The prototype software demonstrated is designed for children with learning and behavioral disabilities. The tools consist of easy-to-use templates for creating organizational, memory, and learning approach guides for use in classrooms and at home.…

  11. The Development of Visual Search Strategies in Biscriptal Readers.

    Science.gov (United States)

    Liow, Susan Rikard; Green, David; Tam, Melissa

    1999-01-01

    To test whether cognitive processing in bilingual depends on script combinations and language proficiency, this study investigated the development of alphabetic and logographic visual search strategies in two kinds of biscriptals: (1) Malay-English and (2) Chinese-English readers. Results support the view that there are script implications of…

  12. Paving the way for low-carbon development strategies

    International Nuclear Information System (INIS)

    Van Tilburg, X.; Wuertenberger, L.; De Coninck, H.; Bakker, S.

    2011-09-01

    The aim of this report is to help move forward the discussion on low-carbon development strategies (LCDS) towards a useful climate policy instrument. It does so through a historical perspective on the use of an LCDS in a national and international context in order to provide high-level guidance to governments and experts who plan the development of an LCDS. The ultimate aim of a low-carbon development strategy is to catalyse concrete actions that support development with lower emissions. Therefore the process of LCDS development should not focus narrowly on producing a strategy document. Depending on the national context, an LCDS can serve different audiences and have different purposes, adding robustness to the attainment of mitigation actions. Rather than specifying a target or producing a document, an LCDS should provide a process that, depending on the developing country's readiness, meets needs to develop and to fill capacity, knowledge and information gaps. It should bring stakeholders from government, the private sector and civil society on the same page and eventually lead to greenhouse gas emissions that are lower compared to the situation in which the LCDS process had not been undertaken. International support could be sought for an LCDS process, but should not be made obligatory.

  13. [10 years of external quality assurance in dialysis in Germany: Results and future prospects].

    Science.gov (United States)

    Büchtemann, Dorothea; Meinhold, Stefan; Follert, Peter

    2017-10-01

    In 2006, the Federal Joint Committee introduced a quality assurance programme for ambulatory dialysis treatment in Germany. Regarding the impact of chronic dialysis treatment on the quality of life of patients and on health care costs, quality assurance in dialysis is considered highly relevant. The directive on Quality Assurance in Dialysis (QSD-RL) established an external quality assurance programme on the basis of the assessment of certain quality parameters combined with an internal quality management system based on benchmarking parameters in all dialysis practices and centres. Data on quality parameters are collected and analysed quarterly. Regional associations of statutory health insurance physicians take responsibility for quality improvement measures and sanctions. This article aims to provide an overview of the development of quality parameters from 2008 to 2015. We analysed the summarised annual quality reports published on the website of the Federal Joint Committee between 2009 and 2016. We present results on the so-called core quality parameters duration and frequency of dialysis sessions (both for haemodialysis patients), wKt/V for peritoneal dialysis patients, and percentage of haemodialysis patients with central venous catheters which has only been measured since 2014. In 2015, 92,000 patients received outpatient dialysis. Between 2008 and 2015, the results for the core quality parameters duration and frequency of haemodialysis improved while the results for wKt/V seemingly show an unfavourable trend. The percentage of patients with central venous catheters appears to be quite high, and thus indicates that there is potential for quality improvement. For the future, the Federal Joint Committee has resolved to merge the quality assurance programmes in dialysis and in kidney transplantation into a newly designed programme that has the potential to follow patients through all stages and kinds of renal replacement therapy and to focus on further aspects

  14. Cultural Development Strategies and Urban Gay Tourism Revitalization

    Directory of Open Access Journals (Sweden)

    Jose M Prat Forga

    2015-12-01

    Full Text Available Municipal governments increasingly turn to cultural and leisure activities to promote and revitalize their cities. This study analysed the development of gay tourism in Barcelona (Spain by means of music festivals. While a significant body of literature has examined revitalization strategies that focus primarily around entertainment and commerce, this paper focuses on strategies in the development of cultural and leisure activities around this specific tourism population. It presents findings from a local survey distributed to key stakeholders in the promotion and development of this tourism (local agents and gay tourists. The survey data indicate that although most agents are guided by a varied set of goals, marketing objectives (“image city” and “brand city” guide the development and support of urban gay tourism in Barcelona.

  15. Managing scientists leadership strategies in research and development

    CERN Document Server

    Sapienza, Alice M

    1995-01-01

    Managing Scientists Leadership Strategies in Research and Development Alice M. Sapienza "I found ...this book to be exciting ...Speaking as someone who has spent 30 years grappling with these issues, I certainly would be a customer." -Robert I. Taber, PhD Senior Vice President of Research & Development Synaptic Pharmaceutical Corporation In today's climate of enormous scientific and technologic competition, it is more crucial than ever that scientists involved in research and development be managed well. Often trained as individual researchers, scientists can find integration into teams difficult. Managers, from both scientific and nonscientific backgrounds, who are responsible for these teams frequently find effective team building a long and challenging process. Managing Scientists offers strategies for fostering communication and collaboration among scientists. It shows how to build cohesive, productive, and focused teams to succeed in the competitive research and development marketplace. This book wil...

  16. Strategy for the development and management of deserts

    Energy Technology Data Exchange (ETDEWEB)

    1978-02-01

    Recommendations from the June 1977 Conference on Alternative Strategies for Desert Development and Management apply primarily to arid lands, although some can be applied to true desert with no vegetation as well. The causes of desertification are reviewed and corrective measures suggested for both developed and developing countries. A range of strategies is proposed, but all are based on the efficient use of water and most are concerned with water used for agricultural purposes. The conference papers also addressed water management, agricultural development, field crops versus animal husbandry, grazing, land use and allocation, wild life resources, industry coastal resources, tourism, energy and minerals, and establishing the infrastructure needed to improve and retain desert health.

  17. Risky business for dialysis services.

    Science.gov (United States)

    Schohl, Joseph

    2010-05-01

    When self-insured health plans and their third-party administrators pay an artificially low out-of-network rate for dialysis services, they could be liable for the difference between that rate and the reimbursement level provided for by their health plan. Paying a rate that the repricers advised them to pay does not relieve self-insured health plans and third-party administrators of that obligation; only where the repricer has legitimately secured a negotiated contract rate is a lower payment justified. [Editor's note: The term "repricer" has no universally-accepted or formal definition, but it will be used here to describe those companies formed to act as middlemen between health care payers-like self-insured employer plans and TPAs working on behalf of such plans-and health care providers.] Failing to adhere to this will result in lawsuits against self-insured health plans and third-party administrators where they will be forced to defend the repricers' recommended payment amounts, while the repricers try to get themselves dismissed. A better option for plan holders and third-party administrators would be to negotiate directly with the dialysis providers and agree upon a mutually acceptable rate.

  18. Strategy Development of Community Base Tourism in Tidung Island, Jakarta

    Directory of Open Access Journals (Sweden)

    Dhian Tyas Untari

    2018-05-01

    Full Text Available The aim of thus study is to establish a community-based tourism development strategy in Tidung Island. Researcher use Strategy Management matrix, In this research, tourist entrepreneurs and tourist as an observation unit and is determined as an analysis unit of the company that is the decision makers are very influential in the company itself, including related Human Resources, Finance, Production, and Marketing. Eigen Factor score is use ase the weighting input data from the results of questionnaires. From the questionnaire, a score is obtained from the average given by the respondents at each key success factors, where in the input process the researcher used IFAS / IFAS Matrix, and in the process of strategy formulation, the researcher used the recommendation from the Grand Matrix Strategy output. The results of the output recommendations, which will then be implemented in the development of community-based tourism on the island of Tidung. Based on the Grand Matrix Strategy chart seen that the outline of Tidung Island tourism into the weak category, where the quadrant Challenges and Weaknesses is much greater than the strength and opportunities. Thus the strategy that can be done is with; improve tourism governance by maximizing the function of tourism development programs of DKI Jakarta Province, encouraging the Provincial Government of DKI Jakarta to allocate funds and attention to alternative tourism such as marine tourism located in Kepulauan Seribu, maximizing Community Service Activities of Higher Education as a medium of knowladge community transfer Tidung Island, improving the mode of transportation and increasing the frequency of ship felling Jakarta - Pulau Tidung.

  19. Virtual laboratory strategies for data sharing, communications and development

    Directory of Open Access Journals (Sweden)

    Enrique Canessa

    2006-01-01

    Full Text Available We present an overview of the VL approach to promote research and education in developing countries and to help reduce the technology gap of the digital divide. We discuss software tools for instrument control, data sharing and e-collaboration and communications with special attention to low-bandwidth networks. We analyse the tentative costs involved in VL and the skills needed for VL administration. We conclude by identifying some VL strategies for development.

  20. Developing competitive marketing and sales strategy for HS-Eden

    OpenAIRE

    Dragusha, Cajup

    2016-01-01

    Start-ups are faced with variety of challenges and uncertainty therefore comprehensive marketing and sales strategy must be in place to make sure that limited resources are spend wisely in order to minimize uncertainty and pave a path that would lead to successful business. HS Eden is a new-start-up venture created in Lappeenranta University of Technology with an ambition to develop AMB systems for commercial use. The aim of this study was to build a marketing and sales strategy to help HS-Ed...

  1. Strategy for the development of EU Test Blanket Systems instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Calderoni, P., E-mail: Pattrick.Calderoni@f4e.europa.eu; Ricapito, I.; Poitevin, Y.

    2013-10-15

    Highlights: • We developed a strategy for the development of instrumentation for EU ITER TBSs. • TBSs instrumentation functions: safety, operation and scientific mission. • Described activities are in support of ITER design review process. -- Abstract: The instrumentation of the HCLL and HCPB Test Blanket System is fundamental in ensuring that ITER safety and operational requirements are satisfied as well as in enabling the scientific mission of the TBM program. It carries out three essential functions: (i) safety, intended as compliance with ITER requirements toward public and workers protection; (ii) system control, intended as compliance with ITER operational requirements and investment protection; and (iii) scientific mission, intended as validating technology and predictive tools for blanket concepts relevant to fusion energy systems. This paper describes the strategy for instrumentation development by providing details of the following five steps to be implemented in procured activities in the short to mid-term (3–4 years): (i) provide mapping of sensors requirements based on critical review of preliminary design data; (ii) develop functional specifications for TBS sensors based on the analysis of operative conditions in the various ITER buildings in which they are located; (iii) assess availability of commercial sensors against developed specifications; (iv) develop prototypes when no available solution is identified; and (v) perform single effect tests for the most critical solicitations and post-test examination of commercial products and prototypes. Examples of technology assessment in two technical areas are included to reinforce and complement the strategy description.

  2. Landscape function analysis as a base of rural development strategies

    Directory of Open Access Journals (Sweden)

    Filepné Kovács Krisztina

    2017-11-01

    Full Text Available Research on ecosystem services and landscape functions are highly important in landscape ecology, landscape planning and open space design. The terms of ecosystem service and landscape function have been evolved parallel to each other in the scientific literature but have different focus. The term of landscape functions evolved from the scientific field of landscape ecology; it reflects the goods and services provided by regions, landscapes where the cultural, economic factors are important as well. As a framework assessment method with additional economic assessment, a landscape function analysis could be an additional tool of rural development, as it gives a complex analysis of multiple aspects, thus it is highly appropriate to explore, analyze the potentials, resources and limits of landscapes and land use systems. In the current research a landscape function analysis was compared with the rural development strategies in Hungarian micro-regions. We focused on the level of landscape functions and the objectives of the rural development strategies of the study areas. The local development strategies do not focus on territorial differences nor potentials evolving from natural, cultural resources or local constrains. The only exception is tourism development, where in some cases there is a holistic spatial approach which intends to develop the region as a whole.

  3. Adequacy in dialysis: intermittent versus continuous therapies.

    Science.gov (United States)

    Misra, M; Nolph, K D

    2000-01-01

    A vital conceptual difference between intermittent and continuous dialysis therapies is the difference in the relationship between Kt/V urea and dietary protein intake. For a given level of protein intake the intermittent therapies require a higher Kt/V urea due to the reasons mentioned above. The recently released adequacy guidelines by DOQI for intermittent and continuous therapies are based on these assumptions. The link between adequacy targets and patient survival is well documented for an intermittent therapy like HD. For a continuous therapy like CAPD however, the evidence linking improved peritoneal clearance to better survival is not as direct. However, present consensus allows one to extrapolate results based on HD. The concept of earlier and healthier initiation of dialysis is gaining hold and incremental dialysis forms an integral aspect of the whole concept. Tools like urea kinetic modeling give us valuable insight in making mathematical projections about the timing as well as dosing of dialysis. Daily home hemodialysis is still an underutilized modality despite offering best survival figures. Hopefully, with increasing availability of better and simpler machines its use will increase. Still several questions remain unanswered. Despite availability of data in hemodialysis patients suggesting that an increased dialysis prescription leads to a better survival, optimal dialysis dose is yet to be defined. Concerns regarding methodology of such studies and conclusions thereof has been raised. Other issues relating to design of the studies, variation in dialysis delivery, use of uncontrolled historical standards and lack of patient randomization etc also need to be considered when designing such trials. Hopefully an ongoing prospective randomized trial, namely the HEMO study, looking at two precisely defined and carefully maintained dialysis prescriptions will provide some insight into adequacy of dialysis dose and survival. In diabetic patients, the

  4. Strategies for effective collaborative manuscript development in interdisciplinary science teams

    Science.gov (United States)

    Oliver, Samantha K.; Fergus, C. Emi; Skaff, Nicholas K.; Wagner, Tyler; Tan, Pang-Ning; Cheruvelil, Kendra Spence; Soranno, Patricia A.

    2018-01-01

    Science is increasingly being conducted in large, interdisciplinary teams. As team size increases, challenges can arise during manuscript development, where achieving one team goal (e.g., inclusivity) may be in direct conflict with other goals (e.g., efficiency). Here, we present strategies for effective collaborative manuscript development that draw from our experiences in an interdisciplinary science team writing collaborative manuscripts for six years. These strategies are rooted in six guiding principles that were important to our team: to create a transparent, inclusive, and accountable research team that promotes and protects team members who have less power to influence decision‐making while fostering creativity and productivity. To help alleviate the conflicts that can arise in collaborative manuscript development, we present the following strategies: understand your team composition, create an authorship policy and discuss authorship early and often, openly announce manuscript ideas, identify and communicate the type of manuscript and lead author management style, and document and describe authorship contributions. These strategies can help reduce the probability of group conflict, uphold individual and team values, achieve fair authorship practices, and increase science productivity.

  5. An Education Initiative Modifies Opinions of Hemodialysis Nurses towards Home Dialysis

    Directory of Open Access Journals (Sweden)

    Matthew Phillips

    2015-04-01

    . Limitations: Single-center study Conclusions: CNE initiatives can modify the opinions of in-center HD nurses towards home modalities and should complement the multitude of strategies aimed at promoting home dialysis.

  6. Strategy and Development Plan Strategy and Development Plan of Croatian Transport and Economic System ...

    Directory of Open Access Journals (Sweden)

    Ivan Miloš

    2005-11-01

    Full Text Available The Republic of Croatia, as well as many transition countries,is facing a number of difficulties in the field of transport,economy, foreign trade and foreign exchange transactions, externaland internal debt, social policy, demography, etc. In orderto solve these extremely complex problems it is necessary todetermine a strategy and an implementation plan of special instrumentsincluded in the state economic policy of the developmentof transport and economy. Until now the results haveshown that the implementation of conventional instrumentscannot lead to satisfactory results. One of the instruments of thecentral state economic policy - recognised internationally andmost frequently used instruments for solving the mentionedproblems without state investment and state risk - is the instituteof "Free Zone". The aim of this work is to help governmentauthorities and bodies to accept possibly quicker and more efficientsolutions to the actual problems by elaborating special instrumentsof state transport and economic policy and by proposingmeasures for their implementation in the Republic ofCroatia. Moreover, it invites professionals and scientists to contributethrough their expert knowledge in finding out new solutions.

  7. Reproductive strategy, sexual development and attraction to facial characteristics.

    Science.gov (United States)

    Cornwell, R Elisabeth; Law Smith, Miriam J; Boothroyd, Lynda G; Moore, Fhionna R; Davis, Hasker P; Stirrat, Michael; Tiddeman, Bernard; Perrett, David I

    2006-12-29

    Sexual reproduction strategies vary both between and within species in the level of investment in offspring. Life-history theories suggest that the rate of sexual maturation is critically linked to reproductive strategy, with high investment being associated with few offspring and delayed maturation. For humans, age of puberty and age of first sex are two developmental milestones that have been associated with reproductive strategies. Stress during early development can retard or accelerate sexual maturation and reproduction. Early age of menarche is associated with absence of younger siblings, absence of a father figure during early life and increased weight. Father absence during early life is also associated with early marriage, pregnancy and divorce. Choice of partner characteristics is critical to successful implementation of sexual strategies. It has been suggested that sexually dimorphic traits (including those evident in the face) signal high-quality immune function and reproductive status. Masculinity in males has also been associated with low investment in mate and offspring. Thus, women's reproductive strategy should be matched to the probability of male investment, hence to male masculinity. Our review leads us to predict associations between the rate of sexual maturation and adult preferences for facial characteristics (enhanced sexual dimorphism and attractiveness). We find for men, engaging in sex at an early age is related to an increased preference for feminized female faces. Similarly, for women, the earlier the age of first sex the greater the preference for masculinity in opposite-sex faces. When we controlled sexual dimorphism in male faces, the speed of sexual development in women was not associated with differences in preference for male facial attractiveness. These developmental influences on partner choice were not mediated by self-rated attractiveness or parental relationships. We conclude that individuals assort in preferences based on

  8. Reproductive strategy, sexual development and attraction to facial characteristics

    Science.gov (United States)

    Cornwell, R. Elisabeth; Law Smith, Miriam J; Boothroyd, Lynda G; Moore, Fhionna R; Davis, Hasker P; Stirrat, Michael; Tiddeman, Bernard; Perrett, David I

    2006-01-01

    Sexual reproduction strategies vary both between and within species in the level of investment in offspring. Life-history theories suggest that the rate of sexual maturation is critically linked to reproductive strategy, with high investment being associated with few offspring and delayed maturation. For humans, age of puberty and age of first sex are two developmental milestones that have been associated with reproductive strategies. Stress during early development can retard or accelerate sexual maturation and reproduction. Early age of menarche is associated with absence of younger siblings, absence of a father figure during early life and increased weight. Father absence during early life is also associated with early marriage, pregnancy and divorce. Choice of partner characteristics is critical to successful implementation of sexual strategies. It has been suggested that sexually dimorphic traits (including those evident in the face) signal high-quality immune function and reproductive status. Masculinity in males has also been associated with low investment in mate and offspring. Thus, women's reproductive strategy should be matched to the probability of male investment, hence to male masculinity. Our review leads us to predict associations between the rate of sexual maturation and adult preferences for facial characteristics (enhanced sexual dimorphism and attractiveness). We find for men, engaging in sex at an early age is related to an increased preference for feminized female faces. Similarly, for women, the earlier the age of first sex the greater the preference for masculinity in opposite-sex faces. When we controlled sexual dimorphism in male faces, the speed of sexual development in women was not associated with differences in preference for male facial attractiveness. These developmental influences on partner choice were not mediated by self-rated attractiveness or parental relationships. We conclude that individuals assort in preferences based on

  9. Acquired cystic kidney disease in dialysis and renal transplant patients: ultrasonography and CT analysis

    International Nuclear Information System (INIS)

    Jeon, Young Tae; Lee, Hae Kyung; Jung, Mi Sun; Yoon, Jong Pil; Hong, Hyun Sook; Kwon, Kui Hyang; Choi, Deuk Lin; Hwang, Seung Duk; Lee, Hi Bahl

    1997-01-01

    hemorrhage may occur in dialysis patients, but ACKD and its complications did not develop in renal transplant patients. In long-term dialysis patients, regular follow-up studies of kidneys using US or CT are therefore needed. CT was superior to US in diagnosing ACKD

  10. Strategy and business development practices in Danish constrution industry SMEs

    DEFF Research Database (Denmark)

    Thuesen, Christian Langhoff; Koch, Christian; Nielsen, Jesper Salling

    2010-01-01

    practices. 19 qualitative interviews have been conducted in total representing architects, engineering companies, contractors and subcontractors. Based on an in-depth analysis of this empirical material, the study finds: (1) he market is characterized by a typical “red ocean” environment, where...... the companies compete on their overhead rather than their ability to reduce production cost and create value. (2) the companies have a reactive practice towards development, where they try to follow the development in the market rather than shaping their own market. (3) their approach towards strategy...... development represents an important but unacknowledged practice for innovation of the building industry and suggests that strategy processes should be facilitated and subject to more detailed research in order to escape the present unhealthy market practices in the construction industry....

  11. Cognitive impact of social stress and coping strategy throughout development.

    Science.gov (United States)

    Snyder, Kevin P; Barry, Mark; Valentino, Rita J

    2015-01-01

    Stress experience during adolescence has been linked to the development of psychiatric disorders in adulthood, many of which are associated with impairments in prefrontal cortex function. The current study was designed to determine the immediate and enduring effects of repeated social stress on a prefrontal cortex-dependent cognitive task. Early adolescent (P28), mid-adolescent (P42), and adult (P70) rats were exposed to resident-intruder stress for 5 days and tested in an operant strategy-shifting task (OSST) during the following week or several weeks later during adulthood. Engagement of prefrontal cortical neurons during the task was assessed by expression of the immediate early gene, c-fos. Social stress during adolescence had no immediate effects on task performance, but impaired strategy-shifting in adulthood, whereas social stress that occurred during adulthood had no effect. The cognitive impairment produced by adolescent social stress was most pronounced in rats with a passive coping strategy. Notably, strategy-shifting performance was positively correlated with medial prefrontal cortical c-fos in adulthood but not in adolescence, suggesting that the task engages different brain regions in adolescents compared to adults. Adolescent social stress produces a protracted impairment in prefrontal cortex-mediated cognition that is related to coping strategy. This impairment may be selectively expressed in adulthood because prefrontal cortical activity is integral to task performance at this age but not during adolescence.

  12. Coping strategies: gender differences and development throughout life span.

    Science.gov (United States)

    Meléndez, Juan Carlos; Mayordomo, Teresa; Sancho, Patricia; Tomás, José Manuel

    2012-11-01

    Development during life-span implies to cope with stressful events, and this coping may be done with several strategies. It could be useful to know if these coping strategies differ as a consequence of personal characteristics. This work uses the Coping with Stress Questionnaire with this aim using a sample of 400 participants. Specifically, the effects of gender and age group (young people, middle age and elderly), as well as its interaction on coping strategies is studied. With regard to age, on one hand, it is hypothesised a decrement in the use of coping strategies centred in problem solving and social support seeking as age increases. On the other hand, the use of emotional coping is hypothesised to increase with age. With respect to gender, it is hypothesised a larger use of emotional coping and social support seeking within women, and a larger use of problem solving within men. A MANOVA found significant effects for the two main effects (gender and age) as well as several interactions. Separate ANOVAs allowed us to test for potential differences in each of the coping strategies measured in the CAE. These results partially supported the hypotheses. Results are discussed in relation to scientific literature on coping, age and gender.

  13. Developing a strategy for a regulated electronic bioanalytical laboratory.

    Science.gov (United States)

    McDowall, R D

    2014-01-01

    This perspective article considers the strategy, design and implementation of an electronic bioanalytical laboratory working to GLP and/or GCP regulations. There are a range of available automated systems and laboratory informatics that could be implemented and integrated to make an electronic laboratory. However, which are the appropriate ones to select and what is realistic and cost-effective for an individual laboratory? The answer is to develop an overall automation strategy that is updated periodically after each system or application has been implemented to assess if the strategy is still valid or needs to be changed. As many laboratory informatics applications have functional overlap or convergence, for example, Laboratory Information Management System, Electronic Laboratory Notebook, and Instrument and Chromatography Data Systems, the decision of which application performs a specific task needs to be carefully considered in the overall strategy. Ensuring data integrity and regulatory compliance, especially in light of a number of recent falsification cases, is a mandatory consideration for the overall strategy for an electronic bioanalytical laboratory submitting data to regulatory authorities.

  14. Mobile learning: a workforce development strategy for nurse supervisors.

    Science.gov (United States)

    Mather, Carey; Cummings, Elizabeth

    2014-01-01

    Digital technology provides opportunities for using mobile learning strategies in healthcare environments. To realise the vision of the National Workforce Development Strategy there needs to be innovation of health professionals to further develop knowledge and skills of clinical supervisors to access and gain an understanding of the value of mobile learning at the workplace. The use of digital technology by clinical supervisors was explored in 2012 as part of a teaching development grant to evaluate the use of Web 2.0 technology to develop a community of practice about clinical supervision. Prior to developing the virtual network of clinical supervisors, feedback about the use of Web 2.0 technology by clinicians was sought via an online survey. Over 90% of respondents used social media, 85% understood what a blog and wiki were and approximately half of the respondents used smart phones. More than one-third indicated they would participate in a virtual community of practice and would like to receive information about clinical facilitation at least once per week. Findings indicate both inhibitors and opportunities for workforce development within healthcare environments that need to be addressed. Support of graduate-ready nurses can be achieved through an integrated outlook that enables health professionals within organisations to undertake mobile learning in situ. A flexible and collaborative approach to continuing professional development within organisations could enhance practice development and could positively impact on workforce development.

  15. Is hypoalbuminemia a prognostic risk factor for contrast-induced nephropathy in peritoneal dialysis patients?

    OpenAIRE

    Hassan, Kamal; Fadi,Hassan

    2014-01-01

    Kamal Hassan,1,2 Hassan Fadi3 1Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel; 2Peritoneal Dialysis Unit, Galilee Medical Center, Nahariya, Israel; 3Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Objective: Residual renal function (RRF) is an important predictor of outcome in peritoneal dialysis (PD) patients. Hypoalbuminemia was found to be an independent risk factor for the development of acute kidney injury. We investigated the possibility of a...

  16. High fall incidence and fracture rate in elderly dialysis patients.

    Science.gov (United States)

    Polinder-Bos, H A; Emmelot-Vonk, M H; Gansevoort, R T; Diepenbroek, A; Gaillard, C A J M

    2014-12-01

    Although it is recognised that the dialysis population is ageing rapidly, geriatric complications such as falls are poorly appreciated, despite the many risk factors for falls in this population. The objective of this study was to determine the incidence, complications and risk factors for falls in an elderly dialysis population. A one-year observational study of chronic dialysis patients aged ≥ 70 years. At baseline, patient characteristics were noted and during follow-up the vital parameters and laboratory values were recorded. Patients were questioned weekly about falls, fall circumstances and consequences by trained nurses. 49 patients were included with a median age of 79.3 years (70-89 years). During follow-up 40 fall accidents occurred in 27 (55%) patients. Falls resulted in fractures in 15% of cases and in hospital admissions in 15%. In haemodialysis (HD) patients, the mean systolic blood pressure (SBP) before HD was lower in fallers compared with non-fallers (130 vs. 143 mmHg). Several patients in the lower blood pressure category received antihypertensive medication. For every 5 mmHg lower SBP (before HD) the fall risk increased by 30% (hazard ratio (HR) 1.30, 95% CI 1.03-1.65, p = 0.03). Furthermore, fall risk increased by 22% for every 10 pmol/l rise of parathyroid hormone (HR 1.22, 95% CI 1.06-1.39, p = 0.004). Elderly dialysis patients have a high incidence of falls accompanied by a high fracture rate. Given the high complication rate, elderly patients at risk of falling should be identified and managed. Reduction of blood pressure-lowering medication might be a treatment strategy to reduce falls.

  17. Game Development as Didactic Strategy for Biochemistry Teaching

    Directory of Open Access Journals (Sweden)

    G.G. Hornink

    2010-05-01

    Full Text Available It is well known that students and teachers have difficulties in learning and teaching Biochemistry due to its abstract and interconnected contents. This work proposes a didactic strategy in order to facilitate teaching and learning process in Biochemistry. The strategy was implemented with biological science undergraduate students. At first, the students were divided into groups with a specific topic to develop a game. During the semester, problem based learning cases, online activities like crossword puzzle, essay questions and educational softwares were used to present the content of each topic. The groups were oriented in classroom and online, to choose and organize contents and create ways to approach them in games. At the end of the course the groups played each other games, which were evaluated by teacher and students following some criteria like: creativity, content organization, interdisciplinarity, proposal coherence, instructions clarity, specific content. The game elaboration contributed to the development of social and cognitive functions, such as teamwork and troubleshooting, providing an interesting perspective to the student about knowledge construction process. The strategy showed up students' creativity and ability to reorganize their knowledge to a different education level. In an overview, the results indicate that the proposed didactic strategy is an effective way to enhance learning and to motivate students into Biochemistry topics.

  18. Developing and Implementing a Quality Assurance Strategy for Electroconvulsive Therapy.

    Science.gov (United States)

    Hollingsworth, Jessa; Baliko, Beverly; McKinney, Selina; Rosenquist, Peter

    2018-04-17

    The literature provides scant guidance in effective quality assurance strategies concerning the use of electroconvulsive therapy (ECT) for the treatment of psychiatric conditions. Numerous guidelines are published that provide guidance in the delivery of care; however, little has been done to determine how a program or facility might ensure compliance to best practice for safety, tolerability, and efficacy in performing ECT. The objective of this project was to create a quality assurance strategy specific to ECT. Determining standards for quality care and clarifying facility policy were key outcomes in establishing an effective quality assurance strategy. An audit tool was developed utilizing quality criteria derived from a systematic review of ECT practice guidelines, peer review, and facility policy. All ECT procedures occurring over a 2-month period of May to June 2017 were retrospectively audited and compared against target compliance rates set for the facility's ECT program. Facility policy was adapted to reflect quality standards, and audit findings were used to inform possible practice change initiatives, were used to create benchmarks for continuous quality monitoring, and were integrated into regular hospital quality meetings. Clarification on standards of care and the use of clinical auditing in ECT was an effective starting point in the development of a quality assurance strategy. Audit findings were successfully integrated into the hospital's overall quality program, and recognition of practice compliance informed areas for future quality development and policy revision in this small community-based hospital in the southeastern United States. This project sets the foundation for a quality assurance strategy that can be used to help monitor procedural safety and guide future improvement efforts in delivering ECT. Although it is just the first step in creating meaningful quality improvement, setting clear standards and identifying areas of greatest

  19. An Assessment of Dialysis Provider's Attitudes towards Timing of Dialysis Initiation in Canada

    Directory of Open Access Journals (Sweden)

    Bikaramjit S Mann

    2014-04-01

    Full Text Available Background: Physicians' perceptions and opinions may influence when to initiate dialysis. Objective: To examine providers' perspectives and opinions regarding the timing of dialysis initiation. Design: Online survey. Setting: Community and academic dialysis practices in Canada. Participants: A nationally-representative sample of dialysis providers. Measurements and Methods: Dialysis providers opinions assessing reasons to initiate dialysis at low or high eGFR. Responses were obtained using a 9-point Likert scale. Early dialysis was defined as initiation of dialysis in an individual with an eGFR greater than or equal to 10.5 ml/min/m 2 . A detailed survey was emailed to all members of the Canadian Society of Nephrology (CSN in February 2013. The survey was designed and pre-tested to evaluate duration and ease of administration. Results: One hundred and forty one (25% response rate physicians participated in the survey. The majority were from urban, academic centres and practiced in regionally administered renal programs. Very few respondents had a formal policy regarding the timing of dialysis initiation or formally reviewed new dialysis starts (N = 4, 3.1%. The majority of respondents were either neutral or disagreed that late compared to early dialysis initiation improved outcomes (85–88%, had a negative impact on quality of life (89%, worsened AVF or PD use (84–90%, led to sicker patients (83% or was cost effective (61%. Fifty-seven percent of respondents felt uremic symptoms occurred earlier in patients with advancing age or co-morbid illness. Half (51.8% of the respondents felt there was an absolute eGFR at which they would initiate dialysis in an asymptomatic patient. The majority of respondents would initiate dialysis for classic indications for dialysis, such as volume overload (90.1% and cachexia (83.7% however a significant number chose other factors that may lead them to early dialysis initiation including avoiding an emergency (28

  20. An ecological solution in power development strategy: hydroelectric Power

    International Nuclear Information System (INIS)

    Ionescu, S.; Teodorescu, D.

    1994-01-01

    One of the fundamental criteria in establishing the power development strategy is represented by the environmental protection. Besides increasing the power efficiency for users, the hydro power stands for a handy alternative to generate thermal power. Comparatively, if hydro power is properly planed and developed, it could allow conservation of fossil fuel resources (as it makes use of a renewable resources) and avoids air and water pollution and in addition would lead to certain positive effects upon the natural and anthropic environment (flood routing, optimizes the power supply-demand relationship, and so on). By making use of the data available in the international specific literature and the information on the power development strategy in Romania the effects incurred by hydro power are both qualitatively and quantitatively emphasized as compared to alternative power generation by fossil fuel combustion. The proposal is made to adopt certain law regulations as well as a methodology to evaluate the general efficiency of various types of power generating devices suiting the particular conditions of Romania and taking into account the social cost as well as environmental effects. Hence a power development strategy could be undertaking at the national level provided it meets the requirements of both power system and environment protection. (Author)

  1. Dialysis search filters for PubMed, Ovid MEDLINE, and Embase databases.

    Science.gov (United States)

    Iansavichus, Arthur V; Haynes, R Brian; Lee, Christopher W C; Wilczynski, Nancy L; McKibbon, Ann; Shariff, Salimah Z; Blake, Peter G; Lindsay, Robert M; Garg, Amit X

    2012-10-01

    Physicians frequently search bibliographic databases, such as MEDLINE via PubMed, for best evidence for patient care. The objective of this study was to develop and test search filters to help physicians efficiently retrieve literature related to dialysis (hemodialysis or peritoneal dialysis) from all other articles indexed in PubMed, Ovid MEDLINE, and Embase. A diagnostic test assessment framework was used to develop and test robust dialysis filters. The reference standard was a manual review of the full texts of 22,992 articles from 39 journals to determine whether each article contained dialysis information. Next, 1,623,728 unique search filters were developed, and their ability to retrieve relevant articles was evaluated. The high-performance dialysis filters consisted of up to 65 search terms in combination. These terms included the words "dialy" (truncated), "uremic," "catheters," and "renal transplant wait list." These filters reached peak sensitivities of 98.6% and specificities of 98.5%. The filters' performance remained robust in an independent validation subset of articles. These empirically derived and validated high-performance search filters should enable physicians to effectively retrieve dialysis information from PubMed, Ovid MEDLINE, and Embase.

  2. [The development of novel tumor targeting delivery strategy].

    Science.gov (United States)

    Gao, Hui-le; Jiang, Xin-guo

    2016-02-01

    Tumor is one of the most serious threats for human being. Although many anti-tumor drugs are approved for clinical use, the treatment outcome is still modest because of the poor tumor targeting efficiency and low accumulation in tumor. Therefore, it is important to deliver anti-tumor drug into tumor efficiently, elevate drug concentration in tumor tissues and reduce the drug distribution in normal tissues. And it has been one of the most attractive directions of pharmaceutical academy and industry. Many kinds of strategies, especially various nanoparticulated drug delivery systems, have been developed to address the critical points of complex tumor microenvironment, which are partially or mostly satisfied for tumor treatment. In this paper, we carefully reviewed the novel targeting delivery strategies developed in recent years. The most powerful method is passive targeting delivery based on the enhanced permeability and retention(EPR) effect, and most commercial nanomedicines are based on the EPR effect. However, the high permeability and retention require different particle sizes, thus several kinds of size-changeable nanoparticles are developed, such as size reducible particles and assemble particles, to satisfy the controversial requirement for particle size and enhance both tumor retention and penetration. Surface charge reversible nanoparticles also shows a high efficiency because the anionic charge in blood circulation and normal organs decrease the unintended internalization. The charge can change into positive in tumor microenvironment, facilitating drug uptake by tumor cells. Additionally, tumor microenvironment responsive drug release is important to decrease drug side effect, and many strategies are developed, such as p H sensitive release and enzyme sensitive release. Except the responsive nanoparticles, shaping tumor microenvironment could attenuate the barriers in drug delivery, for example, decreasing tumor collagen intensity and normalizing tumor

  3. Being-in-dialysis: The experience of the machine-body for home dialysis users.

    Science.gov (United States)

    Shaw, Rhonda

    2015-05-01

    New Zealand leads the world in rates of home dialysis use, yet little is known about the experience of home dialysis from the patient's perspective. This article contributes to the literature on the self-care of dialysis patients by examining the relevance of the concept of the machine-body and cyborg embodiment for the lived experience of people with end-stage renal failure. The article, which presents a discussion of 24 in-depth interviews undertaken between 2009 and 2012, shows that although dialysis therapy is disruptive of being and time, study participants experience home dialysis in terms of flexibility, control and independence. While they do not use the term machine-body as a descriptor, the concept resonates with felt experience. Data also indicate that positive experience of home dialysis is relative to socio-economic positioning and the lived relation of patients to others, necessitating further research to examine these factors. © The Author(s) 2014.

  4. Development Strategies for Tourism Destinations: Tourism Sophistication vs. Resource Investments

    OpenAIRE

    Rainer Andergassen; Guido Candela

    2010-01-01

    This paper investigates the effectiveness of development strategies for tourism destinations. We argue that resource investments unambiguously increase tourism revenues and that increasing the degree of tourism sophistication, that is increasing the variety of tourism related goods and services, increases tourism activity and decreases the perceived quality of the destination's resource endowment, leading to an ambiguous effect on tourism revenues. We disentangle these two effects and charact...

  5. Development of predictive control strategies for building climate control

    OpenAIRE

    NAGPAL, HIMANSHU

    2018-01-01

    APPROVED The rapid growth in energy usage and CO2 emissions has become a critical issue for the whole world. It is noteworthy that buildings are a major contributor to global primary energy consumption. Among building services, use of energy in heating-ventilation-air-conditioning (HVAC) system is particularly significant (about 50\\% of the total building energy consumption). Therefore, the development and implementation of effective control strategies to optimize the operation of HVAC sys...

  6. Sodium fires: French strategy - theoretical and experimental developments

    International Nuclear Information System (INIS)

    Descombes; Thomann; Malet, J.C.; Rzekiecki, R.

    1985-01-01

    After a description of the needs relating to LMFBR safety analysis and design in terms of prevention, detection and protection, the French strategy concerning sodium fires it presented. It includes theoretical developments supported with relevant experimental program, to allow reliable calculations and predictions for safety and design. The following physical phenomena are detailed: (1) sodium fire (mechanical and thermal effects); (2) sodium-structures interactions; (3) aerosols behavior

  7. The energy situation and its sustainable development strategy in China

    International Nuclear Information System (INIS)

    Zhang, Na; Lior, Noam; Jin, Hongguang

    2011-01-01

    The paper briefly summarizes China's energy situation and sustainable development strategy as they were by 2009. The energy consumption in 2009 is reported to be 3.1 billion tons standard coal equivalent, 1/7 of the world total, 6.3% higher than in the year 2008, and its share of world CO 2 emissions increased rapidly to 20.3% in 2006. These trends are most likely to continue with China's plan to accomplish its social and economy development goals. To address these problems and also respond to increasing world pressure for reduction of greenhouse gas emissions, the Chinese government plans and has legislated promotion of energy conservation, efficiency, renewable energy technologies and use, and reduction of energy-related environmental impacts to reduce energy intensity by 20% during the 2006-2010 period, and to reduce the CO 2 emission/GDP ratio by 40-45% by 2020 relative to 2005. China is facing severe energy-related challenges that conflict resources shortages with the planned rapid economic development, energy use with the related environmental pollution, and new technology with the old production/consumption patterns. It is recognized that energy development must, however, follow a sustainable path to coordinate economy growth, social development, and environmental protection. -- Highlights: → A brief summary of China's energy situation and plans in 2009; → Energy consumption and CO 2 emissions are likely to continue rising; → China to reduce energy intensity, and the (CO 2 emission)/GDP ratio by 40-45% by 2020; → Energy-related challenges and desired sustainable development strategy are discussed; → The strategy core is energy conservation and non-fossil fuel energy development.

  8. 76 FR 37119 - Development of Best Practices for Community Health Needs Assessment and Implementation Strategy...

    Science.gov (United States)

    2011-06-24

    ... Best Practices for Community Health Needs Assessment and Implementation Strategy; Public Forum AGENCY... processes relating to community health needs assessment (CHNA) and implementation strategy/plan development... practices in CHNA and implementation strategy development and execution for improved community health...

  9. [Strategy Development for International Cooperation in the Clinical Laboratory Field].

    Science.gov (United States)

    Kudo, Yoshiko; Osawa, Susumu

    2015-10-01

    The strategy of international cooperation in the clinical laboratory field was analyzed to improve the quality of intervention by reviewing documents from international organizations and the Japanese government. Based on the world development agenda, the target of action for health has shifted from communicable diseases to non-communicable diseases (NCD). This emphasizes the importance of comprehensive clinical laboratories instead of disease-specific examinations in developing countries. To achieve this goal, the World Health Organization (WHO) has disseminated to the African and Asian regions the Laboratory Quality Management System (LQMS), which is based on the same principles of the International Organization of Standardization (ISO) 15189. To execute this strategy, international experts must have competence in project management, analyze information regarding the target country, and develop a strategy for management of the LQMS with an understanding of the technical aspects of laboratory work. However, there is no appropriate pre- and post-educational system of international health for Japanese international workers. Universities and academic organizations should cooperate with the government to establish a system of education for international workers. Objectives of this education system must include: (1) training for the organization and understanding of global health issues, (2) education of the principles regarding comprehensive management of clinical laboratories, and (3) understanding the LQMS which was employed based on WHO's initiative. Achievement of these objectives will help improve the quality of international cooperation in the clinical laboratory field.

  10. Minapadi Development Strategy in Supporting National Food Security

    Science.gov (United States)

    Lestari, Sri; Bambang, Azis Nur

    2018-02-01

    Efforts to achieve food security, especially food self-sufficiency, face severe challenges. Intensification needs to be done in optimizing the existing land by applying integrated agriculture. One of them is by integrating agriculture and fishery aspect with implementation of minapadi. Minapadi cultivation has actually grown since a long time, but in the course of time this system Began displaced because of pesticides and chemical fertilizers. Become flagship Minapadi back in line with the increasing public awareness of the importance of sustainable environment, health, increasing demand for organic products that are free from pesticide residues which means safe for consumption. Minapadi is the answer to the fulfillment of people's need for carbohydrate and protein food. Blending the fulfillment of carbohydrates is rice as the staple food of most people with the fulfillment of animal protein from fish commodities to add nutritional value. In realizing the food security strategy is required Minapadi development. This descriptive research aims to find out various minapadi development strategies in several regions with different methods based on the literature and previous studies. The result is the formulation of minapadi development strategy in an area not necessarily can be applied in other areas.This occurs because of differences in setting criteria/ variables based on the characteristics and potential of a region, the strengths and opportunities, as well as the weaknesses and threats that the area may encounter.

  11. A national study of efficiency for dialysis centers: an examination of market competition and facility characteristics for production of multiple dialysis outputs.

    Science.gov (United States)

    Ozgen, Hacer; Ozcan, Yasar A

    2002-06-01

    dialysis outputs, which may explain the ongoing tendency toward single-output production. Ownership form does make a positive difference in production efficiency, but only in local markets where competition exists between nonprofit and for-profit facilities. The increasing inefficiency associated with membership in large chains suggests that the growing consolidation in the dialysis industry may not, in fact, be the strategy for attaining more technical efficiency in the production of multiple dialysis outputs.

  12. Peritoneal dialysis peritonitis by anaerobic pathogens: a retrospective case series

    OpenAIRE

    Chao, Chia-Ter; Lee, Szu-Ying; Yang, Wei-Shun; Chen, Huei-Wen; Fang, Cheng-Chung; Yen, Chung-Jen; Chiang, Chih-Kang; Hung, Kuan-Yu; Huang, Jenq-Wen

    2013-01-01

    Background Bacterial infections account for most peritoneal dialysis (PD)-associated peritonitis episodes. However, anaerobic PD peritonitis is extremely rare and intuitively associated with intra-abdominal lesions. In this study, we examined the clinical characteristics of PD patients who developed anaerobic peritonitis. Methods We retrospectively identified all anaerobic PD peritonitis episodes from a prospectively collected PD registry at a single center between 1990 and 2010. Only patient...

  13. Key factors of low carbon development strategy for sustainable transport

    Science.gov (United States)

    Thaveewatanaseth, K.; Limjirakan, S.

    2018-02-01

    Cities become more vulnerable to climate change impacts causing by urbanization, economic growth, increasing of energy consumption and carbon dioxide (CO2) emissions. People who live in the cities have already been affected from the impacts in terms of socioeconomic and environmental aspects. Sustainable transport plays the key role in CO2 mitigation and contributes positive impacts on sustainable development for the cities. Several studies in megacities both in developed and developing countries support that mass transit system is an important transportation mode in CO2 mitigation and sustainable transport development. This paper aims to study key factors of low carbon development strategy for sustainable transport. The Bangkok Mass Rapid Transit System (MRT) located in Bangkok was the study area. Data collection was using semi-structured in-depth interview protocol with thirty respondents consisting of six groups i.e. governmental agencies, the MRT operators, consulting companies, international organizations, non-profit organizations, and experts. The research findings highlighted the major factors and supplemental elements composing of institution and technical capacity, institutional framework, policy setting and process, and plan of implementation that would support more effective strategic process for low carbon development strategy (LCDS) for sustainable transport. The study would highly recommend on readiness of institution and technical capacities, stakeholder mapping, high-level decision- makers participation, and a clear direction of the governmental policies that are strongly needed in achieving the sustainable transport.

  14. Perspective on Eco-Hydrology Developing Strategy in China

    Science.gov (United States)

    Xia, J.

    2017-12-01

    China is one of developing countries with higher eco-environmental press in the world due to large population and its socio-economic development. In China, water is not only the sources for life, but also the key for production, and the foundation for eco-system. Thus, Eco-hydrology becomes a fundamental also an applied sciences related to describe the hydrologic mechanisms that underlie ecologic patterns and processes. This paper addresses the issue of Eco-hydrology Developing Strategy in China, supported by Chinese Academy of Sciences (CAS). Major contents include four aspects, namely: (1) Demands and frontier of eco-hydrology in the world; (2) Major theories and approaches of Eco-hydrology; (3) Perspective of future development on Eco-hydrology; (4) Enacting and proposal for China development strategy on Eco-hydrology. Application fields involves urban, rural area, wetland, river & lake, forest and special regions in China, such as the arid and semi-arid region and so on. The goal is to promote the disciplinary development of eco-hydrology, and serve for national demands on ecological civilization construction in China.

  15. Human Sustainable Development in the Context of Europa 2020 Strategy

    Directory of Open Access Journals (Sweden)

    Alina-Mihaela Ion

    2016-01-01

    Full Text Available Human development is a constant concern at European level. Thus, various programs have been proposed with the main objective of developing skills of citizens and informing them about training courses as part of lifelong learning and of employment in the labour market. The article highlights the evolution of European Union through the investments in human capital. The objective of this paper is represented by the analysis of the impact of sustainable human development through trans-disciplinary and inter-disciplinary education in the context of the European Union strategy proposed for the following period up to 2020. Europe 2020 represents a strategic plan for European Union development until 2020, having as main objective raising the standard of living and the quality of life for European citizens. Europe 2020 strategy promotes a new vision for the economy of European Union. For the following period until 2020 there is a major concern for creating favourable conditions for development of a sustainable intelligent economy that promotes inclusion. Some of the main activities with a major impact on creating such conditions are investments in education, research and innovation. The article analyses the current and recent past years’ situation in terms of sustainable development from educational and economic perspectives at European Union level. The analysis was done based on Eurostat data, using specific statistical methods.

  16. A strategy to improve priority setting in developing countries.

    Science.gov (United States)

    Kapiriri, Lydia; Martin, Douglas K

    2007-09-01

    Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. Priority setting in developing countries is fraught with uncertainty due to lack of credible information, weak priority setting institutions, and unclear priority setting processes. Efforts to improve priority setting in these contexts have focused on providing information and tools. In this paper we argue that priority setting is a value laden and political process, and although important, the available information and tools are not sufficient to address the priority setting challenges in developing countries. Additional complementary efforts are required. Hence, a strategy to improve priority setting in developing countries should also include: (i) capturing current priority setting practices, (ii) improving the legitimacy and capacity of institutions that set priorities, and (iii) developing fair priority setting processes.

  17. Preclinical assessment of adjunctive tPA and DNase for peritoneal dialysis associated peritonitis.

    Directory of Open Access Journals (Sweden)

    Amanda L McGuire

    Full Text Available A major complication of peritoneal dialysis is the development of peritonitis, which is associated with reduced technique and patient survival. The inflammatory response elicited by infection results in a fibrin and debris-rich environment within the peritoneal cavity, which may reduce the effectiveness of antimicrobial agents and predispose to recurrence or relapse of infection. Strategies to enhance responses to antimicrobial agents therefore have the potential to improve patient outcomes. This study presents pre-clinical data describing the compatibility of tPA and DNase in combination with antimicrobial agents used for the treatment of PD peritonitis. tPA and DNase were stable in standard dialysate solution and in the presence of antimicrobial agents, and were safe when given intraperitoneally in a mouse model with no evidence of local or systemic toxicity. Adjunctive tPA and DNase may have a role in the management of patients presenting with PD peritonitis.

  18. Hemodialysis Reliable Outflow (HeRO) device in end-stage dialysis access: a decision analysis model.

    Science.gov (United States)

    Dageforde, Leigh Anne; Bream, Peter R; Moore, Derek E

    2012-09-01

    The Hemodialysis Reliable Outflow (HeRO) dialysis access device is a permanent tunneled dialysis graft connected to a central venous catheter and is used in patients with end-stage dialysis access (ESDA) issues secondary to central venous stenosis. The safety and effectiveness of the HeRO device has previously been proven, but no study thus far has compared the cost of its use with tunneled dialysis catheters (TDCs) and thigh grafts in patients with ESDA. A decision analytic model was developed to simulate outcomes for patients with ESDA undergoing placement of a HeRO dialysis access device, TDC, or thigh graft. Outcomes of interest were infection, thrombosis, and ischemic events. Baseline values, ranges, and costs were determined from a systematic review of the literature. Total costs were based on 1 year of post-procedure outcomes. Sensitivity analyses were conducted to test model strength. The HeRO dialysis access device is the least costly dialysis access with an average 1-year cost of $6521. The 1-year cost for a TDC was $8477. A thigh graft accounted for $9567 in a 1-year time period. The HeRO dialysis access device is the least costly method of ESDA. The primary determinants of cost in this model are infection in TDCs and leg ischemia necessitating amputation in thigh grafts. Further study is necessary to incorporate patient preference and quality of life into the model. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. The Development of Low-Carbon Strategy in Croatia

    International Nuclear Information System (INIS)

    Grgasovic, V.

    2013-01-01

    United Nations Framework Convention on Climate Change and the Kyoto Protocol have initiated an awareness of the necessity to reduce greenhouse gas emissions and have provided guidelines of the energy in the world, especially within the European Union. EU sets its action within the negotiations on a new global agreement in the field of climate change, for the period after the 2020. Croatia, also, has to follow these guidelines. Therefore, Croatia conducts activities to develop low-carbon development strategy and to establish the legal and institutional framework for the successful implementation of measures to reduce greenhouse gas emissions.(author)

  20. Development of a strategy for decontamination of an urban area

    International Nuclear Information System (INIS)

    Roed, J.; Andersson, K.G.

    2000-01-01

    The Chernobyl accident in 1986 lead to high level contamination in urban areas in different parts of Europe and showed the importance of preparedness in the optimisation of any mitigatory interference. To meet this demand, a method for development of a decontamination strategy for urban areas has been developed based on measurements of radionuclide distribution in the urban environment after the Chernobyl accident, calculations of dose and experimentally obtained data on effectiveness and cost of practicable clean-up procedures. The approach highlights where decontamination would be of greatest benefit in terms of dose reduction and cost. (author)

  1. DEVELOPMENT STRATEGY OF PARTNERSHIP OF HIGHER EDUCATION, SCIENCE AND BUSINESS

    Directory of Open Access Journals (Sweden)

    I. Mazur

    2014-12-01

    Full Text Available In the article the cooperation of higher education, science and business is analysed. A conflict of civilizations wave development in the confrontation of two forces: the "factory of Education" and force change is disclosed. European and Ukrainian higher education quality estimation is analysed. The effect of unsynchronization in time is educed between the necessities of business and possibilities of education and science. Reasons of bribery are exposed at higher school. The development strategy of partnership of higher education, science and business is proposed.

  2. Green Toxicology: a strategy for sustainable chemical and material development.

    Science.gov (United States)

    Crawford, Sarah E; Hartung, Thomas; Hollert, Henner; Mathes, Björn; van Ravenzwaay, Bennard; Steger-Hartmann, Thomas; Studer, Christoph; Krug, Harald F

    2017-01-01

    Green Toxicology refers to the application of predictive toxicology in the sustainable development and production of new less harmful materials and chemicals, subsequently reducing waste and exposure. Built upon the foundation of "Green Chemistry" and "Green Engineering", "Green Toxicology" aims to shape future manufacturing processes and safe synthesis of chemicals in terms of environmental and human health impacts. Being an integral part of Green Chemistry, the principles of Green Toxicology amplify the role of health-related aspects for the benefit of consumers and the environment, in addition to being economical for manufacturing companies. Due to the costly development and preparation of new materials and chemicals for market entry, it is no longer practical to ignore the safety and environmental status of new products during product development stages. However, this is only possible if toxicologists and chemists work together early on in the development of materials and chemicals to utilize safe design strategies and innovative in vitro and in silico tools. This paper discusses some of the most relevant aspects, advances and limitations of the emergence of Green Toxicology from the perspective of different industry and research groups. The integration of new testing methods and strategies in product development, testing and regulation stages are presented with examples of the application of in silico, omics and in vitro methods. Other tools for Green Toxicology, including the reduction of animal testing, alternative test methods, and read-across approaches are also discussed.

  3. Development of a mentorship strategy: a knowledge translation case study.

    Science.gov (United States)

    Straus, Sharon E; Graham, Ian D; Taylor, Mark; Lockyer, Jocelyn

    2008-01-01

    There are many theories and frameworks for achieving knowledge translation, and the assortment can be confusing to those responsible for planning, evaluation, or policymaking in knowledge translation. A conceptual framework developed by Graham and colleagues provides an approach that builds on the commonalities found in an assessment of planned-action theories. This article describes the application of this knowledge to action framework to a mentorship initiative in academic medicine. Mentorship influences career success but is threatened in academia by increased clinical, research, and administrative demands. A case study review was undertaken of the role of mentors, the experiences of mentors and mentees, and mentorship initiatives in developing and retaining clinician scientists at two universities in Alberta, Canada. This project involved relevant stakeholders including researchers, university administrators, and research funders. The knowledge to action framework was used to develop a strategy for mentorship for clinician researchers. The framework highlights the need to identify and engage stakeholders in the process of knowledge implementation. A series of initiatives were selected and tailored to barriers and facilitators to implementation of the mentorship initiative; strategies for evaluating the knowledge use and its impact on outcomes were developed. The knowledge to action framework can be used to develop a mentorship initiative for clinician researchers. Future work to evaluate the impact of this intervention on recruitment and retention is planned.

  4. Regional sustainable development strategy for the Athabasca Oil Sands area

    International Nuclear Information System (INIS)

    1999-07-01

    The Regional Sustainable Development Strategy (RSDS) provides a framework for balancing development with environmental protection. This provisional direction for sustainable resource management was confirmed in a March 1999 policy document. It is as follows: the use of Alberta's natural resources shall be sustainable, the management of Alberta's natural resources shall support and promote the Alberta economy, Alberta's environment shall be protected, resources shall be managed on an integrated basis, and Alberta's natural resources shall be managed for multiple benefits. The focus of the RSDS is to address the need to balance resource development and environmental protection. The report covers: an overview, the Regional Sustainable Development Strategy and the RSDS management model. Blueprints for action concerning the impacts of oilsands development are provided under 14 themes, including 1) cumulative impacts on wildlife, fish habitat and populations, surface and groundwater quality and 2) human health effects of air emissions and effects of air emissions on wildlife and vegetation. The RSDS will apply provincial and federal policy, legislation, standards and programs in a regional context, including principles in the Canadian Council of Ministers of the Environment (CCME) Harmonization Accord

  5. Are Diuretics Underutilized in Dialysis Patients?

    Science.gov (United States)

    Trinh, Emilie; Bargman, Joanne M

    2016-09-01

    While oral diuretics are commonly used in patients with chronic kidney disease for the management of volume and blood pressure, they are often discontinued upon initiation of dialysis. We suggest that diuretics are considerably underutilized in peritoneal dialysis and haemodialysis patients despite numerous potential benefits and few side effects. Moreover, when diuretics are used, optimal doses are not always prescribed. In peritoneal dialysis, the use of diuretics can improve volume status and minimize the need for higher glucose-containing solutions. In patients on haemodialysis, diuretics can help lessen interdialytic weight gain, resulting in decreased ultrafiltration rates and fewer episodes of intradialytic hypotension. This paper will review the mechanism of action of diuretics in patients with renal insufficiency, quantify the risk of side effects and elaborate on the potential advantages of diuretic use in peritoneal dialysis and hemodialysis patients with residual kidney function. © 2016 Wiley Periodicals, Inc.

  6. Collagen markers in peritoneal dialysis patients

    DEFF Research Database (Denmark)

    Graff, J; Joffe, P; Fugleberg, S

    1995-01-01

    Possible relationships between the dialysate-to-plasma creatinine equilibration ratio (D/Pcreatinine 4 hour), duration of peritoneal dialysis treatment, number of peritonitis episodes, and mass appearance rates of three connective tissue markers [carboxyterminal propeptide of type I procollagen...... (PICP), aminoterminal propeptide of type III procollagen (PIIINP), and carboxyterminal telopeptide of type I collagen (ICTP)] were studied in 19 nondiabetic peritoneal dialysis patients. The absence of correlation between the mass appearance rates of the markers and the duration of dialysis treatment...... as well as the number of peritonitis episodes supports the concept that peritoneal dialysis does not cause persistent changes in the deposition and degradation rates of collagen. A correlation between the D/Pcreatinine 4 hr and the PICP mass appearance rates was found. Since it is unlikely...

  7. Dialysis: MedlinePlus Health Topic

    Science.gov (United States)

    ... access for hemodialysis (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Dialysis updates by ... for hemodialysis Show More Show Less Related Health Topics Creatinine Kidney Cysts Kidney Failure Peritoneal Disorders National ...

  8. Horizontal integration in the development strategy of mining companies

    Directory of Open Access Journals (Sweden)

    Jan Kudełko

    2016-01-01

    Full Text Available Integration strategy is one option in the development of mining companies and is implemented through a connection of either processes or economic entities which operate or may operate separately. Usually this strategy is carried out by companies that occupy a very strong competitive position. Considering its direction, it may be horizontal or vertical. Horizontal integration strategy stems from a desire to increase market share by an entrepreneur or create a new company based on common know-how and combined operational processes. It can be realized in an external dimension through a merger or takeover, as well as in the internal dimension based on its own resources. The external dimension is based on capital or contractual integration of a company with external economic entities performing related or conglomerate activity. The targets of such integration have a resource, a market effectiveness, or a competence nature. In the case of mining companies, it covers all important activity areas, including geology, mining, processing, environmental protection, and waste management, and is carried out with due diligence. In the internal dimension, the strategy of horizontal integration consists in consolidating the strategic targets of all business units around the company’s (corporation’s targets. The authors focused on two trends most relevant to pursuing a horizontal integration strategy, including increasing the company’s flexibility and undertaking joint activities. Flexibility consists in the potential ability of the company to adapt quickly to changed environment conditions. Joint activity includes co-operation of its respective units in terms of products, markets, and functions.

  9. Development of Operation Strategy for Hybrid-SIT in SBO

    International Nuclear Information System (INIS)

    Jeon, In Seop; Kang, Hyun Gook

    2015-01-01

    The Fukushima accident was not managed properly due to a lack of effective mitigation systems against Station Black Out (SBO) accident. For this reason, development of passive system is suggested as an alternative way for active system because passive system doesn't need external energy source and passive system can also increase the diversity of mitigation technique of Nuclear Power Plant (NPP). H-SIT is a passive injection system that is newly planned to adjust into the Advanced Power Reactor plus (APR+). This system is specialized for mitigation of SBO scenarios because it is passive system and it can inject coolant even in high pressure condition. Main function of H-SIT is injection of coolant to the Reactor Coolant System (RCS) in a passive way. The H-SIT system can inject water using the pressure from nitrogen gas as a normal SIT in low pressure accidents such as large and medium break loss-of-coolant accidents. This operation strategy is divided according to numbers of PAFS which can be used. When one H-SIT is used, H-SIT is recommended to use operation strategy which is explained as follow. In case of operation number, 1+1+1+1 strategy is the best and first operation timing, the time when upper plenum level is 5% is the best and next operation timing, the time when water level of H-SIT which is operated in previous round is 5% and operation order, 4-3-2-1 is the best. Even if one PAFS can be used, the minimum flow of H-SIT can maintain core in normal condition before H-SIT dried out thus if two PAFS can be used, the strategy which is used in the condition one PAFS can be operated is also used as a best operation strategy

  10. Cyanobacterial Biofuels: Strategies and Developments on Network and Modeling.

    Science.gov (United States)

    Klanchui, Amornpan; Raethong, Nachon; Prommeenate, Peerada; Vongsangnak, Wanwipa; Meechai, Asawin

    Cyanobacteria, the phototrophic microorganisms, have attracted much attention recently as a promising source for environmentally sustainable biofuels production. However, barriers for commercial markets of cyanobacteria-based biofuels concern the economic feasibility. Miscellaneous strategies for improving the production performance of cyanobacteria have thus been developed. Among these, the simple ad hoc strategies resulting in failure to optimize fully cell growth coupled with desired product yield are explored. With the advancement of genomics and systems biology, a new paradigm toward systems metabolic engineering has been recognized. In particular, a genome-scale metabolic network reconstruction and modeling is a crucial systems-based tool for whole-cell-wide investigation and prediction. In this review, the cyanobacterial genome-scale metabolic models, which offer a system-level understanding of cyanobacterial metabolism, are described. The main process of metabolic network reconstruction and modeling of cyanobacteria are summarized. Strategies and developments on genome-scale network and modeling through the systems metabolic engineering approach are advanced and employed for efficient cyanobacterial-based biofuels production.

  11. Recombinant vaccines and the development of new vaccine strategies

    Energy Technology Data Exchange (ETDEWEB)

    Nascimento, I.P.; Leite, L.C.C. [Centro de Biotecnologia, Instituto Butantan, São Paulo, SP (Brazil)

    2012-09-07

    Vaccines were initially developed on an empirical basis, relying mostly on attenuation or inactivation of pathogens. Advances in immunology, molecular biology, biochemistry, genomics, and proteomics have added new perspectives to the vaccinology field. The use of recombinant proteins allows the targeting of immune responses focused against few protective antigens. There are a variety of expression systems with different advantages, allowing the production of large quantities of proteins depending on the required characteristics. Live recombinant bacteria or viral vectors effectively stimulate the immune system as in natural infections and have intrinsic adjuvant properties. DNA vaccines, which consist of non-replicating plasmids, can induce strong long-term cellular immune responses. Prime-boost strategies combine different antigen delivery systems to broaden the immune response. In general, all of these strategies have shown advantages and disadvantages, and their use will depend on the knowledge of the mechanisms of infection of the target pathogen and of the immune response required for protection. In this review, we discuss some of the major breakthroughs that have been achieved using recombinant vaccine technologies, as well as new approaches and strategies for vaccine development, including potential shortcomings and risks.

  12. Recombinant vaccines and the development of new vaccine strategies

    Directory of Open Access Journals (Sweden)

    I.P. Nascimento

    2012-12-01

    Full Text Available Vaccines were initially developed on an empirical basis, relying mostly on attenuation or inactivation of pathogens. Advances in immunology, molecular biology, biochemistry, genomics, and proteomics have added new perspectives to the vaccinology field. The use of recombinant proteins allows the targeting of immune responses focused against few protective antigens. There are a variety of expression systems with different advantages, allowing the production of large quantities of proteins depending on the required characteristics. Live recombinant bacteria or viral vectors effectively stimulate the immune system as in natural infections and have intrinsic adjuvant properties. DNA vaccines, which consist of non-replicating plasmids, can induce strong long-term cellular immune responses. Prime-boost strategies combine different antigen delivery systems to broaden the immune response. In general, all of these strategies have shown advantages and disadvantages, and their use will depend on the knowledge of the mechanisms of infection of the target pathogen and of the immune response required for protection. In this review, we discuss some of the major breakthroughs that have been achieved using recombinant vaccine technologies, as well as new approaches and strategies for vaccine development, including potential shortcomings and risks.

  13. Dispatch Strategy Development for Grid-tied Household Energy Systems

    Science.gov (United States)

    Cardwell, Joseph

    The prevalence of renewable generation will increase in the next several decades and offset conventional generation more and more. Yet this increase is not coming without challenges. Solar, wind, and even some water resources are intermittent and unpredictable, and thereby create scheduling challenges due to their inherent "uncontrolled" nature. To effectively manage these distributed renewable assets, new control algorithms must be developed for applications including energy management, bridge power, and system stability. This can be completed through a centralized control center though efforts are being made to parallel the control architecture with the organization of the renewable assets themselves--namely, distributed controls. Building energy management systems are being employed to control localized energy generation, storage, and use to reduce disruption on the net utility load. One such example is VOLTTRONTM, an agent-based platform for building energy control in real time. In this thesis, algorithms developed in VOLTTRON simulate a home energy management system that consists of a solar PV array, a lithium-ion battery bank, and the grid. Dispatch strategies are implemented to reduce energy charges from overall consumption (/kWh) and demand charges (/kW). Dispatch strategies for implementing storage devices are tuned on a month-to-month basis to provide a meaningful economic advantage under simulated scenarios to explore algorithm sensitivity to changing external factors. VOLTTRON agents provide automated real-time optimization of dispatch strategies to efficiently manage energy supply and demand, lower consumer costs associated with energy usage, and reduce load on the utility grid.

  14. Recombinant vaccines and the development of new vaccine strategies

    International Nuclear Information System (INIS)

    Nascimento, I.P.; Leite, L.C.C.

    2012-01-01

    Vaccines were initially developed on an empirical basis, relying mostly on attenuation or inactivation of pathogens. Advances in immunology, molecular biology, biochemistry, genomics, and proteomics have added new perspectives to the vaccinology field. The use of recombinant proteins allows the targeting of immune responses focused against few protective antigens. There are a variety of expression systems with different advantages, allowing the production of large quantities of proteins depending on the required characteristics. Live recombinant bacteria or viral vectors effectively stimulate the immune system as in natural infections and have intrinsic adjuvant properties. DNA vaccines, which consist of non-replicating plasmids, can induce strong long-term cellular immune responses. Prime-boost strategies combine different antigen delivery systems to broaden the immune response. In general, all of these strategies have shown advantages and disadvantages, and their use will depend on the knowledge of the mechanisms of infection of the target pathogen and of the immune response required for protection. In this review, we discuss some of the major breakthroughs that have been achieved using recombinant vaccine technologies, as well as new approaches and strategies for vaccine development, including potential shortcomings and risks

  15. A conceptual approach to the development of motivational strategies.

    Science.gov (United States)

    Wong, J; Wong, S; Mensah, L L

    1983-03-01

    Teachers in both general and professional education are well aware of the importance of motivation as the basis of effective teaching. Heidgerken maintains that a major problem that faces nursing educators is to select the right type of motivation and to know how to effect motivation. The authors propose a conceptual model for developing strategies to deal with motivational problems. This model is an application of Vroom's value/expectancy theory and Rotter's social learning theory, and is based on the premise that nursing faculty are in strategic positions to enhance student motivation for learning by manipulating variables that are believed to influence motivation. These suggested strategies include: enhancing student's need value by rewarding them with rewards that they value the most; increasing student's perceptions of a strong link between performance and rewards; providing students with consistent and clear role perceptions; improving student satisfaction towards learning.

  16. Development of Individualized Anti-Metastasis Strategies by Engineering Nanomedicines

    Science.gov (United States)

    He, Qianjun; Guo, Shengrong; Qian, Zhiyong; Chen, Xiaoyuan

    2015-01-01

    Metastasis is deadly and also tough to treat as it is much more complicated than the primary tumour. Anti-metastasis approaches available so far are far from being optimal. A variety of nanomedicine formulas provide a plethora of opportunities for developing new strategies and means for tackling metastasis. It should be noted that individualized anti-metastatic nanomedicines are different from common anti-cancer nanomedicines as they specifically target different populations of malignant cells. This review briefly introduces the features of the metastatic cascade, and proposes a series of nanomedicine-based anti-metastasis strategies aiming to block each metastatic step. Moreover, we also concisely introduce the advantages of several promising nanoparticle platforms and their potential for constructing state-of-the-art individualized anti-metastatic nanomedicines. PMID:26056688

  17. International trends and strategies in educational development at universities

    Directory of Open Access Journals (Sweden)

    James Wisdom

    2012-03-01

    Full Text Available This article considers four areas of educational development work which may become more significant in the future. The range and quality of professional development for teaching in higher education has expanded in many countries, the investment in academic frameworks of outcomes, credits and standards has yet to be exploited, the research into student learning is both productive and challenging to existing structures, and the practice of educational development is becoming more extensive – for example, practitioners are now expected to contribute to institutional strategy as much as to provide support for individual lecturers. The article notes significant changes in assumptions about the relations between students, their teachers and their courses, the need for revised approaches to assessment, and the importance of the professional development of the program leader and team to support the modernization of higher education.

  18. An empiric estimate of the value of life: updating the renal dialysis cost-effectiveness standard.

    Science.gov (United States)

    Lee, Chris P; Chertow, Glenn M; Zenios, Stefanos A

    2009-01-01

    Proposals to make decisions about coverage of new technology by comparing the technology's incremental cost-effectiveness with the traditional benchmark of dialysis imply that the incremental cost-effectiveness ratio of dialysis is seen a proxy for the value of a statistical year of life. The frequently used ratio for dialysis has, however, not been updated to reflect more recently available data on dialysis. We developed a computer simulation model for the end-stage renal disease population and compared cost, life expectancy, and quality adjusted life expectancy of current dialysis practice relative to three less costly alternatives and to no dialysis. We estimated incremental cost-effectiveness ratios for these alternatives relative to the next least costly alternative and no dialysis and analyzed the population distribution of the ratios. Model parameters and costs were estimated using data from the Medicare population and a large integrated health-care delivery system between 1996 and 2003. The sensitivity of results to model assumptions was tested using 38 scenarios of one-way sensitivity analysis, where parameters informing the cost, utility, mortality and morbidity, etc. components of the model were by perturbed +/-50%. The incremental cost-effectiveness ratio of dialysis of current practice relative to the next least costly alternative is on average $129,090 per quality-adjusted life-year (QALY) ($61,294 per year), but its distribution within the population is wide; the interquartile range is $71,890 per QALY, while the 1st and 99th percentiles are $65,496 and $488,360 per QALY, respectively. Higher incremental cost-effectiveness ratios were associated with older age and more comorbid conditions. Sensitivity to model parameters was comparatively small, with most of the scenarios leading to a change of less than 10% in the ratio. The value of a statistical year of life implied by dialysis practice currently averages $129,090 per QALY ($61,294 per year), but

  19. Intraperitoneal pressure in peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Vicente Pérez Díaz

    2017-11-01

    Full Text Available The measure of intraperitoneal pressure in peritoneal dialysis is easy and provides clear therapeutic benefits. However it is measured only rarely in adult peritoneal dialysis units. This review aims to disseminate the usefulness of measuring intraperitoneal pressure. This measurement is performed in supine before initiating the drain of a manual exchange with “Y” system, by raising the drain bag and measuring from the mid-axillary line the height of the liquid column that rises from the patient. With typical values of 10–16 cm H2O, intraperitoneal pressure should never exceed 18 cm H2O. With basal values that depend on body mass index, it increases 1–3 cm H2O/L of intraperitoneal volume, and varies with posture and physical activity. Its increase causes discomfort, sleep and breathing disturbances, and has been linked to the occurrence of leaks, hernias, hydrothorax, gastro-esophageal reflux and enteric peritonitis. Less known and valued is its ability to decrease the effectiveness of dialysis significantly counteracting ultrafiltration and decreasing solute clearance to a smaller degree. Because of its easy measurement and potential utility, should be monitored in case of ultrafiltration failure to rule out its eventual contribution in some patients. Although not yet mentioned in the clinical practice guidelines for PD, its clear benefits justify its inclusion among the periodic measurements to consider for prescribing and monitoring peritoneal dialysis. Resumen: La medida de la presión intraperitoneal en diálisis peritoneal es muy sencilla y aporta claros beneficios terapéuticos. Sin embargo, su monitorización todavía no se ha generalizado en las unidades de diálisis peritoneal de adultos. Esta revisión pretende divulgar su conocimiento y la utilidad de su medida. Se realiza en decúbito antes de iniciar el drenaje de un intercambio manual con bolsa en Y, elevando la bolsa de

  20. Sustainable development and low carbon growth strategy for India

    International Nuclear Information System (INIS)

    Parikh, Kirit

    2012-01-01

    For India, sustainable strategy means one that is economically, environmentally and socially sustainable. This calls for rapid economic growth to deal with poverty and human development. However, the relatively meagre energy resources of the country pose a huge challenge. At the same time concern for climate change has raised the bar on the use of the one energy resource that India has in some abundance, namely coal. India's strategy for sustainable development has to explore all options of reducing energy needs, enhancing efficiency of use of conventional energy resources and develop new and renewable sources. The paper identifies various technical options, their potential roles and alternative policy measures to realize them in a cost effective manner. Even for the same objectives different policy instruments are available and how one chooses a particular instrument is often critical for the success. Self-implementing incentive compatible policy that does not create vested interests that would get entrenched should be preferred. -- Highlights: ► Energy efficiency is critical for sustainable development. ► India can reduce its emission intensity by 25 % by 2020 as proposed by India at Copenhagen. ► With a more aggressive effort even 35% reduction is attainable even with 8% or 9% growth. ► Energy efficient appliances, vehicles, buildings and industrial processes are needed. ► Policies that incentivize adoption of these pose critical challenges.

  1. Conceptual framework for holistic dialysis management based on key performance indicators.

    Science.gov (United States)

    Liu, Hu-Chen; Itoh, Kenji

    2013-10-01

    This paper develops a theoretical framework of holistic hospital management based on performance indicators that can be applied to dialysis hospitals, clinics or departments in Japan. Selection of a key indicator set and its validity tests were performed primarily by a questionnaire survey to dialysis experts as well as their statements obtained through interviews. The expert questionnaire asked respondents to rate the degree of "usefulness" for each of 66 indicators on a three-point scale (19 responses collected). Applying the theoretical framework, we selected a minimum set of key performance indicators for dialysis management that can be used in the Japanese context. The indicator set comprised 27 indicators and items that will be collected through three surveys: patient satisfaction, employee satisfaction, and safety culture. The indicators were confirmed by expert judgment from viewpoints of face, content and construct validity as well as their usefulness. This paper established a theoretical framework of performance measurement for holistic dialysis management from primary healthcare stakeholders' perspectives. In this framework, performance indicators were largely divided into healthcare outcomes and performance shaping factors. Indicators of the former type may be applied for the detection of operational problems or weaknesses in a dialysis hospital, clinic or department, while latent causes of each problem can be more effectively addressed by the latter type of indicators in terms of process, structure and culture/climate within the organization. © 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.

  2. Pleuroperitoneal leak complicating peritoneal dialysis: a case series.

    LENUS (Irish Health Repository)

    Kennedy, C

    2012-02-01

    Pressure related complications such as abdominal wall hernias occur with relative frequency in patients on peritoneal dialysis. Less frequently, a transudative pleural effusion containing dialysate can develop. This phenomenon appears to be due to increased intra-abdominal pressure in the setting of congenital or acquired diaphragmatic defects. We report three cases of pleuroperitoneal leak that occurred within a nine-month period at our institution. We review the literature on this topic, and discuss management options. The pleural effusion resolved in one patient following drainage of the peritoneum and a switch to haemodialysis. One patient required emergency thoracocentesis. The third patient developed a complex effusion requiring surgical intervention. The three cases highlight the variability of this condition in terms of timing, symptoms and management. The diagnosis of a pleuroperitoneal leak is an important one as it is managed very differently to most transudative pleural effusions seen in this patient population. Surgical repair may be necessary in those patients who wish to resume peritoneal dialysis, or in those patients with complex effusions. Pleuroperitoneal leak should be considered in the differential diagnosis of a pleural effusion, particularly a right-sided effusion, in a patient on peritoneal dialysis.

  3. Economic impact of extended time on peritoneal dialysis as a result of using polyglucose: the application of a Markov chain model to forecast changes in the development of the ESRD programme over time

    NARCIS (Netherlands)

    T.J. Weijnen; H.W. van Hamersvelt; P.M. Just; D.G. Struijk; P.M. ter Wee (Piet); Y.I. Tjandra; F.Th. de Charro

    2003-01-01

    textabstractBACKGROUND: The use of polyglucose as a peritoneal dialysis (PD) fluid extends time on PD treatment. It is anticipated, therefore, that the share of patients treated with PD will be positively influenced. The relationship between extension of PD treatment time and an

  4. Catalysis in electrochemistry: from fundamentals to strategies for fuel cell development

    National Research Council Canada - National Science Library

    Santos, Elizabeth; Schmickler, Wolfgang

    2011-01-01

    "Catalysis in Electrochemistry: From Fundamentals to Strategies for Fuel Cell Development is a modern, comprehensive reference work on catalysis in electrochemistry, including principles, methods, strategies, and applications...

  5. Strategy and tactics of nanoindustry development in the Russian Federation

    Directory of Open Access Journals (Sweden)

    Oleg Vasil’evich Inshakov

    2011-09-01

    Full Text Available This paper describes the features, priorities and directions of state policy in nanotechnological development in the Russian Federation. The basic concepts of nanoeconomics in the modern economic theory were defined, these are: utilitarian, evolutionary, institutional and behaviorist ones. The content of the strategic multi-level process as a component of nanoindustrialization within the VI technological mode based on a structural model of the global economic system and metaindustrial function was disclosed. The most important area of nanoindustrialization (as identified by the author is the development of economic genetics and analysis of human activity on the nanoscale level (operations, activities, methods and movements. A powerful technological breakthrough and modernization of the Russian economy in the conditions of formation and growth of the VI technological mode are possible in form of organization of large-scale studies on the evolution, strategy and technology of social relations development that are adequate to the specifics of the new socio-economic structure.

  6. DEVELOPMENT AND IMPLEMENTATION OF CREATIVITY-ORIENTED TEACHING STRATEGY

    Directory of Open Access Journals (Sweden)

    S. N. Degtyarev

    2014-01-01

    Full Text Available The research investigates the principles of creativity-oriented teaching (COT, substantiates its strategy based on developing the didactic structure of creative educational environment, and looks for the invariant of pedagogical activity guaranteeing the creativity development. The methodology involves a theoretical analysis and specification of COT principles, and empirical methods of identifying the creative teaching invariant.The paper describes the content of COT principles, and provides recommendations for their implementation; the concepts of creative teaching invariant and creative potential being defined. The author supplements the theory of heuristic teaching and applies the methods of logical and graphical structuring of information to foster students’ creative activity.The research findings can be implemented in the system of school education for developing the students’ intellectual potential and creative abilities.

  7. Development strategy research of low-carbon tourist city

    Science.gov (United States)

    Dong, Xiaohong

    2017-04-01

    Construction of low-carbon tourist city has become a strategic choice for the development of city construction in our country, becoming the direction and goal of future city development in China. In this paper, the development strategy of low-carbon tourist city is put forward from the aspects of building low-carbon tourism culture, strengthening and perfecting the relevant rules and regulations, establishing and perfecting the decision-making management mechanism of low-carbon tourist city construction, establishing accurate, timely, efficient and comprehensive ecological environment monitoring and supervision network, building economical resource utilization system, strengthening science and technology supporting of low-carbon city construction, establishing low-carbon tourism scenic spot, low-carbon community or low-carbon demonstration area, etc.

  8. Rambutan Commodity Development Strategy as Regional Potential Product

    Directory of Open Access Journals (Sweden)

    Amin Pujiati

    2016-06-01

    Full Text Available The potential product of a region needs to be developed in order to improve the social welfare. Commonly, at harvest time, there is abundant horticulture commodity. Unluckily, the price of the commodity drops significantly. In other words, it costs extremely cheap. The purpose of research is analyzing the internal and external factors and determining an appropriate strategy for developing rambutan in Central Java, especially at Gunungpati District, Semarang, Central Java Province. The primary data of this research is obtained from 58 rambutan farmers that have been interviewed and have filled out the questionnaire forms. The secondary data is taken from the Central Bureau of Statistics, the monograph of the village and the internet by implementing the literature study method. Then, SWOT analysis is implemented for analizing the data. The internal factors that become the strengths are fertilized land for rambutan to grow and the farmers’ hereditary experiences in cultivating rambutan. Further, the lack of absorbing power of knowledge and technologies and the low existence of rambutan business are the weaknesses. Next, the external factor that becomes opportunity is the continuous increasing market demand, while the threat is the young generations having no interest in rambutan business. Finally, the stability (hold and maintain strategy should be implemented for developing rambutan business

  9. Rambutan Commodity Development Strategy as Regional Potential Product

    Directory of Open Access Journals (Sweden)

    Amin Pujiati

    2016-06-01

    Full Text Available The potential product of a region needs to be developed in order to improve the social welfare. Commonly, at harvest time, there is abundant horticulture commodity. Unluckily, the price of the commodity drops significantly. In other words, it costs  extremely cheap. The purpose of research is analyzing the internal and external factors and determining an appropriate strategy for developing rambutan in Central Java, especially at Gunungpati District, Semarang, Central Java Province. The primary data of this research is obtained from 58 rambutan farmers that have been interviewed and have filled out the questionnaire forms. The secondary data is taken from the Central Bureau of Statistics, the monograph of the village and the internet by implementing the literature study method. Then, SWOT analysis is implemented for analizing the data. The internal factors that become the strengths are fertilized land for rambutan to grow and the farmers’ hereditary experiences in cultivating rambutan. Further, the lack of absorbing power of knowledge and technologies and the low existence of rambutan business are the weaknesses. Next, the external factor that becomes opportunity is the continuous increasing market demand, while the threat is the young generations having no interest in rambutan business. Finally, the stability (hold and maintain strategy should be implemented for developing rambutan business

  10. Energy strategies for a sustainable development in India

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, A K.N. [Department of Management Studies, Indian Institute og Science, Bangalore (IN)

    1991-07-01

    There must be an end-use orientation to energy planning. What is required therefore is a development-focused end-use-oriented service-directed paradigm such as DEFENDUS. The fundamental cause of India's current oil crisis is the country's unchecked appetite for diesel, kerosene and gasoline due to railway freight being de-emphasized, homes not being electrified and personal transportation being preferred. The DEFENDUS strategy for resolving India's oil crisis is implementing efficiency improvements in the use of petroleum products, shifting passenger traffic from personal vehicles to public transportation, shifting freight traffic from road to rail, and replacing oil with alternative non-oil fuels, particularly biomass-derived fuels. The proposed strategy is a massive programme of home electrification. When all homes are electrified, kerosene becomes unnecessary as an illuminant. Once this is done, the subsidy on diesel can be removed and its price can be brought on par with that of gasoline. The increase of diesel prices would create a favourable environment in which supporting policy measures can be adopted. For the railways to exploit the situation and increase their freight haulage, there must be substantial investments in the improvement of the railways' freight operations. These funds can come from the diversion of the implicit subsidies on kerosene and diesel. This strategy of shifting freight from trucks to rail can reduce drastically the diesel demand in the transport sector. The next component of the strategy consists of the provision of high-efficiency cooking fuels and/or devices in rural and urban areas and would make available large amounts of wood provided that all the firewood being used today for cooking can still be collected. This saved fuelwood can be converted into methanol. If diesel fuel in trucks and buses is replaced with methanol, then the only diesel demand from the transport sector will come from the railways. (author).

  11. Restless legs syndrome in patients on dialysis

    International Nuclear Information System (INIS)

    AlJahdali, Hamdan H; AlQadhi, Waleed A; Khogeer, Haithm A; AlHejaili, Fayez F; Al Sayyari, Abdullah A; AlGhamdi, Saeed M

    2009-01-01

    Restless legs syndrome (RLS) is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG). This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD) on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH), Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC), Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG's RLS Questionnaire (RLSQ). Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 + - 17.2 years and mean duration on dialysis 40.4 + - 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM), coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively). Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS) (P= < 0.001 and 0.001, respectively). Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis and

  12. Restless legs syndrome in patients on dialysis

    Directory of Open Access Journals (Sweden)

    Al-Jahdali Hamdan

    2009-01-01

    Full Text Available Restless legs syndrome (RLS is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG. This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH, Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC, Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG′s RLS Questionnaire (RLSQ. Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 ± 17.2 years and mean duration on dialysis 40.4 ± 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM, coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively. Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS (P= < 0.001 and 0.001, respectively. Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis

  13. Croatian Recommendations for Dialysis of HIV-Positive Patients

    Directory of Open Access Journals (Sweden)

    Gulin Marijana

    2016-06-01

    Full Text Available Human immunodeficiency virus (HIV infection may be associated with renal impairment since about 0.4% of all HIV-positive patients develop end-stage renal disease. The share of patients with HIV infection in hemodialysis centers throughout the world ranges from 0.3% to as high as 38%. In Croatia, renal replacement therapy was needed by 1% of all the HIV-positive patients from 1985 until the end of 2014. Healthcare professionals (HP should be aware of the risks of occupational exposure to blood-borne infections in their daily work. Performing dialysis in HIV-positive patients increases the risk of exposure to HIV during the extracorporeal circulation of the infected blood. However, post-exposure prophylaxis (PEP with effective antiretroviral drugs significantly reduces the risk of infection after occupational exposure. On behalf of the Croatian Society of Nephrology, Dialysis and Transplantation, the authors of this paper have proposed recommendations for the management of HIVpositive patients on dialysis, which aim to prevent the transmission of HIV among patients and HPs. The important recommendations include the following: 1. when the need arises, it is necessary to provide HIV-positive patients with dialysis in the vicinity of their place of residence. 2. HIV-positive patients should be dialyzed with a separate hemodialysis machine in an isolated area. Alternatively, they can be dialyzed in an area for the hemodialysis of HCV-positive and/or HBVpositive patients. 3. Specialized and trained personnel should be provided during the hemodialysis procedure, together with strict compliance with the standard precautions for the prevention of blood-borne infections. 4. There should be a good and prompt cooperation with the National Referral Center for HIV infection.

  14. Strategies and challenges for safe injection practice in developing countries.

    Science.gov (United States)

    Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, Kc Vikash

    2013-01-01

    Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of "Safe Injection Global Network (SIGN)" was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.

  15. SWOT ANALYSIS AND STRATEGIES TO DEVELOP SUSTAINABLE TOURISM IN BANGLADESH

    Directory of Open Access Journals (Sweden)

    Sanaul Haque Mondal

    2017-06-01

    Full Text Available Bangladesh is a small country with enormous natural beauty and cultural attractions. These gorgeous natural and cultural traits make this country as one of the important tourist destinations in the world but, this potentiality has been overlooked. The tourism industry is facing several challenges, and development efforts of this industry are not sustainable. This paper maps out a way to sustainable growth of the tourism industry in Bangladesh using the SWOT (strengths, weaknesses, opportunities and threats model and a derived matrix out of it. The data used for this study were derived from multiple sources, including literature review and interviews with professionals. To analyze strategic factors of the tourism industry in the country, internal strengths and weaknesses as well as external opportunities and threats were determined to be followed by development of strategic planning based on the SWOT matrix. Results showed that existing tourism activities in Bangladesh are unsustainable. To develop a sustainable tourism industry to attract tourists, this study suggests different WT (weaknesses- threats strategies such as ensuring safety and security of tourists, effective planning for sustainable economic benefits, strict implementation of environmental regulations for ecological sustainability, alerting people about the importance of sustainable tourism development, and infrastructure development. Perhaps the findings of this study would be important in the effort to develop and promote a sustainable tourism industry in beautiful Bangladesh.

  16. Strategies for Sustainable Urban Development and Urban-Rural Linkages

    DEFF Research Database (Denmark)

    Nilsson, Kjell; Nielsen, Thomas Alexander Sick; Aalbers, Carmen

    2014-01-01

    , identified how land use conflicts and the pressure towards peri- urban areas can be strategically managed in different development and regulatory contexts. To summarise, the following strategies were identified as important steps towards more sustainable urban-rural futures: (i) better coordination...... of transport, land use and open space planning; (ii) urban containment and densification – development a green compact city; (iii) preservation of blue and green infrastructure; and (iv) preservation of agricultural land and the promotion of local production. The need also remains to strengthen governance...... at the regional level while at the pan-European level there is clearly a need for more policy attention to be given to urban-rural linkages....

  17. The development of a high level radioactive waste management strategy

    International Nuclear Information System (INIS)

    Beale, H.

    1979-11-01

    The management of high level radioactive waste, from the removal of spent fuel from reactors to final disposal of vitrified waste, involves a complex choice of operational variables which interact one with another. If the various operations are designed and developed in isolation it will almost certainly lead to suboptimal choice. Management of highly active waste should therefore be viewed as a complete system and analysed in such a way that account is taken of the interactions between the various operations. This system must have clearly defined and agreed objectives as well as criteria against which performance can be judged. A thorough analysis of the system will provide a framework within which the necessary research and development can be carried out in a co-ordinated fashion and lead to an optimised strategy for managing highly active wastes. (author)

  18. Strategies for sustainable development of the Polish electric power system

    International Nuclear Information System (INIS)

    Janiczek, R.

    1996-01-01

    The key features of sustainable development of the Polish electric power industry are discussed. Priorities and limitations for changes and power demand forecasts are described. Results of least-cost planning for existing power plants' modernization and generation expansion with environmental impacts are presented. The least-cost strategy is given by the optimal upgrades of older plants until year 2002 and by expansion of gas-fired units. The limited availability of gas after 2010 will lead to the construction of new coal-fired plants. For the next planning process, an integrated resource planning methodology is proposed, which includes dynamic optimization of supply and demand side options. Innovative mechanisms are shown to overcome barriers of development like long-terms contracts and decentralization of the power system planning process. (author)

  19. Improving Distress in Dialysis (iDiD): A tailored CBT self-management treatment for patients undergoing dialysis.

    Science.gov (United States)

    Hudson, Joanna L; Moss-Morris, Rona; Game, David; Carroll, Amy; Chilcot, Joseph

    2016-12-01

    There is significant psychological distress in adults with end-stage kidney disease (ESKD). However, psychological treatments tailored to address the unique challenges of kidney failure are absent. We identified psychological correlates of distress in ESKD to develop a cognitive-behavioural therapy (CBT) treatment protocol that integrates the mental health needs of patients alongside their illness self-management demands. Studies which examined relationships between distress and psychological factors that apply in the context of ESKD including: health threats, cognitive illness representations and illness management behaviours were narratively reviewed. Review findings were translated into a CBT formulation model to inform the content of a renal-specific seven session CBT treatment protocol, which was commented on and refined by patient representatives. Health threats related to distress were grouped into four themes including: acute ESKD events, loss of role, uncertainty and illness self-management. Having pessimistic illness and treatment perceptions were associated with elevated distress. Non-adherence and avoidance behaviours were related to feelings of distress, whereas cognitive reappraisal, acceptance, social support and assertiveness were associated with less distress. The dialysis-specific CBT formulation identifies the importance of targeting ESKD-specific correlates of distress to allow the delivery of integrated mental and physical health care. The 'Improving Distress in Dialysis (iDiD)' treatment protocol now requires further evaluation in terms of content, feasibility and potential efficacy. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  20. Sustainable Development Strategy for Russian Mineral Resources Extracting Economy

    Science.gov (United States)

    Dotsenko, Elena; Ezdina, Natalya; Prilepskaya, Angelina; Pivnyk, Kirill

    2017-11-01

    The immaturity of strategic and conceptual documents in the sphere of sustainable development of the Russian economy had a negative impact on long-term strategic forecasting of its neo-industrialization. At the present stage, the problems of overcoming the mineral and raw material dependence, the negative structural shift of the Russian economy, the acceleration of the rates of economic growth, the reduction of technological gap from the developed countries become strategically in demand. The modern structure of the Russian economy, developed within the framework of the proposed market model, does not generate a sustainable type of development. It became obvious that in conditions of the market processes' entropy, without neo-industrial changes, the reconstruction of industry on a new convergence-technological basis and without increasing the share of high technology production the instability of macroeconomic system, the risks of environmental and economic security of Russia are growing. Therefore, today we need a transition from forming one industry development strategy to the national one that will take into account both the social and economic and environmental challenges facing Russia as a mineral resources extracting country.

  1. Turkey’s Strategy towards Afghanistan: Security and Development Assistance

    Directory of Open Access Journals (Sweden)

    Altunay Ilgar Aliyeva

    2016-01-01

    Full Text Available Providing assistance to the least developed countries has remained one of the top priorities for leading international actors in the XXI century, and the Republic of Turkey is no exception in this regard. The Justice and Development Party's ascension to power in 2002 led to a drastic revision of the Turkish foreign policy and adoption of a novel approach to the least developed countries accounting for the complex interdependence between security and development. This approach was tested in Afghanistan where Turkey contributed to both post-conflict reconstruction of the country and to the activities of the International Security Assistance Force (ISAF. Since 2015 Turkey has been actively engaged in the new NATO 'Resolute Support' mission, while continuing its economic support to Afghanistan on bilateral and multilateral basis. This paper aims to unveil the particularities of the Turkey's Afghan strategy, which has yet escaped the Russian scholars' attention, with the help of the Turkish primary sources and academic works. It studies the specificity of bilateral relations and their determinants, including historic ties and religious and cultural proximity. It provides an in-depth analysis of the activities of both Turkish Cooperation and Development Agency (TIKA and the Turkish Provincial Reconstruction Team (PRT in Afghanistan and examines the challenges of Turkish troops' presence on the Afghan soil and the way how the Turkish elites and Turkey's NATO allies perceive it.

  2. Nutrition intervention strategies to combat zinc deficiency in developing countries.

    Science.gov (United States)

    Gibson, R S; Ferguson, E L

    1998-06-01

    Widespread zinc deficiency is likely to exist in developing countries where staple diets are predominantly plant based and intakes of animal tissues are low. The severe negative consequences of zinc deficiency on human health in developing countries, however, have only recently been recognized. An integrated approach employing targeted supplementation, fortification and dietary strategies must be used to maximize the likelihood of eliminating zinc deficiency at a national level in developing countries. Supplementation is appropriate only for populations whose zinc status must be improved over a relatively short time period, and when requirements cannot be met from habitual dietary sources. As well, the health system must be capable of providing consistent supply, distribution, delivery and consumption of the zinc supplement to the targeted groups. Uncertainties still exist about the type, frequency, and level of supplemental zinc required for prevention and treatment of zinc deficiency. Salts that are readily absorbed and at levels that will not induce antagonistic nutrient interactions must be used. At a national level, fortification with multiple micronutrients could be a cost effective method for improving micronutrient status, including zinc, provided that a suitable food vehicle which is centrally processed is available. Alternatively, fortification could be targeted for certain high risk groups (e.g. complementary foods for infants). Efforts should be made to develop protected fortificants for zinc, so that potent inhibitors of zinc absorption (e.g. phytate) present either in the food vehicle and/or indigenous meals do not compromise zinc absorption. Fortification does not require any changes in the existing food beliefs and practices for the consumer and, unlike supplementation, does not impose a burden on the health sector. A quality assurance programme is required, however, to ensure the quality of the fortified food product from production to consumption

  3. Suggestions on the development strategy of shale gas in China

    Directory of Open Access Journals (Sweden)

    Dazhong Dong

    2016-12-01

    Full Text Available From the aspects of shale gas resource condition, main exploration and development progress, important breakthrough in key technologies and equipment, this paper systematically summarized and analyzed current situation of shale gas development in China and pointed out five big challenges such as misunderstandings, lower implementation degree and higher economic uncertainty of shale gas resource, and still no breakthrough in exploration and development core technologies and equipment for shale gas buried depth more than 3500 m, higher cost and other non-technical factors that restrict the development pace. Aiming at the above challenges, we put forward five suggestions to promote the shale gas development in China: (1 Make strategies and set goals according to our national conditions and exploration and development stages. That is, make sure to realize shale gas annual production of 20 × 109 m3, and strives to reach 30 × 109 m3. (2 Attach importance to the research of accumulation and enrichment geological theory and exploration & development key engineering technologies for lower production and lower pressure marine shale gas reservoir, and at the same time orderly promote the construction of non-marine shale gas exploration & development demonstration areas. (3 The government should introduce further policies and set special innovation funds to support the companies to carry out research and development of related technologies and equipment, especially to strengthen the research and development of technology, equipment and process for shale gas bellow 3500 m in order to achieve breakthrough in deep shale gas. (4 Continue to promote the geological theory, innovation in technology and management, and strengthen cost control on drilling, fracturing and the whole process in order to realize efficient, economic and scale development of China's shale gas. (5 Reform the mining rights management system, establish information platform of shale

  4. Remote Patient Management for Home Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Eric L. Wallace

    2017-11-01

    Full Text Available Remote patient management (RPM offers renal health care providers and patients with end-stage kidney disease opportunities to embrace home dialysis therapies with greater confidence and the potential to obtain better clinical outcomes. Barriers and evidence required to increase adoption of RPM by the nephrology community need to be clearly defined. Ten health care providers from specialties including nephrology, cardiology, pediatrics, epidemiology, nursing, and health informatics with experience in home dialysis and the use of RPM systems gathered in Vienna, Austria to discuss opportunities for, barriers to, and system requirements of RPM as it applies to the home dialysis patient. Although improved outcomes and cost-effectiveness of RPM have been demonstrated in patients with diabetes mellitus and heart disease, only observational data on RPM have been gathered in patients on dialysis. The current review focused on RPM systems currently in use, on how RPM should be integrated into future care, and on the evidence needed for optimized implementation to improve clinical and economic outcomes. Randomized controlled trials and/or large observational studies could inform the most effective and economical use of RPM in home dialysis. These studies are needed to establish the value of existing and/or future RPM models among patients, policy makers, and health care providers.

  5. Liver fat, visceral adiposity, and sleep disturbances contribute to the development of insulin resistance and glucose intolerance in nondiabetic dialysis patients.

    Science.gov (United States)

    Sakkas, Giorgos K; Karatzaferi, Christina; Zintzaras, Elias; Giannaki, Christoforos D; Liakopoulos, Vassilios; Lavdas, Eleftherios; Damani, Eleni; Liakos, Nikos; Fezoulidis, Ioannis; Koutedakis, Yiannis; Stefanidis, Ioannis

    2008-12-01

    Hemodialysis patients exhibit insulin resistance (IR) in target organs such as liver, muscles, and adipose tissue. The aim of this study was to identify contributors to IR and to develop a model for predicting glucose intolerance in nondiabetic hemodialysis patients. After a 2-h, 75-g oral glucose tolerance test (OGTT), 34 hemodialysis patients were divided into groups with normal (NGT) and impaired glucose tolerance (IGT). Indices of insulin sensitivity were derived from OGTT data. Measurements included liver and muscle fat infiltration and central adiposity by computed tomography scans, body composition by dual energy X-ray absorptiometer, sleep quality by full polysomnography, and functional capacity and quality of life (QoL) by a battery of exercise tests and questionnaires. Cut-off points, as well as sensitivity and specificity calculations were based on IR (insulin sensitivity index by Matsuda) using a receiver operator characteristics (ROC) curve analysis. Fifteen patients were assigned to the IGT, and 19 subjects to the NGT group. Intrahepatic fat content and visceral adiposity were significantly higher in the IGT group. IR indices strongly correlated with sleep disturbances, visceral adiposity, functional capacity, and QoL. Visceral adiposity, O2 desaturation during sleep, intrahepatic fat content, and QoL score fitted into the model for predicting glucose intolerance. A ROC curve analysis identified an intrahepatic fat content of > 3.97% (sensitivity, 100; specificity, 35.7) as the best cutoff point for predicting IR. Visceral and intrahepatic fat content, as well as QoL and sleep seemed to be involved at some point in the development of glucose intolerance in hemodialysis patients. Means of reducing fat depots in the liver and splachnic area might prove promising in combating IR and cardiovascular risk in hemodialysis patients.

  6. Construct of Dialysis Employee Satisfaction: Acquiring Satisfaction Factors and Their Contributions.

    Science.gov (United States)

    Gu, Xiuzhu; Itoh, Kenji

    2015-10-01

    We developed a construct of dialysis employees' satisfaction as an assessment framework and identified the crucial factors that contribute to overall job satisfaction. We also seek to capture some important characteristics of dialysis professionals' job satisfaction/dissatisfaction in Japan. A questionnaire was developed, including 35 facet-specific job-related satisfaction and 10 general satisfaction items in closed-ended questions. A questionnaire-based survey was conducted between August and October 2013. A total of 799 valid responses (87% of response rate) were collected from 46 physicians, 470 nurses and 251 technologists in the dialysis department of 43 facilities in Japan. Five satisfaction factors were derived by applying principal component analysis with 61% of cumulative variance accounted for. Physicians, nurses and technologists in the dialysis department shared a similar trend of job satisfaction that they were more satisfied with leadership, and communication and teamwork among the five factors, whereas their satisfaction level was relatively low with salary and welfare conditions. Physicians expressed the strongest satisfaction with any factor while nurses were the least satisfied. Nurses' and technologists' overall job satisfaction was mostly determined by satisfaction with self-actualization, and work demands and workload. A five-factor construct of dialysis employee satisfaction was identified. Overall job satisfaction of dialysis nurses and technologists were not overly high in Japan, and this seems to be caused by their relatively low satisfaction with self-actualization and with work demands and workload. Therefore, it is suggested that their work conditions and environment must be improved to support their self-actualization and to reduce their workload. © 2015 The Authors. Therapeutic Apheresis and Dialysis © 2015 International Society for Apheresis.

  7. Infantile cystinosis: From dialysis to renal transplantation

    Directory of Open Access Journals (Sweden)

    Manel Jellouli

    2017-01-01

    Full Text Available Cystinosis is an autosomal recessive, lysosomal storage disease characterised by the accumulation of the amino acid cystine in different organs and tissues. It is a multisystemic disease that can present with renal and extra-renal manifestations. In this report, we present the first case of transplanted nephropathic cystinosis in a Tunisian child. A 4-year-old Tunisian boy born to nonconsanguineous parents, was treated in our medical services in 1990 for cystinosis. Since the age of five months, he developed symptoms of severe weight loss, vomiting, dehydration, and polyuria. He manifested the Toni Debré Fanconi syndrome. Slit lamp examination of the anterior segment of both eyes revealed fine, shiny crystal-like deposits diffusely distributed in the corneal epithelium and the stroma. Our patient had renal failure. At the age of seven, he reached terminal chronic renal failure and was treated with peritoneal dialysis. Hemodialysis was started at the age of nine years. At the age of 13 years, he received a renal transplantation and was started on cysteamine 1999, five months after the renal transplantation. Currently, the patient is 28-year-old. The graft has survived 15 years after the transplantation. Renal functions were stable with a serum creatinine of 123 μmol/L at last follow-up.

  8. Development of a positioning strategy for a product to the millennials using the social media

    OpenAIRE

    Shetty, Sachidanand

    2018-01-01

    The aim of the diploma paper is to develop a positioning strategy for a product to the millennials using the social media. The diploma paper consists of three main parts. The first part is dedicated to the theoretical analysis which focusses on the concepts of positioning strategy, Factors which can influence a positioning strategy, development of a positioning strategy in the context of Social media and theoretical frameworks which can help in developing a positioning strategy. The second...

  9. Developing noise control strategies for entire railway networks

    Science.gov (United States)

    Oertli, Jakob

    2006-06-01

    The EU Environmental Noise Directive (2002/49) requires member states to deliver noise maps to the commission by 2007 and action plans by 2008 both for agglomerations as well as for major roads, railways and airports. Noise mitigation projects resulting from action plans are usually very expensive and therefore may threaten the economic viability of the railways in the current harsh competitive transport market, thus hindering sustainable transport policies. It is therefore of vital interest that the action plans and the resulting projects are designed in the most cost-effective way possible. The EU and Union of Railways (UIC) sponsored project Strategies and Tools to Assess and Implement noise Reducing measures for Railway Systems (STAIRRS) recognized this need and developed a tool, with which such optimal solutions can be obtained for entire railway networks. Since data collection is the most expensive part of the analysis, noise mapping data is ideally collected in such a way that it can be used for the calculation of the different scenarios, from which the most cost-effective action plans are chosen. The paper shows how the STAIRRS tool is used for this purpose and how cost-effectiveness considerations have led to optimal railway noise mitigation strategies in Switzerland and have given a basis for noise related decision making in Luxembourg.

  10. Applying real options analysis to assess cleaner energy development strategies

    International Nuclear Information System (INIS)

    Cheng, Ching-Tsung; Lo, Shang-Lien; Lin, Tyrone T.

    2011-01-01

    The energy industry, accounts for the largest portion of CO 2 emissions, is facing the issue of compliance with the national clean energy policy. The methodology for evaluating the energy mix policy is crucial because of the characteristics of lead time embedded with the power generation facilities investment and the uncertainty of future electricity demand. In this paper, a modified binomial model based on sequential compound options, which may account for the lead time and uncertainty as a whole is established, and a numerical example on evaluating the optional strategies and the strategic value of the cleaner energy policy is also presented. It is found that the optimal decision at some nodes in the binomial tree is path dependent, which is different from the standard sequential compound option model with lead time or time lag concept. The proposed modified binomial sequential compound real options model can be generalized and extensively applied to solve the general decision problems that deal with the long lead time of many government policies as well as capital intensive investments. - Highlights: → Introducing a flexible strategic management approach for government policy making. → Developing a modified binomial real options model based on sequential compound options. → Proposing an innovative model for managing the long term policy with lead time. → Applying to evaluate the options of various scenarios of cleaner energy strategies.

  11. REALIZATION STRATEGY OF BUDGET ALLOCATION TO DISSEMINATING OF DEVELOPMENT INFOMATION

    Directory of Open Access Journals (Sweden)

    Tarmidzi

    2018-03-01

    Full Text Available The objectives of this study is to know the strategy of realization for budget allocation of 2016 for disseminating of development information in news and communication Information Division, especially in Publication and Media Relation Sub Division at Public Relation and Protocol Bureau, Provincial Secretariat of West Nusa Tenggara. This study uses descriptive qualitative approach and tends to find a meaning from data obtained from the result of a research. It is intended to describe the description of existing data or theories and the resulting findings. In this case, the researchers collected data by conducting in-depth interviews and the use of information access test methods of eleven informants. The results show that there are limitations of publication budget on Sub Division of Publication and Media Relations at Public Relations Bureau and Protocol Provincial Secretariat of West Nusa Tenggara, the inappropriate use of the strategy, the lack of harmony of internal relations both within the environment of public relations officials themselves and with the media crew, the presumption that the Trip Press budget is in vain, less than the maximum use of media Internal and outdoor media.

  12. Cluster strategies in the regional economy development: legal aspects

    Directory of Open Access Journals (Sweden)

    Irina V. Mikheeva

    2016-09-01

    Full Text Available Objective to study the state of legal support of the cluster strategies implementation to identify the problems and possible directions for improving the legal support of cluster development in the regions. Methods systemic structuralfunctional induction and deduction analysis and synthesis formal legal. Results the paper formulates the definition of cluster as a form of cooperative interaction of organizations interacting in some economic sphere due to functional dependence complementing each other and reinforcing the competitive advantages of individual companies. The hypothesis is proposed that the organizational and management structure of clusters should be unified and obtain normative fixation so that the same type of bodies including executive bodies and the structure of the different clusters deliberative specialized organizations organizationcoordinator etc. had similar competence and position in the management hierarchy. Scientific novelty following the most general conception of a cluster as interacting institutions in a specific area one can see that the lack of clarity in the legal support of the clusters functioning does not allow to determine the status of authoritative and nonauthoritative subjects of economic activities their organizationallegal forms and the procedure of their interaction. Practical significance the identified problems of legal support of the cluster strategies implementation can help in the improvement of state regulation of cluster relations in the regions and their implementation.

  13. Developing an institutional strategy for transporting defense transuranic waste materials

    International Nuclear Information System (INIS)

    Guerrero, J.V.; Kresny, H.S.

    1986-01-01

    In late 1988, the US Department of Energy (DOE) expects to begin emplacing transuranic waste materials in the Waste Isolation Pilot Plant (WIPP), an R and D facility to demonstrate the safe disposal of radioactive wastes resulting from defense program activities. Transuranic wastes are production-related materials, e.g., clothes, rags, tools, and similar items. These materials are contaminated with alpha-emitting transuranium radionuclides with half-lives of > 20 yr and concentrations > 100 nCi/g. Much of the institutional groundwork has been done with local communities and the State of New Mexico on the siting and construction of the facility. A key to the success of the emplacement demonstration, however, will be a qualified transportation system together with institutional acceptance of the proposed shipments. The DOE's Defense Transuranic Waste Program, and its contractors, has lead responsibility for achieving this goal. The Joint Integration Office (JIO) of the DOE, located in Albuquerque, New Mexico, is taking the lead in implementing an integrated strategy for assessing nationwide institutional concerns over transportation of defense transuranic wastes and in developing ways to resolve or mitigate these concerns. Parallel prototype programs are under way to introduce both the new packaging systems and the institutional strategy to interested publics and organizations

  14. Development of immunotoxicity testing strategies for immunomodulatory drugs.

    Science.gov (United States)

    Kawabata, Thomas T; Evans, Ellen W

    2012-01-01

    The ICH S8 immunotoxicity testing guideline for human pharmaceuticals was published in 2006 and was intended to provide guidance for assessing the immunotoxicity potential of low-molecular-weight drugs that are not intended to alter the immune system. For drugs intended to modulate the immune system, immunotoxicity testing strategies are generally developed on a case-by-case approach since the targets, intended patient population, and mechanisms of action of the test compound will determine the type of testing needed. Some of the general principles of ICH S8, however, may be applied to immunotoxicity testing strategies for immunomodulatory drugs. A weight-of-evidence approach using factors discussed in ICH S8 in concert with an assessment of the potential value of additional immunotoxicity testing should be considered. For most situations, immunotoxicity studies with immunomodulatory compounds evaluate off-target effects on the immune system and exaggerated pharmacology. The potential use of data from these studies and considerations such as translatability to humans are discussed.

  15. A Study on Planning Strategies for Urban Housing Block Development

    Institute of Scientific and Technical Information of China (English)

    Zeng Wei; Wang Hua; You Juanjuan; Wang Linlin; Li Caige

    2016-01-01

    As a city is the carrier of human society and housing is an important part of a citizen's life and survival,the citizens' choice of their housing mode will influence the material and spiritual life of the individuals,families,and society.In view of the diversification of values and investments,people are eager for a harmonious relationship between the community and the city.As a kind of compact and efficient housing mode,the housing block highlights the organic link of the community within the city in an open and shared living environment.This paper reviews the development of housing blocks in various countries and summarizes the characteristics of housing blocks through a comparison with traditional gated residential quarters and urban blocks.It then analyzes the current difficulties of housing block development in China from aspects such as the planning concept,planning system,management mode,and development mode and accordingly proposes planning principles and strategies in hope of providing theoretical supports for the development and construction of housing blocks in China.

  16. Lymphangiogenesis and Lymphatic Absorption Are Related and Increased in Chronic Kidney Failure, Independent of Exposure to Dialysis Solutions

    NARCIS (Netherlands)

    Vlahu, Carmen A.; de Graaff, Marijke; Aten, Jan; Struijk, Dirk G.; Krediet, Raymond T.

    2015-01-01

    Increased lymphatic absorption might contribute to ultrafiltration failure in peritoneal dialysis (PD). Lymphangiogenesis develops during PD, but little is known about the relationship between its morphologic and functional parameters. The relationships between lymph vessel density, the effective

  17. Republic of Lithuania national energy strategy. Vol. 2: Background material for strategy development. Final report

    Energy Technology Data Exchange (ETDEWEB)

    IC Consult-ERM Energy Limited-COWI Consult-EC-PHARE Programme Collaboration

    1993-12-01

    Volume II presents supplementary Background Material collected and analysed during the course of the project. Volume II consists of two parts: PART A (Sources and Methods) and PART B (Special Sub sector Issues). PART A contains seven chapters. The subject of Chapter 1 is to integrate the material of this volume into the analytical approach as a whole and to give an outline of the tools applied in the Strategy development. Reference data provided in Chapter 2 summarizes the information as to the past energy consumption and the future economic development. Chapter 3 compiles basic parameters and assumptions with regard to energy forms, costs, the economic development as laid down for use in the project. Chapter 4 discusses in detail the projection of energy demand. Chapter 5 draws up the Projects under consideration. Chapter 6 presents key results of energy scenario computations, and Chapter 7 provides energy scenario indicators and assessment information. PART B of this Volume II contains full reports regarding topics, which have only briefly been addressed in Volume I. (author).[Data].

  18. Republic of Lithuania national energy strategy. Vol. 2: Background material for strategy development. Final report

    International Nuclear Information System (INIS)

    1993-12-01

    Volume II presents supplementary Background Material collected and analysed during the course of the project. Volume II consists of two parts: PART A (Sources and Methods) and PART B (Special Sub sector Issues). PART A contains seven chapters. The subject of Chapter 1 is to integrate the material of this volume into the analytical approach as a whole and to give an outline of the tools applied in the Strategy development. Reference data provided in Chapter 2 summarizes the information as to the past energy consumption and the future economic development. Chapter 3 compiles basic parameters and assumptions with regard to energy forms, costs, the economic development as laid down for use in the project. Chapter 4 discusses in detail the projection of energy demand. Chapter 5 draws up the Projects under consideration. Chapter 6 presents key results of energy scenario computations, and Chapter 7 provides energy scenario indicators and assessment information. PART B of this Volume II contains full reports regarding topics, which have only briefly been addressed in Volume I. (author).[Data

  19. Administration of calcimimetics after dialysis: Same effectiveness, better gastrointestinal tolerability

    Directory of Open Access Journals (Sweden)

    Vicent Esteve Simo

    2015-07-01

    Conclusions: Post-dialysis use of calcimimetic was effective in secondary hyperparathyroidism control, improved gastrointestinal tolerability and ameliorated patients’ satisfaction. Based on our findings, post-dialysis use of calcimimetics should be considered in selected patients with low therapeutic compliance.

  20. DEMO development strategy based on China FPP program

    International Nuclear Information System (INIS)

    Pan Chuanhong; Feng, K.M.; Wu, W.C.; Liu, S.L.

    2007-01-01

    The DEMO in China is to demonstrate the safety, reliability and environment feasibility of the fusion power plants, while to demonstrate the prospective economic feasibility of the commercial fusion power plants. Considering that there is still a long way to go towards an economically competitive commercial power plant, DEMO in China should be an indispensable step prior to the commercial one. Two options of breeding blanket with ceramic and lead lithium breeders might be chosen as DEMO concepts under the conditions of meeting the requirement of the neutronics, thermal-hydraulics and mechanics aspects. The DEMO development strategy, related R and D activities, based on China fusion power plant (FPP) program are presented. (orig.)

  1. Non-machinery dialysis that achieves blood purification therapy without using full-scale dialysis machines.

    Science.gov (United States)

    Abe, Takaya; Onoda, Mistutaka; Matsuura, Tomohiko; Sugimura, Jun; Obara, Wataru; Sato, Toshiya; Takahashi, Mihoko; Chiba, Kenta; Abe, Tomiya

    2017-09-01

    An electrical or water supply and a blood purification machine are required for renal replacement therapy. There is a possibility that acute kidney injury can occur in large numbers and on a wide scale in the case of a massive earthquake, and there is the potential risk that the current supply will be unable to cope with acute kidney injury cases. However, non-machinery dialysis requires exclusive circuits and has the characteristic of not requiring the full-scale dialysis machines. We performed perfusion experiments that used non-machinery dialysis and recent blood purification machines in 30-min intervals, and the effectiveness of non-machinery dialysis was evaluated by the assessing the removal efficiency of potassium, which causes lethal arrhythmia during acute kidney injury. The non-machinery dialysis potassium removal rate was at the same level as continuous blood purification machines with a dialysate flow rate of 5 L/h after 15 min and continuous blood purification machines with a dialysate flow rate of 3 L/h after 30 min. Non-machinery dialysis required an exclusive dialysate circuit, the frequent need to replace bags, and new dialysate exchanged once every 30 min. However, it can be seen as an effective renal replacement therapy for crush-related acute kidney injury patients, even in locations or facilities not having the full-scale dialysis machines.

  2. Testing and development strategy for the tank waste remediation system

    International Nuclear Information System (INIS)

    Reddick, G.W.

    1994-12-01

    This document provides a strategy for performing radioactive (hot) and nonradioactive testing to support processing tank waste. It evaluates the need for hot pilot plant(s) to support pretreatment and other processing functions and presents a strategy for performing hot test work. A strategy also is provided for nonradioactive process and equipment testing. The testing strategy supports design, construction, startup, and operation of Tank Waste Remediation System (TWRS) facilities

  3. Testing and development strategy for the tank waste remediation system

    International Nuclear Information System (INIS)

    Reddick, G.W.

    1995-01-01

    This document provides a strategy for performing radioactive (hot) and nonradioactive testing to support processing tank waste. It evaluates the need for hot pilot plant(s) to support pretreatment and other processing functions and presents a strategy for performing hot test work. A strategy also is provided for nonradioactive process and equipment testing. The testing strategy supports design, construction, startup, and operation of Tank Waste Remediation System (TWRS) facilities

  4. Issues in developing a mitigation strategy for Bangladesh

    Energy Technology Data Exchange (ETDEWEB)

    Asaduzzaman, M. [Bangladesh Institute of Development Studies, Dhaka (Bangladesh)

    1996-12-31

    Bangladesh, it is by now well-known, is at the receiving end, in the literal sense of the term, of the global climate change and its potential impacts. She contributes very little to the current global emission of greenhouse gases (GHGs). The Emission Inventory under the present umbrella project, Bangladesh Climate Change Study (BCCS), has found that her annual emission of carbon has been only 3.99 mn metric tons per year. An earlier study arrived at exactly the same figure. The figures for estimated release of methane is far less firm. The estimated methane emission in 1990 could be anywhere between 1 million and 6 million metric tons. In any case the total emission is unlikely to be more than one-half of one percent of the global total. On the other hand, however, she faces specter of widespread and more frequent floods, more frequent droughts, cyclones and above all sea-level rise (SLR) which may inundate a substantial part of the country all of these bringing in immeasurable misery and destitution and loss of income, employment and growth. One would expect that in such a situation, Bangladesh`s basic concern should be to prepare an appropriate adaptation strategy. This is already a major policy concern of the Government. There is, however, an increasing realization that Bangladesh should as well emphasize an appropriate mitigation strategy (MS). There may be at least three reasons why this should be so. The first is that she is a signatory of the Framework Convention on Climate Change. The second is that in the medium, if not short term she expects major growth due to a developing economy. Third is that Bangladesh depends primarily on fossil fuel imports for energy, and will become a larger source with further development.

  5. Affordable Development and Qualification Strategy for Nuclear Thermal Propulsion

    Science.gov (United States)

    Gerrish, Harold P., Jr.; Doughty, Glen E.; Bhattacharyya, Samit K.

    2013-01-01

    Nuclear Thermal Propulsion (NTP) is a concept which uses a nuclear reactor to heat a propellant to high temperatures without combustion and can achieve significantly greater specific impulse than chemical engines. NTP has been considered many times for human and cargo missions beyond low earth orbit. A lot of development and technical maturation of NTP components took place during the Rover/NERVA program of the 60's and early 70's. Other NTP programs and studies followed attempting to further mature the NTP concept and identify a champion customer willing to devote the funds and support the development schedule to a demonstration mission. Budgetary constraints require the use of an affordable development and qualification strategy that takes into account all the previous work performed on NTP to construct an existing database, and include lessons learned and past guidelines followed. Current guidelines and standards NASA uses for human rating chemical rocket engines is referenced. The long lead items for NTP development involve the fuel elements of the reactor and ground testing the engine system, subsystem, and components. Other considerations which greatly impact the development plans includes the National Space Policy, National Environmental Policy Act, Presidential Directive/National Security Council Memorandum #25 (Scientific or Technological Experiments with Possible Large-Scale Adverse Environmental Effects and Launch of Nuclear Systems into Space), and Safeguards and Security. Ground testing will utilize non-nuclear test capabilities to help down select components and subsystems before testing in a nuclear environment to save time and cost. Existing test facilities with minor modifications will be considered to the maximum extent practical. New facilities will be designed to meet minimum requirements. Engine and test facility requirements are based on the driving mission requirements with added factors of safety for better assurance and reliability

  6. Nutritional status of maintenance dialysis patients

    DEFF Research Database (Denmark)

    Koefoed, Mette Juul; Kromann, Charles Boy; Juliussen, Sophie Ryberg

    2016-01-01

    Background and Aims Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean bodymass index and obesity...... protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients. Results Seventy-nine eligible maintenance dialysis patients participated. The prevalence of proteinenergy wasted patients was 4%(95%CI: 2-12) as assessed......-energy wasting and obesity varied considerably, depending on nutritional assessment methodology. Conclusions Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase...

  7. SUSTAINABLE DEVELOPMENT STRATEGY FOR ECOTOURISM AT TANGKAHAN, NORTH SUMATERA

    Directory of Open Access Journals (Sweden)

    Agung Suryawan Wiranatha

    2016-03-01

    Full Text Available Ecotourism Destination of Tangkahan is located at the edge of Gunung Leuser National Park, within the Sub-regency of Batang Serangan, Regency of Langkat, Province of North Sumatera, Indonesia. The Ecotourism Destination of Tangkahan relies upon a distinctive tourist attraction, namely elephant trekking that is undertaken along the edge of the river and in the Gunung Leuser National Park (GLNP, as well as the diversity of flora and fauna available at the GLNP. There are many activities can be undertaken by visitors at this destination, such as: elephant trekking, wildlife watching at the GLNP, trekking at the edge of Buluh river and come back by swimming wearing life jacket, tubing (traditional rafting and canoeing at Batang Serangan river, swimming at Buluh river, camping and outbound activities at the camping ground, village tour at sub-village of Kuala Buluh, and traditional massage (pijat / kusuk by local therapist. The research was undertaken to develop strategies which could be used as guidance in managing and developing this ecotourism destination. The proposed strategies were based upon the results of SWOT analysis. Data were assembled from the visitors’ survey, focus group discussions and workshop involving tourism stakeholders and several interested groups. Based upon the analysis of existing tourist attractions offered at the Ecotourism Destination of Tangkahan, it could be said that the nature based tourist attractions were considered to be interesting up to very interesting. The uniqueness of elephant jungle trekking in the GLNP was the tourism icon of the Ecotourism Destination of Tangkahan. Camping ground, plant nursery, and agriculture plantation were potential to be promoted as tourist attractions at the Ecotourism Destination of Tangkahan.\tBased upon the results of SWOT analysis of the Ecotourism Destination of Tangkahan, several strategies could be recommended for ecotourism development at Tangkahan, namely, to maintain the

  8. Cardiovascular and noncardiovascular mortality among men and women starting dialysis

    DEFF Research Database (Denmark)

    Carrero, Juan J; de Jager, Dinanda J; Verduijn, Marion

    2011-01-01

    Although women have a survival advantage in the general population, women on dialysis have similar mortality to men. We hypothesized that this paired mortality risk during dialysis may be explained by a relative excess of cardiovascular-related mortality in women.......Although women have a survival advantage in the general population, women on dialysis have similar mortality to men. We hypothesized that this paired mortality risk during dialysis may be explained by a relative excess of cardiovascular-related mortality in women....

  9. Seroprevalence of Anti-HCV Antibody in Patients with Chronic Kidney Disease before Starting Dialysis Therapy

    Directory of Open Access Journals (Sweden)

    Fareha Jesmin Rabbi

    2017-01-01

    Full Text Available Background: Hepatitis C virus (HCV infection and chronic kidney disease are common and potentially serious medical problems throughout the world. In recent years, it has become clear that these two conditions are linked in several important ways. Indeed, some forms of renal diseases are precipitated by HCV infection and patients with end-stage renal disease (ESRD are at increased risk for acquiring HCV infection. Patients with chronic kidney disease typically show an impaired immune response compared with healthy individuals and also other risk factors related with treatment and management. CKD patients ultimately undergo end stage renal therapy like dialysis for their treatment and survival. Risk factors for the infections are more in dialysis period than in predialytic stages. Like other developing countries CKD patients with HCV infection are very common in our country. For this reason the CKD patients should be properly diagnosed knowing the infection status before dialysis which would help both the patient and doctor to choose their proper treatment approach. Objective: This cross-sectional study was done to know the prevalence of HCV infection in the CKD patients before starting dialysis therapy. Materials and Methods: A total of 197 patients with chronic kidney disease stage five (CKD-V before starting dialysis therapy were included as subjects of this study. Among the CKD patients anti-HCV was detected to see prevalence of hepatitis C virus infection. The patients were also tested for HBsAg to assess co-infection. After collecting all the data of different test results analyses were done by SPSS version 15.0. Results: In this study 195 (99% patients were anti-HCV negative and only two patients (1% were found positive. Conclusion: HCV infection in CKD patients before dialysis should be taken into account so that HCV negative CKD patients would not get the infection during dialysis and standard screening procedures should be taken to

  10. User-driven conversations about dialysis through Facebook: A qualitative thematic analysis.

    Science.gov (United States)

    Ahmed, Salim; Haines-Saah, Rebecca J; Afzal, Arfan R; Tam-Tham, Helen; Al Mamun, Mohammad; Hemmelgarn, Brenda R; Turin, Tanvir C

    2017-04-01

    As one of the most popular social networking sites in the world, Facebook has strong potential to enable peer support and the user-driven sharing of health information. We carried out a qualitative thematic analysis of the wall posts of a public Facebook group focused on dialysis to identify some of the major themes discussed. We searched Facebook using the word 'dialysis'. A Facebook group (Dialysis Discussion Uncensored) with the highest number of members was selected amongst publicly available forums related to dialysis and operated in English (http://www.facebook.com/groups/DialysisUncensored). Two researchers independently extracted information on features of the group including purpose, group members and the user-generated posts on the group wall. Posts were further analysed to develop major themes. Characteristics of a Facebook group based on its participants and activities are presented. Three themes are described with representative quotations. In a period of 2 weeks, we found 1257 wall posts with total of 31 636 likes and 15 972 comments. All messages were in English, and the majority of the participants were dialysis patients. However, we observed the participation of family members and care providers as well. Posts were categorized into three major themes: sharing information, seeking and providing emotional and social support and sharing experience. Findings of this study provide an example of how a social networking platform can enable patients and their families to share information and to encourage peer-based support for managing dialysis-related experiences. © 2016 Asian Pacific Society of Nephrology.

  11. Significance of Serum Leptin Assessment in Chronic Renal Patients on Dialysis

    International Nuclear Information System (INIS)

    Salem, E.S; Tawfik, M.S; ELaseily, E.S.

    2013-01-01

    The number of patients suffering from renal failure indicating dialysis has been increasing worldwide. Leptin hormone plays an important role in the development of malnutrition in these patients. Bone produces different hormones, such as osteocalcin (OC), which influences energy expenditure in humans. Disturbances in mineral metabolism and bone disease are common complications of chronic kidney disease (CKD). There are increasing evidences suggesting that these disorders in mineral and bone metabolism are associated with increased risk of cardiovascular calcification, morbidity, and mortality, especially among those who undergo maintenance renal dialysis. The present study was carried out to evaluate the importance of serum leptin assessment in renal dialysis patients. Serum leptin level was estimated by radioimmunoassay (RIA) using recombinant human leptin (Leptin- Human Ria-CT). Immunoradiometric assay kit (host IRMA) was used for in-vitro quantitative measurement of human intact OC. Serum creatinine level was determined by colorimetric method. This study included 60 patients (twenty suffering from CKD, thirty on dialysis and ten healthy controls). Serum leptin, OC and creatinine were found to be higher in patients of both groups compared to that of controls. Maximum increase was observed in patients on dialysis. From these results it is possible to conclude that, although patients with chronic renal disease exhibited significant increase in serum leptin, yet sudden additional increase can be related to serious pathology that can end in renal failure. The present study also highlighted the importance of OC as a marker of disturbed mineral-bone metabolism in chronic kidney disease (CKD) patients and those receiving dialysis that could lead to the atherosclerosis, extravascular calcification, morbidity and mortality. KeywoRdSLeptin, osteocalcin, Radioimmunoassay (RIA), Chronic kidney disease, Renal dialysis, Creatinine.

  12. The practical problem of improving quality in multicenter dialysis facilities.

    Science.gov (United States)

    Balter, Paul

    2003-01-01

    Multifacility dialysis groups are frequently interested in improving overall quality and find that there are major differences between individual units. Upper management must consider what strategy is needed for the whole company and what strategy must be formulated by individual facilities. To make substantive changes, management must decide to adopt a new culture of true teamwork, drive out fear, and emphasize leadership and education both at the management level and in the individual unit. Both at the corporate and unit levels, leaders must be chosen who are able to recognize people who have the ability, the educational background, the enthusiasm, and the time to direct change. Empowering the individual units and individual employees to make changes and be enthusiastic about improvement is the key to success.

  13. Optimizing home dialysis: role of hemodiafiltration.

    Science.gov (United States)

    Vilar, Enric; Farrington, Ken; Bates, Chris; Mumford, Carol; Greenwood, Roger

    2011-01-01

    Over the last 40 years the technical obstacles which prevented a convective contribution to diffusive dialysis have been overcome. Hemodiafiltration represents a natural evolution of intermittent extracorporeal blood purification and the technology is now available to offer this as standard treatment in-center. The first randomized control trial of dialysis dose (National Cooperative Dialysis Study) showed that for three times weekly dialysis a critical level of urea clearance was necessary to ensure complication-free survival, the effect being noticeable by 3 months. Following this, observational studies suggested that higher doses improved longer term outcome. In a second large randomized controlled study (HEMO), higher small molecule clearance did not further improve outcome, but high-flux membranes, which permitted enhanced clearance of middle molecules, appeared to confer survival benefit in patients who had already been on dialysis > 3.7 years. Recently, outcomes from the Membrane Permeability Outcome study confirmed a survival benefit of high-flux membranes in high-risk patients. These studies indicate that in the medium term survival is critically dependent on achieving a minimum level of small solute removal. However, longer term survival (measured in years or decades) not only requires better small solute clearance but also enhanced clearance of middle molecules, the toxicity of which manifest over longer time scales. The rationale for convective treatment is strongest, therefore in those patients who have the greatest potential for long-term survival. Patients who opt for self-care at home to allow frequent dialysis generally are constituents of this group. Hemodiafiltration is likely to become standard therapy in-center and in the home. Copyright © 2011 S. Karger AG, Basel.

  14. The WHO-ITU national eHealth strategy toolkit as an effective approach to national strategy development and implementation.

    Science.gov (United States)

    Hamilton, Clayton

    2013-01-01

    With few exceptions, national eHealth strategies are the pivotal tools upon which the launch or refocusing of national eHealth programmes is hinged. The process of their development obviates cross-sector ministerial commitment led by the Ministry of Health. Yet countries often grapple with the task of strategy development and best efforts frequently fail to address strategic components of eHealth key to ensure successful implementation and stakeholder engagement. This can result in strategies that are narrowly focused, with an overemphasis placed on achieving technical outcomes. Without a clear link to a broader vision of health system development and a firm commitment from partners, the ability of a strategy to shape development of a national eHealth framework will be undermined and crucial momentum for implementation will be lost. WHO and ITU have sought to address this issue through the development of the National eHealth Strategy Toolkit that provides a basis for the components and processes to be considered in a strategy development or refocusing exercise. We look at this toolkit and highlight those areas which the countries should consider in formulating their national eHealth strategy.

  15. Quality of life in automated and continuous ambulatory peritoneal dialysis

    NARCIS (Netherlands)

    Michels, Wieneke M.; van Dijk, Sandra; Verduijn, Marion; le Cessie, Saskia; Boeschoten, Elisabeth W.; Dekker, Friedo W.; Krediet, Raymond T.; Apperloo, A. J.; Bijlsma, J. A.; Boekhout, M.; Boer, W. H.; van der Boog, P. J. M.; Büller, H. R.; van Buren, M.; de Charro, F. Th; Doorenbos, C. J.; van den Dorpel, M. A.; van Es, A.; Fagel, W. J.; Feith, G. W.; de Fijter, C. W. H.; Frenken, L. A. M.; Grave, W.; van Geelen, J. A. C. A.; Gerlag, P. G. G.; Gorgels, J. P. M. C.; Huisman, R. M.; Jager, K. J.; Jie, K.; Koning-Mulder, W. A. H.; Koolen, M. I.; Kremer Hovinga, T. K.; Lavrijssen, A. T. J.; Luik, A. J.; van der Meulen, J.; Parlevliet, K. J.; Raasveld, M. H. M.; van der Sande, F. M.; Schonck, M. J. M.; Schuurmans, M. M. J.; Siegert, C. E. H.; Stegeman, C. A.; Stevens, P.; Thijssen, J. G. P.; Valentijn, R. M.; Vastenburg, G. H.; Verburgh, C. A.; Vincent, H. H.; Vos, P. F.

    2011-01-01

    Despite a lack of strong evidence, automated peritoneal dialysis (APD) is often prescribed on account of an expected better quality of life (QoL) than that expected with continuous ambulatory peritoneal dialysis (CAPD). Our aim was to analyze differences in QoL in patients starting dialysis on APD

  16. Dialysis-associated steal syndrome (DASS).

    Science.gov (United States)

    Mohamed, Ahmed S; Peden, Eric K

    2017-03-06

    In this article, we will review the clinical symptoms of dialysis access steal syndrome (DASS), evaluation, treatment options, and our approach and treatment algorithm. We reviewed the literature discussing different aspects of DASS including its epidemiology, pathogenesis, clinical presentation, evaluation and management options. DASS is the most dreaded complication of access surgery. Although the incidence is low, all providers caring for dialysis patients should be aware of this problem. Symptoms can range from mild to limb threatening. Although various tests are available, the diagnosis of DASS remains a clinical one and requires thoughtful management to have the best outcomes. Multiple treatment options exist for steal. We present diagnostic evaluation and management algorithm.

  17. Dialysis-related amyloidosis: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Scarpioni R

    2016-12-01

    Full Text Available R Scarpioni, M Ricardi, V Albertazzi, S De Amicis, F Rastelli, L Zerbini Department of Nephrology and Dialysis, Azienda Unità Sanitaria Local (AUSL Hospital “Guglielmo da Saliceto”, Piacenza, Italy Abstract: Amyloidosis refers to the extracellular tissue deposition of fibrils composed of low-molecular-weight subunits of a variety of proteins. These deposits may result in a wide range of clinical manifestations depending upon their type, location, and the amount of deposition. Dialysis-related amyloidosis is a serious complication of long-term dialysis therapy and is characterized by the deposition of amyloid fibrils, principally composed of β2 microglobulins (β2M, in the osteoarticular structures and viscera. Most of the β2M is eliminated through glomerular filtration and subsequent reabsorption and catabolism by the proximal tubules. As a consequence, the serum levels of β2M are inversely related to the glomerular filtration rate; therefore, in end-stage renal disease patients, β2M levels increase up to 60-fold. Serum levels of β2M are also elevated in several pathological conditions such as chronic inflammation, liver disease, and above all, in renal dysfunction. Retention of amyloidogenic protein has been attributed to several factors including type of dialysis membrane, prolonged uremic state and/or decreased diuresis, advanced glycation end products, elevated levels of cytokines and dialysate. Dialysis treatment per se has been considered to be an inflammatory stimulus, inducing cytokine production (such as interleukin-1, tumor necrosis factor-α, interleukin-6 and complement activation. The released cytokines are thought to stimulate the synthesis and release of β2M by the macrophages and/or augment the expression of human leukocyte antigens (class I, increasing β2M expression. Residual renal function is probably the best determinant of β2M levels. Therefore, it has to be maintained as long as possible. In this article

  18. Risk of serous retinal detachment in patients with end-stage renal disease on dialysis.

    Directory of Open Access Journals (Sweden)

    Yuh-Shin Chang

    Full Text Available The aim of this retrospective, nationwide, matched cohort study was to investigate the association of serous retinal detachment with having end-stage renal disease (ESRD while on dialysis. The cohort study included 94,024 patients with ESRD on dialysis registered between January 2000 to December 2009 in the Taiwan National Health Insurance Research Database. An age- and sex-matched control group comprised 94,024 patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected from the index date until December 2011. Twenty-seven ESRD patients and 11 controls developed serous retinal detachment (P < 0.001 during follow-up, demonstrating a significantly increased risk of serous retinal detachment in patients with ESRD on dialysis compared with controls (incidence rate ratio = 3.39, 95% confidence interval [CI] = 1.68-6.83. After adjustment for potential confounders, patients were 3.86 times more likely to develop serous retinal detachment than the full cohort (adjusted HR = 3.86, 95% CI = 1.15-12.96. In conclusion, patients with ESRD on dialysis demonstrate an increased risk of serous retinal detachment. Interdisciplinary collaboration between nephrologists and ophthalmologists is important to deal with serous retinal detachment in patients with ESRD on dialysis and prevent impairments of visual acuity.

  19. Potential Role of Vegetarianism on Nutritional and Cardiovascular Status in Taiwanese Dialysis Patients: A Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Shih-Hsiang Ou

    Full Text Available Cardiovascular disease remains the most common cause of death for patients on chronic dialysis. End stage renal disease patients undergoing dialysis imposed to reduce phosphorus intake, which likely contributes to development of vegetarian diet behaviors. Vegetarian diets are often lower in protein content, in contradiction to the recommendation that a high protein diet is followed by patients undergoing dialysis. The purpose of the study was to investigate the effects of a vegetarian diet on the nutritional and cardiovascular status of dialysis patients.A study of 21 vegetarian dialysis patients and 42 age- and sex-matched non-vegetarian dialysis patients selected as controls was conducted in the Kaohsiung Veterans General Hospital. Brachial-ankle pulse wave velocity and biochemistry data including total homocysteine levels, serum lipid profiles, high-sensitivity C-reactive protein, vitamin D levels, albumin, and normalized protein catabolic rate were measured.Compared with the non-vegetarian control group, vegetarian subjects had lower body weight, body mass index, serum phosphate, blood urea nitrogen, serum creatinine, vitamin D, uric acid, albumin, and normalized protein catabolic rate (p < 0.05. The vegetarian group showed higher brachial-ankle pulse wave velocity than the non-vegetarian group (1926.95 ± 456.45 and 1684.82 ± 309.55 cm/sec, respectively, p < 0.05. After adjustment for age, albumin, pre-dialysis systolic blood pressure, and duration of dialysis, vegetarian diet remained an independent risk factor for brachial-ankle pulse wave velocity.The present study revealed that patients on dialysis who follow vegetarian diets may experience subclinical protein malnutrition and vitamin D deficiency that could offset the beneficial cardiovascular effects of vegetarianism.

  20. Strategy for developing and conducting nuclear emergency exercises

    International Nuclear Information System (INIS)

    2007-01-01

    Emergency situations demand that actions be taken by responsible organisations and individuals at the site of the emergency and at the local, national and international levels to mitigate the impact on people and the environment. Effective emergency response requires development and implementation of emergency plans and procedures; established arrangements at the local, national and international levels; acquisition and maintenance of resources (funding, equipment and personnel); training of personnel; conduct of exercises; and a 'feedback programme' whereby improvements to the emergency management system are made based on lessons identified from exercises and actual events. A means for demonstrating the effectiveness of an emergency programme is through the conduct of exercises. Exercises demonstrate the effectiveness of plans, procedures, training and equipment; adequacy of response arrangements and resources; capabilities of response personnel in performing their assigned tasks; ability of individuals and organisations to work together; and provide a forum for exploring and testing revisions, modifications, and new and/or proposed changes to any emergency programme element in near realistic situations. Exercises may range in scope from small-scale drills to large-scale national or international exercises. There is clear benefit to organisations in supporting, developing and conducting well-managed exercises. Exercising is a resource-intensive tool; however, it is a critical tool for enhancing performance, testing arrangements and identifying areas for improvement. A thoroughly developed strategy should therefore be in place to ensure maximum value from an exercise programme. This report contributes to the good practice and management of exercise programmes by providing a strategy for improving the value of planning, conducting, participating in and/or supporting exercises. The OECD/NEA International Nuclear Emergency Exercise (INEX) series undertaken over the

  1. The Impact of a Strategies-Based Instruction on Iranian EAP Students’ Reading Strategy Use: Developing Strategic EAP Readers

    Directory of Open Access Journals (Sweden)

    Seyyed Hossein Kashef

    2014-01-01

    Full Text Available Underperformance of students in EAP reading comprehension has been an issue of concern for teachers, syllabus designers, and curriculum developers in general and for EAP practitioners in particular. In spite of the fact that considerable efforts have been made to improve reading comprehension of students through strategies instruction over past decades, EAP students however have not benefited much from learning strategies. Thus, this study intended to investigate the impact of a Strategies-Based Instruction (SBI on undergraduate students’ reading strategy use in an EAP context. Taking an instructional model from strategies taxonomy of Oxford (1990; 2001, it was assumed that in contrast to conventional EAP reading methods, SBI would be more effective in encouraging reading strategy use and as a result developing reading comprehension of EAP students through encouraging the use of effective strategies and skills. To do so, 80 freshman undergraduate students were chosen as the participants of this study who were in two intact classes. After administration of a pre-test, treatment (22 sessions, 2 sessions per week, and a post-test, the collected data was analyzed using t-test to examine the effect of the proposed method of instruction. The results of the analysis showed that the teaching intervention had a significant effect on students’ reading strategy use. The findings have implications for teachers encouraging effective reading comprehension instruction through the use of strategies in EAP teaching contexts.

  2. About the development strategies of power plant in energy market

    Science.gov (United States)

    Duinea, Adelaida Mihaela

    2017-12-01

    The paper aims at identifying and assessing the revenues and costs incurred by various modernization and modernization-development strategies for a power plant in order to optimize the electric and thermal energy are produced and to conduct a sensitivity analysis of the main performance indicators. The Romanian energy system and the energy market have gone a long transition way, from the vertically integrated model, the responsibility for the delivery of the electricity comes exclusively to a state monopoly, to a decentralized system, characterized by the decentralization of production and transport, respectively distribution activities. Romania chose the liberal market model where the relations between the actors in the market - producers and suppliers free to make sales and purchase transactions for electrical energy - are mostly governed by contracts, which may be either bilaterally negotiated or are already regulated. Therefore, the importance of understanding the development trend of the Romanian energy market lies in its economic effects upon the solutions which could be adopted for the evolution of the cogeneration power plant in question.

  3. Source removal strategy development for manufactured gas plant sites

    International Nuclear Information System (INIS)

    Golchin, J.; Nelson, S.

    1994-01-01

    A source removal action plan was developed by Midwest Gas and the Iowa Department of Natural Resources to address the source coal tar contamination within the underground gas holder basin at former Manufactured Gas Plant (MGP) sites. The procedure utilizes a mixture of coal, contaminated soil and coal rat sludge to provide a material that had suitable material handling characteristics for shipment and burning in high efficiency utility boilers. Screening of the mixture was required to remove oversized debris and ferrous metal. The resulting mixture did not exhibit toxic characteristics when tested under the Toxicity Characteristics Leaching Procedure (TCLP). Test results on the coal tar sludges have indicated that the more pure coal tar materials may fail the TCLP test and be classified as a RCRA hazardous waste. The processing procedure was designed to stabilize the coal tar sludges and render those sludges less hazardous and, as a result, able to pass the TCLP test. This procedure was adopted by the Edison Electric Institute to develop a national guidance document for remediation of MGP sites. The EPA Office of Solid Waste and Emergency Response recommended this strategy to the Regional Waste Management Directors as a practical tool for handling wastes that may exhibit the RCRA characteristics

  4. THE TOURISM IN THE OLTENIA REGION – STRATEGIES OF DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    GHEORGHE GABRIEL SANDA

    2017-12-01

    Full Text Available Oltenia is one of the nine regions of Romania. Its tourism potential refers to an ensemble of components like geographical ones, historical, folkloric, religious and cultural, which create the premise for the development of diversified forms of tourism. Taking into consideration the fact that the region is not one of the most developed regions of Romania it is necessary to attract funds from the European Union to create an image of the destination so that more tourists will come in the area and these tourists will buy different tourism products. Tourism represents an important part in the economy of each country. There are regions in the entire world which have managed to create a unique image by creating a unitary tourism product. Regions like Toscana in Italy, Bordeaux in France, Campania from Italy, Palawan in Philippines. Following the examples of these regions we have in Romania regions like Maramures and Bucovina which attract annually tourists not only from Romania but also from other countries. We belive that the main strategy for Oltenia Region is the publicity so this Region be as well known as the other touristical Regions of Romania (Maramures, Bucovina.

  5. Strategy for development of the Polish electricity sector

    Energy Technology Data Exchange (ETDEWEB)

    Dybowski, J. [Polish Power Grid Co., Warsaw (Poland)

    1995-12-01

    This paper represents the strategy for development of the Polish Electricity Sector dealing with specific problems which are common for all of East Central Europe. In 1990 Poland adopted a restructuring program for the entire energy sector. Very ambitious plans were changed several times but still the main direction of change was preserved. The most difficult period of transformation is featured by several contradictions which have to be balanced. Electricity prices should increase in order to cover the modernization and development program but the society is not able to take this burden in such a short time. Furthermore the new environment protection standards force the growth of capital investment program which sooner or later has to be transferred through the electricity prices. New economic mechanisms have to be introduced to the electricity sector to replace the old ones noneffective, centrally planned. This process has to follow slow management changes. Also, introduction of new electricity market is limited by those constraints. However, this process of change would not be possible without parallel governmental initiation like preparation of new energy law and regulatory frames.

  6. Development of Investment Strategy Applying Corporate Social Responsibility

    Directory of Open Access Journals (Sweden)

    Jekaterina Kuzmina

    2017-12-01

    Full Text Available Purpose of the article: Due to globalization processes and technological development, companies are having more influence on global society than ever. Therefore, business misconduct causes enormous harm to stakeholders, whereas ethical behavior is becoming an important issue. The goal of the following study is to verify and measure a positive effect from investments in social activities on financial attractiveness of companies in the form of its stock portfolio value growth. Methodology/methods: In order to achieve the goal of the research, quantitative analysis is used by comparing performance of stock portfolio of companies having long-term investments in social activities with market index increment. The quantitative results are accompanied with the review of corporate social responsibility definition and some practical issues on governmental and corporation level. Scientific aim: The conducted research contributes both to the scientific discussion about development of appropriate investment strategy in companies applying CSR principles as well as to the discussion of related terminology used in the field. Findings: The research has shown that engagement in the CSR activities tends to have strong positive effect on companies’ financial results and investors’ financial performance. The research proves this fact by comparing value increment of CSR-portfolio (+35.99% gained from January 2015 to March 2017 with market index (+22.37% in the same period. Conclusions: Regardless the positive result achieved in the study the authors have determined several gaps in the research, which will be discussed in the further studies on the field.

  7. Development of Relocation Strategies Regarding Eruption Hazard in Mount Merapi

    Directory of Open Access Journals (Sweden)

    Rosdiana Puji Lestari

    2015-09-01

    Full Text Available The research was conducted to answer a questions: 1 how the relocation of the current strategy was carried out by the government 2 the problems that arise in the relocation which has yet to be resolved, 3 how the good concept of relocation so that these problems can be minimized. The research methodology used in this study combined quantitative and qualitative methods. Qualitative methods are used to explain the empirical facts that exist in each of these conditions in the relocation settlements. SWOT analysis is used to provide an overview of the strengths, weaknesses, opportunities and threats in the relocation of victims of Merapi. Information, facts and issues that arise in the study will be described, explained and analyzed primarily for the impact of residential relocation on social and economic life of the community. Relocation concept of the economic aspects of community empowerment efforts should be made related to community economic recovery after a change in livelihood. In addition, the potential of community mapping needs to be done by the government to be optimized and developed. From the aspect of government settlements seek to transfer ownership of land in the new settlement which may be the property of the citizens so that citizens obtain legal certainty while occupying the new settlement. The social aspects of the development potential of relocating residents and making it as a tourist village, residents need to support that relocation is no longer a newcomer, they have the same rights and obligations with citizens of another.

  8. Effects of Different Models of Dialysis Care on Patient-Important Outcomes: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Ramar, Priya; Ahmed, Ahmed T; Wang, Zhen; Chawla, Sagar S; Suarez, Maria Lourdes Gonzalez; Hickson, LaTonya J; Farrell, Ann; Williams, Amy W; Shah, Nilay D; Murad, M Hassan; Thorsteinsdottir, Bjorg

    2017-12-01

    Ongoing payment reform in dialysis necessitates better patient outcomes and lower costs. Suggested improvements to processes of care for maintenance dialysis patients are abundant; however, their impact on patient-important outcomes is unclear. This systematic review included comparative randomized controlled trials or observational studies with no restriction on language, published from 2000 to 2014, involving at least 5 adult dialysis patients who received a minimum of 6 months of follow-up. The effect size was pooled and stratified by intervention strategy (multidisciplinary care [MDC], home dialysis, alternate dialysis settings, and electronic health record implementation). Heterogeneity (I 2 ) was used to assess the variability in study effects related to study differences rather than chance. Of the 1988 articles screened, 25 international studies with 74,833 maintenance dialysis patients were included. Interventions with MDC or home dialysis were associated with a lower mortality (hazard ratio [HR] = 0.72, 95% confidence interval [CI] 0.61, 0.84, I 2  = 41.6%; HR = 0.57, 95% CI 0.41, 0.81, I 2  = 89.0%; respectively) and hospitalizations (incidence rate ratio [IRR] = 0.68, 95% CI 0.51, 0.91, I 2  = NA; IRR = 0.88, 95% CI 0.64, 1.20, I 2  = 79.6%; respectively). Alternate dialysis settings also were associated with a reduction in hospitalizations (IRR = 0.41, 95% CI 0.25, 0.69, I 2  = 0.0%). This systematic review underscores the importance of multidisciplinary care, and also the value of telemedicine as a means to increase access to providers and enhance outcomes for those dialyzing at home or in alternate settings, including those with limited access to nephrology expertise because of travel distance.

  9. Exploring the Interconnectedness among Strategy Development, Shared Mental Models, Organisational Learning and Organisational Change

    Science.gov (United States)

    Malan, Renee

    2011-01-01

    The cognitive psychological processes related to learning and change behaviour are factors that impact on organisational strategy development. Strategy development is dependent on strategic thinking that is reciprocally influenced by shared mental models, organisational learning and organisational change. Although strategy development, shared…

  10. Strategy Development of PT XYZ a Startup Technology Company

    OpenAIRE

    Rahman, Leila Fatmasari; Mangkusubroto, Kuntoro; Sunitiyoso, Yos

    2012-01-01

    PT. XYZ (XYZ) is an Indonesian startup technology company which provides IT Consulting and System Integration services. In this research, XYZ's strategy for the next three years (until 2015) will be crafted by going through the strategic management process which consists of the following stages: (1) environment analysis of XYZ, (2) setting strategic vision, (3) setting objective, (4) crafting strategy and (5) executing the strategy. Based on the result of the environment analysis, XYZ's visio...

  11. Market Structure in the Context of Developing Competitive Strategy

    OpenAIRE

    Algirdas Krivka; Romualdas Ginevičius

    2011-01-01

    The abstract deals with the application of positioning strategies under the conditions of classical market structures. It is discovered that the assumptions of pure competition leave no space for M. Porter’s generic cost leadership and differentiation strategies to be applied. The enterprise’s actions, influencing five competitive forces and implementing generic strategies, are reasonable under the conditions of imperfect competition market structures. The game theory models, applied to oligo...

  12. Development of strategies for communication with public on nuclear power

    International Nuclear Information System (INIS)

    Narayanan, K.K.

    2012-01-01

    Nuclear industry, as a whole, has so often communicated a lack of confidence in the public. There are historical reasons for this, including the fact that the tremendous power of atom was introduced to mankind in a most, destructive way by exploding two atomic devices at Hiroshima and Nagasaki. Other reasons are the secrecy rooted in its activities, problems in communicating scientific concepts with general public and use of jargons, which on occasions resulted in misinterpretation by the public. The resulting lack of public confidence is a major road-block in its development in many countries, including India. So it is essential to establish a trust between nuclear industry and general public. To achieve this, effective communication with public on issues related to nuclear power is imperative. The important components of this strategy are: 1. The goals 2. The message 3. The communicators 4.The audience 5.The tools. These components are briefly discussed below. The Goals: What are the goals to be achieved? The aim should be building awareness, understanding and public support for the nuclear power program across the country. If this is achieved half the battle is won. The Message: What are your messages to the public? At the outset you should be very clear about your message, believe it, and make it believable to your audience. The message should be positive, clear and simple. It should stress the inevitability of nuclear power in the energy scenario and the overall development of the country. The communicators: Who are the communicators? Identify, and prepare the communicators of the message. Put a human face on them. Make sure that those who deliver the message must really believe in the message. Third party communicators have a higher level of credibility, because they are not from the nuclear industry. It is vital that communicators be skilled in the art of listening to the audience - a two-way dialogue has to be maintained. Special training is essential for

  13. Exploring the association between macroeconomic indicators and dialysis mortality.

    Science.gov (United States)

    Kramer, Anneke; Stel, Vianda S; Caskey, Fergus J; Stengel, Benedicte; Elliott, Robert F; Covic, Adrian; Geue, Claudia; Cusumano, Ana; Macleod, Alison M; Jager, Kitty J

    2012-10-01

    Mortality on dialysis varies greatly worldwide, with patient-level factors explaining only a small part of this variation. The aim of this study was to examine the association of national-level macroeconomic indicators with the mortality of incident dialysis populations and explore potential explanations through renal service indicators, incidence of dialysis, and characteristics of the dialysis population. Aggregated unadjusted survival probabilities were obtained from 22 renal registries worldwide for patients starting dialysis in 2003-2005. General population age and health, macroeconomic indices, and renal service organization data were collected from secondary sources and questionnaires. Linear modeling with log-log transformation of the outcome variable was applied to establish factors associated with survival on dialysis. Two-year survival on dialysis ranged from 62.3% in Iceland to 89.8% in Romania. A higher gross domestic product per capita (hazard ratio=1.02 per 1000 US dollar increase), a higher percentage of gross domestic product spent on healthcare (1.10 per percent increase), and a higher intrinsic mortality of the dialysis population (i.e., general population-derived mortality risk of the dialysis population in that country standardized for age and sex; hazard ratio=1.04 per death per 10,000 person years) were associated with a higher mortality of the dialysis population. The incidence of dialysis and renal service indicators were not associated with mortality on dialysis. Macroeconomic factors and the intrinsic mortality of the dialysis population are associated with international differences in the mortality on dialysis. Renal service organizational factors and incidence of dialysis seem less important.

  14. China's strategy for energy development and climate change mitigation

    International Nuclear Information System (INIS)

    He Jiankun; Yu Zhiwei; Zhang Da

    2012-01-01

    In recent years, China has made great efforts in energy saving and carbon emission reduction by pushing forward domestic sustainable development along with global climate change mitigation. The efforts have paid off with a dramatic decrease in carbon intensity. Nevertheless, China is still confronted with tough challenges in emission control due to the fast pace of industrialization, large total historical emission and high growth rate of emissions. Therefore, China should give priority to energy saving by improving energy efficiency and sectoral structure adjustment and upgrade, and develop sustainable and renewable energy to optimize energy mix and its carbon content. China should continue to regard significant reduction of energy intensity and carbon intensity as the main objective in the near future, strive to achieve peak emissions around 2030, and realize a relatively sharp emissions reduction by 2050 in order to address climate change to meet the goal of making the warming less than 2°. During the 12th Five Year Plan (FYP), China will further strengthen measures to control the amount of energy consumption, establish a statistics, accounting and evaluation system of carbon emissions, and promote a market-based carbon emissions trading mechanism to facilitate the low-carbon transformation of China's economy. - Highlights: ► This paper studies China's strategy for energy development and climate change mitigation. ► We suggest that China should focus on reducing the energy intensity and carbon intensity of GDP, and optimization of energy mix in the near term. ► In the long term, China should achieve the peak emission around 2030, and realize a relative sharp emission reduction by 2050. ► The paper also concludes some important measures which China should take during the 12th Five-Year-Plan (2011–2015).

  15. Developing Marketing Higher Education Strategies Based on Students’ Satisfaction Evolution

    Directory of Open Access Journals (Sweden)

    Andreea Orîndaru

    2015-09-01

    Full Text Available The educational system worldwide is currently under the spotlight as it shows significant signs of an ongoing crisis in its search for resources, visibility in the crowded market and significance to the ever-changing society. Within this framework, higher education institutions (HEIs are taking significant actions for maintaining students as clients of their educational services. As competition on this market is becoming stronger, HEIs face difficulties in keeping students, leading them to a continuous evaluation of student satisfaction indicators. Beyond HEIs’ managers, researchers in marketing higher education have contributed to the development of a comprehensive literature where still very few have forwarded a longitudinal research model for student satisfaction evaluation despite the need for such approaches. Given this context, the current paper presents a first step towards a longitudinal study as it displays, in a compare and contrast vision, the results of two different quantitative research projects developed in the same student community, with the same objective, but conducted in two different years. Among the most significant results of this research refer to an important decline in students’ satisfaction with a significant increase in the number of students that have a neutral perception. This is highly expected to determine a major impact on university’s overall performance and, therefore, it constitutes a strong argument for determining underlying causes, and especially developing the appropriate marketing strategies to tackle with these issues. Based on this result and other similar research outcomes, strategic and tactic recommendations are granted in the final part of this paper.

  16. Energy access and security strategies in Small Island Developing States

    International Nuclear Information System (INIS)

    Wolf, Franziska; Surroop, Dinesh; Singh, Anirudh; Leal, Walter

    2016-01-01

    Small Islands Developing States (SIDS) are isolated and surrounded by ocean. The generation and use of energy resources are two very important aspects for the development of SIDS. Unfortunately, most of SIDS do not use their potential in respect of energy resources, and they as a result have to depend on the import of fossil fuels in order to meet their energy needs. This increases the overall vulnerability of SIDS as they have to depend on the rising or fluctuating fossil fuels prices. Some SIDS, especially in the geographically dispersed Pacific region, do not have proper access to energy whereas other SIDS struggle more with energy security issue. At the same time, SIDS are most vulnerable to the impacts and effects of climate change, as they are among the ones to be most severely affected in case of natural calamities and sea-level rise. Drawing on experiences from Fiji and Mauritius, this paper explains core elements related to energy access and security in SIDS, contextualizes and discusses barriers and list some of the strategies that may be used to ensure access to and a continuous supply of energy in SIDS. A situational analysis of two SIDS outlines their current energy situation and compares their energy policies to globally accepted criteria for SIDS policies as well as with each other. It is claimed that the diverging energy performances of Fiji and Mauritius cannot be explained by policies differences. The reasons for the varying energy performances may therefore lie in the administrative and institutional mechanisms used by the two countries in implementing their energy policies. Finally, to enable SIDS to reduce their overall vulnerability and become truly sustainable islands, it is recommended to undertake careful assessments of the particular local contexts under which island energy regimes operate. - Highlights: • Core elements related to energy access/security in SIDS, barriers and strategies. • Situational analysis of two SIDS: Fiji and

  17. Criteria for method selection and process design of a technical development strategy

    CSIR Research Space (South Africa)

    Joseph-Malherbe, S

    2012-08-01

    Full Text Available delivery strategy and a testing strategy with the associated approach and methods for each strategy. For example, the testing strategy will describe the testing approach of the system development cycle and it will include methods of testing, testing...

  18. Strategy for Self-Centered Development from the Perspective of an Historical Analysis of Development

    Directory of Open Access Journals (Sweden)

    Alfredo Pérez Sánchez

    1998-04-01

    Full Text Available After acknowledging the three phases of historical analysis of development, and especially considering the research work done in the last twenty-five years by the Germans Dieter Sengcheus and Ulrich Mezel, the author presents the principle elements of a self-centered development strategy which highlights the following perspectives:dissociation, economic restructuring, and the new forms of an international division of labor among Third World economies.This document calls into question the underlying operation of the conventional theory of development and its current policy, which call for the increasing integration of the Third World in the world market as a means of going beyond development as it is commonly understood. Though being an integral element in the theory of self-centereddevelopment, temporary dissociation from the world market is proposed. The justification for the strategy of dissociation, excepting the recourse to some historical and paradigmatic reflections sketched by Friedrich List, has kept itself, of necessity, to the global and abstract level. This position is nothing, however, but a most direct analytical result deduced fromthe principle theoretical beginnings and the empirical observations of both the Theory of Dependence and Peripheral Capitalism. Although the review vents its criticism on (and mainly questions the practicality of the aforesaid conception, a more penetratingunderstanding of what the wager for such a strategy entails is found. Thus, the notion of self-centered development influences and gives impulse to a most extensive ideologicallymarked debate about the alternative conceptions of development.

  19. Eco-dialysis: the financial and ecological costs of dialysis waste products: is a 'cradle-to-cradle' model feasible for planet-friendly haemodialysis waste management?

    Science.gov (United States)

    Piccoli, Giorgina Barbara; Nazha, Marta; Ferraresi, Martina; Vigotti, Federica Neve; Pereno, Amina; Barbero, Silvia

    2015-06-01

    Approximately 2 million chronic haemodialysis patients produce over 2,000,000 tons of waste per year that includes about 600,000 tons of potentially hazardous waste. The aim of the present study was to analyse the characteristics of the waste that is produced through chronic haemodialysis in an effort to identify strategies to reduce its environmental and financial impact. The study included three dialysis machines and disposables for bicarbonate dialysis, haemodiafiltration (HFR) and lactate dialysis. Hazardous waste is defined as waste that comes into contact with bodily fluids. The weight and cost of waste management was evaluated by various policies of differentiation, ranging from a careful-optimal differentiation to a careless one. The amount of time needed for optimal management was recorded in 30 dialysis sessions. Non-hazardous materials were assessed for potential recycling. The amount of plastic waste that is produced per dialysis session ranges from 1.5 to 8 kg (from 1.1 to 8 kg of potentially hazardous waste), depending upon the type of dialysis machine and supplies, differentiation and emptying policies. The financial cost of waste disposal is high, and is mainly related to hazardous waste disposal, with costs ranging from 2.2 to 16 Euro per session (2.7-21 USD) depending on the waste management policy. The average amount of time needed for careful, optimal differentiation disposal is approximately 1 minute for a haemodialysis session and 2 minutes for HFR. The ecological cost is likewise high: less than one-third of non-hazardous waste (23-28%) is potentially recyclable, while the use of different types of plastic, glues, inks and labels prevents the remaining materials from being recycled. Acknowledging the problem of waste management in dialysis could lead to savings of hundreds of millions of Dollars and to the reuse and recycling of hundreds of tons of plastic waste per year on a world-wide scale with considerable financial and ecological savings

  20. The Green Dialysis Survey: Establishing a Baseline for Environmental Sustainability across Dialysis Facilities in Victoria, Australia.

    Science.gov (United States)

    Barraclough, Katherine A; Gleeson, Alice; Holt, Stephen G; Agar, John Wm

    2017-11-02

    The Green Dialysis Survey aimed to 1) establish a baseline for environmental sustainability (ES) across Victorian dialysis facilities, and 2) guide future initiatives to reduce the environmental impact of dialysis delivery. Nurse unit managers of all Victorian public dialysis facilities received an online link to the survey, which asked 107 questions relevant to the ES of dialysis services. Responses were received from 71/83 dialysis facilities in Victoria (86%), representing 628/660 dialysis chairs (95%). Low energy lighting was present in 13 facilities (18%), 18 (25%) recycled reverse osmosis water and 7 (10%) reported use of renewable energy. Fifty-six facilities (79%) performed comingled recycling but only 27 (38%) recycled polyvinyl chloride plastic. A minority educated staff in appropriate waste management (n=30;42%) or formally audited waste generation and segregation (n=19;27%). Forty-four (62%) provided secure bicycle parking but only 33 (46%) provided shower and changing facilities. There was limited use of tele- or video-conferencing to replace staff meetings (n=19;27%) or patient clinic visits (n=13;18%). A minority considered ES in procurement decisions (n=28;39%) and there was minimal preparedness to cope with climate change. Only 39 services (49%) confirmed an ES policy and few had ever formed a green group (n=14; 20%) or were currently undertaking a green project (n=8;11%). Only 15 facilities (21%) made formal efforts to raise awareness of ES. This survey provides a baseline for practices that potentially impact the environmental sustainability of dialysis units in Victoria, Australia. It also identifies achievable targets for attention. This article is protected by copyright. All rights reserved.

  1. Fungal peritonitis in children on peritoneal dialysis.

    NARCIS (Netherlands)

    Raaijmakers, R.; Schroder, C.; Monnens, L.A.H.; Cornelissen, E.A.M.; Warris, A.

    2007-01-01

    Fungal peritonitis is a rare but serious complication in children on peritoneal dialysis (PD). In this study, risk factors were evaluated, and therapeutic measures were reviewed. A retrospective, multi-centre study was performed in 159 Dutch paediatric PD patients, between 1980 and 2005 (3,573

  2. Modern development strategies of the Russian education in the conditions of the information society

    OpenAIRE

    Boguslavskii Mikhail V.; Lelchitskii Igor D.

    2016-01-01

    The article presents current development strategies of the Russian education in the conditions of information society. Western-liberal and traditional-conservative strategies of modern Russian education development are substantively presented. The ways of harmonization of these strategies in the area of national education in the information age are characterized. Approaches to the implementation of historical and pedagogical expertise of modern development strategies of the Russian education ...

  3. Developing an Integrated Design Strategy for Chip Layout Optimization

    NARCIS (Netherlands)

    Wits, Wessel Willems; Jauregui Becker, Juan Manuel; van Vliet, Frank Edward; te Riele, G.J.

    2011-01-01

    This paper presents an integrated design strategy for chip layout optimization. The strategy couples both electric and thermal aspects during the conceptual design phase to improve chip performances; thermal management being one of the major topics. The layout of the chip circuitry is optimized

  4. Characteristics of Strategies in Product/Service-System Development

    DEFF Research Database (Denmark)

    Tan, Adrian; McAloone, Timothy Charles

    2006-01-01

    The underlying principle in Product/Service-Systems (PSS) strategy is to shift from business based on the value of the transfer of product ownership and responsibility, to business based on the value of utility of the product and services. This paper identifies characteristics of various strategi...

  5. Information society development through ICT market strategies Albania versus other developing countries

    CERN Document Server

    Kordha Tolica, Ermelinda; Gorica, Klodiana

    2015-01-01

    ​This book examines the relationship between information society and information communication technology (ICT) markets, while evaluating the ICT impact on Albanian society and its economy. It offers insights on the country's information society development and compares it to other nations. The book begins with a general introduction to information society and efforts that can be used for ICT strategy. It then takes a look at ICT as an industrial sector and uncovers the importance for a strong ICT infrastructure management. Using this background information, the book finally explores the growing information society and ICT sector found in Albania. It measures the information society being created, and compares it to other countries in South Eastern Europe. Next the authors introduce a theoretical model for ICT driven development, focusing on ICT innovation and investment as factors that can affect the ICT market. These factors have also taken into account for strategy development in the national and industr...

  6. Market Structure in the Context of Developing Competitive Strategy

    Directory of Open Access Journals (Sweden)

    Algirdas Krivka

    2011-04-01

    Full Text Available The abstract deals with the application of positioning strategies under the conditions of classical market structures. It is discovered that the assumptions of pure competition leave no space for M. Porter’s generic cost leadership and differentiation strategies to be applied. The enterprise’s actions, influencing five competitive forces and implementing generic strategies, are reasonable under the conditions of imperfect competition market structures. The game theory models, applied to oligopoly, indicate the close interaction of enterprises and interdependence of their strategic decisions: cost reduction and differentiation strategies not only increase the profit of the enterprise, implementing the strategy, but by affecting market price and residual demand decrease the competitor’s profit.Article in Lithuanian

  7. A Strategy for Nuclear Energy Research and Development

    International Nuclear Information System (INIS)

    Bennett, Ralph G.

    2008-01-01

    The United States is facing unprecedented challenges in climate change and energy security. President-elect Obama has called for a reduction of CO2 emissions to 1990 levels by 2020, with a further 80% reduction by 2050. Meeting these aggressive goals while gradually increasing the overall energy supply requires that all non-emitting technologies must be advanced. The development and deployment of nuclear energy can, in fact, help the United States meet several key challenges: (1) Increase the electricity generated by non-emitting sources to mitigate climate change, (2) Foster the safe and proliferation-resistant use of nuclear energy throughout the world, (3) Reduce the transportation sector's dependence on imported fossil fuels, and (4) Reduce the demand on natural gas for process heat and hydrogen production. However, because of the scale, cost, and time horizons involved, increasing nuclear energy's share will require a coordinated research effort-combining the efforts of industry and government, supported by innovation from the research community. This report outlines the significant nuclear energy research and development (R and D) necessary to create options that will allow government and industrial decision-makers to set policies and create nuclear energy initiatives that are decisive and sustainable. The nuclear energy R and D strategy described in this report adopts the following vision: Safe and economical nuclear energy in the United States will expand to address future electric and non-electric needs, significantly reduce greenhouse gas emissions and provide energy diversity, while providing leadership for safe, secure and responsible expansion of nuclear energy internationally

  8. Developing Hydrogeological Site Characterization Strategies based on Human Health Risk

    Science.gov (United States)

    de Barros, F.; Rubin, Y.; Maxwell, R. M.

    2013-12-01

    In order to provide better sustainable groundwater quality management and minimize the impact of contamination in humans, improved understanding and quantification of the interaction between hydrogeological models, geological site information and human health are needed. Considering the joint influence of these components in the overall human health risk assessment and the corresponding sources of uncertainty aid decision makers to better allocate resources in data acquisition campaigns. This is important to (1) achieve remediation goals in a cost-effective manner, (2) protect human health and (3) keep water supplies clean in order to keep with quality standards. Such task is challenging since a full characterization of the subsurface is unfeasible due to financial and technological constraints. In addition, human exposure and physiological response to contamination are subject to uncertainty and variability. Normally, sampling strategies are developed with the goal of reducing uncertainty, but less often they are developed in the context of their impacts on the overall system uncertainty. Therefore, quantifying the impact from each of these components (hydrogeological, behavioral and physiological) in final human health risk prediction can provide guidance for decision makers to best allocate resources towards minimal prediction uncertainty. In this presentation, a multi-component human health risk-based framework is presented which allows decision makers to set priorities through an information entropy-based visualization tool. Results highlight the role of characteristic length-scales characterizing flow and transport in determining data needs within an integrated hydrogeological-health framework. Conditions where uncertainty reduction in human health risk predictions may benefit from better understanding of the health component, as opposed to a more detailed hydrogeological characterization, are also discussed. Finally, results illustrate how different dose

  9. [Evaluation of methods to calculate dialysis dose in daily hemodialysis].

    Science.gov (United States)

    Maduell, F; Gutiérrez, E; Navarro, V; Torregrosa, E; Martínez, A; Rius, A

    2003-01-01

    Daily dialysis has shown excellent clinical results because a higher frequency of dialysis is more physiological. Different methods have been described to calculate dialysis dose which take into consideration change in frequency. The aim of this study was to calculate all dialysis dose possibilities and evaluate the better and practical options. Eight patients, 6 males and 2 females, on standard 4 to 5 hours thrice weekly on-line hemodiafiltration (S-OL-HDF) were switched to daily on-line hemodiafiltration (D-OL-HDF) 2 to 2.5 hours six times per week. Dialysis parameters were identical during both periods and only frequency and dialysis time of each session were changed. Time average concentration (TAC), time average deviation (TAD), normalized protein catabolic rate (nPCR), Kt/V, equilibrated Kt/V (eKt/V), equivalent renal urea clearance (EKR), standard Kt/V (stdKt/V), urea reduction ratio (URR), hemodialysis product and time off dialysis were measured. Daily on-line hemodiafiltration was well accepted and tolerated. Patients maintained the same TAC although TAD decreased from 9.7 +/- 2 in baseline to a 6.2 +/- 2 mg/dl after six months, p time off dialysis was reduced to half. Dialysis frequency is an important urea kinetic parameter which there are to take in consideration. It's necessary to use EKR, stdKt/V or weekly URR to calculate dialysis dose for an adequate comparison between different frequency dialysis schedules.

  10. The Association between Peritoneal Dialysis Modality and Peritonitis

    Science.gov (United States)

    Johnson, David W.; McDonald, Stephen P.; Boudville, Neil; Borlace, Monique; Badve, Sunil V.; Sud, Kamal; Clayton, Philip A.

    2014-01-01

    Background and objectives There is conflicting evidence comparing peritonitis rates among patients treated with continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD). This study aims to clarify the relationship between peritoneal dialysis (PD) modality (APD versus CAPD) and the risk of developing PD-associated peritonitis. Design, setting, participants, & measurements This study examined the association between PD modality (APD versus CAPD) and the risks, microbiology, and clinical outcomes of PD-associated peritonitis in 6959 incident Australian PD patients between October 1, 2003, and December 31, 2011, using data from the Australia and New Zealand Dialysis and Transplant Registry. Median follow-up time was 1.9 years. Results Patients receiving APD were younger (60 versus 64 years) and had fewer comorbidities. There was no association between PD modality and time to first peritonitis episode (adjusted hazard ratio [HR] for APD versus CAPD, 0.98; 95% confidence interval [95% CI], 0.91 to 1.07; P=0.71). However, there was a lower hazard of developing Gram-positive peritonitis with APD than CAPD, which reached borderline significance (HR, 0.90; 95% CI, 0.80 to 1.00; P=0.05). No statistically significant difference was found in the risk of hospitalizations (odds ratio, 1.12; 95% CI, 0.93 to 1.35; P=0.22), but there was a nonsignificant higher likelihood of 30-day mortality (odds ratio, 1.33; 95% CI, 0.93 to 1.88; P=0.11) at the time of the first episode of peritonitis for patients receiving APD. For all peritonitis episodes (including subsequent episodes of peritonitis), APD was associated with lower rates of culture-negative peritonitis (incidence rate ratio [IRR], 0.81; 95% CI, 0.69 to 0.94; P=0.002) and higher rates of gram-negative peritonitis (IRR, 1.28; 95% CI, 1.13 to 1.46; P=0.01). Conclusions PD modality was not associated with a higher likelihood of developing peritonitis. However, APD was associated with a borderline

  11. Solar heating - status and strategy. Research, development and demonstration; Solvarme - status og strategi. Forskning, udvikling og demonstration

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-05-15

    The Danish Energy Authority has prepared research and development strategies for a number of energy technologies, including solar heating. This report presents an inventory of solar heating and proposes a strategy for further development. The report has been prepared by a number of important stakeholders in the Danish solar heating area. The inventory part of the report includes most solar heating technologies, however, emphasis is on technologies which have had or are expected to become important for exploitation in Denmark. The strategy part of the report proposes prioritized areas in research, development and demonstration based on international trends and Danish strong and weak points, which are: 1) centralized solar heating supply, district heating, 2) individual solar heating supply in connection with development and construction of buildings, building integration, and finally 3) product development of solar collectors. (BA)

  12. Evaluation of biofouling in stainless microfluidic channels for implantable multilayered dialysis device

    Science.gov (United States)

    Ota, Takashi; To, Naoya; Kanno, Yoshihiko; Miki, Norihisa

    2017-06-01

    An implantable artificial kidney can markedly improve the quality of life of renal disease patients. Our group has developed an implantable multilayered dialysis system consisting of microfluidic channels and dialysis membranes. Long-term evaluation is necessary for implant devices where biofouling is a critical factor, culminating in the deterioration of dialysis performance. Our previous work revealed that surface conditions, which depend on the manufacturing process, determine the amount of biofouling, and that electrolytic etching is the most suitable technique for forming a channel wall free of biofouling. In this study, we investigated the electrolytic etching conditions in detail. We conducted in vitro experiments for 7 d and evaluated the adhesion of biomaterials by scanning electron microscopy. The experiments revealed that a surface mirror-finished by electrolytic etching effectively prevents biofouling.

  13. Intoxication by star fruit (Averrhoa carambola) in six dialysis patients? (Preliminary report)

    Science.gov (United States)

    Neto, M M; Robl, F; Netto, J C

    1998-03-01

    We observed six cases of patients in a dialysis programme who were apparently intoxicated by ingestion of star fruit. After ingestion of 2-3 fruits or 150-200 ml of the fruit juice, the six patients, who had previously been stable in a regular dialysis programme, developed a variety of symptoms ranging from insomnia and hiccups to agitation, mental confusion and (in one case) death. In preliminary investigations to characterize the hypothetical neurotoxin in the fruit, an extract, when injected intraperitoneally or intracerebroventricularly in rats, provoked persistent convulsions of the tonic-clonic type. It appears that star fruit (Averrhoa carambola) contains an excitatory neurotoxin. Patients with renal failure on conservative or dialysis treatment should be dissuaded from ingestion of the fruit.

  14. Rethinking import-substituting industrialization: Development strategies and institutions in Taiwan and China

    OpenAIRE

    Zhu, Tianbiao

    2006-01-01

    Conventional explanations of Taiwan and China’s economic success point to the shift from an import-substituting industrialization (ISI) strategy to an export-oriented industrialization (EOI) strategy. This paper argues that the development strategies in Taiwan and China have always been a combination of ISI and EOI strategies during their entire miracle-creating period; far from the shift from ISI to EOI strategies, export promotion was used in both cases to sustain ISI, which has always been...

  15. 45 CFR 1336.64 - Development of goals and strategies: Responsibilities of the Loan Administrator.

    Science.gov (United States)

    2010-10-01

    ... for providing borrowers with the needed management assistance; (4) Marketing Strategy: to generate... availability of business capital; (4) Local resources for economic development and their availability; and (5... strategies developed by the Revolving Loan Fund must include the following: (1) Business Targeting Strategy...

  16. Phalaris minor control, resistance development and strategies for ...

    African Journals Online (AJOL)

    Administrator

    2011-09-26

    Sep 26, 2011 ... strategies for integrated management of resistance to fenoxaprop-ethyl ... 1University College of Agriculture, University of Sargodha, Sargodha, 40100, Pakistan. ... However, tillage method, planting time, method of herbicide.

  17. Sampling strategy to develop a primary core collection of apple ...

    African Journals Online (AJOL)

    PRECIOUS

    2010-01-11

    Jan 11, 2010 ... Physiology and Molecular Biology for Fruit, Tree, Beijing 100193, China. ... analyzed on genetic diversity to ensure their represen- .... strategy, cluster and random sampling. .... on isozyme data―A simulation study, Theor.

  18. Risk communication strategy development using the aerospace systems engineering process

    Science.gov (United States)

    Dawson, S.; Sklar, M.

    2004-01-01

    This paper explains the goals and challenges of NASA's risk communication efforts and how the Aerospace Systems Engineering Process (ASEP) was used to map the risk communication strategy used at the Jet Propulsion Laboratory to achieve these goals.

  19. Model based investigation of the potential lactate recovery using Electro-Enhanced Dialysis - Static analysis

    DEFF Research Database (Denmark)

    Prado Rubio, Oscar Andres; Jørgensen, Sten Bay; Jonsson, Gunnar Eigil

    2011-01-01

    The competitive ion transport through anion exchange membranes under current load conditions, referred to as the electro-enhanced dialysis process, is modeled and investigated through simulations. A dynamic model has been developed for simultaneous transport of multiple ions based on the Nernst......–Plank equation. This model accounts for the convective transport of the dissociated and undissociated species in the module channels, and the diffusion and migration across the boundary layers and membranes. The potential static flux enhancement is evaluated and compared to Donnan dialysis operation for lactate...

  20. Work Strategies: The Development and Testing of a Model.

    Science.gov (United States)

    1986-03-01

    strategies (e.g., Craik & Lockhart , 1972); hemispheric process - -7 ing differences (e.g., Seamon & Gazzaniga, 1973); problem-solving strategies (e.g...Charness, N. (1931). Aging and skilled problem solving. 3ournal of Experimental Psychology: General, 110, 21-38. Craik , F. I. \\., & Lockhart , R. S...1972). Levels of processing : A framework for memory research. Journal of Verbal Learning and Verbal Behavior, L1, 671-684. 3ansereau, D. F., McDonald

  1. Strategies and models for agricultural sustainability in developing Asian countries.

    Science.gov (United States)

    Kesavan, P C; Swaminathan, M S

    2008-02-27

    The green revolution of the 1960s and 1970s which resulted in dramatic yield increases in the developing Asian countries is now showing signs of fatigue in productivity gains. Intensive agriculture practiced without adherence to the scientific principles and ecological aspects has led to loss of soil health, and depletion of freshwater resources and agrobiodiversity. With progressive diversion of arable land for non-agricultural purposes, the challenge of feeding the growing population without, at the same time, annexing more forestland and depleting the rest of life is indeed daunting. Further, even with food availability through production/procurement, millions of marginal farming, fishing and landless rural families have very low or no access to food due to lack of income-generating livelihoods. Approximately 200 million rural women, children and men in India alone fall in this category. Under these circumstances, the evergreen revolution (pro-nature, pro-poor, pro-women and pro-employment/livelihood oriented ecoagriculture) under varied terms are proposed for achieving productivity in perpetuity. In the proposed 'biovillage paradigm', eco-friendly agriculture is promoted along with on- and non-farm eco-enterprises based on sustainable management of natural resources. Concurrently, the modern ICT-based village knowledge centres provide time- and locale-specific, demand-driven information needed for evergreen revolution and ecotechnologies. With a system of 'farm and marine production by masses', the twin goals of ecoagriculture and eco-livelihoods are addressed. The principles, strategies and models of these are briefly discussed in this paper.

  2. Smart consumer products with a pathfinder product development strategy

    Science.gov (United States)

    Robertson, Alec

    1994-09-01

    It is generally acknowledged that technologies diffuse through industry and that the rate of diffusion varies both within different industries and according to the circumstances. Innovation is a process involving risk, especially during the adoption and adaptation of a powerful new technology. Central to a consumer products success using new technology is the quality of their designs and the nature of their forms. Form is of prime importance in influencing the purchasing decisions of consumers and it is also influential in determining the relationships between people in its use environment. The acceptance of a new product into the world is often unduly ad hoc. Many failures are created for each success and there are few guidelines to assist the formulation of a strategy for creating an appropriate form. It is suggested below that success of consumer products incorporating 'smart structures' may be determined not only by the function of products and systems, but also by the form they take. The definition of a desirable product form depends entirely on the point of view taken: technological, commercial, ecological, cultural, and social. However any design using new will incorporate the old and the new. The probability of acceptance of a new product is enhanced by maintaining a fine balance between imaginative and creative form and that with which people are familiar and prefer: a new design may be rejected if it is too novel and unfamiliar, or too traditional. The acceptance of a new product and its subsequent development depends on the success designers and engineers have when dealing with the initial forms, particularly using new technology such as 'smart structures'.

  3. Development of competitive strategy of the enterprises of agrarian and industrial complex

    Directory of Open Access Journals (Sweden)

    Dzhabbarova N. O.

    2016-04-01

    Full Text Available presented challenges and stages of the development process of marketing strategies for competitive agricultural enterprises, consider a system of competitive strategies are disclosed function to ensure their implementation.

  4. Road map for the development of an e-healthcare strategy.

    Science.gov (United States)

    Gilbert, I; Johnson, E S; Szenczy, C

    2001-01-01

    This article presents a case study describing how Saint Francis Care developed its strategy for using the Internet and e-commerce. Planning strategies are discussed, as are implementation plans and expected benefits.

  5. Cardiovascular risk factors in hemodialysis and peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Helal Imed

    2010-01-01

    Full Text Available Cardiovascular diseases are a major cause of morbidity and mortality in patients with end-stage renal disease (ESRD. The aim of our investigation was the evaluation of an extensive cardiovascular profile in hemodialysis (HD and peritoneal dialysis (PD patients. We studied 74 patients with ESRD (38 males, 36 females, maintained either on chronic HD (n= 50 or chronic PD (n= 24 and age and sex matched 20 healthy subjects as controls. The lipid profile, homo-cysteine (Hcy and C reactive protein (CRP were measured. When compared to a healthy popu-lation, HD patients displayed a marked atherogenic profile, as attested by increased levels of total cholesterol (TC, triglycerides (TG, low-density lipoprotein-cholesterol (LDL-C, apolipoprotein A (Apo A, CRP, Hcy and lower concentrations of high-density lipoprotein-cholesterol (HDL-C, Apo B, albumin (ALB. A significant difference was noted concerning the rates of Apo B, HDL-C, TC, ALB and Hcy. Same biological disorders that those found at HD patients were noted in these PD patients. One also noted lower concentration in Apo A. there were a significant diffe-rence with the reference group concerning the rates of albumin, Apo A, HDL-Cl and Hcy. When compared to PD patients, HD patients had significantly decreased concentration of LDL-C. The peculiar metabolic changes observed in the present study confirm the marked tendency of patients with impaired renal function for developing cardiovascular diseases, irrespectively of the type of dialysis. We suggest including uremia-related risk factors in the panel for evaluation of cardio-vascular risk in dialysis patients.

  6. 77 FR 19178 - Proposed Information Collection; Comment Request; Comprehensive Economic Development Strategy

    Science.gov (United States)

    2012-03-30

    ... DEPARTMENT OF COMMERCE Economic Development Administration Proposed Information Collection; Comment Request; Comprehensive Economic Development Strategy AGENCY: Economic Development Administration... to John Cobb, Program Analyst, Office of Regional Affairs, Room 7009, Economic Development...

  7. In Vitro Dialysis of Cytokine-Rich Plasma With High and Medium Cut-Off Membranes Reduces Its Procalcific Activity.

    Science.gov (United States)

    Willy, Kevin; Hulko, Michael; Storr, Markus; Speidel, Rose; Gauss, Julia; Schindler, Ralf; Zickler, Daniel

    2017-09-01

    Recently developed high-flux (HF) dialysis membranes with extended permeability provide better clearance of middle-sized molecules such as interleukins (ILs). Whether this modulation of inflammation influences the procalcific effects of septic plasma on vascular smooth muscle cells (VSMCs) is not known. To assess the effects of high cut-off (HCO) and medium cut-off (MCO) membranes on microinflammation and in vitro vascular calcification we developed a miniature dialysis model. Plasma samples from lipopolysaccharide-spiked blood were dialyzed with HF, HCO, and MCO membranes in an in vitro miniature dialysis model. Afterwards, IL-6 concentrations were determined in dialysate and plasma. Calcifying VSMCs were incubated with dialyzed plasma samples and vascular calcification was assessed. Osteopontin (OPN) and matrix Gla protein (MGP) were measured in VSMC supernatants. IL-6 plasma concentrations were markedly lower with HCO and MCO dialysis. VSMC calcification was significantly lower after incubation with MCO- and HCO-serum compared to HF plasma. MGP and OPN levels in supernatants were significantly lower in the MCO but not in the HCO group compared to HF. In vitro dialysis of cytokine-enriched plasma samples with MCO and HCO membranes reduces IL-6 levels. The induction of vascular calcification by cytokine-enriched plasma is reduced after HCO and MCO dialysis. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  8. Method for selecting FBR development strategies in the presence of uncertainty

    International Nuclear Information System (INIS)

    Fraley, D.W.; Burnham, J.B.

    1981-12-01

    This report describes the methods used to probabilistically analyze data related to the uranium supply the FBR's competitive dates, development strategies' time and costs, and economic benefits. It also describes the econometric methods used to calculate the economic risks of mistiming the development. Seven strategies for developing the FBR are analyzed. The various measures of a strategy's performance - timing, costs, benefits, and risks - are combined into several criteria which are used to evaluate the seven strategies. Methods are described for selecting a strategy based on a number of alternative criteria

  9. Dynamic strategy for sustainable business development: mania or hazard?

    Directory of Open Access Journals (Sweden)

    Jarmila Šebestová

    2013-06-01

    Full Text Available The main goal of this paper is to present a practical model of sustainability ratio. In this context, the study provides an analysis of theoretical literature sources in area of strategy evaluation and possible measurement of success. The purpose of presented research was to discover the impact of external business environment factors (based on previous PESTLE analysis on current strategic behavior in small and medium sized business area. The survey was conducted on SMEs in the Czech Republic in 2011 within own research project. The proposed model of sustainability ratio incorporates dynamic behavior and shows how manipulating certain items can alter outcomes in the strategic system in a predicable way. As a contribution to the literature, the paper highlights on the flexibility of business strategy types and which items are the most important for strategy making in an uncertain and turbulent environment.

  10. Bioanalytical outsourcing strategy at Janssen Research and Development.

    Science.gov (United States)

    Verhaeghe, Tom

    2014-05-01

    The times when all bioanalytical work was supported in-house are long behind us. In the modern bioanalytical laboratory, workload is divided between in-house support and outsourcing to contract research organizations. This paper outlines the outsourcing strategy of the Janssen-regulated bioanalytical group. Keeping the knowledge of the assay and the compound internally is a cornerstone of this strategy and is a driver for balancing the workload between the internal laboratory and contract laboratories. The number of contract laboratories that are being used is limited and criteria for selecting laboratories are discussed. Special attention is paid to the experience with outsourcing clinical studies to China.

  11. The right to life movement: sources, development, and strategies.

    Science.gov (United States)

    Cassidy, K

    1995-01-01

    This article considers the history of the anti-abortion movement by first reviewing and assessing current images and interpretations of the movement, including the negative images used by the mass media as well as the interpretation which categorizes the movement as one of moral and political conservatism and that set out by Kristin Luker which sees the conflict between anti-abortion and pro-choice women as being between women who have lived radically different lives. The second section of the essay sets forth an explanation of the social sources and context of the pro-life movement, which is diverse and complex because it is embraced by those who see abortion as a civil rights question, as a family values issues, as a class/cultural issue, as a Church-related issue, as a gender issue, as a right-to-life issue embracing euthanasia, or as a movement of political conservatives. The institutional origins and development of the movement are explored in the next section. The next two section are devoted to two phases of the movement's search for a strategy. The first phase involved an attempt to use educational materials designed to reveal the reality rather than the abstract aspects of abortion. After Roe vs. Wade, attaching a "Human Life Amendment" to the constitution became a strategic goal. The second phase involved attempting to reverse the Roe decision by gaining the appointment of pro-life jurists to the Supreme Court. The pro-life movement entered national politics through the efforts of Catholic Bishops, the emergence of the New Right, and its own increasing political sophistication. The final section of the essay considers the situation after the Supreme Court's decision in Webster vs. Reproductive Health Services, which allowed states to restrict abortion. This decision precipitated a decline in support for the anti-abortion forces because the American public would rather have completely free access to abortion than a complete ban. The movement continues to

  12. Sustainability Assessment in Development Planning in Sub-National Territories: Regional Development Strategies in Chile

    Directory of Open Access Journals (Sweden)

    Iván Franchi-Arzola

    2018-05-01

    Full Text Available In Chile, the increasing occurrence of socio-environmental conflicts demonstrates that Regional Development Strategies—Estrategia Regional de Desarrollo (ERD—as the main development policy of subnational territories (Regions, must consider sustainability as a central objective. The Taxonomy of Sustainability constitutes an assessment method that allows us to determine the correlation between the definitions of these public policies and the strategies for transition to sustainable development. The ERD of the Antofagasta and Aysén regions are the ones presenting the highest Taxonomic Index; this indicates a higher strategic content for the promotion of sustainability. It is also noted that the political will that conditions the principles and values on which the ERD are based is strongly determined by investment projects and socio-environmental conflicts, which represent the tension between environmental protection and the capacity and interests of regional society in the development project.

  13. Alternaria alternata peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Yosra Guedri

    2017-01-01

    Full Text Available Fungal peritonitis is a serious complication of peritoneal dialysis (PD leading to loss of ultrafiltration and discontinuation of PD treatment. The most frequently isolated fungi are Candida albicans and, filamentous fungi such Alternaria alternata species are found only rarely. We report the case of a 75-year-old woman who developed peritonitis due to this black fungus.

  14. Peritonitis in children on peritoneal dialysis in Cape Town, South Africa: epidemiology and risks.

    NARCIS (Netherlands)

    Raaijmakers, R.; Gajjar, P.; Schroder, C.; Nourse, P.

    2010-01-01

    Peritonitis is a frequent complication of peritoneal dialysis (PD) in children as well in adults. Data on PD and peritonitis in pediatric patients are very scarce in developing countries. A retrospective cohort study was performed between 2000 and 2008 with the aim to evaluate PD treatment and

  15. A prime determinant in selecting dialysis modality: peritoneal dialysis patient survival

    Directory of Open Access Journals (Sweden)

    Hyunwook Kim

    2017-03-01

    Full Text Available The number of patients with end-stage renal disease (ESRD has rapidly increased, as has the cost of dialysis. Peritoneal dialysis (PD is an established treatment for ESRD patients worldwide; it has a variety of advantages, including autonomy and flexibility, as well as economic benefits in many countries compared to hemodialysis (HD. However, the long-term survival rate of PD remains poor. Although direct comparison of survival rate between the dialysis modalities by randomized controlled trials is difficult due to the ethical issues, it has always been a crucial point when deciding which dialysis modality should be recommended to patients. Recently, in many countries, including the United States, Brazil, Spain, Australia, and New Zealand, the survival rate in PD patients has significantly improved. PD patient survival in Korea has also improved, but Korean PD patients are known to have higher risk of mortality and major adverse cardiovascular, cerebrovascular events than HD patients. Herein, we further evaluate why Korean PD patients had worse outcomes; we suggest that special attention should be paid to patients with diabetes, coronary artery disease, or congestive heart failure when they choose PD as the first dialysis modality in order to reduce mortality risk.

  16. Capacitive Neutralization Dialysis for Direct Energy Generation.

    Science.gov (United States)

    Liu, Yue; Zhang, Yi; Ou-Yang, Wei; Bastos Sales, Bruno; Sun, Zhuo; Liu, Fei; Zhao, Ran

    2017-08-15

    Capacitive neutralization dialysis energy (CNDE) is proposed as a novel energy-harvesting technique that is able to utilize waste acid and alkaline solutions to produce electrical energy. CNDE is a modification based on neutralization dialysis. It was found that a higher NaCl concentration led to a higher open-circuit potential when the concentrations of acid and alkaline solutions were fixed. Upon closing of the circuit, the membrane potential was used as a driving force to move counter ions into the electrical double layers at the electrode-liquid interface, thereby creating an ionic current. Correspondingly, in the external circuit, electrons flow through an external resistor from one electrode to the other, thereby generating electrical energy directly. The influence of external resistances was studied to achieve greater energy extraction, with the maximum output of 110 mW/m 2 obtained by employing an external resistance of 5 Ω together with the AC-coated electrode.

  17. Developing e-Health Information by Empowerment Strategy

    DEFF Research Database (Denmark)

    Pallesen, Bodil; Engberg, Axel; Barlach, Anders

    2006-01-01

    This innovative study relates patient empowerment to strategies for education and e-health information to support self-care to patients with knee surgery in a Danish university hospital outpatient clinic. Interdisciplinary teamwork and Information and Communication Technology are integral parts...

  18. Evaluation Methods Basis of Strategy Development Effectiveness of the Enterprise

    Science.gov (United States)

    Zotova, Anna S.; Kandrashina, Elena A.; Ivliev, Andrey D.; Charaeva, Marina V.

    2016-01-01

    The urgency to study the problem is caused by the necessity to make management decisions in terms of reducing goods life cycle, reducing profitability of production, increasing speed of technological progress. In this context, this article aims to identify and elaborate the tools for integrated diagnostic of strategy efficiency, taking into…

  19. Developing Argumentation Strategies in Electronic Dialogs: Is Modeling Effective?

    Science.gov (United States)

    Mayweg-Paus, Elisabeth; Macagno, Fabrizio; Kuhn, Deanna

    2016-01-01

    The study presented here examines how interacting with a more capable interlocutor influences use of argumentation strategies in electronic discourse. To address this question, 54 young adolescents participating in an intervention centered on electronic peer dialogs were randomly assigned to either an experimental or control condition. In both…

  20. Horizontal Learning as a promising strategy for Continuous Professional Development

    DEFF Research Database (Denmark)

    Knudsen, Hans Jørgen; Jukic, Maja; Nielsen, Søren

    2009-01-01

    Rapport i forlængelse af et 3 årigt udviklingsprojekt på Balkan, initieret og finansieret af European Training Foundation (ETF) i Torino. Rapporten beskræftiger sig med hvorledes horisontal læring, hvor deltagerene primært lærer af hinanden, er en velegnet strategi i forbindelse med efteruddannelse...