WorldWideScience

Sample records for discuss emerging approaches

  1. Assessing Online Discussions: A Holistic Approach

    Science.gov (United States)

    Wang, Yu-mei; Chen, Der-Thanq

    2017-01-01

    This article reports a holistic approach to assessing online discussions. This holistic approach integrates three assessment methods: assessment of learning, assessment for learning, and assessment as learning. Assessment of learning directly examines students' learning products to decide whether they have achieved the expected learning through…

  2. Orion Emergency Mask Approach

    Science.gov (United States)

    Tuan, George C.; Graf, John C.

    2009-01-01

    Emergency mask approach on Orion poses a challenge to the traditional Shuttle or Station approaches. Currently, in the case of a fire or toxic spill event, the crew utilizes open loop oxygen masks that provide the crew with oxygen to breath, but also dumps the exhaled oxygen into the cabin. For Orion, with a small cabin volume, the extra oxygen will exceed the flammability limit within a short period of time, unless a nitrogen purge is also provided. Another approach to a fire or toxic spill event is the use of a filtering emergency masks. These masks utilize some form of chemical beds to scrub the air clean of toxic providing the crew safe breathing air for a period without elevating the oxygen level in the cabin. Using the masks and a form of smoke-eater filter, it may be possible to clean the cabin completely or to a level for safe transition to a space suit to perform a cabin purge. Issues with filters in the past have been the reaction time, breakthroughs, and high breathing resistance. Development in a new form of chemical filters has shown promise to make the filtering approach feasible.

  3. Measuring Skill in Games : Several Approaches Discussed

    NARCIS (Netherlands)

    Dreef, M.R.M.; Borm, P.E.M.; van der Genugten, B.B.

    2003-01-01

    An aspect of casino games that in general leads to discussions among both participants and spectators, is the relative extent to which a player can positively influence his results by making appropriate strategic choices.This question is closely related to the issue of how to distinguish between

  4. [Discussion of the implementation of MIMIC database in emergency medical study].

    Science.gov (United States)

    Li, Kaiyuan; Feng, Cong; Jia, Lijing; Chen, Li; Pan, Fei; Li, Tanshi

    2018-05-01

    To introduce Medical Information Mart for Intensive Care (MIMIC) database and elaborate the approach of critically emergent research with big data based on the feature of MIMIC and updated studies both domestic and overseas, we put forward the feasibility and necessity of introducing medical big data to research in emergency. Then we discuss the role of MIMIC database in emergency clinical study, as well as the principles and key notes of experimental design and implementation under the medical big data circumstance. The implementation of MIMIC database in emergency medical research provides a brand new field for the early diagnosis, risk warning and prognosis of critical illness, however there are also limitations. To meet the era of big data, emergency medical database which is in accordance with our national condition is needed, which will provide new energy to the development of emergency medicine.

  5. Emerging Therapeutic Approaches to Mitochondrial Diseases

    Science.gov (United States)

    Wenz, Tina; Williams, Sion L.; Bacman, Sandra R.; Moraes, Carlos T.

    2010-01-01

    Mitochondrial diseases are very heterogeneous and can affect different tissues and organs. Moreover, they can be caused by genetic defects in either nuclear or mitochondrial DNA as well as by environmental factors. All of these factors have made the development of therapies difficult. In this review article, we will discuss emerging approaches to…

  6. Discussion on emergency aerial survey system for practical use

    International Nuclear Information System (INIS)

    Moriuchi, Shigeru; Nagaoka, Toshi; Sakamoto, Ryuichi; Tsutsumi, Masahiro; Satio, Kimiaki; Amano, Hikaru; Matsunaga, Takeshi; Yanase, Nobuyuki; Kasai, Atsushi

    1989-02-01

    In 1980, after the occurrence of the TMI-2 accident in the United States, JAERI started the research and development of aerial survey techniques, and completed two prototype aerial survey systems in 1985 for gamma ray survey and for radioactivity monitoring. Following the Chernobyl reactor accident which occured in Soviet Union in 1986, European countries experienced environmental radiological monitoring using their aerial survey systems, and proved the effectiveness of aerial survey in the emergency. This report describes the outline of the prototype survey systems developed at JAERI, and showed the practical survey systems data processing, data analysis and the techniques including data processing, data analysis and the example outputs. Also, this report made some proposals concerning practical construction and the arrangement of the aerial survey equipments and the establishment of organization which takes charge of the practical emergency survey and the routine maintenance, based on our past experience. (author)

  7. Discussion

    International Nuclear Information System (INIS)

    Sutcliffe, W.G.

    1991-01-01

    This is an edited transcript of the recorded discussions that followed the presentation of each paper and on the general comments at the conclusion of the session. No attempt was made to identity those who offered comments or asked questions

  8. Effective emergency management: reconsidering the bureaucratic approach.

    Science.gov (United States)

    Neal, D M; Phillips, B D

    1995-12-01

    The command and control approach is compared with the Emergent Human Resources Model (EHRM) approach to emergency management. Four decades of systematic research shows that a rigid, bureaucratic command and control approach to emergency management generally leads to an ineffective emergency response. Previous studies and our own research suggest that flexible, malleable, loosely coupled, organizational configurations can create a more effective disaster response.

  9. Discussion on safety analysis approach for sodium fast reactors

    International Nuclear Information System (INIS)

    Hong, Soon Joon; Choo, Yeon Joon; Suh, Nam Duk; Shin, Ahn Dong; Bae, Moo Hoon

    2012-01-01

    Utilization of nuclear energy is increasingly necessary not only because of the increasing energy consumption but also because of the controls on greenhouse emissions against global warming. To keep step with such demands, advanced reactors are now world widely under development with the aims of highly economical advances, and enhanced safety. Recently, further elaborating is encouraged on the research and development program for Generation IV (GEN IV) reactors, and in collaboration with other interested countries through the Generation IV International Forum (GIF). Sodium cooled Fast Reactor (SFR) is a strong contender amongst the GEN IV reactor concepts. Korea also takes part in that program and plans to construct demonstration reactor of SFR. SFR is under the development for a candidate of small modular reactors, for example, PRISM (Power Reactor Innovative Small Module). Understanding of safety analysis approach has also advanced by the demand of increasing comprehensive safety requirement. Reviewing the past development of the licensing and safety basis in the advanced reactors, such approaches seemed primarily not so satisfactory because the reference framework of licensing and safety analysis approach in the advanced reactors was always the one in water reactors. And, the framework is very plant specific one and thereby the advanced reactors and their frameworks don't look like a well assorted couple. Recently as a result of considerable advances in probabilistic safety assessment (PSA), risk informed approaches are increasingly applied together with some of the deterministic approaches like as the ones in water reactors. Technology neutral framework (TNF) can be said to be the utmost works of such risk informed approaches, even though an intensive assessment of the applicability has not been sufficiently accomplished. This study discusses the viable safety analysis approaches for the urgent application to the construction of pool type SFR. As discussed in

  10. Emerging approaches in predictive toxicology.

    Science.gov (United States)

    Zhang, Luoping; McHale, Cliona M; Greene, Nigel; Snyder, Ronald D; Rich, Ivan N; Aardema, Marilyn J; Roy, Shambhu; Pfuhler, Stefan; Venkatactahalam, Sundaresan

    2014-12-01

    Predictive toxicology plays an important role in the assessment of toxicity of chemicals and the drug development process. While there are several well-established in vitro and in vivo assays that are suitable for predictive toxicology, recent advances in high-throughput analytical technologies and model systems are expected to have a major impact on the field of predictive toxicology. This commentary provides an overview of the state of the current science and a brief discussion on future perspectives for the field of predictive toxicology for human toxicity. Computational models for predictive toxicology, needs for further refinement and obstacles to expand computational models to include additional classes of chemical compounds are highlighted. Functional and comparative genomics approaches in predictive toxicology are discussed with an emphasis on successful utilization of recently developed model systems for high-throughput analysis. The advantages of three-dimensional model systems and stem cells and their use in predictive toxicology testing are also described. © 2014 Wiley Periodicals, Inc.

  11. Radiological emergency response - a functional approach

    Energy Technology Data Exchange (ETDEWEB)

    Chowdhury, Prosanta [Louisiana Radiation Protection Div., Baton Rouge, LA (United States)

    1997-12-31

    The radiological emergency response program in the State of Louisiana is discussed. The improved approach intends to maximize the efficiency for both nuclear power plant and radiological emergency response as a whole. Several broad-based components are identified: cluster of `nodes` are generated for each component; these `nodes` may be divided into `sub-nodes` which will contain some `attributes`; `relational bonds` among the `attributes` will exist. When executed, the process begins and continues with the `nodes` assuming a functional and dynamic role based on the nature and characteristics of the `attributes`. The typical response based on stand-alone elements is eliminated; overlapping of functions is avoided, and is produced a well-structure and efficient organization 1 ref., 6 figs.; e-mail: prosanta at deq.state.la.us

  12. Radiological emergency response - a functional approach

    International Nuclear Information System (INIS)

    Chowdhury, Prosanta

    1997-01-01

    The radiological emergency response program in the State of Louisiana is discussed. The improved approach intends to maximize the efficiency for both nuclear power plant and radiological emergency response as a whole. Several broad-based components are identified: cluster of 'nodes' are generated for each component; these 'nodes' may be divided into 'sub-nodes' which will contain some 'attributes'; 'relational bonds' among the 'attributes' will exist. When executed, the process begins and continues with the 'nodes' assuming a functional and dynamic role based on the nature and characteristics of the 'attributes'. The typical response based on stand-alone elements is eliminated; overlapping of functions is avoided, and is produced a well-structure and efficient organization

  13. Collaborative Approaches in Emerging Markets

    DEFF Research Database (Denmark)

    Søberg, Peder Veng; Han, Yang

    2011-01-01

    , in order to increase innovation performance. The theoretical framework is based on theories on trust, as well as institutional theory. The findings suggest that cognition-based trust as well as affect-based trust is needed for successful innovative collaboration, however, in emerging markets affect......The paper investigates innovative collaboration undertaken by newly established foreign invested R&D units in emerging markets. In particular, the paper investigates how foreign invested newly established R&D centers in emerging markets can leverage local knowledge networks, such as universities......-based trust is more important than Westerners are used to. This is due to the different institutional backgrounds, in emerging markets and developed markets respectively....

  14. Thigh infection and subcutaneous emphysema: an emergency, review of literature and case discussion.

    LENUS (Irish Health Repository)

    Thakral, R

    2011-06-01

    Thigh infection associated with local emphysematous signs on presentation to the emergency room should alert the medical staff at once of potential complication associated with it. The infection may be associated with underlying bowel pathology and has a high mortality rate. Hence, emergency treatment should be instituted. We discuss a case with this uncommon presentation, treatment administered and relevant literature.

  15. Discussing agrochemical themes: an approach through socio-scientific controversies

    Directory of Open Access Journals (Sweden)

    Eril Medeiros da Fonseca

    2017-12-01

    Full Text Available The theme of "agro-toxicology" in the Rural Education pervades key issues to be problematized, such as the care of rural workers, from the concept of health as something broad, involving access to cultural goods, leisure and communication and still, the collective physical, mental and social well-being. The use of pesticides, in addition to compromising the health of those who work in the field and those who feed on what is produced in the field, brings with it a conception of health that, in addition to suffering and individualizing, affects our biological diversity. The objective of this study is to discuss pesticides and their implications for health, through the approach of Socio-Scientific Controversies (CSC in Science Teaching and Rural Education.

  16. Approach to Reptile Emergency Medicine.

    Science.gov (United States)

    Long, Simon Y

    2016-05-01

    This article summarizes the physiology and anatomy of reptiles, highlighting points relevant for emergency room veterinarians. Other systems, such as the endocrine and immune systems, have not been covered. The many other aspects of reptile species variation are too numerous to be covered. This article provides an overview but encourages clinicians to seek additional species-specific information to better medically diagnose and treat their reptile patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. An emergent approach to analogical inference

    Science.gov (United States)

    Thibodeau, Paul H.; Flusberg, Stephen J.; Glick, Jeremy J.; Sternberg, Daniel A.

    2013-03-01

    In recent years, a growing number of researchers have proposed that analogy is a core component of human cognition. According to the dominant theoretical viewpoint, analogical reasoning requires a specific suite of cognitive machinery, including explicitly coded symbolic representations and a mapping or binding mechanism that operates over these representations. Here we offer an alternative approach: we find that analogical inference can emerge naturally and spontaneously from a relatively simple, error-driven learning mechanism without the need to posit any additional analogy-specific machinery. The results also parallel findings from the developmental literature on analogy, demonstrating a shift from an initial reliance on surface feature similarity to the use of relational similarity later in training. Variants of the model allow us to consider and rule out alternative accounts of its performance. We conclude by discussing how these findings can potentially refine our understanding of the processes that are required to perform analogical inference.

  18. Security technology discussion for emergency command system of nuclear power plant

    International Nuclear Information System (INIS)

    Liu Zhenjun

    2014-01-01

    Nuclear power plant emergency command system can provide valuable data for emergency personnel, such as the unit data, weather data, environmental radiation data. In the course of emergency response, the emergency command system provides decision support to quickly and effectively control and mitigate the consequences of the nuclear accident, to avoid and reduce the dose received by staff and the public, to protect the environment and the public. There are high performance requirements on the security of the system and the data transmission. Based on the previous project and new demand after the Fukushima incident, the security technology design of emergency system in nuclear power plant was discussed. The results show that the introduction of information security technology can effectively ensure the security of emergency systems, and enhance the capacity of nuclear power plant to deal with nuclear accidents. (author)

  19. Emergency Contraception and RU-486 (Mifepristone): Do Bioethical Discussions Improve Learning and Retention?

    Science.gov (United States)

    Bodensteiner, Karin J.

    2012-01-01

    To systematically investigate whether the inclusion of a bioethical discussion improves the learning and retention of biological content, students in two sections of an introductory zoology class were taught the biology behind emergency contraception and RU-486. Students in one section of the course participated in a bioethical discussion, whereas…

  20. Nanomedicine-emerging or re-emerging ethical issues? A discussion of four ethical themes.

    Science.gov (United States)

    Lenk, Christian; Biller-Andorno, Nikola

    2007-06-01

    Nanomedicine plays a prominent role among emerging technologies. The spectrum of potential applications is as broad as it is promising. It includes the use of nanoparticles and nanodevices for diagnostics, targeted drug delivery in the human body, the production of new therapeutic materials as well as nanorobots or nanoprotheses. Funding agencies are investing large sums in the development of this area, among them the European Commission, which has launched a large network for life-sciences related nanotechnology. At the same time government agencies as well as the private sector are putting forward reports of working groups that have looked into the promises and risks of these developments. This paper will begin with an introduction to the central ethical themes as identified by selected reports from Europe and beyond. In a next step, it will analyse the most frequently invoked ethical concerns-risk assessment and management, the issues of human identity and enhancement, possible implications for civil liberties (e.g. nanodevices that might be used for covert surveillance), and concerns about equity and fair access. Although it seems that the main ethical issues are not unique to nanotechnologies, the conclusion will argue against shrugging them off as non-specific items that have been considered before in the context of other biomedical technologies, such as gene therapy or xenotransplantation. Rather, the paper will call on ethicists to help foster a rational, fair and participatory discourse on the different potential applications of nanotechnologies in medicine, which can form the basis for informed and responsible societal and political decisions.

  1. Automated Announcements of Approaching Emergency Vehicles

    Science.gov (United States)

    Bachelder, Aaron; Foster, Conrad

    2006-01-01

    Street intersections that are equipped with traffic lights would also be equipped with means for generating audible announcements of approaching emergency vehicles, according to a proposal. The means to generate the announcements would be implemented in the intersection- based subsystems of emergency traffic-light-preemption systems like those described in the two immediately preceding articles and in "Systems Would Preempt Traffic Lights for Emergency Vehicles" (NPO-30573), NASA Tech Briefs, Vol. 28, No. 10 (October 2004), page 36. Preempting traffic lights is not, by itself, sufficient to warn pedestrians at affected intersections that emergency vehicles are approaching. Automated visual displays that warn of approaching emergency vehicles can be helpful as a supplement to preemption of traffic lights, but experience teaches that for a variety of reasons, pedestrians often do not see such displays. Moreover, in noisy and crowded urban settings, the lights and sirens on emergency vehicles are often not noticed until a few seconds before the vehicles arrive. According to the proposal, the traffic-light preemption subsystem at each intersection would generate an audible announcement for example, emergency vehicle approaching, please clear intersection whenever a preemption was triggered. The subsystem would estimate the time of arrival of an approaching emergency vehicle by use of vehicle identity, position, and time data from one or more sources that could include units connected to traffic loops and/or transponders connected to diagnostic and navigation systems in participating emergency vehicles. The intersection-based subsystem would then start the announcement far enough in advance to enable pedestrians to leave the roadway before any emergency vehicles arrive.

  2. A unified innovation approach to emerging markets

    DEFF Research Database (Denmark)

    Agarwal, Nivedita; Brem, Alexander; Grottke, Michael

    2014-01-01

    for emerging markets (2) and establish relative importance of key factors for product managers while conceptualizing a new product for emerging markets. In the first part, the study assembles the list of characteristics from the selected innovation theories revolving around emerging markets. Subsequently...... the overarching innovation approach for emerging markets and provides a common definition for a product considered relevant for emerging market. The results show high prioritization given to cost effective, easy to use and problem centric as compared to the sustainability, no-frills, resourceful, breakthrough...... and fast-to-market factors by product managers. However, the paper acknowledges that the prioritization results are subject to change given different motivation behind the various theories. Finally the paper proposes that, the eight key factors required factors to “play in” emerging markets would...

  3. A Learner-led, Discussion-based Elective on Emerging Infectious Disease.

    Science.gov (United States)

    Mathias, Clinton

    2015-08-25

    Objective. To implement a learner-led, discussion-based course aimed at exposing second-year pharmacy learners to the study of emerging infectious diseases from a global health perspective and to assess the role and importance of pharmacists in the management of disease outbreaks. Design. Learners examined literature pertinent to an emerging infectious disease in a 3-credit, discussion-based course and participated in peer discussion led by a designated learner. Instructional materials included journal articles, audio-visual presentations, documentaries, book chapters, movies, newspaper/magazine articles, and other materials. Learning outcomes were measured based on the ability of learners to perform critical thinking and analysis, communicate with their peers, and participate in class discussions. Assessment. The course was offered to 2 consecutive cohorts consisting of 14 and 16 learners, respectively. Overall, every learner in the first cohort achieved a final grade of A for the course. In the second cohort, the overall grade distribution consisted of grades of A, B, and C for the course. Learner evaluations indicated that the active-learning, discussion-based environment significantly enhanced interest in the topic and overall performance in the course. Conclusion. The elective course on emerging infectious diseases provided in-depth exposure to disease topics normally not encountered in the pharmacy curriculum. Learners found the material and format valuable, and the course enhanced their appreciation of infectious diseases, research methodology, critical thinking and analysis, and their roles as pharmacists.

  4. Discussing spirituality with patients: a rational and ethical approach.

    Science.gov (United States)

    McCord, Gary; Gilchrist, Valerie J; Grossman, Steven D; King, Bridget D; McCormick, Kenelm E; Oprandi, Allison M; Schrop, Susan Labuda; Selius, Brian A; Smucker, D O William D; Weldy, David L; Amorn, Melissa; Carter, Melissa A; Deak, Andrew J; Hefzy, Hebah; Srivastava, Mohit

    2004-01-01

    This study was undertaken to determine when patients feel that physician inquiry about spirituality or religious beliefs is appropriate, reasons why they want their physicians to know about their spiritual beliefs, and what they want physicians to do with this information. Trained research assistants administered a questionnaire to a convenience sample of consenting patients and accompanying adults in the waiting rooms of 4 family practice residency training sites and 1 private group practice in northeastern Ohio. Demographic information, the SF-12 Health Survey, and participant ratings of appropriate situations, reasons, and expectations for physician discussions of spirituality or religious beliefs were obtained. Of 1,413 adults who were asked to respond, 921 completed questionnaires, and 492 refused (response rate = 65%). Eighty-three percent of respondents wanted physicians to ask about spiritual beliefs in at least some circumstances. The most acceptable scenarios for spiritual discussion were life-threatening illnesses (77%), serious medical conditions (74%) and loss of loved ones (70%). Among those who wanted to discuss spirituality, the most important reason for discussion was desire for physician-patient understanding (87%). Patients believed that information concerning their spiritual beliefs would affect physicians' ability to encourage realistic hope (67%), give medical advice (66%), and change medical treatment (62%). This study helps clarify the nature of patient preferences for spiritual discussion with physicians.

  5. Learning Analytics for Online Discussions: Embedded and Extracted Approaches

    Science.gov (United States)

    Wise, Alyssa Friend; Zhao, Yuting; Hausknecht, Simone Nicole

    2014-01-01

    This paper describes an application of learning analytics that builds on an existing research program investigating how students contribute and attend to the messages of others in asynchronous online discussions. We first overview the E-Listening research program and then explain how this work was translated into analytics that students and…

  6. Radiological emergency response - a functional approach

    International Nuclear Information System (INIS)

    Chowdhury, P.

    1998-01-01

    The state of Louisiana's radiological emergency response programme is based on the federal guidance 'Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants' (NUREG-0654, FEMA-REP-1 Rev. 1). Over the past 14 years, the planning and implementation of response capabilities became more organized and efficient; the training programme has strengthened considerably; co-ordination with all participating agencies has assumed a more co-operative role, and as a result, a fairly well integrated response planning has evolved. Recently, a more 'functional' approach is being adopted to maximize the programme's efficiency not only for nuclear power plant emergency response, but radiological emergency response as a whole. First, several broad-based 'components' are identified; clusters of 'nodes' are generated for each component; these 'nodes' may be divided into 'sub-nodes' which will contain some 'attributes'; 'relational bonds' among the 'attributes' will exist. When executed, the process begins and continues with the 'nodes' assuming a functional and dynamic role based on the nature and characteristics of the 'attributes'. The typical response based on stand-alone elements is thus eliminated, the overlapping of functions is avoided, and a well structured and efficient organization is produced, that is essential for today's complex nature of emergency response. (author)

  7. Online research article discussion board to increase knowledge translation during emergency medicine residency.

    Science.gov (United States)

    Stoneking, Lisa R; Grall, Kristi H; Min, Alice A; Panchal, Ashish R

    2013-01-01

    Many clinicians have difficulties reading current best practice journal articles on a regular basis. Discussion boards are one method of online asynchronous learning that facilitates active learning and participation. We hypothesized that an online repository of best practice articles with a discussion board would increase journal article reading by emergency medicine residents. PARTICIPANTS ANSWERED THREE QUESTIONS WEEKLY ON A DISCUSSION BOARD: What question does this study address? What does this study add to our knowledge? How might this change clinical practice? A survey regarding perceived barriers to participating was then distributed. Most participants completed an article summary once or twice in total (23/32, 71.9%). Only three were involved most weeks (3/32, 9.4%) whereas 5/32 (15.6%) participated monthly. The most common barriers were lack of time (20/32, 62.5%), difficulty logging on (7/32, 21.9%), and forgetting (6/32, 18.8%). Although subjects were provided weekly with an article link, email, and feedback, journal article reading frequency did not increase.

  8. Global approach of emergency response, reflection analysis

    International Nuclear Information System (INIS)

    Velasco Garcia, E.; Garcia Ahumada, F.; Albaladejo Vidal, S.

    1998-01-01

    The emergency response management approach must be dealt with adequately within company strategy, since a badly managed emergency situation can adversely affect a company, not only in terms of asset, but also in terms of the negative impact on its credibility, profitability and image. Thereby, it can be said that there are three main supports to manage the response in an emergency situation. a) Diagnosis b) Prognosis. c) Communications. To reach these capabilities it is necessary a co-ordination of different actions at the following levels. i. Facility Operation implies Local level. ii. Facility Property implies National level iii. Local Authority implies Local level iv. National Authority implies National level Taking into account all the last, these following functions must be covered: a) Management: incorporating communication, diagnosis and prognosis areas. b) Decision: incorporating communication and information means. c) Services: in order to facilitate the decision, as well as the execution of this decision. d) Analysis: in order to facilitate the situations that make easier to decide. e) Documentation: to seek the information for the analysts and decision makers. (Author)

  9. A symptom based decision tree approach to boiling water reactor emergency operating procedures

    International Nuclear Information System (INIS)

    Knobel, R.C.

    1984-01-01

    This paper describes a Decision Tree approach to development of BWR Emergency Operating Procedures for use by operators during emergencies. This approach utilizes the symptom based Emergency Procedure Guidelines approved for implementation by the USNRC. Included in the paper is a discussion of the relative merits of the event based Emergency Operating Procedures currently in use at USBWR plants. The body of the paper is devoted to a discussion of the Decision Tree Approach to Emergency Operating Procedures soon to be implemented at two United States Boiling Water Reactor plants, why this approach solves many of the problems with procedures indentified in the post accident reviews of Three Mile Island procedures, and why only now is this approach both desirable and feasible. The paper discusses how nuclear plant simulators were involved in the development of the Emergency Operating Procedure decision trees, and in the verification and validation of these procedures. (orig./HP)

  10. Approaches to emergency management teaching at the master's level.

    Science.gov (United States)

    Alexander, David

    2013-01-01

    Training and education enable emergency managers to deal with complex situations, create durable networks of people with appropriate expertise, and ensure that knowledge is utilized to improve resilience in the face of disaster risk. Although there is a discrete literature on emergency management training, few attempts have been made to create an overview that discusses the key issues and proposes a standardized approach. This article examines the nature of training and education in emergency and disaster management. It analyzes the composition and requirements of courses at the master's degree level, which is considered to be the most appropriate tier for in-depth instruction in this field. This article defines "training" and "education" in the context of emergency management courses. It reviews the developing profile of the emergency manager in the light of training requirements. This article examines the question of whether emergency management is a branch of management science or whether it is something distinct and separate. Attention is given to the composition of a core curriculum and to the most appropriate pedagogical forms of delivering it. The article reviews the arguments for and against standardization of the curriculum and describes some of the pedagogical methods for delivering courses. Briefly, it considers the impact on training and education of new pedagogic methods based on information technology. It is concluded that the master's level is particularly suited to emergency and crisis management education, as it enables students to complement the in-depth knowledge they acquired in their disciplinary first degrees with a broader synthetic approach at the postgraduate level. Some measures of standardization of course offerings are desirable, in favor of creating a core curriculum that will ensure that essential core knowledge is imparted. Education and training in this field should include problem-solving approaches that enable students to learn

  11. A contemporary view of systems engineering. [definition of system and discussion of systems approach

    Science.gov (United States)

    Miles, R. F., Jr.

    1974-01-01

    The concept of a 'system' is defined, and the 'systems approach' is discussed. Four contemporary examples of the systems approach are presented: an operations research project, the planning-programming-budgeting system, an information processing system, and aerospace programs.

  12. Use of the Emergency First Response Program as a Tool for Teaching English as a Foreign Language: A Discussion

    Science.gov (United States)

    Cordice, Kurt

    2009-01-01

    This paper discussed both the theoretical and practical implications of using a first aid training course, specifically the Emergency First Response (EFR) program, as a tool for the teaching and practice of English as a Foreign Language (EFL). The conceptual origins of the idea are discusses through comparisons with theories of learning found in…

  13. A systematic approach to emergencies in uveitis.

    Science.gov (United States)

    Al-Dhibi, Hassan A; Al-Mahmood, Ammar M; Arevalo, J Fernando

    2014-01-01

    Uveitis is a common cause of preventable blindness although it is consider a sight-threatening condition particularly in cases with posterior segment inflammation. To deal with emergency conditions in uveitis, we must aware of the essential signs and symptoms that reflect a true uveitic emergency. Failure to recognize these essential signs and symptoms of a true uveitic emergency may result in a devastating visual outcome. This review provides general ophthalmologists and residents, clinical guidelines for the main uveitic entities that require immediate recognition and urgent intervention in the emergency room to prevent severe permanent visual loss.

  14. A Janus-Faced Approach to Learning. A Critical Discussion of Habermas' Pragmatic Approach

    Science.gov (United States)

    Italia, Salvatore

    2017-01-01

    A realist approach to learning is what I propose here. This is based on a non-epistemic dimension whose presence is a necessary assumption for a concept of learning of a life-world as complementary to learning within a life-world. I develop my approach in opposition to Jürgen Habermas' pragmatic approach, which seems to lack of something from a…

  15. Critical realism in nursing: an emerging approach.

    Science.gov (United States)

    Schiller, Catharine J

    2016-04-01

    Critical realism, a philosophical framework originally developed by Roy Bhaskar in the 1970s, represents a relatively new approach to research generally and to nursing research in particular. This article explores the ontological and epistemological tenets of critical realism and examines the application of critical realist principles to nursing research and practice through a review of the literature. It is evident that few published nursing research studies have, as of yet, utilized critical realism as their paradigm of choice. Both the strengths and limitations of the presentation and use of critical realism in these studies are discussed in this article. Given the varying degrees of success of the authors in explicating critical realism as a philosophical framework, the value of critical realism to the research study, and the ways in which usage of the critical realist framework influenced development of the study and interpretation of findings, it is evident that the quality of future publications espousing the use of critical realism must continue to be strengthened significantly. © 2015 John Wiley & Sons Ltd.

  16. Chemical toxicity approach for emergency response

    International Nuclear Information System (INIS)

    Bauer, T.

    2009-01-01

    In the event of an airborne release of chemical agent or toxic industrial chemical by accidental or intentional means, emergency responders must have a reasonable estimate of the location and size of the resulting hazard area. Emergency responders are responsible for warning persons downwind of the hazard to evacuate or shelter-in-place and must know where to look for casualties after the hazard has passed or dissipated. Given the same source characterization, modern hazard assessment models provide comparable concentration versus location and time estimates. Even urban hazard assessment models often provide similar predictions. There is a major shortcoming, though, in applying model output to estimating human toxicity effects. There exist a variety of toxicity values for non-lethal effects ranging from short-term to occupational to lifetime exposures. For health and safety purposes, these estimates are all safe-sided in converting animal data to human effects and in addressing the most sensitive subset of the population. In addition, these values are usually based on an assumed 1 hour exposure duration at constant concentration and do not reflect either a passing clouds concentration profile or duration. Emergency responders need expected value toxicity parameters rather than the existing safe-sided ones. This presentation will specify the types of toxicity values needed to provide appropriate chemical hazard estimates to emergency responders and will demonstrate how dramatically their use changes the hazard area.(author)

  17. A discussion of approaches to transforming care: contemporary strategies to improve patient safety.

    Science.gov (United States)

    Burston, Sarah; Chaboyer, Wendy; Wallis, Marianne; Stanfield, Jane

    2011-11-01

    This article presents a discussion of three contemporary approaches to transforming care: Transforming Care at the Bedside, Releasing Time to Care: the Productive Ward and the work of the Studer Group(®). International studies of adverse events in hospitals have highlighted the need to focus on patient safety. The case for transformational change was identified and recently several approaches have been developed to effect this change. Despite limited evaluation, these approaches have spread and have been adopted outside their country of origin and contextual settings. Medline and CINAHL databases were searched for the years 1999-2009. Search terms included derivatives of 'transformation' combined with 'care', 'nursing', 'patient safety', 'Transforming Care at the Bedside', 'the Productive Ward' and 'Studer Group'. A comparison of the three approaches revealed similarities including: the foci of the approaches; interventions employed; and the outcomes measured. Key differences identified are the implementation models used, spread strategies and sustainability of the approaches. The approaches appear to be complementary and a hybrid of the approaches such as a blend of a top-down and bottom-up leadership strategy may offer more sustainable behavioural change. These approaches transform the way nurses do their work, how they work with others and how they view the care they provide to promote patient safety. All the approaches involve the implementation of multiple interventions occurring simultaneously to affect improvements in patient safety. The approaches are complementary and a hybrid approach may offer more sustainable outcomes. © 2011 Blackwell Publishing Ltd.

  18. An Emerging Approach to Systems Design

    DEFF Research Database (Denmark)

    Kensing, Finn; Bødker, Keld; Simonsen, Jesper

    The paper presents our first attempt to formulate a design approach based upon our experiences from nine design projects in various organizations. In the projects we have experimented with techniques for analyzing the needs of the organization in question and for supporting the design process....... The term "approach" is used as something in between commodified methods and isolated techniques supporting one or a few activities....

  19. Nuclear Emergency and the Atmospheric Dispersion of Nuclear Aerosols: Discussion of the Shared Nuclear Future - 13163

    International Nuclear Information System (INIS)

    Rana, Mukhtar A.; Ali, Nawab; Akhter, Parveen; Khan, E.U.

    2013-01-01

    This paper has a twofold objective. One is to analyze the current status of high-level nuclear waste disposal along with presentation of practical perspectives about the environmental issues involved. Present disposal designs and concepts are analyzed on a scientific basis and modifications to existing designs are proposed from the perspective of environmental safety. Other is to understand the aerosol formation in the atmosphere for the case of the leakage from the nuclear waste containers or a nuclear accident. Radio-nuclides released from the waste will attach themselves to the existing aerosols in the atmosphere along with formation of new aerosols. Anticipating the nuclear accident when a variety of radioactive aerosols will form and exist in the atmosphere, as a simple example, measurement of naturally existing radioactive aerosols are made in the atmosphere of Islamabad and Murree. A comparison with similar measurements in 3 cities of France is provided. Measurement of radionuclides in the atmosphere, their attachment to aerosols and follow up transport mechanisms are key issues in the nuclear safety. It is studied here how "7Be concentration in the atmospheric air varies in the capital city of Islamabad and a Himalaya foothill city of Murree (Pakistan). Present results are compared with recent related published results to produce a "7Be concentration versus altitude plot up to an altitude of 4000 m (a.s.l.). Origin and variance of "7Be concentration at different altitudes is discussed in detail. The relevance of results presented here with the evaluation of implications of Chernobyl and Fukushima nuclear disasters has been discussed in a conclusive manner. It is the first international report of a joint collaboration/project. The project is being generalized to investigate and formulate a smooth waste storage and disposal policy. The project will address the fission and fusion waste reduction, its storage, its recycling, air, water and soil quality

  20. Nuclear Emergency and the Atmospheric Dispersion of Nuclear Aerosols: Discussion of the Shared Nuclear Future - 13163

    Energy Technology Data Exchange (ETDEWEB)

    Rana, Mukhtar A. [Science-Admin Coherence Cell (SACC), PINSTECH Admin Blk, PAEC, Islamabad (Pakistan); Ali, Nawab [Physics Division, Directorate of Science, Pakistan Institute of Nuclear Science and Technology (PINSTECH), P.O. Nilore, Islamabad (Pakistan); Akhter, Parveen [Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad (Pakistan); Khan, E.U. [Department of Physics, International Islamic University (IIU), Kettle Fields, Kashmir Highways, Islamabad (Pakistan)

    2013-07-01

    This paper has a twofold objective. One is to analyze the current status of high-level nuclear waste disposal along with presentation of practical perspectives about the environmental issues involved. Present disposal designs and concepts are analyzed on a scientific basis and modifications to existing designs are proposed from the perspective of environmental safety. Other is to understand the aerosol formation in the atmosphere for the case of the leakage from the nuclear waste containers or a nuclear accident. Radio-nuclides released from the waste will attach themselves to the existing aerosols in the atmosphere along with formation of new aerosols. Anticipating the nuclear accident when a variety of radioactive aerosols will form and exist in the atmosphere, as a simple example, measurement of naturally existing radioactive aerosols are made in the atmosphere of Islamabad and Murree. A comparison with similar measurements in 3 cities of France is provided. Measurement of radionuclides in the atmosphere, their attachment to aerosols and follow up transport mechanisms are key issues in the nuclear safety. It is studied here how {sup 7}Be concentration in the atmospheric air varies in the capital city of Islamabad and a Himalaya foothill city of Murree (Pakistan). Present results are compared with recent related published results to produce a {sup 7}Be concentration versus altitude plot up to an altitude of 4000 m (a.s.l.). Origin and variance of {sup 7}Be concentration at different altitudes is discussed in detail. The relevance of results presented here with the evaluation of implications of Chernobyl and Fukushima nuclear disasters has been discussed in a conclusive manner. It is the first international report of a joint collaboration/project. The project is being generalized to investigate and formulate a smooth waste storage and disposal policy. The project will address the fission and fusion waste reduction, its storage, its recycling, air, water and soil

  1. Emerging Therapeutic Enhancement Enabling Health Technologies and Their Discourses: What Is Discussed within the Health Domain?

    Science.gov (United States)

    Wolbring, Gregor; Diep, Lucy; Yumakulov, Sophya; Ball, Natalie; Leopatra, Verlyn; Yergens, Dean

    2013-01-01

    So far, the very meaning of health and therefore, treatment and rehabilitation is benchmarked to the normal or species-typical body. We expect certain abilities in members of a species; we expect humans to walk but not to fly, but a bird we expect to fly. However, increasingly therapeutic interventions have the potential to give recipients beyond species-typical body related abilities (therapeutic enhancements, TE). We believe that the perfect storm of TE, the shift in ability expectations toward beyond species-typical body abilities, and the increasing desire of health consumers to shape the health system will increasingly influence various aspects of health care practice, policy, and scholarship. We employed qualitative and quantitative methods to investigate among others how human enhancement, neuro/cognitive enhancement, brain machine interfaces, and social robot discourses cover (a) healthcare, healthcare policy, and healthcare ethics, (b) disability and (c) health consumers and how visible various assessment fields are within Neuro/Cogno/Human enhancement and within the BMI and social robotics discourse. We found that health care, as such, is little discussed, as are health care policy and ethics; that the term consumers (but not health consumers) is used; that technology, impact and needs assessment is absent; and that the imagery of disabled people is primarily a medical one. We submit that now, at this early stage, is the time to gain a good understanding of what drives the push for the enhancement agenda and enhancement-enabling devices, and the dynamics around acceptance and diffusion of therapeutic enhancements. PMID:27429129

  2. Emerging Therapeutic Enhancement Enabling Health Technologies and Their Discourses: What Is Discussed within the Health Domain?

    Directory of Open Access Journals (Sweden)

    Gregor Wolbring

    2013-07-01

    Full Text Available So far, the very meaning of health and therefore, treatment and rehabilitation is benchmarked to the normal or species-typical body. We expect certain abilities in members of a species; we expect humans to walk but not to fly, but a bird we expect to fly. However, increasingly therapeutic interventions have the potential to give recipients beyond species-typical body related abilities (therapeutic enhancements, TE. We believe that the perfect storm of TE, the shift in ability expectations toward beyond species-typical body abilities, and the increasing desire of health consumers to shape the health system will increasingly influence various aspects of health care practice, policy, and scholarship. We employed qualitative and quantitative methods to investigate among others how human enhancement, neuro/cognitive enhancement, brain machine interfaces, and social robot discourses cover (a healthcare, healthcare policy, and healthcare ethics, (b disability and (c health consumers and how visible various assessment fields are within Neuro/Cogno/ Human enhancement and within the BMI and social robotics discourse. We found that health care, as such, is little discussed, as are health care policy and ethics; that the term consumers (but not health consumers is used; that technology, impact and needs assessment is absent; and that the imagery of disabled people is primarily a medical one. We submit that now, at this early stage, is the time to gain a good understanding of what drives the push for the enhancement agenda and enhancement-enabling devices, and the dynamics around acceptance and diffusion of therapeutic enhancements.

  3. Nuclear emergency response planning based on participatory decision analytic approaches

    International Nuclear Information System (INIS)

    Sinkko, K.

    2004-10-01

    This work was undertaken in order to develop methods and techniques for evaluating systematically and comprehensively protective action strategies in the case of a nuclear or radiation emergency. This was done in a way that the concerns and issues of all key players related to decisions on protective actions could be aggregated into decision- making transparently and in an equal manner. An approach called facilitated workshop, based on the theory of Decision Analysis, was tailored and tested in the planning of actions to be taken. The work builds on case studies in which it was assumed that a hypothetical accident in a nuclear power plant had led to a release of considerable amounts of radionuclides and therefore different types of protective actions should be considered. Altogether six workshops were organised in which all key players were represented, i.e., the authorities, expert organisations, industry and agricultural producers. The participants were those responsible for preparing advice or presenting matters for those responsible for the formal decision-making. Many preparatory meetings were held with various experts to prepare information for the workshops. It was considered essential that the set-up strictly follow the decision- making process to which the key players are accustomed. Key players or stakeholders comprise responsible administrators and organisations, politicians as well as representatives of the citizens affected and other persons who will and are likely to take part in decision-making in nuclear emergencies. The realistic nature and the disciplined process of a facilitated workshop and commitment to decision-making yielded up insight in many radiation protection issues. The objectives and attributes which are considered in a decision on protective actions were discussed in many occasions and were defined for different accident scenario to come. In the workshops intervention levels were derived according justification and optimisation

  4. Theoretical triangulation as an approach for revealing the complexity of a classroom discussion

    NARCIS (Netherlands)

    van Drie, J.; Dekker, R.

    2013-01-01

    In this paper we explore the value of theoretical triangulation as a methodological approach for the analysis of classroom interaction. We analyze an excerpt of a whole-class discussion in history from three theoretical perspectives: interactivity of the discourse, conceptual level raising and

  5. Emerging Approaches to Food Desensitization in Children.

    Science.gov (United States)

    Hamad, Ahmad; Burks, Wesley A

    2017-05-01

    The purpose of this review is to highlight the recent advances in food desensitization in children with food allergy. Recent advancements in epicutaneous, sublingual, and oral immunotherapy for food allergy in the future may offer children with food allergy and their families a viable option to reduce risk or severity of anaphylaxis with phase III trials ongoing for two of these treatment modalities. Food allergy prevalence in children is estimated to be up to 8%. These children are at risk of significant allergic reactions and anaphylaxis. Food avoidance and use of antihistamines or epinephrine has been the standard of care for these patients. This approach also has a significant socioeconomic effects on patients and their families. Recent advancements in understanding food allergy have allowed for exploring new methods of treatment. There is an increasing interest in oral immunotherapy, epicutaneous immunotherapy, or sublingual immunotherapy for food allergy. There have been also innovative approaches to immunotherapy by modification of food allergens (to make them less allergenic while maintain their immunogenicity) or adding adjunctive treatments (probiotics, anti-IgE, etc.) to increase efficacy or safety.

  6. An Approach to the Discussions on Education and Pedagogy: State of the Art

    Directory of Open Access Journals (Sweden)

    Ana Cristina León Palencia

    2016-08-01

    Full Text Available This reflection paper is a product of a research aimed at making a map of discussions in the field of education and pedagogy. For that purpose, it takes up again some classifications developed from concepts such as currents, trends, approaches and pedagogical traditions. Focusing on the latter and its developments —connected with the concepts of education, bildung and curriculum— a new cartography is proposed the design of a new cartography. Finally, the paper elaborates on some elements of the current discussion in Colombia and the need for new paths to bring up to date the field of pedagogical studies in the country.

  7. An Approach to the Discussions on Education and Pedagogy: State of the Art

    OpenAIRE

    Ana Cristina León Palencia

    2016-01-01

    This reflection paper is a product of a research aimed at making a map of discussions in the field of education and pedagogy. For that purpose, it takes up again some classifications developed from concepts such as currents, trends, approaches and pedagogical traditions. Focusing on the latter and its developments —connected with the concepts of education, bildung and curriculum— a new cartography is proposed the design of a new cartography. Finally, the paper elaborates on some elements of t...

  8. Mathematizing: An Emergent Math Curriculum Approach for Young Children

    Science.gov (United States)

    Rosales, Allen C.

    2015-01-01

    Based on years of research with early childhood teachers, author Allen Rosales provides an approach to create an emergent math curriculum that integrates children's interests with math concepts. The mathematizing approach is different from traditional math curriculums, as it immerses children in a process that is designed to develop their…

  9. Holistic feedback approach with video and peer discussion under teacher supervision.

    Science.gov (United States)

    Hunukumbure, Agra Dilshani; Smith, Susan F; Das, Saroj

    2017-09-29

    High quality feedback is vital to learning in medical education but many students and teachers have expressed dissatisfaction on current feedback practices. Lack of teachers' insight into students' feedback requirements may be a key, which might be addressed by giving control to the students with student led feedback practices. The conceptual framework was built on three dimensions of learning theory by Illeris and Vygotsky's zone of proximal development and scaffolding. We introduced a feedback session with self-reflection and peer feedback in the form of open discussion on video-recorded student performances under teacher's guidance. The aims of this qualitative study were to explore students' perception on this holistic feedback approach and to investigate ways of maximising effective feedback and learning. Semi-structured interviews were used to gather data which were evaluated using a thematic analytical approach. The participants were third year medical students of Imperial College London on clinical placements at Hillingdon Hospital. Video based self-reflection helped some students to identify mistakes in communication and technical skills of which they were unaware prior to the session. Those who were new to video feedback found their expected self-image different to that of their actual image on video, leading to some distress. However many also identified that mistakes were not unique to themselves through peer videos and learnt from both model performances and from each other's mistakes. Balancing honest feedback with empathy was a challenge for many during peer discussion. The teacher played a vital role in making the session a success by providing guidance and a supportive environment. This study has demonstrated many potential benefits of this holistic feedback approach with video based self-reflection and peer discussion with students engaging at a deeper cognitive level than the standard descriptive feedback.

  10. Novel approach to the exploitation of the tidal energy. Volume 1: Summary and discussion

    Science.gov (United States)

    Gorlov, A. M.

    1981-12-01

    The hydropneumatic concept in the approach to harnessing low tidal hydropower is discussed. The energy of water flow is converted into the energy of an air jet by a specialized air chamber which is placed on the ocean floor across a flowing watercourse. Water passes through the chamber where it works as a natural piston compressing air in the upper part of the closure. Compressed air is used as a new working plenum to drive air turbines. The kinetic energy of an air jet provided by the air chamber is sufficient for stable operation of industrial air turbines. It is possible to use light plastic barriers instead of conventional rigid dams (the water sail concept). It is confirmed that the concept can result in a less expensive and more effective tidal power plant project than the conventional hydroturbine approach.

  11. A systemic approach to the discussion of sustainability of nuclear energy

    International Nuclear Information System (INIS)

    Aegerter, Irene

    2001-01-01

    In 1998 the four Swiss Scientific Academies formed a working group to study sustainability of electricity production. Having been a member of this group since the beginning I witnessed the evolution of the discussion that led to a consensus. The group found the criteria of sustainability to be special for nuclear energy. While the resource uranium is not needed for any other purpose and thus the use of uranium is sustainable, the possible harm to future generations by nuclear reactors is difficult to evaluate: the potential damage can be large but the probability of its occurrence is very small. Therefore some people judge nuclear power as an environmentally friendly source of electricity production and an important contribution towards a sustainable energy future whereas others look at the potential damage and value nuclear power as not sustainable. The discussion of alternatives then reveals that it is definitely not sustainable to replace nuclear power by fossil fuels. This was a consensus reached by the members of the working group, which consists of the pro and anti nuclear camp. Sustainable energy production is a complex topic and not easy to tackle with our everyday methods. The group decided to solve the problem with a systemic approach to get to know the hidden and indirect effects of electricity production and usage. A system approach brings a new concept into the often blocked discussion of proponents and antinuclear people. In order to assure that a holistic evaluation results which reaches a high degree of consensus, several subgroups were formed representing divergent views on the issues analysed. These groups do not communicate their findings while work on their cross impact matrices (CIMs) is under way. The results are compared and discrepancies are discussed. Usually this shows that once the wording of the variables is corrected and their interpretations are shared by the parties involved, consensus concerning evaluations is achieved

  12. A positive risk approach when clients choose to live at risk: a palliative case discussion.

    Science.gov (United States)

    De Bono, Christopher E; Henry, Blair

    2016-09-01

    The article discusses recent approaches in the literature about clients who chose to live at risk in their homes. It argues for a positive risk-based approach and a tool to help manage risk in the home, and applies these to a hypothetical end-of-life scenario. Historically, safety plans to consider risk management involved a culture of risk aversion supported by sometimes paternalistic motives intended to protect vulnerable clients. New findings in the literature engage in a process that respects the ethical principles underlying harm reduction philosophies. The literature also argues for a perspective that moves away from viewing risk as only harmful, to one that supports a positive understanding of risk as part of a client's informed choice. A risk support management plan, based on a positive approach, can provide a way to both support a client's choice to live at risk, anticipate for expected complications, and inform the creation of a contingency plan to address concerns as they may arise. The added value of a structured approach like the one proposed here for risk support management plans is that it provides adequate due diligence and informed decision-making when planning for risk-taking in complex situations.

  13. A Systematic Approach to Discussing Active Surveillance with Patients with Low-risk Prostate Cancer.

    Science.gov (United States)

    Ehdaie, Behfar; Assel, Melissa; Benfante, Nicole; Malhotra, Deepak; Vickers, Andrew

    2017-06-01

    Physicians report difficulty convincing patients with prostate cancer about the merits of active surveillance (AS); as a result, a majority of patients unnecessarily choose to undergo radical treatment. To develop and evaluate a systematic approach for physicians to counsel patients with low-risk prostate cancer to increase acceptance of AS. A systematic counseling approach was developed and piloted in one clinic. Then five surgeons participated in a 1-h training session in which they learned about the approach. A total of 1003 patients with Gleason 3+3 prostate cancer were included in the study. We compared AS rates for 761 patients who were counseled over a 24-mo period before the training intervention with AS rates for 242 patients who were counseled over a 12-mo period afterwards, controlling for temporal trends and case mix. A systematic approach for communicating the merits of AS using appropriate framing techniques derived from principles studied by negotiation scholars. The rate of AS acceptance by patients for management of low-risk prostate cancer. In the pilot phase, 81 of 86 patients (94%) accepted AS after counseling by the physician who developed the counseling approach. In the subsequent study, the cohort for the training intervention comprised 1003 consecutive patients, 80% of whom met the Epstein criteria for very low-risk disease. The proportion of patients who selected AS increased from 69% before the training intervention to 81% afterwards. After adjusting for time trends and case mix, the rate of AS after the intervention was 9.1% higher (95% confidence interval -0.4% to 19.4%) than expected, a relative reduction of approximately 30% in the risk of unnecessary curative treatment. A systematic approach to counseling can be taught to physicians in a 1-h lecture. We found evidence that even this minimal intervention can decrease overtreatment. Our novel approach offers a framework to help address cancer screening-related overtreatment that occurs

  14. An innovative approach to capability-based emergency operations planning.

    Science.gov (United States)

    Keim, Mark E

    2013-01-01

    This paper describes the innovative use information technology for assisting disaster planners with an easily-accessible method for writing and improving evidence-based emergency operations plans. This process is used to identify all key objectives of the emergency response according to capabilities of the institution, community or society. The approach then uses a standardized, objective-based format, along with a consensus-based method for drafting capability-based operational-level plans. This information is then integrated within a relational database to allow for ease of access and enhanced functionality to search, sort and filter and emergency operations plan according to user need and technological capacity. This integrated approach is offered as an effective option for integrating best practices of planning with the efficiency, scalability and flexibility of modern information and communication technology.

  15. A discussion of the limitations of the psychometric and cultural theory approaches to risk perception

    International Nuclear Information System (INIS)

    Sjoeberg, L.

    1996-01-01

    Risk perception has traditionally been conceived as a cognitive phenomenon, basically a question of information processing. The very term perception suggests that information processing is involved and of crucial importance. Kahneman and Tversky suggested that the use of 'heuristics' in the intuitive estimation of probabilities accounts for biased probability perception, hence claiming to explain risk perception as well. The psychometric approach of Slovic et al, a further step in in the cognitive tradition, conceives of perceived risk as a function of general properties of a hazard. However, the psychometric approach is shown here to explain only about 20% of the variance of perceived risk, even less of risk acceptability. Its claim to explanatory power is based on a statistical illusion: mean values were investigated and accounted for, across hazards. A currently popular alternative to the psychometric tradition, Cultural Theory, is even less successful and explains only about 5% of the variance of perceived risk. The claims of this approach were also based on a statistical illusion: 'significant' results were reported and interpreted as being of substantial importance. The present paper presents a new approach: attitude to the risk generating technology, general sensitivity to risks and specific risk explained well over 60% of the variance of perceived risk of nuclear waste, in a study of extensive data from a representative sample of the Swedish population. The attitude component functioning as an explanatory factor of perceived risk, rather than as a consequence of perceived risk, suggests strongly that perceived risk is something other than cognition. Implications for risk communication are discussed. (author)

  16. Can material matters and critique be dealt with at the same time? Discussion of analytical approaches

    DEFF Research Database (Denmark)

    Andersen, Nina Blom

    2016-01-01

    . Several theoretical traditions offer perspectives that take objects into account even though they approach the understanding of how material relations shape social life differently. This presentation discusses how the research area on disaster, social crisis and conflict can benefit and be widen up from......Material matters has to be dealt with in analysis of disasters, social crisis and conflicts since an important part of the unpredictability in these courses not only stems from human agency but as well from objects that are as well involved in complex webs of relations that shape the processes...... (e.g. Mol 2002) distances itself from the ANT-tradition by focusing on the practices where humans and materiality are gathered instead of focusing on the relations between these actants. Working with Clarke?s (2005) notion of situational analysis as well as Practice Theory (e.g. Reckwitz 2002...

  17. Can material matters and critique be dealt with at the same time? Discussion of analytical approaches

    DEFF Research Database (Denmark)

    Andersen, Nina Blom

    2013-01-01

    . Several theoretical traditions offer perspectives that take objects into account even though they approach the understanding of how material relations shape social life differently. This presentation discusses how the research area on disaster, social crisis and conflict can benefit and be widen up from......Material matters has to be dealt with in analysis of disasters, social crisis and conflicts since an important part of the unpredictability in these courses not only stems from human agency but as well from objects that are as well involved in complex webs of relations that shape the processes...... (e.g. Mol 2002) distances itself from the ANT-tradition by focusing on the practices where humans and materiality are gathered instead of focusing on the relations between these actants. Working with Clarke’s (2005) notion of situational analysis as well as Practice Theory (e.g. Reckwitz 2002...

  18. Global emergency medicine journal club: a social media discussion about the Age-Adjusted D-Dimer Cutoff Levels To Rule Out Pulmonary Embolism trial.

    Science.gov (United States)

    Rezaie, Salim R; Swaminathan, Anand; Chan, Teresa; Shaikh, Sam; Lin, Michelle

    2015-05-01

    Annals of Emergency Medicine collaborated with an educational Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Journal of the American Medical Association publication on the Age-Adjusted D-Dimer Cutoff Levels to Rule Out Pulmonary Embolism (ADJUST-PE) trial by Righini et al. The objective is to describe a 14-day (August 25 to September 7, 2014) worldwide academic dialogue among clinicians in regard to 4 preselected questions about the age-adjusted D-dimer cutoff to detect pulmonary embolism. Five online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and Google Hangout. Comments across the social media platforms were curated for this report, as framed by the 4 preselected questions, and engagement was tracked through various Web analytic tools. Blog and Twitter comments, as well as video expert commentary involving the ADJUST-PE trial, are summarized. The dialogue resulted in 1,169 page views from 391 cities in 52 countries on the ALiEM Web site, 502,485 Twitter impressions, and 159 views of the video interview with experts. A postdiscussion summary on the Journal Jam podcast resulted in 3,962 downloads in its first week of publication during September 16 to 23, 2014. Common themes that arose in the multimodal discussions included the heterogeneity of practices, D-dimer assays, provider knowledge about these assays, and prevalence rates in different areas of the world. This educational approach using social media technologies demonstrates a free, asynchronous means to engage a worldwide audience in scholarly discourse. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  19. Approaches relating to decommissioning of nuclear facilities. Peer discussions on regulatory practices

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-04-01

    This report arises from the fifth series of peer discussions on regulatory practices entitled 'Approaches relating to decommissioning of nuclear facilities'. Senior regulators from 22 Member States participated in three peer group discussions during 1996-1997. This report presents the outcome of these meetings and recommendations of good practices identified by senior regulators, which do not necessarily reflect those of the governments of the nominating Member States, the nominating organizations, nor the IAEA. In many Member States nuclear facilities such as power and research reactors, nuclear fuel cycle facilities and various industrial and medical facilities have reached the end of their useful life or will reach it in the near future. These facilities need to be safely decommissioned without causing any undue radiological, chemical or other risks to workers, the public and the environment. Today, there is a growing consensus that decommissioning needs to be given consideration from the design phase of a new facility and that planning for decommissioning is to be carried out during the entire life of the nuclear facility. In most Member States, there is no comprehensive set of requirements, be it on a legal or technical level, available to plan, assess, approve and carry out decommissioning operations. Since most of the facilities to be decommissioned in the near future are demonstration or prototype facilities, case by case specific and prescriptive requirements will have to be developed. However, such case by case requirements need to be based on existing applicable regulations as well as on generally accepted principles. In order to assist Member States in ensuring safe decommissioning operations, the IAEA has convened the fifth series of peer discussions on 'Approaches relating to decommissioning of nuclear facilities'. The results and findings of these discussions are summarized in this report, concentrating on recommendations and established good

  20. Approaches relating to decommissioning of nuclear facilities. Peer discussions on regulatory practices

    International Nuclear Information System (INIS)

    1998-04-01

    This report arises from the fifth series of peer discussions on regulatory practices entitled 'Approaches relating to decommissioning of nuclear facilities'. Senior regulators from 22 Member States participated in three peer group discussions during 1996-1997. This report presents the outcome of these meetings and recommendations of good practices identified by senior regulators, which do not necessarily reflect those of the governments of the nominating Member States, the nominating organizations, nor the IAEA. In many Member States nuclear facilities such as power and research reactors, nuclear fuel cycle facilities and various industrial and medical facilities have reached the end of their useful life or will reach it in the near future. These facilities need to be safely decommissioned without causing any undue radiological, chemical or other risks to workers, the public and the environment. Today, there is a growing consensus that decommissioning needs to be given consideration from the design phase of a new facility and that planning for decommissioning is to be carried out during the entire life of the nuclear facility. In most Member States, there is no comprehensive set of requirements, be it on a legal or technical level, available to plan, assess, approve and carry out decommissioning operations. Since most of the facilities to be decommissioned in the near future are demonstration or prototype facilities, case by case specific and prescriptive requirements will have to be developed. However, such case by case requirements need to be based on existing applicable regulations as well as on generally accepted principles. In order to assist Member States in ensuring safe decommissioning operations, the IAEA has convened the fifth series of peer discussions on 'Approaches relating to decommissioning of nuclear facilities'. The results and findings of these discussions are summarized in this report, concentrating on recommendations and established good

  1. An Emergent Micro-Services Approach to Digital Curation Infrastructure

    Directory of Open Access Journals (Sweden)

    Stephen Abrams

    2010-07-01

    Full Text Available In order better to meet the needs of its diverse University of California (UC constituencies, the California Digital Library UC Curation Center is re-envisioning its approach to digital curation infrastructure by devolving function into a set of granular, independent, but interoperable micro-services. Since each of these services is small and self-contained, they are more easily developed, deployed, maintained, and enhanced; at the same time, complex curation function can emerge from the strategic combination of atomistic services. The emergent approach emphasizes the persistence of content rather than the systems in which that content is managemed, thus the paradigmatic archival culture is not unduly coupled to any particular technological context. This results in a curation environment that is comprehensive in scope, yet flexible with regard to local policies and practices and sustainable despite the inevitability of disruptive change in technology and user expectation.

  2. An Emergent Micro-Services Approach to Digital Curation Infrastructure

    OpenAIRE

    Abrams, Stephen; Kunze, John; Loy, David

    2010-01-01

    In order better to meet the needs of its diverse University of California (UC) constituencies, the California Digital Library UC Curation Center is re-envisioning its approach to digital curation infrastructure by devolving function into a set of granular, independent, but interoperable micro-services. Since each of these services is small and self-contained, they are more easily developed, deployed, maintained, and enhanced; at the same time, complex curation function can emerge from the str...

  3. The emerging knowledge governance approach : challenges and characteristics

    OpenAIRE

    Foss, Nicolai Juul

    2006-01-01

    The “knowledge governance approach” is characterized as a distinctive, emerging approach that cuts across the fields of knowledge management, organisation studies, strategy, and human resource management. Knowledge governance is taken up with how the deployment of governance mechanisms influences knowledge processes, such as sharing, retaining and creating knowledge. It insists on clear micro (behavioural) foundations, adopts an economizing perspective, and examines the links between knowledg...

  4. Operational intervention levels in a nuclear emergency, general concepts and a probabilistic approach

    International Nuclear Information System (INIS)

    Lauritzen, B.; Baeverstam, U.; Naadland Holo, E.; Sinkko, K.

    1997-12-01

    This report deals with Operational Intervention Levels (OILs) in a nuclear or radiation emergency. OILs are defined as the values of environmental measurements, in particular dose rate measurements, above which specific protective actions should be carried out in emergency exposure situations. The derivation and the application of OILs are discussed, and an overview of the presently adopted values is provided, with emphasis on the situation in the Nordic countries. A new, probabilistic approach to derive OILs is presented and the method is illustrated by calculating dose rate OILs in a simplified setting. Contrary to the standard approach, the probabilistic approach allows for optimization of OILs. It is argued, that optimized OILs may be much larger than the presently adopted or suggested values. It is recommended, that the probabilistic approach is further developed and employed in determining site specific OILs and in optimizing environmental measuring strategies. (au)

  5. Cooperative approach to training for radiological emergency preparedness and response in Southeast Asia

    International Nuclear Information System (INIS)

    Bus, John; Popp, Andrew; Holland, Brian; Murray, Allan

    2011-01-01

    The paper describes the collaborative and systematic approach to training for nuclear and radiological emergency preparedness and response and the outcomes of this work with ANSTO's Southeast Asian counterparts, particularly in the Philippines. The standards and criteria being applied are discussed, along with the methods, design and conduct of workshops, table-top and field exercises. The following elements of this training will be presented: (a) identifying the priority areas for training through needs analysis;(b) strengthening individual profesional expertise through a structured approach to training; and (c) enhancing individual Agency and National nuclear and radiological emergency preparedness and response arrangements and capabilities. Whilst the work is motivated by nuclear security concerns, the implications for effective and sustainable emergency response to any nuclear or radiological incidents are noted. (author)

  6. From reactive to proactive use of social media in emergency response: A critical discussion of the Twitcident Project

    NARCIS (Netherlands)

    Boersma, F.K.; Diks, D.; Ferguson, J.E.; Wolbers, J.J.; Silvius, G.

    2016-01-01

    This chapter examines the introduction and implementation of the pilot project Twitcident in an emergency response room setting. Twitcident is a web-based system for filtering, searching and analyzing data on real-world incidents or crises. Social media data is seen as important for emergency

  7. A User Centered Approach to Developing Emergent Technology Products

    DEFF Research Database (Denmark)

    Restrepo-Giraldo, John Dairo; McAloone, Timothy Charles; Schlegel, Tanja

    2008-01-01

    be used too early in the design process, given that users respond best to issues they know or can relate to. This paper presents a case study where a user-centred approach was used to determine when and how to involve users in the design of a TV-enabled mobile telephone. The aim of the study......Current participatory design methods do not allow designers to gain the insight required to develop products with emerging technologies, that is, products that do not have any precedents in the users’ knowledge base and experience. This poses challenges to the designers, as input from users cannot...... methodological issues related to user involvement in the implementation of emerging technologies in the consumer electronics industry....

  8. Exploring public attitudes towards approaches to discussing costs in the clinical encounter.

    Science.gov (United States)

    Danis, Marion; Sommers, Roseanna; Logan, Jean; Weidmer, Beverly; Chen, Shirley; Goold, Susan; Pearson, Steven; Donley, Greer; McGlynn, Elizabeth

    2014-01-01

    Patients' willingness to discuss costs of treatment alternatives with their physicians is uncertain. To explore public attitudes toward doctor-patient discussions of insurer and out-of-pocket costs and to examine whether several possible communication strategies might enhance patient receptivity to discussing costs with their physicians. Focus group discussions and pre-discussion and post-discussion questionnaires. Two hundred and eleven insured individuals with mean age of 48 years, 51 % female, 34 % African American, 27 % Latino, and 50 % with incomes below 300 % of the federal poverty threshold, participated in 22 focus groups in Santa Monica, CA and in the Washington, DC metro area. Attitudes toward discussing out-of-pocket and insurer costs with physicians, and towards physicians' role in controlling costs; receptivity toward recommended communication strategies regarding costs. Participants expressed more willingness to talk to doctors about personal costs than insurer costs. Older participants and sicker participants were more willing to talk to the doctor about all costs than younger and healthier participants (OR = 1.8, p = 0.004; OR = 1.6, p = 0.027 respectively). Participants who face cost-related barriers to accessing health care were in greater agreement than others that doctors should play a role in reducing out-of-pocket costs (OR = 2.4, p = 0.011). Participants did not endorse recommended communication strategies for discussing costs in the clinical encounter. In contrast, participants stated that trust in one's physician would enhance their willingness to discuss costs. Perceived impediments to discussing costs included rushed, impersonal visits, and clinicians who are insufficiently informed about costs. This study suggests that trusting relationships may be more conducive than any particular discussion strategy to facilitating doctor-patient discussions of health care costs. Better public understanding of how medical

  9. Ultrasensitive superconducting terahertz detectors: novel approaches and emerging materials

    International Nuclear Information System (INIS)

    Sergeev, Andrei; Mitin, Vladimir; Karasik, Boris; Vitkalov, Sergey

    2014-01-01

    Novel approaches to THz sensing based superconductor detectors and emerging superconducting nanomaterials have a strong potential to boost development of advanced optoelectronic devices, such as THz detectors, THz mixers, single photon counters and quantum calorimeters with outstanding sensitivity. Such devices have a number of applications in THZ environmental and industrial monitoring, astrophysics, homeland security, and medicine. Single photon counters have potential as key elements for optical communication and networking, quantum imaging and metrology, quantum optical computing and bio-photonics, and single-molecule spectroscopy

  10. Refusal of emergency caesarean section in Ireland: a relational approach.

    Science.gov (United States)

    Wade, Katherine

    2014-01-01

    This article examines the issue of emergency caesarean section refusal. This raises complex legal and ethical issues surrounding autonomy, capacity, and the right to refuse treatment. In Ireland, the situation is complicated further by the constitutional right to life of the unborn. While cases involving caesarean section refusal have occurred in other jurisdictions, a case of this nature has yet to be reported in Ireland. This article examines possible ways in which the interaction of a woman's right to refuse treatment and the right to life of the unborn could be approached in Ireland in the context of caesarean section refusal. The central argument of the article is that the liberal individualistic approach to autonomy evident in the caesarean section cases in England and Wales is difficult to apply in the Irish context, due to the conflicting constitutional rights of the woman and foetus. Thus, alternative visions of autonomy which take the interests and rights of others into account in medical decision-making are examined. In particular, this article focuses on the concept of relational consent, as developed by Alasdair Maclean and examines how such an approach could be applied in the context of caesarean section refusal in Ireland. The article explains why this approach is particularly appropriate and identifies mechanisms through which such a theory of consent could be applied. It is argued that this approach enhances a woman's right to autonomy, while at the same time allows the right to life of the unborn to be defended.

  11. Systems engineering approach towards performance monitoring of emergency diesel generator

    International Nuclear Information System (INIS)

    Nurhayati Ramli; Lee, Y.K.

    2013-01-01

    Full-text: Systems engineering is an interdisciplinary approach and means to enable the realization of successful systems. In this study, systems engineering approach towards the performance monitoring of Emergency Diesel Generator (EDG) is presented. Performance monitoring is part and parcel of predictive maintenance where the systems and components conditions can be detected before they result into failures. In an effort to identify the proposal for addressing performance monitoring, the EDG boundary has been defined. Based on the Probabilistic Safety Analysis (PSA) results and industry operating experiences, the most critical component is identified. This paper proposed a systems engineering concept development framework towards EDG performance monitoring. The expected output of this study is that the EDG reliability can be improved by the performance monitoring alternatives through the systems engineering concept development effort. (author)

  12. Building communities through performance: emerging approaches to interculturality.

    Science.gov (United States)

    Parent, Roger

    2009-08-01

    Changing definitions of culture are modifying approaches to intercultural education and training. This paper outlines the principal features of these emerging models for innovation and capacity building in communities. Semiotics provides a theoretical frame for the interdisciplinary analysis of research on cultural competency, especially regarding recent studies on "cultural intelligence", performance and creativity. Interdisciplinary research on cultural literacy is shifting from cultural knowledge to intercultural know-how. This know-how translates into the individual's capacity to innovate and illustrates the influence of culture on individual and group performance. Research on cultural intelligence, performance and creativity provides promising new models for capacity building in communities. These approaches constitute a synthesis of previous research on cultural competency and provide new avenues for innovative social action through intercultural exchange.

  13. Acceptability of the flipped classroom approach for in-house teaching in emergency medicine.

    Science.gov (United States)

    Tan, Eunicia; Brainard, Andrew; Larkin, Gregory L

    2015-10-01

    To evaluate the relative acceptability of the flipped classroom approach compared with traditional didactics for in-house teaching in emergency medicine. Our department changed its learning model from a 'standard' lecture-based model to a 'flipped classroom' model. The 'flipped classroom' included provided pre-session learning objectives and resources before each 2 h weekly session. In-session activities emphasised active learning strategies and knowledge application. Feedback was sought from all medical staff regarding the acceptability of the new approach using an online anonymous cross-sectional qualitative survey. Feedback was received from 49/57 (86%) medical staff. Ninety-eight per cent (48/49) of respondents preferred the flipped classroom over the traditional approach. Aspects of the flipped classroom learners liked most included case-based discussion, interaction with peers, application of knowledge, self-directed learning and small-group learning. Barriers to pre-session learning include work commitments, 'life', perceived lack of time, family commitments, exam preparation and high volume of learning materials. Reported motivational factors promoting pre-session learning include formal assessment, participation requirements, more time, less material, more clinical relevance and/or more interesting material. Case studies and 'hands-on' activities were perceived to be the most useful in-session activities. The flipped classroom shows promise as an acceptable approach to in-house emergency medicine teaching. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  14. Selected approaches to determining the purpose of emergency planning zones

    Science.gov (United States)

    Dobeš, Pavel; Baudišová, Barbora; Sluka, Vilém; Skřínský, Jan; Danihelka, Pavel; Dlabka, Jakub; Řeháček, Jakub

    2013-04-01

    One of the major accident hazards (hereinafter referred to as "MAH") tools to determine the range of effects of a major accident and consequent protection of the public is the determination of the emergency planning zone (hereinafter referred to as "zone"). In the Czech Republic, the determination of the zone is regulated by the Decree No. 103/2006 Coll. laying down the principles for determination of the emergency planning zone and the extent and manner of elaborating the external emergency plan (hereinafter referred to as "Decree") 3. The Decree is based on the principles of the IAEA-TECDOC-727 method - Manual for the Classification and Prioritization of Risks Due to Major Accidents in Process and Related Industries (hereinafter referred to as "method" and "manual", respectively)3. In the manual, it is pointed out that the method used is not suitable for making emergency plans for special situations (industrial activities in an inhabited area). Nonetheless, its principles and procedures are still used for such purposes in the Czech Republic. The expert scientific community dealing with MAH issues in the Czech Republic, however, realizes that the procedure of the zone boundary delineation should be modified to reflect up-to-date knowledge in protection of the public and its enhancement. Therefore, the OPTIZON Project (Optimization of the Emergency Planning Zone Designation and Elaboration of Emergency Plans Based on Threatening Effects of Dangerous Chemical Substances at Operational Accidents with Respect to Inhabitant Protection Enhancement) was developed and approved for the Program of Security Research of the Czech Republic 2010 - 2015 (BV II/2-VS). One of the main project's objectives is to define clearly the purpose of the zone because at present it is not quite apparent. From the general view, this step may seem insignificant or trivial, but the reverse is true. It represents one of the most important stages in seeking the approach to the zone designation as

  15. Reliability of emergency alternating-current power systems at nuclear power plants: a discussion of NUREG/CR-2989

    International Nuclear Information System (INIS)

    Battle, R.E.

    1985-01-01

    The reliability of emergency alternating-current power systems typical of most nuclear power plants was estimated by using fault-tree analysis of selected typical designs. The failure probabilities used in the fault trees were calculated from extensive historical data collected from Licensee Event Reports and from operating experience information obtained from nuclear plant licensees. Trends of diesel generator independent failure on demand are included. No one or two improvements can be made at all plants to increase significantly the industry-average emergency alternating-current power system reliability; the most beneficial improvements are varied and plant specific

  16. Limited endoscopic transsphenoidal approach for cavernous sinus biopsy: illustration of 3 cases and discussion.

    Science.gov (United States)

    Graillon, T; Fuentes, S; Metellus, P; Adetchessi, T; Gras, R; Dufour, H

    2014-01-01

    Advances in transsphenoidal surgery and endoscopic techniques have opened new perspectives for cavernous sinus (CS) approaches. The aim of this study was to assess the advantages and disadvantages of limited endoscopic transsphenoidal approach, as performed in pituitary adenoma surgery, for CS tumor biopsy illustrated with three clinical cases. The first case was a 46-year-old woman with a prior medical history of parotid adenocarcinoma successfully treated 10 years previously. The cavernous sinus tumor was revealed by right third and sixth nerve palsy and increased over the past three years. A tumor biopsy using a limited endoscopic transsphenoidal approach revealed an adenocarcinoma metastasis. Complementary radiosurgery was performed. The second case was a 36-year-old woman who consulted for diplopia with right sixth nerve palsy and amenorrhea with hyperprolactinemia. Dopamine agonist treatment was used to restore the patient's menstrual cycle. Cerebral magnetic resonance imaging (MRI) revealed a right sided CS tumor. CS biopsy, via a limited endoscopic transsphenoidal approach, confirmed a meningothelial grade 1 meningioma. Complementary radiosurgery was performed. The third case was a 63-year-old woman with progressive installation of left third nerve palsy and visual acuity loss, revealing a left cavernous sinus tumor invading the optic canal. Surgical biopsy was performed using an enlarged endoscopic transsphenoidal approach to the decompress optic nerve. Biopsy results revealed a meningothelial grade 1 meningioma. Complementary radiotherapy was performed. In these three cases, no complications were observed. Mean hospitalization duration was 4 days. Reported anatomical studies and clinical series have shown the feasibility of reaching the cavernous sinus using an endoscopic endonasal approach. Trans-foramen ovale CS percutaneous biopsy is an interesting procedure but only provides cell analysis results, and not tissue analysis. However, radiotherapy and

  17. Discussion of Regulatory Guide 7.10, emphasizing the graded approach for establishing QA programs

    International Nuclear Information System (INIS)

    Gordon, L.; Lake, W.H.

    1983-01-01

    To assist applicants in establishing an acceptable QA program to meet the programmatic elements of Appendix E to 10 CFR Part 71, Regulatory Guide 7.10 was developed. Regulatory Guide 7.10 is organized in three self-contained ANNEXES. Guidance applicable to designer/fabricators, to users, and users of radiographic devices are in separate annexes. QA programs for packaging to transport radioactive material are similar in regard to the various operations a licensee may be involved in. However, the appropriate QA/QC effort to verify the program elements may vary significantly. This is referred to as the graded approach. Appendix A in the guide addresses the graded approach

  18. Confronting the climate change challenge: discussing the role of rural India under cumulative emission budget approach

    International Nuclear Information System (INIS)

    Kaechele, Harald; Amjath-Babu, T.S.; Kutter, Thomas; Specht, Kathrin; Nautiyal, Sunil; Müller, Klaus; Raju, K.V.

    2011-01-01

    Current global climate policy architecture does not aim at stabilizing the greenhouse gases concentration in the atmosphere that may achieve the proclaimed 2 °C guard rail. An alternative approach that targets on limiting the global cumulative emission to accomplish such an outcome is put forward by German Advisory Board of Global Change (WBGU). This research work further elaborates the approach and its flexibility instrument i.e. carbon trading. As the approach visualises sharing of the carbon budget (750Gt CO 2 ) equally to every human being (2.7 t CO 2 per capita), India is the country with largest tradable surplus reflecting its low emission per capita and large population. The research work further analyzes the emission profile of rural India and the significance of its future emission pathways within the proposed framework. It also shows how low carbon development in India can assist in cost effective decarbonization of industrialized countries and mitigation of climate change, given a global climate treaty based on the WBGU approach.

  19. An approach to discussing personal and social identity terminology with patients.

    Science.gov (United States)

    Sloboda, Alexander; Mustafa, Aesha; Schober, Justine

    2018-03-01

    As the United States of America becomes more socially diverse, it is more important now than ever for health care providers to become more aware of their patients' social identities. It is imperative that providers engage with their patients and see how each of them identifies personally in relation to social construction terminology. As with the terminology of human anatomy, there is a vast and diverse vocabulary concerning the anatomy of society, which is also clinically relevant to health care providers. If health care providers take the initiative to discuss how their patients identify, they can understand better how those patients experience the world, and this can significantly affect many facets of their health and health care experience. Giving respect fosters the creation of a strong relationship within which patients can share very personal and intimate information, which in turn allows health care providers the possibility of providing the best healthcare. This discussion will build upon and integrate current academic research and opinion for tangible clinical use while discussing various social and personal identities, including but not limited to race, gender, gender expression, sex, sexual orientation, religion, ethnicity, socioeconomic class, and physical and mental abilities. Clin. Anat. 31:136-139, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  20. Discussion of vascular vagovagal reflexes in interventional approach of peripheral arterial diseases

    International Nuclear Information System (INIS)

    Zhuang Baixi; Yu Chunli; Ma Lubo; Yang Miao; Shi Bo

    2007-01-01

    Objective: To investigate the vascular vagovagal reflexes (VVRs) during interventional approach of peripheral arterial disease (PAD). Methods: Twelve patients with VVRs during intervention of 528 patients with peripheral arterial diseases were analyzed retrospectively. Results: The 12 patients with VVRs belonging to mixed type, included 2 cases of occurrence during intervention and 10 cases after intervention. All patients recovered well without adverse reaction. Conclusion: VVRs should always be looking after and prompt management be ready in hand. (authors)

  1. Olfactory groove meningioma: discussion of clinical presentation and surgical outcomes following excision via the subcranial approach.

    Science.gov (United States)

    Pepper, Jon-Paul; Hecht, Sarah L; Gebarski, Stephen S; Lin, Erin M; Sullivan, Stephen E; Marentette, Lawrence J

    2011-11-01

    To describe surgical outcomes and radiographic features of olfactory groove meningiomas treated by excision through the subcranial approach. Special emphasis is placed on paranasal sinus and orbit involvement. Retrospective review of a series of patients. Nineteen patients underwent excision of olfactory groove meningioma (OGM) via the transglabellar/subcranial approach between December 1995 and November 2009. Nine patients had previously undergone prior resection at outside institutions, and four had prior radiotherapy in addition to a prior excision. Transglabellar/subcranial surgical approach to the anterior skull base was performed. Tumor histology included three World Health Organization (WHO) grade III lesions, one WHO grade II lesion, and 15 WHO grade I lesions. Fourteen patients had evidence of extension into the paranasal sinuses, with the ethmoid sinus being most commonly involved. Kaplan-Meier estimates of mean overall and disease-free survival were 121.45 months and 93.03 months, respectively. The mean follow-up interval was 41.0 months, and at the time of data analysis three patients had recurrent tumors. Seven (36.8%) patients experienced a major complication in the perioperative period; there were no perioperative mortalities. Orbit invasion was observed in four patients, with optic nerve impingement in 11 patients. Of these, three patients had long-term diplopia. No patients experienced worsening of preoperative visual acuity. Olfactory groove meningiomas demonstrate a propensity to spread into the paranasal sinuses, particularly in recurrent cases. Given a tendency for infiltrative recurrence along the skull base, this disease represents an important area of collaboration between neurosurgery and otolaryngology. The subcranial approach offers excellent surgical access for excision, particularly for recurrences that involve the paranasal sinuses and optic apparatus. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society

  2. Emerging nanotechnology approaches for HIV/AIDS treatment and prevention

    Science.gov (United States)

    Mamo, Tewodros; Moseman, E Ashley; Kolishetti, Nagesh; Salvador-Morales, Carolina; Shi, Jinjun; Kuritzkes, Daniel R; Langer, Robert; von Andrian, Ulrich

    2010-01-01

    Currently, there is no cure and no preventive vaccine for HIV/AIDS. Combination antiretroviral therapy has dramatically improved treatment, but it has to be taken for a lifetime, has major side effects and is ineffective in patients in whom the virus develops resistance. Nanotechnology is an emerging multidisciplinary field that is revolutionizing medicine in the 21st century. It has a vast potential to radically advance the treatment and prevention of HIV/AIDS. In this review, we discuss the challenges with the current treatment of the disease and shed light on the remarkable potential of nanotechnology to provide more effective treatment and prevention for HIV/AIDS by advancing antiretroviral therapy, gene therapy, immunotherapy, vaccinology and microbicides. PMID:20148638

  3. Capability Building and Learning: An Emergent Behavior Approach

    Directory of Open Access Journals (Sweden)

    Andreu Rafael

    2014-12-01

    Full Text Available Economics-based models of firms typically overlook management acts and capability development. We propose a model that analyzes the aggregate behavior of a population of firms resulting from both specific management decisions and learning processes, that induce changes in companies’ capabilities. Decisions are made under imperfect information and bounded rationality, and managers may sacrifice short-term performance in exchange for qualitative outcomes that affect their firm’s future potential. The proposed model provides a structured setting in which these issues -often discussed only informally- can be systematically analyzed through simulation, producing a variety of hard-to-anticipate emergent behaviors. Economic performance is quite sensitive to managers’ estimates of their firms’ capabilities, and companies willing to sacrifice short-run results for future potential appear to be more stable than the rest. Also, bounded rationality can produce chaotic dynamics reminiscent of real life situations.

  4. Controversy in Biology Classrooms—Citizen Science Approaches to Evolution and Applications to Climate Change Discussions

    Directory of Open Access Journals (Sweden)

    Rachel A. Yoho

    2015-11-01

    Full Text Available The biological sciences encompass topics considered controversial by the American public, such as evolution and climate change. We believe that the development of climate change education in the biology classroom is better informed by an understanding of the history of the teaching of evolution. A common goal for science educators should be to engender a greater respect for and appreciation of science among students while teaching specific content knowledge. Citizen science has emerged as a viable yet underdeveloped method for engaging students of all ages in key scientific issues that impact society through authentic data-driven scientific research. Where successful, citizen science may open avenues of communication and engagement with the scientific process that would otherwise be more difficult to achieve. Citizen science projects demonstrate versatility in education and the ability to test hypotheses by collecting large amounts of often publishable data. We find a great possibility for science education research in the incorporation of citizen science projects in curriculum, especially with respect to “hot topics” of socioscientific debate based on our review of the findings of other authors.

  5. Expanding the Possibilities of Discussion: A Strategic Approach to Using Online Discussion Boards in the Middle and High School English Classroom

    Science.gov (United States)

    Ruday, Sean

    2011-01-01

    This paper focused on whether the use of online discussion boards can enhance the quality of interaction in the middle and high school English classroom, covering both the characteristics of online discussion boards and potential negative effects of their features. The features of online discussion boards, their effects, and how these boards…

  6. Argumentation Skills: A Peer Assessment Approach to Discussions in the EFL Classroom

    Directory of Open Access Journals (Sweden)

    Diego Fernando Ubaque Casallas

    2016-07-01

    Full Text Available This paper presents an exploratory action research study carried out by two English as a foreign language teachers in a private, non-profit institution in Bogota, Colombia, with a group of 12 learners in a B1 English course. These students faced difficulties elaborating on their ideas when discussing issues in class. The study placed emphasis on the use of argumentation outlines and peer assessment to boost learners’ argumentative abilities. Audio-taped conversations and open-ended interviews were used to understand the impact on the pedagogical intervention. Findings revealed that argumentation outlines and peer assessment can promote learners’ awareness and ability to engage in argumentation processes. Moreover, peer assessment appears to be an essential tool for enhancing personal and collaborative learning, as well as for promoting learner reflection and agency.

  7. Novel and emerging approaches to combat adolescent obesity.

    Science.gov (United States)

    Sharma, Manoj; Branscum, Paul

    2010-01-01

    Overweight and obesity continue to be health concerns facing today's adolescent population. Along with metabolic and physical problems associated with obesity, today's obese adolescents also face many psychological issues such as high rates of depression, anxiety, and social discrimination. Obesity is commonly recognized as having many causes, such as genetic, lifestyle and environmental. There are four major modalities for management of overweight and obesity in adolescents: dietary management, increasing physical activity, pharmacological therapy, and bariatric surgery. The purpose of this study was to conduct a review of novel and emerging approaches for preventing and managing adolescent obesity. It was found that while not always the case, theory driven approaches are being better utilized in newer interventions especially by those directed toward prevention. New theories that are being used are the theories of reasoned action, planned behavior, intervention mapping, and social marketing. Schools are found to be the most common place for such interventions, which is appropriate since virtually all children attend some form of private or public school. Limitations found in many studies include the underuse of process evaluations, the low number of studies attempted, environmental or policy changes, and that not all studies used a similar control group for comparison.

  8. Novel and emerging approaches to combat adolescent obesity

    Directory of Open Access Journals (Sweden)

    Manoj Sharma

    2010-02-01

    Full Text Available Manoj Sharma, Paul BranscumHealth Promotion and Education and Public Health Sciences, University of Cincinnati, Cincinnati, OH, USAAbstract: Overweight and obesity continue to be health concerns facing today’s adolescent population. Along with metabolic and physical problems associated with obesity, today’s obese adolescents also face many psychological issues such as high rates of depression, anxiety, and social discrimination. Obesity is commonly recognized as having many causes, such as genetic, lifestyle and environmental. There are four major modalities for management of overweight and obesity in adolescents: dietary management, increasing physical activity, pharmacological therapy, and bariatric surgery. The purpose of this study was to conduct a review of novel and emerging approaches for preventing and managing adolescent obesity. It was found that while not always the case, theory driven approaches are being better utilized in newer interventions especially by those directed toward prevention. New theories that are being used are the theories of reasoned action, planned behavior, intervention mapping, and social marketing. Schools are found to be the most common place for such interventions, which is appropriate since virtually all children attend some form of private or public school. Limitations found in many studies include the underuse of process evaluations, the low number of studies attempted, environmental or policy changes, and that not all studies used a similar control group for comparison.Keywords: adolescent overweight, adolescent obesity, interventions

  9. A Systems Medicine Approach: Translating Emerging Science into Individualized Wellness

    Directory of Open Access Journals (Sweden)

    J. S. Bland

    2017-01-01

    Full Text Available In today’s aging society, more people are living with lifestyle-related noncommunicable diseases (NCDs such as cardiovascular disease, type 2 diabetes, obesity, and cancer. Numerous opinion-leader organizations recommend lifestyle medicine as the first-line approach in NCD prevention and treatment. However, there is a strong need for a personalized approach as “one-size-fits-all” public health recommendations have been insufficient in addressing the interindividual differences in the diverse populations. Advancement in systems biology and the “omics” technologies has allowed comprehensive analysis of how complex biological systems are impacted upon external perturbations (e.g., nutrition and exercise, and therefore is gradually pushing personalized lifestyle medicine toward reality. Clinicians and healthcare practitioners have a unique opportunity in advocating lifestyle medicine because patients see them as a reliable source of advice. However, there are still numerous technical and logistic challenges to overcome before personal “big data” can be translated into actionable and clinically relevant solutions. Clinicians are also facing various issues prior to bringing personalized lifestyle medicine to their practice. Nevertheless, emerging ground-breaking research projects have given us a glimpse of how systems thinking and computational methods may lead to personalized health advice. It is important that all stakeholders work together to create the needed paradigm shift in healthcare before the rising epidemic of NCDs overwhelm the society, the economy, and the dated health system.

  10. How to measure the international development of palliative care? A critique and discussion of current approaches.

    Science.gov (United States)

    Loucka, Martin; Payne, Sheila; Brearley, Sarah

    2014-01-01

    A number of research projects have been conducted that aim to gather data on the international development of palliative care. These data are important for policy makers and palliative care advocates. The aim of this article was to provide a critical comparative analysis of methodological approaches used to assess the development and status of palliative care services and infrastructure at an international level. A selective literature review that focused on the methodological features of eight identified reports was undertaken. Reviewed reports were found to differ in adopted methodologies and provided uneven amounts of methodological information. Five major methodological limitations were identified (lack of theory, use of experts as source of information, grey literature, difficulties in ranking, and the problematic nature of data on service provision). A set of recommendations on how to deal with these issues in future research is provided. Measuring the international development of palliative care is a difficult and challenging task. The results of this study could be used to improve the validity of future research in this field. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  11. Towards an integrated approach to emergency management: interdisciplinary challenges for research and practice

    Directory of Open Access Journals (Sweden)

    Christian Webersik

    2015-10-01

    Full Text Available This article presents an interdisciplinary vision for large-scale integrated emergency management that has been inspired by the transition from platform centric to inte-grated operations in the oil and gas fields, which uses remote emergency control centres collaborating virtually with local responders. The article discusses some of the most salient research challenges for integrated emergency management, including the role of mobile technology, human-centred sensing, citizen participation and social media, and the socio-cultural determinants of disaster management. The purpose of this article is to frame an integrated emergency management approach that adopts a multi-disciplinary approach, including human computer interaction, information systems, computer science, development studies and organization science employing different methodologies.Most importantly, we need to better understand the socio-cultural determinants of how people prepare to, respond and perceive disasters, in order to evaluate whether and what kind of information and communication technology (ICT support is appropriate. There is need for more research as to why in some regions local people ignore official orders to evacuate, and rather follow the advice of local leaders, elders or religious leaders. In other instances, disasters are seen as 'acts of God' thus shaping disaster preparedness and response.

  12. Emerging nanotechnology approaches in tissue engineering for peripheral nerve regeneration.

    Science.gov (United States)

    Cunha, Carla; Panseri, Silvia; Antonini, Stefania

    2011-02-01

    Effective nerve regeneration and functional recovery subsequent to peripheral nerve injury is still a clinical challenge. Autologous nerve graft transplantation is a feasible treatment in several clinical cases, but it is limited by donor site morbidity and insufficient donor tissue, impairing complete functional recovery. Tissue engineering has introduced innovative approaches to promote and guide peripheral nerve regeneration by using biomimetic conduits creating favorable microenvironments for nervous ingrowth, but despite the development of a plethora of nerve prostheses, few approaches have as yet entered the clinic. Promising strategies using nanotechnology have recently been proposed, such as the use of scaffolds with functionalized cell-binding domains, the use of guidance channels with cell-scale internally oriented fibers, and the possibility of sustained release of neurotrophic factors. This review addresses the fabrication, advantages, drawbacks, and results achieved by the most recent nanotechnology approaches in view of future solutions for peripheral nerve repair. Peripheral nerve repair strategies are very limited despite numerous advances on the field of neurosciences and regenerative medicine. This review discusses nanotechnology based strategies including scaffolds with functionalized cell binding domains, the use of guidance channels, and the potential use of sustained release neurotropic factors. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. A Structural Knowledge Representation Approach in Emergency Knowledge Reorganization

    OpenAIRE

    Wang, Qingquan; Rong, Lili

    2007-01-01

    Facing complicate problems in emergency responses, decision makers should acquire sufficient background knowledge for efficient decision-making. Emergency knowledge acquired can be a kind of special product that is transferred among emergency decision makers and functional departments. The processing of knowledge product motivates the emergency knowledge decomposition and event-oriented knowledge integration, i.e. knowledge reorganization. Supported by the semantic power of category theory, t...

  14. Emerging models for facilitating contact between people genetically related through donor conception: a preliminary analysis and discussion

    Directory of Open Access Journals (Sweden)

    Marilyn Crawshaw

    2015-12-01

    Full Text Available Previous research indicates interest among some donor-conceived people, donors and recipient parents in having contact. Outcomes of such contact appear largely, but not universally, positive. This paper seeks to understand better the characteristics of associated support services. Information gathered using the authors' direct experiences and professional and personal networks in different parts of the world indicates the emergence of four main groupings: (i publically funded services outside of treatment centers; (ii services provided by fertility treatment or gamete bank services; (iii services provided privately by independent psychosocial or legal practitioners; and (4 services organized by offspring and/or recipient parents. Key operational features examined were: (i who can access such services and when; (ii what professional standards and funding are in place to provide them; and (iii how ‘matching’ and contact processes are managed. Differences appear influenced variously by the needs of those directly affected, local policies, national legislation and the interests of the fertility services which recruit gamete donors and/or deliver donor conception treatments. The paper is intended to inform fuller debate about how best to meet the needs of those seeking information and contact, the implications for the way that fertility treatment and gametes donation services are currently provided and future research needs.

  15. Skeletal muscle proteomics: current approaches, technical challenges and emerging techniques

    LENUS (Irish Health Repository)

    Ohlendieck, Kay

    2011-02-01

    Abstract Background Skeletal muscle fibres represent one of the most abundant cell types in mammals. Their highly specialised contractile and metabolic functions depend on a large number of membrane-associated proteins with very high molecular masses, proteins with extensive posttranslational modifications and components that exist in highly complex supramolecular structures. This makes it extremely difficult to perform conventional biochemical studies of potential changes in protein clusters during physiological adaptations or pathological processes. Results Skeletal muscle proteomics attempts to establish the global identification and biochemical characterisation of all members of the muscle-associated protein complement. A considerable number of proteomic studies have employed large-scale separation techniques, such as high-resolution two-dimensional gel electrophoresis or liquid chromatography, and combined them with mass spectrometry as the method of choice for high-throughput protein identification. Muscle proteomics has been applied to the comprehensive biochemical profiling of developing, maturing and aging muscle, as well as the analysis of contractile tissues undergoing physiological adaptations seen in disuse atrophy, physical exercise and chronic muscle transformation. Biomedical investigations into proteome-wide alterations in skeletal muscle tissues were also used to establish novel biomarker signatures of neuromuscular disorders. Importantly, mass spectrometric studies have confirmed the enormous complexity of posttranslational modifications in skeletal muscle proteins. Conclusions This review critically examines the scientific impact of modern muscle proteomics and discusses its successful application for a better understanding of muscle biology, but also outlines its technical limitations and emerging techniques to establish new biomarker candidates.

  16. A portable approach for PIC on emerging architectures

    Science.gov (United States)

    Decyk, Viktor

    2016-03-01

    A portable approach for designing Particle-in-Cell (PIC) algorithms on emerging exascale computers, is based on the recognition that 3 distinct programming paradigms are needed. They are: low level vector (SIMD) processing, middle level shared memory parallel programing, and high level distributed memory programming. In addition, there is a memory hierarchy associated with each level. Such algorithms can be initially developed using vectorizing compilers, OpenMP, and MPI. This is the approach recommended by Intel for the Phi processor. These algorithms can then be translated and possibly specialized to other programming models and languages, as needed. For example, the vector processing and shared memory programming might be done with CUDA instead of vectorizing compilers and OpenMP, but generally the algorithm itself is not greatly changed. The UCLA PICKSC web site at http://www.idre.ucla.edu/ contains example open source skeleton codes (mini-apps) illustrating each of these three programming models, individually and in combination. Fortran2003 now supports abstract data types, and design patterns can be used to support a variety of implementations within the same code base. Fortran2003 also supports interoperability with C so that implementations in C languages are also easy to use. Finally, main codes can be translated into dynamic environments such as Python, while still taking advantage of high performing compiled languages. Parallel languages are still evolving with interesting developments in co-Array Fortran, UPC, and OpenACC, among others, and these can also be supported within the same software architecture. Work supported by NSF and DOE Grants.

  17. Support-vector-based emergent self-organising approach for emotional understanding

    Science.gov (United States)

    Nguwi, Yok-Yen; Cho, Siu-Yeung

    2010-12-01

    This study discusses the computational analysis of general emotion understanding from questionnaires methodology. The questionnaires method approaches the subject by investigating the real experience that accompanied the emotions, whereas the other laboratory approaches are generally associated with exaggerated elements. We adopted a connectionist model called support-vector-based emergent self-organising map (SVESOM) to analyse the emotion profiling from the questionnaires method. The SVESOM first identifies the important variables by giving discriminative features with high ranking. The classifier then performs the classification based on the selected features. Experimental results show that the top rank features are in line with the work of Scherer and Wallbott [(1994), 'Evidence for Universality and Cultural Variation of Differential Emotion Response Patterning', Journal of Personality and Social Psychology, 66, 310-328], which approached the emotions physiologically. While the performance measures show that using the full features for classifications can degrade the performance, the selected features provide superior results in terms of accuracy and generalisation.

  18. Teaching emergent bilingual students flexible approaches in an era of new standards

    CERN Document Server

    Proctor, C Patrick; Hiebert, Elfrieda H

    2016-01-01

    Recent educational reform initiatives such as the Common Core State Standards (CCSS) largely fail to address the needs--or tap into the unique resources--of students who are developing literacy skills in both English and a home language. This book discusses ways to meet the challenges that current standards pose for teaching emergent bilingual students in grades K-8. Leading experts describe effective, standards-aligned instructional approaches and programs expressly developed to promote bilingual learners' academic vocabulary, comprehension, speaking, writing, and content learning. Innovative

  19. Approaches to emergent spacetime in gauge/gravity duality

    Science.gov (United States)

    Sully, James Kenneth

    2013-08-01

    In this thesis we explore approaches to emergent local spacetime in gauge/gravity duality. We first conjecture that every CFT with a large-N type limit and a parametrically large gap in the spectrum of single-trace operators has a local bulk dual. We defend this conjecture by counting consistent solutions to the four-point function in simple scalar models and matching to the number of local interaction terms in the bulk. Next, we proceed to explicitly construct local bulk operators using smearing functions. We argue that this construction allows one to probe inside black hole horizons for only short times. We then suggest that the failure to construct bulk operators inside a black hole at late times is indicative of a break-down of local effective field theory at the black hole horizon. We argue that the postulates of black hole complementarity are inconsistent and cannot be realized within gauge/gravity duality. We argue that the most conservative solution is a firewall at the black hole horizon and we critically explore alternative resolutions. We then examine the CGHS model of two-dimensional gravity to look for dynamical formation of firewalls. We find that the CGHS model does not exhibit firewalls, but rather contains long-lived remnants. We argue that, while this is consistent for the CGHS model, it cannot be so in higher-dimensional theories of gravity. Lastly, we turn to F-theory, and detail local and global obstructions to writing elliptic fibrations in Tate form. We determine more general possible forms.

  20. Strategic emergency department design: An approach to capacity planning in healthcare provision in overcrowded emergency rooms.

    Science.gov (United States)

    Exadaktylos, Aristomenis K; Evangelopoulos, Dimitrios S; Wullschleger, Marcel; Bürki, Leo; Zimmermann, Heinz

    2008-11-17

    Healthcare professionals and the public have increasing concerns about the ability of emergency departments to meet current demands. Increased demand for emergency services, mainly caused by a growing number of minor and moderate injuries has reached crisis proportions, especially in the United Kingdom. Numerous efforts have been made to explore the complex causes because it is becoming more and more important to provide adequate healthcare within tight budgets. Optimisation of patient pathways in the emergency department is therefore an important factor.This paper explores the possibilities offered by dynamic simulation tools to improve patient pathways using the emergency department of a busy university teaching hospital in Switzerland as an example.

  1. Emergency procedures

    International Nuclear Information System (INIS)

    Abd Nasir Ibrahim; Azali Muhammad; Ab Razak Hamzah; Abd Aziz Mohamed; Mohammad Pauzi Ismail

    2004-01-01

    The following subjects are discussed - Emergency Procedures: emergency equipment, emergency procedures; emergency procedure involving X-Ray equipment; emergency procedure involving radioactive sources

  2. Primary care providers' discussion of fall prevention approaches with their older adult patients-DocStyles, 2014.

    Science.gov (United States)

    Burns, Elizabeth R; Haddad, Yara K; Parker, Erin M

    2018-03-01

    Falls are the leading cause of fatal and non-fatal injuries among older adults. The American and British Geriatric Societies recommend a fall risk assessment to identify risk factors and guide interventions to prevent these falls. This study describes the self-reported discussion of fall prevention approaches used by primary care providers (PCPs)-family practitioners, internists and nurse practitioners-who treat older adults. Results are described overall and by PCP type. We analyzed a sample of 1210 U.S. PCPs who participated in the 2014 DocStyles survey. PCPs reported on their recommendation of fall prevention approaches including general exercise, Tai Chi, medication adjustments, home safety modifications, vitamin D supplements, assistive devices, alarm systems, and referral to physical therapy, foot specialist, or vision specialist. Frequencies and adjusted odds ratios for fall prevention approaches were assessed by provider and practice characteristics. Self-reported discussion of any fall prevention approaches was 89.3%. Controlling for provider and practice characteristics, there were significant differences for some approaches by provider type. Family practitioners were more likely to suggest home modification [adjusted Odds Ratio: 1.8 (1.3-2.4)], exercise [aOR: 2.0 (1.5-2.5)], and Tai Chi [aOR: 1.5 (1.0-2.2)] than internists. Nurse practitioners were more likely to suggest home modification [aOR: 2.1 (1.3-3.4)] and less likely to suggest vitamin D [aOR: 0.6 (0.4-1.0)] than internists. Fall prevention suggestions vary by type of PCP. Dissemination of geriatric guidelines should include all PCPs who routinely see older adults.

  3. Primary care providers' discussion of fall prevention approaches with their older adult patients—DocStyles, 2014

    Directory of Open Access Journals (Sweden)

    Elizabeth R. Burns

    2018-03-01

    Full Text Available Falls are the leading cause of fatal and non-fatal injuries among older adults. The American and British Geriatric Societies recommend a fall risk assessment to identify risk factors and guide interventions to prevent these falls. This study describes the self-reported discussion of fall prevention approaches used by primary care providers (PCPs—family practitioners, internists and nurse practitioners—who treat older adults. Results are described overall and by PCP type.We analyzed a sample of 1210 U.S. PCPs who participated in the 2014 DocStyles survey. PCPs reported on their recommendation of fall prevention approaches including general exercise, Tai Chi, medication adjustments, home safety modifications, vitamin D supplements, assistive devices, alarm systems, and referral to physical therapy, foot specialist, or vision specialist. Frequencies and adjusted odds ratios for fall prevention approaches were assessed by provider and practice characteristics.Self-reported discussion of any fall prevention approaches was 89.3%. Controlling for provider and practice characteristics, there were significant differences for some approaches by provider type. Family practitioners were more likely to suggest home modification [adjusted Odds Ratio: 1.8 (1.3–2.4], exercise [aOR: 2.0 (1.5–2.5], and Tai Chi [aOR: 1.5 (1.0–2.2] than internists. Nurse practitioners were more likely to suggest home modification [aOR: 2.1 (1.3–3.4] and less likely to suggest vitamin D [aOR: 0.6 (0.4–1.0] than internists.Fall prevention suggestions vary by type of PCP. Dissemination of geriatric guidelines should include all PCPs who routinely see older adults. Keywords: Primary care providers, Falls, Prevention, Older adults, Geriatrics

  4. How oncology fellows discuss transitions in goals of care: a snapshot of approaches used prior to training.

    Science.gov (United States)

    Back, Anthony L; Michaelsen, Kate; Alexander, Stewart; Hopley, Elizabeth; Edwards, Kelly; Arnold, Robert M

    2010-04-01

    The moment when a physician raises the possibility of discontinuing palliative chemotherapy at the end of life is a critical moment in the illness, and a difficult conversation. Expert recommendations cite the importance of giving bad news in these situations but there is limited research addressing how physicians should discuss transitions in goals of care from disease-modifying therapy to end-of-life care. While existing research includes survey data and observational studies of oncologist outpatient visits with patient who have advanced cancer, there are no studies that characterize actual physician communication behaviors when the physician tried to initiate a transitions conversation with a patient who has advanced cancer. In this study, we examined the communication approaches used by oncology fellows discussing transitions with a standardized patient using audiorecordings collected prior to an intensive communication skills workshop. In this preworkshop encounter, each oncology fellow had the task of discussing a transition in goals of care with a patient who was experiencing cancer progression despite treatment with existing evidence-based therapies. We used qualitative methodology to characterize the approaches used by oncology fellows in 20 of these pre-workshop conversations. We identified two themes in the approaches that fellows used: (1) the limitations of biomedical disease-modifying treatments and (2) the possibility of a new direction for medical care when disease-modifying treatments have been exhausted. We found that for each theme, fellows tended to emphasize a logical frame or an experiential frame. Understanding these frames could be useful in designing future communication skills training interventions.

  5. Production layout improvement in emergency services: a participatory approach.

    Science.gov (United States)

    Zanatta, Mateus; Amaral, Fernando Gonçalves

    2012-01-01

    Volunteer fire department is a service that responds emergency situations in places where there are no military emergency services. These services need to respond quickly, because time is often responsible for the operation success besides work environment and setup time interfere with the prompt response to these calls and care efficiency. The layout design is one factor that interferes with the quick setup. In this case, the spaces arrangement can result in excessive or unnecessary movements; also the equipment provision may hinder the selection and collection of these or even create movement barriers for the workers. This work created a new layout for the emergency assistance service, considering the human factors related to work through the task analysis and workers participation on the alternatives of improvement. The results showed an alternate layout with corridors and minimization of unusable sites, allowing greater flexibility and new possibilities of requirements.

  6. Improvement Methods in NPP's Radiation Emergency Plan: An Administrative Approach

    International Nuclear Information System (INIS)

    Lee, Yoon Wook; Yang, He Sun

    2009-01-01

    The Radiation Emergency Plan (REP) can be divided into a technical and an administrative responses. The domestic NPP's REPs are reviewed from the viewpoint of the administrative response and improvement methods are also suggested in this treatise. The fields of the reviews are the composition of the emergency response organizations, the activation criteria of the organizations, the selection of the staffings and the reasonableness of the REP's volume. In addition, the limitations of the current radiation exercises are reviewed and the improvement method of the exercise is presented. It is expected that the suggested recommendations will be helpful in establishing useful REPs and making practical radiation exercises in Korea

  7. Evaluation of Knowledge of Emergency Healthcare Workers Regarding Approach to Emergency Patients

    Directory of Open Access Journals (Sweden)

    Özgür Tanr›verdi

    2010-09-01

    Full Text Available Aim: Emergency units constitute the most important part of all hospitals. The aim of this study was to evaluate practitioners’ and healthcare providers’ knowledge and experience regarding emergency first aid in a hospital with insufficient facilities. Methods: 17 physicians and 25 assistant staff working at our hospital were evaluated in terms of their knowledge about and experience in “emergency medicine and trauma” by a questionnaire and by observations. Results: The results of observations and questionnaire indicated that knowledge and experience among physicians were inadequate in terms of basic life support and advanced cardiac life support. This lack of knowledge was not associated with age, time of employment, faculty graduated and training on “emergency medicine” in the group of physicians (r=0.301 p>0.05, r=0.317 p>0.06, r=0.228 p>0.05, r=0.284 p>0.05, respectively and in the group of assistant staff (r=0.341 p>0.05, r=0.287 p>0.06, r=0.234 p>0.05, r=0.227 p>0.05, respectively. Conclusion: Considering that the most of the physicians are gathered in certain regions of our country and that there is a lack of emergency medicine specialists in underdeveloped regions, it has been concluded that physicians specialized in other areas and practitioners must attend emergency medicine trainings under the concept of “emergency medicine rotation”. (The Medical Bulletin of Haseki 2010; 48:103-5

  8. A Multi Agent Based Approach for Prehospital Emergency Management.

    Science.gov (United States)

    Safdari, Reza; Shoshtarian Malak, Jaleh; Mohammadzadeh, Niloofar; Danesh Shahraki, Azimeh

    2017-07-01

    To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity. Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed. The proposed architecture was simulated using Anylogic simulation software. Anylogic Agent Model, State Chart and Process Model were used to model the system. Multi agent systems (MAS) had a great success in distributed, complex and dynamic problem solving environments, and utilizing autonomous agents provides intelligent decision making capabilities.  The proposed architecture presents prehospital management operations. The main identified agents are: EMS Center, Ambulance, Traffic Station, Healthcare Provider, Patient, Consultation Center, National Medical Record System and quality of service monitoring agent. In a critical condition like prehospital emergency we are coping with sophisticated processes like ambulance navigation health care provider and service assignment, consultation, recalling patients past medical history through a centralized EHR system and monitoring healthcare quality in a real-time manner. The main advantage of our work has been the multi agent system utilization. Our Future work will include proposed architecture implementation and evaluation of its impact on patient quality care improvement.

  9. Compliance Groundwater Monitoring of Nonpoint Sources - Emerging Approaches

    Science.gov (United States)

    Harter, T.

    2008-12-01

    Groundwater monitoring networks are typically designed for regulatory compliance of discharges from industrial sites. There, the quality of first encountered (shallow-most) groundwater is of key importance. Network design criteria have been developed for purposes of determining whether an actual or potential, permitted or incidental waste discharge has had or will have a degrading effect on groundwater quality. The fundamental underlying paradigm is that such discharge (if it occurs) will form a distinct contamination plume. Networks that guide (post-contamination) mitigation efforts are designed to capture the shape and dynamics of existing, finite-scale plumes. In general, these networks extend over areas less than one to ten hectare. In recent years, regulatory programs such as the EU Nitrate Directive and the U.S. Clean Water Act have forced regulatory agencies to also control groundwater contamination from non-incidental, recharging, non-point sources, particularly agricultural sources (fertilizer, pesticides, animal waste application, biosolids application). Sources and contamination from these sources can stretch over several tens, hundreds, or even thousands of square kilometers with no distinct plumes. A key question in implementing monitoring programs at the local, regional, and national level is, whether groundwater monitoring can be effectively used as a landowner compliance tool, as is currently done at point-source sites. We compare the efficiency of such traditional site-specific compliance networks in nonpoint source regulation with various designs of regional nonpoint source monitoring networks that could be used for compliance monitoring. We discuss advantages and disadvantages of the site vs. regional monitoring approaches with respect to effectively protecting groundwater resources impacted by nonpoint sources: Site-networks provide a tool to enforce compliance by an individual landowner. But the nonpoint source character of the contamination

  10. What Lies behind the Concept of Customer Relationship Management? Discussing the Essence of CRM through a Phenomenological Approach

    Directory of Open Access Journals (Sweden)

    Cristiane Drebes Pedron

    2009-01-01

    Full Text Available Several authors and consulting firms show statistics indicating that at least 50% of all CRM projects fail. Some of them attempt to point out a list of factors in order to guarantee successful CRM implementation and application. However, few people (either academics or practitioners attempt to discuss or consider the essence of the idea of CRM. The main goal of this exploratory research is to discuss the CRM essence through a phenomenological approach. This paper assumes that one of the main reasons for CRM failure is the lack of understanding about the true meaning and implication of practices for managing the relationship with customers. Therefore, we need to question the essence of CRM itself and discuss the very concept of relationship. We claim that the idea of CRM involves very serious issues about institutions, roles, power and ethical values that have to be considered. In this article, we attempt to analyze the essence of relationship, trying to go beyond the common meaning of CRM. As the main results of this paper, we offer a critical reflection related to the different faces and aspects of the CRM phenomenon, not only as a matter of IT applications, but also as a strategy and even as an organizational philosophy.

  11. Emerging targets and therapeutic approaches for the treatment of osteoarthritis pain.

    Science.gov (United States)

    Rahman, Wahida; Dickenson, Anthony H

    2015-06-01

    Osteoarthritis is a complex and often painful disease that is inadequately controlled with current analgesics. This review discusses emerging targets and therapeutic approaches that may lead to the development of better analgesics. Aberrant excitability in peripheral and central pain pathways drives osteoarthritis pain, reversing this via modulation of nerve growth factor, voltage-gated sodium channel, voltage-gated calcium channel and transient receptor potential vanilloid one activity, and increasing inhibitory mechanisms through modulation of cannabinoid and descending modulatory systems hold promise for osteoarthritis pain therapy. Somatosensory phenotyping of chronic pain patients, as a surrogate of putative pain generating mechanisms, may predict patient response to treatment. Identification of new targets will inform and guide future research, aiding the development of more effective analgesics. Future clinical trial designs should implement sensory phenotyping of patients, as an inclusion or stratification criterion, in order to establish an individualized, mechanism-based treatment of osteoarthritis pain.

  12. Emergent Macroeconomics An Agent-Based Approach to Business Fluctuations

    CERN Document Server

    Delli Gatti, Domenico; Gallegati, Mauro; Giulioni, Gianfranco; Palestrini, Antonio

    2008-01-01

    This book contributes substantively to the current state-of-the-art of macroeconomics by providing a method for building models in which business cycles and economic growth emerge from the interactions of a large number of heterogeneous agents. Drawing from recent advances in agent-based computational modeling, the authors show how insights from dispersed fields like the microeconomics of capital market imperfections, industrial dynamics and the theory of stochastic processes can be fruitfully combined to improve our understanding of macroeconomic dynamics. This book should be a valuable resource for all researchers interested in analyzing macroeconomic issues without recurring to a fictitious representative agent.

  13. An approach for evaluating expert performance in emergency situations

    International Nuclear Information System (INIS)

    Ujita, Hiroshi; Kawano, Ryutaro; Yoshimura, Sandanori

    1995-01-01

    To understand expert behavior and define what constitutes good performance in emergency situations in huge and complex plants, human performance evaluation should be made from viewpoints of not only error, but also various cognitive, psychological, and behavioral characteristics. Quantitative and qualitative measures of human performance are proposed for both individual operators and crews, based on the operator performance analysis experiment, among which cognitive and behavioral aspects are the most important. Operator performance should be further analyzed experimentally from the cognitive and behavioral viewpoints, using an evaluation based on various gross indexes considering operator's tasks which should be done in response to plant situations

  14. Emergency department crowding in Singapore: Insights from a systems thinking approach.

    Science.gov (United States)

    Schoenenberger, Lukas K; Bayer, Steffen; Ansah, John P; Matchar, David B; Mohanavalli, Rajagopal L; Lam, Sean Sw; Ong, Marcus Eh

    2016-01-01

    Emergency Department crowding is a serious and international health care problem that seems to be resistant to most well intended but often reductionist policy approaches. In this study, we examine Emergency Department crowding in Singapore from a systems thinking perspective using causal loop diagramming to visualize the systemic structure underlying this complex phenomenon. Furthermore, we evaluate the relative impact of three different policies in reducing Emergency Department crowding in Singapore: introduction of geriatric emergency medicine, expansion of emergency medicine training, and implementation of enhanced primary care. The construction of the qualitative causal loop diagram is based on consultations with Emergency Department experts, direct observation, and a thorough literature review. For the purpose of policy analysis, a novel approach, the path analysis, is applied. The path analysis revealed that both the introduction of geriatric emergency medicine and the expansion of emergency medicine training may be associated with undesirable consequences contributing to Emergency Department crowding. In contrast, enhancing primary care was found to be germane in reducing Emergency Department crowding; in addition, it has apparently no negative side effects, considering the boundary of the model created. Causal loop diagramming was a powerful tool for eliciting the systemic structure of Emergency Department crowding in Singapore. Additionally, the developed model was valuable in testing different policy options.

  15. A Historical Approach to Clustering in Emerging Economies

    DEFF Research Database (Denmark)

    Giacomin, Valeria

    of external factors. Indeed, researchers have explained clusters as self-contained entities and reduced their success to local exceptionality. In contrast, emerging literature has shown that clusters are integrated in broader structures beyond their location and are rather building blocks of today’s global...... economy. The working paper goes on to present two historical cases from the global south to explain how clusters work as major tools for international business. Particularly in the developing world, multinationals have used clusters as platforms for channeling foreign investment, knowledge, and imported...... inputs. The study concludes by stressing the importance of using historical evidence and data to look at clusters as agglomerations of actors and companies operating not just at the local level but across broader global networks. In doing so the historical perspective provides explanations lacking...

  16. Protein-Lipid Interactions New Approaches and Emerging Concepts

    CERN Document Server

    Mateo, C. Reyes; Villalaín, José; González-Ros, José M

    2006-01-01

    Biological membranes have long been identified as key elements in a wide variety of cellular processes including cell defense communication, photosynthesis, signal transduction, and motility; thus they emerge as primary targets in both basic and applied research. This book brings together in a single volume the most recent views of experts in the area of protein–lipid interactions, providing an overview of the advances that have been achieved in the field in recent years, from very basic aspects to specialized technological applications. Topics include the application of X-ray and neutron diffraction, infrared and fluorescence spectroscopy, and high-resolution NMR to the understanding of the specific interactions between lipids and proteins within biological membranes, their structural relationships, and the implications for the biological functions that they mediate. Also covered in this volume are the insertion of proteins and peptides into the membrane and the concomitant formation of definite lipid doma...

  17. Theory-based approaches to understanding public emergency preparedness: implications for effective health and risk communication.

    Science.gov (United States)

    Paek, Hye-Jin; Hilyard, Karen; Freimuth, Vicki; Barge, J Kevin; Mindlin, Michele

    2010-06-01

    Recent natural and human-caused disasters have awakened public health officials to the importance of emergency preparedness. Guided by health behavior and media effects theories, the analysis of a statewide survey in Georgia reveals that self-efficacy, subjective norm, and emergency news exposure are positively associated with the respondents' possession of emergency items and their stages of emergency preparedness. Practical implications suggest less focus on demographics as the sole predictor of emergency preparedness and more comprehensive measures of preparedness, including both a person's cognitive stage of preparedness and checklists of emergency items on hand. We highlight the utility of theory-based approaches for understanding and predicting public emergency preparedness as a way to enable more effective health and risk communication.

  18. A "one health" approach to address emerging zoonoses: the HALI project in Tanzania.

    OpenAIRE

    Jonna A K Mazet; Deana L Clifford; Peter B Coppolillo; Anil B Deolalikar; Jon D Erickson; Rudovick R Kazwala

    2009-01-01

    Jonna Mazet and colleagues describe their work in the Tanzania-based HALI Project, which adopts the ?One Health? approach to address emerging zoonoses and that recognizes the interconnectedness of human, animal, and environmental health.

  19. See me! A Discussion on the Quality in Performing Arts for Children Based on a Performative Approach

    Directory of Open Access Journals (Sweden)

    Lisa Nagel

    2013-12-01

    Full Text Available In this article, the writer discusses and analyses what happens to our evaluation of quality in performing arts for children when we move from the notion of art as an object to art as an event. Erika Fischer-Lichte´s theory on the so-called performative turn in the arts and more specifically, the term the feedback loop, constitutes the article´s theoretical backdrop. Two audience-related episodes, respectively the dance performance BZz BZz-DADA dA bee by ICB Productions (3 - 6 year olds and the theatre performance Thought Lab by Cirka Teater (for 6 year olds and above, serve as starting points for the theoretical discussion. By adopting Siemke Böhnisch’s performative approach to performance analysis, focusing on the terms henvendthet (directed-ness, the actors´ and spectators´ mutual turning to the other and kontakt (connection in relations to the audience, the writer makes it possible to show a dissonance (and its reverse between the performers and the audience in the two respective performances. The term dissonance describes moments of unintended breaks in communication, moments of which the performers are most likely unaware. These moments however become apparent when the audience´s reactions are included in the analysis. The author concludes that by deferring to a performative perspective, we become almost obliged to consider the child audience as qualified judges of quality, as opposed to allowing ourselves to dismiss their interactions as either noise or enthusiasm. Such a perspective is important not only for how we see and evaluate performing arts for children, but also for how artists must think when producing performances for this audience.

  20. Epidemiological approach to emergent cranial surgery of cranial traumas

    Directory of Open Access Journals (Sweden)

    Hülagü Kaptan

    2008-03-01

    Full Text Available

    Objective: In this study, we aim to define the emergent cranial surgery of cranial trauma cases in terms of the reason of occurance, diagnosis, prognostic factors and results. Methods: 153 cases hospitalized in our clinic during a four year period were statistically analysed in accordance with trauma etiology, age, gender, application GCS (Glascow Coma Score mortality rate, location and established patology.

    Results: 76% (116 of the 153 cases were male. The most frequent etiological reasons were, in descending order, traffic accident 52% (n = 80, fall 34% (n = 53, direct trauma to the head 14(n =20. 45% (n = 69 were diagnosed epidural haematomas, 26% (n = 40 were diagnosed depression fractures and 3% (n = 5 were diagnosed intracerebral haematomas. A meaningful statistical difference was found in the comparison of the diagnosis regarding gender (p=0,012 age group (p=0,0282 and GCS (p=0,0001.

    Conclusions: In order to prevent cranial traumas, studies aimed at minimizing traffic accidents should be undertaken. The most essential action after the accident has occured is triage, and this is of great importance in order to establish communication among the health institutions.

  1. Developing an emergency department crowding dashboard: A design science approach.

    Science.gov (United States)

    Martin, Niels; Bergs, Jochen; Eerdekens, Dorien; Depaire, Benoît; Verelst, Sandra

    2017-08-30

    As an emergency department (ED) is a complex adaptive system, the analysis of continuously gathered data is valuable to gain insight in the real-time patient flow. To support the analysis and management of ED operations, relevant data should be provided in an intuitive way. Within this context, this paper outlines the development of a dashboard which provides real-time information regarding ED crowding. The research project underlying this paper follows the principles of design science research, which involves the development and study of artifacts which aim to solve a generic problem. To determine the crowding indicators that are desired in the dashboard, a modified Delphi study is used. The dashboard is implemented using the open source Shinydashboard package in R. A dashboard is developed containing the desired crowding indicators, together with general patient flow characteristics. It is demonstrated using a dataset of a Flemish ED and fulfills the requirements which are defined a priori. The developed dashboard provides real-time information on ED crowding. This information enables ED staff to judge whether corrective actions are required in an effort to avoid the adverse effects of ED crowding. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. A tiered analytical approach for investigating poor quality emergency contraceptives.

    Directory of Open Access Journals (Sweden)

    María Eugenia Monge

    Full Text Available Reproductive health has been deleteriously affected by poor quality medicines. Emergency contraceptive pills (ECPs are an important birth control method that women can use after unprotected coitus for reducing the risk of pregnancy. In response to the detection of poor quality ECPs commercially available in the Peruvian market we developed a tiered multi-platform analytical strategy. In a survey to assess ECP medicine quality in Peru, 7 out of 25 different batches showed inadequate release of levonorgestrel by dissolution testing or improper amounts of active ingredient. One batch was found to contain a wrong active ingredient, with no detectable levonorgestrel. By combining ultrahigh performance liquid chromatography-ion mobility spectrometry-mass spectrometry (UHPLC-IMS-MS and direct analysis in real time MS (DART-MS the unknown compound was identified as the antibiotic sulfamethoxazole. Quantitation by UHPLC-triple quadrupole tandem MS (QqQ-MS/MS indicated that the wrong ingredient was present in the ECP sample at levels which could have significant physiological effects. Further chemical characterization of the poor quality ECP samples included the identification of the excipients by 2D Diffusion-Ordered Nuclear Magnetic Resonance Spectroscopy (DOSY 1H NMR indicating the presence of lactose and magnesium stearate.

  3. Emerging geomorphic approaches to guide river management practices

    Science.gov (United States)

    Brierley, Gary; Hooke, Janet

    2015-12-01

    Humans have been modifying river systems across much of the world for many thousands of years. Initially, piecemeal impacts inadvertently affected particular parts of landscapes. Subsequently, many rivers have been subjected to multiple layers of human disturbance, and changes have become widespread and systematic. Increasingly, human impacts reflect deliberative actions as part of river management programmes. These activities entail significant choices in determining the desirable (or acceptable) state and behavioural regime of a river. Typically, contemporary decision-making reflects negotiations among multiple stakeholders, seeking to provide balanced approaches to the management of socio-economic, cultural, and environmental values (e.g. Jähnig et al., 2011).

  4. Diagnostic approach to constipation impacts pediatric emergency department disposition.

    Science.gov (United States)

    Chumpitazi, Corrie E; Rees, Chris A; Camp, Elizabeth A; Henkel, Erin B; Valdez, Karina L; Chumpitazi, Bruno P

    2017-10-01

    Constipation is a common cause of abdominal pain in children presenting to the emergency department (ED). The objectives of this study were to determine the diagnostic evaluation undertaken for constipation and to assess the association of the evaluation with final ED disposition. A retrospective chart review of children presenting to the pediatric ED of a quaternary care children's hospital with abdominal pain that received a soap suds enema therapy. A total of 512 children were included, 270 (52.7%) were female, and the median age was 8.0 (IQR: 4.0-11.0). One hundred and thirty eight patients (27%) had a digital rectal exam (DRE), 120 (22.8%) had bloodwork performed, 218 (43%) had urinalysis obtained, 397 (77.5%) had abdominal radiographs, 120 (23.4%) had abdominal ultrasounds, and 18 (3.5%) had computed tomography scans. Children who had a DRE had a younger median age (6.0, IQR: 3.0-9.25 vs. 8.0, IQR: 4.0-12.0; p<0.001) and were significantly less likely to have radiologic imaging (OR=0.50, 95% CI 0.32-0.78; p=0.002), but did not have an increased odds of being discharged home. After adjusting for gender, ethnicity, and significant past medical history those with an abdominal radiograph were less likely to be discharged to home (aOR=0.56, 95% CI 0.31-1.01; p=0.05). The diagnostic evaluation of children diagnosed with fecal impaction in the ED varied. Abdominal imaging may be avoided if children receive a DRE. When children presenting to the ED with abdominal pain had an abdominal radiograph, they were more likely to be admitted. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Intertextual Content Analysis: An Approach for Analysing Text-Related Discussions with Regard to Movability in Reading and How Text Content Is Handled

    Science.gov (United States)

    Hallesson, Yvonne; Visén, Pia

    2018-01-01

    Reading and discussing texts as a means for learning subject content are regular features within educational contexts. This paper presents an approach for intertextual content analysis (ICA) of such text-related discussions revealing what the participants make of the text. Thus, in contrast to many other approaches for analysing conversation that…

  6. The Right Approach in Practice: A Discussion of the Applicability of EFL Writing Practices in a Saudi Context

    Science.gov (United States)

    Oraif, Iman M.

    2016-01-01

    The aim of this paper is to describe the different approaches applied to teaching writing in the L2 context and the way these different methods have been established so far. The perspectives include a product approach, genre approach and process approach. Each has its own merits and objectives for application. Regarding the study context, it may…

  7. Micro-Level Management of Agricultural Inputs: Emerging Approaches

    Directory of Open Access Journals (Sweden)

    Jonathan Weekley

    2012-12-01

    Full Text Available Through the development of superior plant varieties that benefit from high agrochemical inputs and irrigation, the agricultural Green Revolution has doubled crop yields, yet introduced unintended impacts on environment. An expected 50% growth in world population during the 21st century demands novel integration of advanced technologies and low-input production systems based on soil and plant biology, targeting precision delivery of inputs synchronized with growth stages of crop plants. Further, successful systems will integrate subsurface water, air and nutrient delivery, real-time soil parameter data and computer-based decision-making to mitigate plant stress and actively manipulate microbial rhizosphere communities that stimulate productivity. Such an approach will ensure food security and mitigate impacts of climate change.

  8. Cytometric Approach for Detection of Encephalitozoon intestinalis, an Emergent Agent▿

    Science.gov (United States)

    Barbosa, Joana; Rodrigues, Acácio Gonçalves; Pina-Vaz, Cidália

    2009-01-01

    Encephalitozoon intestinalis is responsible for intestinal disease in patients with AIDS and immunocompetent patients. The infectious form is a small spore that is resistant to water treatment procedures. Its detection is very important, but detection is very cumbersome and time-consuming. Our main objective was to develop and optimize a specific flow cytometric (FC) protocol for the detection of E. intestinalis in hospital tap water and human feces. To determine the optimal specific antibody (Microspor-FA) concentration, a known concentration of E. intestinalis spores (Waterborne, Inc.) was suspended in hospital tap water and stool specimens with different concentrations of Microspor-FA, and the tap water and stool specimens were incubated under different conditions. The sensitivity limit and specificity were also evaluated. To study spore infectivity, double staining with propidium iodide (PI) and Microspor-FA was undertaken. Distinct approaches for filtration and centrifugation of the stool specimens were used. E. intestinalis spores stained with 10 μg/ml of Microspor-FA at 25°C overnight provided the best results. The detection limit was 5 × 104 spores/ml, and good specificity was demonstrated. Simultaneous staining with Microspor-FA and PI ensured that the E. intestinalis spores were dead and therefore noninfectious. With the stool specimens, better spore recovery was observed with a saturated solution of NaCl and centrifugation at 1,500 × g for 15 min. A new approach for the detection of E. intestinalis from tap water or human feces that ensures that the spores are not viable is now available and represents an important step for the prevention of this threat to public health. PMID:19439525

  9. Discussing Inclusive Education: An Inquiry into Different Interpretations and a Search for Ethical Aspects of Inclusion Using the Capabilities Approach

    Science.gov (United States)

    Reindal, Solveig M.

    2016-01-01

    Inclusive education emerged as an idea within United Nations Educational, Scientific and Cultural Organization's Special Education Unit and was presented as a new way ahead at the "World Conference on Special Needs Education" in Salamanca in 1994. Since then, it has been on the global agenda as the overriding political objective within…

  10. Nontraumatic head and neck emergencies: a clinical approach. Part 1: cervicofacial swelling, dysphagia, and dyspnea.

    Science.gov (United States)

    Brea Álvarez, B; Tuñón Gómez, M; Esteban García, L; García Hidalgo, C Y; Ruiz Peralbo, R M

    2016-01-01

    Nontraumatic emergencies of the head and neck represent a challenge in the field of neuroradiology for two reasons: first, they affect an area where the thorax joins the cranial cavity and can thus compromise both structures; second, they are uncommon, so they are not well known. Various publications focus on nontraumatic emergencies of the head and neck from the viewpoints of anatomic location or of particular diseases. However, these are not the most helpful viewpoints for dealing with patients in the emergency department, who present with particular signs and symptoms. We propose an analysis starting from the four most common clinical presentations of patients who come to the emergency department for nontraumatic head and neck emergencies: cervical swelling, dysphagia, dyspnea, and loss of vision. Starting from these entities, we develop an approach to the radiologic management and diagnosis of these patients. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Computer based virtual reality approach towards its application in an accidental emergency at nuclear power plant

    International Nuclear Information System (INIS)

    Yan Jun; Yao Qingshan

    1999-01-01

    Virtual reality is a computer based system for creating and receiving virtual world. As an emerging branch of computer discipline, this approach is extensively expanding and widely used in variety of industries such as national defence, research, engineering, medicine and air navigation. The author intends to present the fundamentals of virtual reality, in attempt to study some interested aspects for use in nuclear power emergency planning

  12. Weight management in type 2 diabetes: current and emerging approaches to treatment.

    Science.gov (United States)

    Van Gaal, Luc; Scheen, André

    2015-06-01

    Diabetes is a growing global health concern, as is obesity. Diabetes and obesity are intrinsically linked: obesity increases the risk of diabetes and also contributes to disease progression and cardiovascular disease. Although the benefits of weight loss in the prevention of diabetes and as a critical component of managing the condition are well established, weight reduction remains challenging for individuals with type 2 diabetes due to a host of metabolic and psychological factors. For many patients, lifestyle intervention is not enough to achieve weight loss, and alternative options, such as pharmacotherapy, need to be considered. However, many traditional glucose-lowering medications may lead to weight gain. This article focuses on the potential of currently available pharmacological strategies and on emerging approaches in development to support the glycemic and weight-loss goals of individuals with type 2 diabetes. Two pharmacotherapy types are considered: those developed primarily for blood glucose control that have a favorable effect on body weight and those developed primarily to induce weight loss that have a favorable effect on blood glucose control. Finally, the potential of combination therapies for the management of obese patients with type 2 diabetes is discussed. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  13. Communication and the Emergence of Collective Behavior in Living Organisms: A Quantum Approach

    Science.gov (United States)

    Bischof, Marco; Del Giudice, Emilio

    2013-01-01

    Intermolecular interactions within living organisms have been found to occur not as individual independent events but as a part of a collective array of interconnected events. The problem of the emergence of this collective dynamics and of the correlated biocommunication therefore arises. In the present paper we review the proposals given within the paradigm of modern molecular biology and those given by some holistic approaches to biology. In recent times, the collective behavior of ensembles of microscopic units (atoms/molecules) has been addressed in the conceptual framework of Quantum Field Theory. The possibility of producing physical states where all the components of the ensemble move in unison has been recognized. In such cases, electromagnetic fields trapped within the ensemble appear. In the present paper we present a scheme based on Quantum Field Theory where molecules are able to move in phase-correlated unison among them and with a self-produced electromagnetic field. Experimental corroboration of this scheme is presented. Some consequences for future biological developments are discussed. PMID:24288611

  14. A discussion of differences in preparation, performance and postreflections in participant observations within two grounded theory approaches

    DEFF Research Database (Denmark)

    Bøttcher Berthelsen, Connie; Damsgaard, Tove Lindhardt; Frederiksen, Kirsten

    2017-01-01

    This paper presents a discussion of the differences in using participant observation as a data collection method by comparing the classic grounded theory methodology of Barney Glaser with the constructivist grounded theory methodology by Kathy Charmaz. Participant observations allow nursing...... researchers to experience activities and interactions directly in situ. However, using participant observations as a data collection method can be done in many ways, depending on the chosen grounded theory methodology, and may produce different results. This discussion shows that how the differences between...

  15. Summary discussions

    International Nuclear Information System (INIS)

    Ritchie, R.H.

    1982-01-01

    Remarks intended to highlight topics of importance for future research were made by three of the participants at the conclusion of the Seminar. A brief listing is given of topics discussed by each of these rapporteurs

  16. Exploring Barriers to Medication Safety in an Ethiopian Hospital Emergency Department: A Human Factors Engineering Approach

    Directory of Open Access Journals (Sweden)

    Ephrem Abebe

    2018-02-01

    Full Text Available Objective: To describe challenges associated with the medication use process and potential medication safety hazards in an Ethiopian hospital emergency department using a human factors approach. Methods: We conducted a qualitative study employing observations and semi-structured interviews guided by the Systems Engineering Initiative for Patient Safety model of work system as an analytical framework. The study was conducted in the emergency department of a teaching hospital in Ethiopia. Study participants included resident doctors, nurses, and pharmacists. We performed content analysis of the qualitative data using accepted procedures. Results: Organizational barriers included communication failures, limited supervision and support for junior staff contributing to role ambiguity and conflict. Compliance with documentation policy was minimal. Task related barriers included frequent interruptions and work-related stress resulting from job requirements to continuously prioritize the needs of large numbers of patients and family members. Person related barriers included limited training and work experience. Work-related fatigue due to long working hours interfered with staff’s ability to document and review medication orders. Equipment breakdowns were common as were non-calibrated or poorly maintained medical devices contributing to erroneous readings. Key environment related barriers included overcrowding and frequent interruption of staff’s work. Cluttering of the work space compounded the problem by impeding efforts to locate medications, medical supplies or medical charts. Conclusions: Applying a systems based approach allows a context specific understanding of medication safety hazards in EDs from low-income countries. When developing interventions to improve medication and overall patient safety, health leaders should consider the interactions of the different factors. Conflict of Interest We declare no conflicts of interest or

  17. Is it acceptable to approach colorectal cancer patients at diagnosis to discuss genetic testing? A pilot study

    OpenAIRE

    Porteous, M; Dunckley, M; Appleton, S; Catt, S; Dunlop, M; Campbell, H; Cull, A

    2003-01-01

    In this pilot study, the acceptability of approaching 111 newly diagnosed colorectal cancer patients with the offer of genetic testing for hereditary nonpolyposis colorectal cancer (HNPCC) was assessed. A total of 78% of participants found it highly acceptable to have the information about HNPCC brought to their attention at that time.

  18. A discussion of differences in preparation, performance and postreflections in participant observations within two grounded theory approaches.

    Science.gov (United States)

    Berthelsen, Connie Bøttcher; Lindhardt, Tove; Frederiksen, Kirsten

    2017-06-01

    This paper presents a discussion of the differences in using participant observation as a data collection method by comparing the classic grounded theory methodology of Barney Glaser with the constructivist grounded theory methodology by Kathy Charmaz. Participant observations allow nursing researchers to experience activities and interactions directly in situ. However, using participant observations as a data collection method can be done in many ways, depending on the chosen grounded theory methodology, and may produce different results. This discussion shows that how the differences between using participant observations in classic and constructivist grounded theory can be considerable and that grounded theory researchers should adhere to the method descriptions of performing participant observations according to the selected grounded theory methodology to enhance the quality of research. © 2016 Nordic College of Caring Science.

  19. Emerging adulthood features and criteria for adulthood : Variable- and person-centered approaches

    NARCIS (Netherlands)

    Tagliabue, Semira; Crocetti, Elisabetta; Lanz, Margherita

    Reaching adulthood is the aim of the transition to adulthood; however, emerging adults differently define both adulthood and the transitional period they are living. Variable-centered and person-centered approaches were integrated in the present paper to investigate if the criteria used to define

  20. Dose assessment and approach to the safety for the public in the emergency. Proceedings

    International Nuclear Information System (INIS)

    Nakajima, Toshiyuki

    1994-03-01

    This issue is the collection of the papers presented at the 21st NIRS seminar on Dose Assessment and Approach to the Safety for the Public in the Emergency. The 16 of the presented papers are indexed individually. (J.P.N.)

  1. State Higher Education Funding Models: An Assessment of Current and Emerging Approaches

    Science.gov (United States)

    Layzell, Daniel T.

    2007-01-01

    This article provides an assessment of the current and emerging approaches used by state governments in allocating funding for higher education institutions and programs. It reviews a number of desired characteristics or outcomes for state higher education funding models, including equity, adequacy, stability, and flexibility. Although there is…

  2. Human Trafficking: A Guide to Identification and Approach for the Emergency Physician.

    Science.gov (United States)

    Shandro, Jamie; Chisolm-Straker, Makini; Duber, Herbert C; Findlay, Shannon Lynn; Munoz, Jessica; Schmitz, Gillian; Stanzer, Melanie; Stoklosa, Hanni; Wiener, Dan E; Wingkun, Neil

    2016-10-01

    Human trafficking is a significant human rights problem that is often associated with psychological and physical violence. There is no demographic that is spared from human trafficking. Traffickers maintain control of victims through physical, sexual, and emotional violence and manipulation. Because victims of trafficking seek medical attention for the medical and psychological consequences of assault and neglected health conditions, emergency clinicians are in a unique position to recognize victims and intervene. Evaluation of possible trafficking victims is challenging because patients who have been exploited rarely self-identify. This article outlines the clinical approach to the identification and treatment of a potential victim of human trafficking in the emergency department. Emergency practitioners should maintain a high index of suspicion when evaluating patients who appear to be at risk for abuse and violence, and assess for specific indicators of trafficking. Potential victims should be evaluated with a multidisciplinary and patient-centered technique. Furthermore, emergency practitioners should be aware of national and local resources to guide the approach to helping identified victims. Having established protocols for victim identification, care, and referrals can greatly facilitate health care providers' assisting this population. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  3. The approach of prehospital health care personnel working at emergency stations towards forensic cases.

    Science.gov (United States)

    Asci, Ozlem; Hazar, Guleser; Sercan, Isa

    2015-09-01

    The objective of this study is to determine the states of health care personnel, working at 112 emergency stations in the province of Artvin, to encounter with regarding forensic cases and determine their practices aimed at recognizing, protecting, and reporting the evidences that may affect the forensic process. This descriptive study was conducted with nurses and emergency medicine technicians working at 112 emergency stations in Artvin between January 2013 and February 2014. Of 141 health personnel that constituted sample of the study, 48.9% were nurses, 9.9% emergency medicine technicians, and 41.1% ambulance and emergency care technicians. The rate of feeling sufficient in coping with forensic cases and incidents was 20.6%. There was a lower rate of receiving education about the approach towards forensic cases (15.6%). In the study, the frequency of encountering with at least one forensic case was 88.7%. Traffic accidents (72.5%), suicides (41.5%) and assaults (41.5%) were among the most frequent reasons of forensic cases. The practices of nurses were more successful in woundings by firearms compared to other health personnel (p forensic cases. The personnel with higher educational level and nurses have more successful practices in forensic cases. Health personnel have approaches that may negatively affect the solution of forensic cases.

  4. Panel discussion

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    The panel discussion at the 10th Allianz Forum on 'Technology and Insurance' dealt with the following topics: New technologies: energy conversion (coal, petroleum, natural gas, nuclear energy, solar energy); infrastructure (transport, data processing); basic products (metallic materials, chemical products, pharmaceutical products); integrated products (microprocessors, production line machines) as well as new risks: political; general economic (financing, market structure); insurance-related, dangers to persons and property; reduction of risks. (orig.) [de

  5. Discussion of impact of relics activation on protection and utilization approaches-take the old summer palace as an example

    Science.gov (United States)

    Xiaoqi, J.

    2015-08-01

    As the popularization of cultural relics and the rapid development of cultural tourism industry, a large number of cultural relic tourism resources goes into public eyes. Activation of relics has became an important way for tourist to contact and understand culture relics. The way of how to properly interpret the historical sense and cultural uniqueness to the masses of tourists in order to achieve social service functions of relic resources has always been research focal point of site protection and utilization, so nowadays it has important significance to protection and utilization of heritage resources in our country. From the point of activation of relics and based on the analysis of resource characteristic, the paper in depth discuss ways of activation of relics of the Old Summer Palace, in order to provide reference for sustainable development of sites tourism in China.

  6. Planned change or emergent change implementation approach and nurses' professional clinical autonomy.

    Science.gov (United States)

    Luiking, Marie-Louise; Aarts, Leon; Bras, Leo; Grypdonck, Maria; van Linge, Roland

    2017-11-01

    Nurses' clinical autonomy is considered important for patients' outcome and influenced by the implementation approach of innovations. Emergent change approach with participation in the implementation process is thought to increase clinical autonomy. Planned change approach without this participation is thought not to increase clinical autonomy. Evidence of these effects on clinical autonomy is however limited. To examine the changes in clinical autonomy and in personal norms and values for a planned change and emergent change implementation of an innovation, e.g. intensive insulin therapy. Prospective comparative study with two geographically separated nurses' teams on one intensive care unit (ICU), randomly assigned to the experimental conditions. Data were collected from March 2008 to January 2009. Pre-existing differences in perception of team and innovation characteristics were excluded using instruments based on the innovation contingency model. The Nursing Activity Scale was used to measure clinical autonomy. The Personal Values and Norms instrument was used to assess orientation towards nursing activities and the Team Learning Processes instrument to assess learning as a team. Pre-implementation the measurements did not differ. Post-implementation, clinical autonomy was increased in the emergent change team and decreased in the planned change team. The Personal Values and Norms instrument showed in the emergent change team a decreased hierarchic score and increased developmental and rational scores. In the planned change team the hierarchical and group scores were increased. Learning as a team did not differ between the teams. In both teams there was a change in clinical autonomy and orientation towards nursing activities, in line with the experimental conditions. Emergent change implementation resulted in more clinical autonomy than planned change implementation. If an innovation requires the nurses to make their own clinical decisions, an emergent change

  7. Therapeutic approach to patients complaining of high blood pressure in a cardiological emergency room

    Directory of Open Access Journals (Sweden)

    Miguel Gus

    1999-03-01

    Full Text Available OBJECTIVE: To evaluate the management of patients complaining of high blood pressure (BP in a cardiological emergency room. METHODS: Patients referred to the cardiological emergency room with the main complaint of high blood pressure were consecutively selected. The prescriptions and the choice of antihypertensive drugs were assessed. The classification of these patients as hypertensive emergencies or pseudoemergencies, according to the physician who provided initial care, was recorded. RESULTS: From a total of 858 patients presenting to the emergency room, 80 (9.3% complained of high BP, and 61 (76.3% received antihypertensive drugs. Sublingual nifedipine was the most commonly used drug (59%. One patient received intravenous medication, one patient was hospitalized and 6 patients (7.5% were classified as hypertensive emergencies or pseudoemergencies. CONCLUSION: High BP could seldom be classified as a hypertensive emergency or pseudoemergency, even though it was a frequent complaint (9.3% of visits. Currently, the therapeutic approach is not recommended, even in specialized clinics.

  8. Bangladesh; Use of Fund Resources: Request for Emergency Assistance: Staff Report; Press Release on the Executive Board Discussion; and Statement by the Executive Director for Bangladesh

    OpenAIRE

    International Monetary Fund

    2008-01-01

    The fiscal impact of these policies will be significant, but donor support, improved revenue, and budget reallocations will contain domestic financing. The authorities have introduced several policies in response to the disasters. IMF staff supports the authorities’ request for a purchase under the IMF's policy on emergency assistance for natural disasters. Following severe flooding, the impact of cyclone Sidr on Bangladesh has been substantial.

  9. Coproduction as an Approach to Technology-Mediated Citizen Participation in Emergency Management

    Directory of Open Access Journals (Sweden)

    Paloma Díaz

    2016-08-01

    Full Text Available Social and mobile computing open up new possibilities for integrating citizens’ information, knowledge, and social capital in emergency management (EM. This participation can improve the capacity of local agencies to respond to unexpected events by involving citizens not only as first line informants, but also as first responders. This participation could contribute to build resilient communities aware of the risks they are threatened by and able to mobilize their social capital to cope with them and, in turn, decrease the impact of threats and hazards. However for this participation to be possible organizations in charge of EM need to realize that involving citizens does not interfere with their protocols and that citizens are a valuable asset that can contribute to the EM process with specific skills and capabilities. In this paper we discuss the design challenges of using social and mobile computing to move to a more participatory EM process that starts by empowering both citizens and organizations in a coproduction service envisioned as a partnership effort. As an example, we describe a case study of a participatory design approach that involved professional EM workers and decision makers in an effort to understand the challenges of using technology-based solutions to integrate citizen skills and capabilities in their operation protocols. The case study made it possible to identify specific roles that citizens might play in a crisis or disaster and to envision scenarios were technologies could be used to integrate their skills into the EM process. In this way the paper contributes to the roles and the scenarios of theory-building about coproduction in EM services.

  10. A Simulation Learning Approach to Training First Responders for Radiological Emergencies

    International Nuclear Information System (INIS)

    Sanders, Robert Lon; Rhodes, Graham S.

    2007-01-01

    This paper describes the application of simulation learning technology, popularized by the emerging serious games industry, for training first responders to properly act in the event of a radiological emergency. Using state-of-the-art video game production tools and runtime engines as an enabling technology, simulation learning combines interactive virtual worlds based on validated engineering models with engaging storylines and scenarios that invoke the emotional response-and the corresponding human stress level-that first responders would encounter during a real-world emergency. For the application discussed here, in addition to providing engaging instruction about the fundamentals of radiological environments and the proper usage of radiological equipment, simulation learning prepares first responders to perform effectively under high stress and enables them to practice in teams

  11. Comparing emerging and mature markets during times of crises: A non-extensive statistical approach

    Science.gov (United States)

    Namaki, A.; Koohi Lai, Z.; Jafari, G. R.; Raei, R.; Tehrani, R.

    2013-07-01

    One of the important issues in finance and economics for both scholars and practitioners is to describe the behavior of markets, especially during times of crises. In this paper, we analyze the behavior of some mature and emerging markets with a Tsallis entropy framework that is a non-extensive statistical approach based on non-linear dynamics. During the past decade, this technique has been successfully applied to a considerable number of complex systems such as stock markets in order to describe the non-Gaussian behavior of these systems. In this approach, there is a parameter q, which is a measure of deviation from Gaussianity, that has proved to be a good index for detecting crises. We investigate the behavior of this parameter in different time scales for the market indices. It could be seen that the specified pattern for q differs for mature markets with regard to emerging markets. The findings show the robustness of the stated approach in order to follow the market conditions over time. It is obvious that, in times of crises, q is much greater than in other times. In addition, the response of emerging markets to global events is delayed compared to that of mature markets, and tends to a Gaussian profile on increasing the scale. This approach could be very useful in application to risk and portfolio management in order to detect crises by following the parameter q in different time scales.

  12. Improving substance information in USEtox® , part 1: Discussion on data and approaches for estimating freshwater ecotoxicity effect factors.

    Science.gov (United States)

    Saouter, Erwan; Aschberger, Karin; Fantke, Peter; Hauschild, Michael Z; Bopp, Stephanie K; Kienzler, Aude; Paini, Alicia; Pant, Rana; Secchi, Michela; Sala, Serenella

    2017-12-01

    The scientific consensus model USEtox ® is recommended by the European Commission as the reference model to characterize life cycle chemical emissions in terms of their potential human toxicity and freshwater aquatic ecotoxicity impacts in the context of the International Reference Life Cycle Data System Handbook and the Environmental Footprint pilot phase looking at products (PEF) and organizations (OEF). Consequently, this model has been systematically used within the PEF/OEF pilot phase by 25 European Union industry sectors, which manufacture a wide variety of consumer products. This testing phase has raised some questions regarding the derivation of and the data used for the chemical-specific freshwater ecotoxicity effect factor in USEtox. For calculating the potential freshwater aquatic ecotoxicity impacts, USEtox bases the effect factor on the chronic hazard concentration (HC50) value for a chemical calculated as the arithmetic mean of all logarithmized geometric means of species-specific chronic median lethal (or effect) concentrations (L[E]C50). We investigated the dependency of the USEtox effect factor on the selection of ecotoxicological data source and toxicological endpoints, and we found that both influence the ecotoxicity ranking of chemicals and may hence influence the conclusions of a PEF/OEF study. We furthermore compared the average measure (HC50) with other types of ecotoxicity effect indicators, such as the lowest species EC50 or no-observable-effect concentration, frequently used in regulatory risk assessment, and demonstrated how they may also influence the ecotoxicity ranking of chemicals. We acknowledge that these indicators represent different aspects of a chemical's ecotoxicity potential and discuss their pros and cons for a comparative chemical assessment as performed in life cycle assessment and in particular within the PEF/OEF context. Environ Toxicol Chem 2017;36:3450-3462. © 2017 The Authors. Environmental Toxicology and Chemistry

  13. Approach to Acute Headache: A Flipped Classroom Module for Emergency Medicine Trainees

    Directory of Open Access Journals (Sweden)

    Jeff Riddell

    2016-07-01

    Full Text Available Audience: This module is designed for emergency medicine trainees. Though it focuses on those early in their career (medical students and junior residents, it is applicable to all emergency medicine learners. Introduction: In the United States, headache is the fifth most-common primary complaint of patients presenting to the emergency department and can be the primary symptomatic manifestation of many life-threatening illnesses. The emergency physician plays a unique role in diagnosing and managing these patients. The emergency physician’s two major responsibilities are to relieve headache pain and to ensure that life-threatening causes are diagnosed and treated. Objectives: At the end of this module, the learner will be able to: 1 list the diagnoses critical to the emergency physician that may present with headache; 2 identify key historical and examination findings that help differentiate primary (benign from secondary (serious causes of headache; 3 discuss the indications for diagnostic imaging, lumbar puncture and laboratory testing in patients with headache; 4 recognize life-threatening diagnoses on CT imaging and CSF examination; 5 describe treatment strategies to relieve headache symptoms. Methods: This module includes a complete flipped classroom module. Learners are responsible for viewing a 20-minute video prior to the 30-minute small-group, case-based didactic discussion portion. The learners are assessed with multiple-choice question assessments, for low stakes retrieval practice or spaced practice. This could alternatively be run as a team-based learning session, with the pre- and post-tests used as an individual or group readiness assessment test, and the small group exercises converted to a group application exercise.

  14. Discussion Graphs

    DEFF Research Database (Denmark)

    Kiciman, Emre; Counts, Scott; Gamon, Michael

    2014-01-01

    , time and other confounding factors, few of the studies that attempt to extract information from social media actually condition on such factors due to the difficulty in extracting these factors from naturalistic data and the added complexity of including them in analyses. In this paper, we present......Much research has focused on studying complex phenomena through their reflection in social media, from drawing neighborhood boundaries to inferring relationships between medicines and diseases. While it is generally recognized in the social sciences that such studies should be conditioned on gender...... a simple framework for specifying and implementing common social media analyses that makes it trivial to inspect and condition on contextual information. Our data model—discussion graphs—captures both the structural features of relationships inferred from social media as well as the context...

  15. The laparoscopic approach in emergency surgery: A review of the literature

    Directory of Open Access Journals (Sweden)

    Ionut Negoi

    2018-01-01

    Full Text Available The role of laparoscopy in the acute care surgery had significantly increased during the latest years, both as a diagnostic and treatment method of all the upper or lower gastrointestinal pathologies. The objective of the present research is to review the current indications for laparoscopy in bdominal emergencies and to detail the benefits and complications associated with this approach. We have reviewed the relevant literature about this topic published between January 2005 and December 2017, using the PubMed/Medline and Web of Science Core Collection databases. According to the current evidence, we may conclude that the laparoscopic approach is an integral part of the emergency surgery for all the abdominal pathologies. Although laparoscopy requires specialized training and curricula, it brings all the benefits of minimal access in acute care arena.

  16. A multivariate time series approach to forecasting daily attendances at hospital emergency department

    KAUST Repository

    Kadri, Farid

    2018-02-07

    Efficient management of patient demands in emergency departments (EDs) has recently received increasing attention by most healthcare administrations. Forecasting ED demands greatly helps ED\\'s managers to make suitable decisions by optimally allocating the available limited resources to efficiently handle patient attendances. Furthermore, it permits pre-emptive action(s) to mitigate and/or prevent overcrowding situations and to enhance the quality of care. In this work, we present a statistical approach based on a vector autoregressive moving average (VARMA) model for a short term forecasting of daily attendances at an ED. The VARMA model has been validated using an experimental data from the paediatric emergency department (PED) at Lille regional hospital centre, France. The results obtained indicate the effectiveness of the proposed approach in forecasting patient demands.

  17. An approach to modeling operator's cognitive behavior using artificial intelligence techniques in emergency operating event sequences

    International Nuclear Information System (INIS)

    Cheon, Se Woo; Sur, Sang Moon; Lee, Yong Hee; Park, Young Taeck; Moon, Sang Joon

    1994-01-01

    Computer modeling of an operator's cognitive behavior is a promising approach for the purpose of human factors study and man-machine systems assessment. In this paper, the states of the art in modeling operator behavior and the current status in developing an operator's model (MINERVA - NPP) are presented. The model is constructed as a knowledge-based system of a blackboard framework and is simulated based on emergency operating procedures

  18. An Analysis of Knowledge Sharing Approaches for Emerging-technology-based Strategic Alliances in Electronic Industry

    Institute of Scientific and Technical Information of China (English)

    LIU Ju; LI Yong-jian

    2006-01-01

    Emerging technologies are now initiating new industries and transforming old ones with tremendous power. They are different games compared with established technologies with distinctive characteristics of knowledge management in knowledge-based and technological-innovation-based competition. How to obtain knowledge advantage and enhance competences by knowledge sharing for emerging-technology-based strategic alliances (ETBSA) is what we concern in this paper. On the basis of our previous work on emerging technologies'distinctive attributes, we counter the wide spread presumption that the primary purpose of strategic alliances is knowledge acquiring by means of learning. We offers new insight into the knowledge sharing approaches of ETBSAs - the knowledge integrating approach by which each member firm integrates its partner's complementary knowledge base into the products and services and maintains its own knowledge specialization at the same time. So that ETBSAs should plan and practice their knowledge sharing strategies from the angle of knowledge integrating rather than knowledge acquiring. A four-dimensional framework is developed to analyze the advantages and disadvantages of these two knowledge sharing approaches. Some cases in electronic industry are introduced to illustrate our point of view.

  19. Testing a new form to document 'Goals-of-Care' discussions regarding plans for end-of-life care for patients in an Australian emergency department.

    Science.gov (United States)

    Mills, Amber C; Levinson, Michele; Dunlop, William A; Cheong, Edward; Cowan, Timothy; Hanning, Jennifer; O'Callaghan, Erin; Walker, Katherine J

    2018-04-16

    There is limited literature to inform the content and format of Goals-of-Care forms, for use by doctors when they are undertaking these important conversations. This was a prospective, qualitative and quantitative study evaluating the utility of a new 'Goals-of-Care' form to doctors in a private, tertiary ED, used from December 2016 to February 2017 at Cabrini, Melbourne. A Goals-of-Care form was designed, incorporating medical aims of therapy and patient values and preferences. Doctors wishing to complete a Not-for-CPR form were also supplied with the trial Goals-of-Care form. Form use, content and patient progress were followed. Doctors completing a form were invited to interview. Forms were used in 3% of attendances, 120 forms were taken for use and 108 were analysed. The median patient age was 91, 81% were Supportive and Palliative Care Indicators Tool (SPICT) positive and patients had a 48% 6-month mortality. A total of 34 doctors completed the forms, 16 were interviewed (two ED trainees, 11 senior ED doctors and three others). Theme saturation was only achieved for the senior doctors interviewed. Having a Goals-of-Care form was valued by 88% of doctors. The frequency of section use was: Aims-of-Care 91%; Quality-of-Life 75% (the term was polarising); Functional Impairments 35%; and Outcomes of Value 29%. Opinions regarding the ideal content and format varied. Some doctors liked free-text space and others tick-boxes. The median duration of the conversation and documentation was 10 min (interquartile range 6-20 min). Having a Goals-of-Care form in emergency medicine is supported; the ideal contents of the form was not determined. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  20. Emergent Trust and Work Life Relationships: How to Approach the Relational Moment of Trust

    Directory of Open Access Journals (Sweden)

    Tone Bergljot Eikeland

    2015-10-01

    Full Text Available How do we trust? What does the basic mechanism of trust look like? These questions define the starting point for a comparison of the classic ideas of how trust works by Mayer et al. (1995, Möllering’s (2006 re-adaption of Giddens’, Simmel’s, and James’ classic ideas of trust, and a phenomenological approach focusing on “emergent trust.” Introducing the concept of emergent trust, the idea is to suggest a phenomenological approach to studies of trust in work-life relationships in professional organizations, as an alternative to trust as a cognitive attitude, where trust becomes a stable, individual possession. The term “emergent” demonstrates a trust that emerges in meetings between persons, it has an immediate, unconditional quality, and shows itself in situations of life where there is a potential for trust to appear. Trust’s basic relationality makes the person morally responsible for the other. Trust appears between persons, as an event, constituting risk and uncertainty as a natural and positive part of our lives. Still, in larger social settings, the responsibility of trust also disperses on to the work itself, and our wider social networks.

  1. Emergency management of blunt chest trauma in children: an evidence-based approach.

    Science.gov (United States)

    Pauzé, Denis R; Pauzé, Daniel K

    2013-11-01

    Pediatric trauma is commonly encountered in the emergency department, and trauma to the head, chest, and abdomen may be a source of significant morbidity and mortality. As children have unique thoracic anatomical and physiological properties, they may present with diagnostic challenges that the emergency clinician must be aware of. This review examines the effects of blunt trauma to the pediatric chest, as well as its relevant etiologies and associated mortality. Diagnostic and treatment options for commonly encountered injuries such as pulmonary contusions, rib fractures, and pneumothoraces are examined. Additionally, this review discusses rarely encountered--yet highly lethal--chest wall injuries such as blunt cardiac injuries, commotio cordis, nonaccidental trauma, and aortic injuries.

  2. The Vietnam Initiative on Zoonotic Infections (VIZIONS): A Strategic Approach to Studying Emerging Zoonotic Infectious Diseases.

    Science.gov (United States)

    Rabaa, Maia A; Tue, Ngo Tri; Phuc, Tran My; Carrique-Mas, Juan; Saylors, Karen; Cotten, Matthew; Bryant, Juliet E; Nghia, Ho Dang Trung; Cuong, Nguyen Van; Pham, Hong Anh; Berto, Alessandra; Phat, Voong Vinh; Dung, Tran Thi Ngoc; Bao, Long Hoang; Hoa, Ngo Thi; Wertheim, Heiman; Nadjm, Behzad; Monagin, Corina; van Doorn, H Rogier; Rahman, Motiur; Tra, My Phan Vu; Campbell, James I; Boni, Maciej F; Tam, Pham Thi Thanh; van der Hoek, Lia; Simmonds, Peter; Rambaut, Andrew; Toan, Tran Khanh; Van Vinh Chau, Nguyen; Hien, Tran Tinh; Wolfe, Nathan; Farrar, Jeremy J; Thwaites, Guy; Kellam, Paul; Woolhouse, Mark E J; Baker, Stephen

    2015-12-01

    The effect of newly emerging or re-emerging infectious diseases of zoonotic origin in human populations can be potentially catastrophic, and large-scale investigations of such diseases are highly challenging. The monitoring of emergence events is subject to ascertainment bias, whether at the level of species discovery, emerging disease events, or disease outbreaks in human populations. Disease surveillance is generally performed post hoc, driven by a response to recent events and by the availability of detection and identification technologies. Additionally, the inventory of pathogens that exist in mammalian and other reservoirs is incomplete, and identifying those with the potential to cause disease in humans is rarely possible in advance. A major step in understanding the burden and diversity of zoonotic infections, the local behavioral and demographic risks of infection, and the risk of emergence of these pathogens in human populations is to establish surveillance networks in populations that maintain regular contact with diverse animal populations, and to simultaneously characterize pathogen diversity in human and animal populations. Vietnam has been an epicenter of disease emergence over the last decade, and practices at the human/animal interface may facilitate the likelihood of spillover of zoonotic pathogens into humans. To tackle the scientific issues surrounding the origins and emergence of zoonotic infections in Vietnam, we have established The Vietnam Initiative on Zoonotic Infections (VIZIONS). This countrywide project, in which several international institutions collaborate with Vietnamese organizations, is combining clinical data, epidemiology, high-throughput sequencing, and social sciences to address relevant one-health questions. Here, we describe the primary aims of the project, the infrastructure established to address our scientific questions, and the current status of the project. Our principal objective is to develop an integrated approach to

  3. A Comprehensive Approach for the Ergonomic Evaluation of 13 Emergency and Transport Ventilators.

    Science.gov (United States)

    Marjanovic, Nicolas; L'Her, Erwan

    2016-05-01

    Mechanical ventilation is an important part of emergency medicine and is frequently used for transportation. Human errors during ventilator settings are frequent and may be associated with high morbidity/mortality. The aim of the study was to provide a complete ergonomic evaluation of emergency and transport ventilators, taking into account objective and subjective human-machine interface assessments and individual mental work load. We performed a prospective bench ergonomic evaluation of 13 emergency and transport ventilators, using standardized conditions and a global methodological approach. The study was performed in an evaluation laboratory dedicated to respiratory care, and 12 emergency physicians unfamiliar with the tested devices were included in the evaluation. The ventilators were classified into 3 categories (simple, sophisticated, and ICU-like). Objective chronometric evaluations were conducted considering 9 tasks, and subjective evaluations were performed (ease of use, willingness to use, and user-friendliness of monitoring) using Likert scales. Mental work load evaluation was performed using the NASA Task Load Index scale. Overall task failure rate represented 4% of all attempts. Setting modifications, ventilation mode changes, and powering down durations were different between simple and other emergency and transport ventilator categories (P < .005). There was no difference between ventilator categories for the ease of use and user-friendliness of the monitoring. In contrast, the willingness to use was lower for simple devices, compared with sophisticated and ICU-like emergency and transport ventilators (2.9 ± 1.4 vs 3.9 ± 1.2, P = .002 and 4.3 ± 1, P < .001). No differences were observed between devices regarding the mental work load, except for several specific devices in the sophisticated category. A comprehensive ergonomic evaluation provides valuable information while investigating operational friendliness in emergency and transport

  4. Experiences of health care providers managing sexual assault victims in the emergency unit Part 2: Discussion of results and literature control

    Directory of Open Access Journals (Sweden)

    Rebecca M. Skhosana

    2009-09-01

    Full Text Available The objective of this study was to explore and describe the experiences of health care providers managing sexual assault victims in the emergency unit of a community hospital in the Nkangala district in the Mpumalanga Province. A qualitative, phenomenological design was applied. Purposeful sampling was used to select participants from health care providers who were working in the emergency unit and had managed more than four sexual assault victims. Data were collected by means of individual interviews and analysed according to the Tesch method of data analysis by the researcher and the independent co-coder. Main categories, subcategories and themes were identified. Participants expressed their emotions, challenges and police attitudes and behaviours, as well as inconsistencies in guidelines and needs identification. It was recommended that members of the multidisciplinary team engage in community activities and that the community participate in matters pertaining to sexual assault. Government should develop clear guidelines that are applicable to rural and urban South Africa. Health care sciences should aim to train more forensic nurses. All relevant departments should work together to alleviate the complications caused by sexual assault incidents. Opsomming Die doel van hierdie studie was om die ervaringe van gesondheidsorgverskaffers wat slagoffers van seksuele aanranding in die ongevalle-eenheid van 'n gemeenskapshospitaal in die Nkangala-distrik in die provinsie van Mpumalanga hanteer, te ontgin en te beskryf. ’n Kwalitatiewe fenomenologiese ontwerp is toegepas. Doelbewuste steekproefneming is gebruik om deelnemers te selekteer uit die groep gesondheidsorgverskaffers wat in die ongevalle-eenheid werksaam was en meer as vier slagoffers van seksuele aanranding hanteer het. Data is by wyse van individuele onderhoude ingesamel en volgens die Tesch-metode van data-analise deur die navorser en die onafhanklike medekodeerder geanaliseer

  5. Emerging Requirements for Technology Management: A Sector-based Scenario Planning Approach

    Directory of Open Access Journals (Sweden)

    Simon Patrick Philbin

    2013-09-01

    Full Text Available Identifying the emerging requirements for technology management will help organisations to prepare for the future and remain competitive. Indeed technology management as a discipline needs to develop and respond to societal and industrial needs as well as the corresponding technology challenges. Therefore, following a review of technology forecasting methodologies, a sector-based scenario planning approach has been used to derive the emerging requirements for technology management. This structured framework provided an analytical lens to focus on the requirements for managing technology in the healthcare, energy and higher education sectors over the next 5-10 years. These requirements include the need for new business models to support the adoption of technologies; integration of new technologies with existing delivery channels; management of technology options including R&D project management; technology standards, validation and interoperability; and decision-making tools to support technology investment.

  6. Emerging technologies and approaches to minimize discharges into Lake Michigan Phase 2, Module 3 report.

    Energy Technology Data Exchange (ETDEWEB)

    Negri, M. C.; Gillenwater, P.; Urgun Demirtas, M. (Energy Systems)

    2011-05-11

    Purdue University Calumet (Purdue) and Argonne National Laboratory (Argonne) have conducted an independent study to identify deployable technologies that could help the BP Whiting Refinery, and other petroleum refineries, meet future wastewater discharge limits. This study has been funded by BP. Each organization tested a subset of the target technologies and retains sole responsibility for its respective test design and implementation, quality assurance and control, test results obtained from each of the technologies, and corresponding conclusions and recommendations. This project was divided in two phases and modules. This report summarizes the work conducted by Argonne in Phase II Module 3 (Bench Scale Testing). Other Modules are discussed elsewhere (Emerging Technologies and Approaches to Minimize Discharges into Lake Michigan, Phase 2, Modules 1-3 Report, April 2011, prepared for BP Americas by the Argonne - Purdue Task Force). The goal of this project was to identify and assess available and emerging wastewater treatment technologies for removing mercury and vanadium from the Whiting Refinery wastewater and to conduct bench-scale tests to provide comparable, transparent, and uniform results across the broad range of technologies tested. After the bench-scale testing phase, a previously developed decision matrix was refined and applied by Argonne to process and review test data to estimate and compare the preliminary performance, engineering configuration, preliminary cost, energy usage, and waste generation of technologies that were shown to be able to remove Hg and/or V to below the target limit at the bench scale. The data were used as the basis to identify the best candidates for further testing at the bench or pilot scale on a slip stream of effluent to lake (ETL) or clarifier effluent (CE) at the Whiting Refinery to determine whether future limits could be met and to generate other pertinent data for scale-up and sustainability evaluation. As a result of

  7. Sustaining the emerging carbon trading industry development: A business ecosystem approach of carbon traders

    International Nuclear Information System (INIS)

    Hu, Guangyu; Rong, Ke; Shi, Yongjiang; Yu, Jing

    2014-01-01

    This paper explores how carbon traders nurture the business ecosystem to sustain the emerging carbon trading industry development. We collected primary data from a multinational carbon trader and its ecosystem partners in China, through the construction of interviews and documentary. The research findings show the carbon trading industry has experienced four-stage evolution with different driving forces; the carbon trader attracted and organized ecosystem partners to facilitate the CDM project owners to create carbon credits and trade them; a systematic business ecosystems approach through the lens of Context, Cooperation and Configuration, initiated by carbon traders, has facilitated the industry development. Our findings also implicate to industrial practitioners and policymakers for sustaining the emerging industry development at both the current- and the post-Kyoto protocol periods. - Highlights: • The carbon trader is a catalyst to link CDM project owner and trading market in China • The evolution of carbon trading industry has four stages with various driving forces. • Nurturing business ecosystems facilitates the carbon trading industry development. • The ecosystem approach works via the lens of Context, Configuration and Cooperation. • The ecosystem approach implicates to carbon trading industry at the post-Kyoto era

  8. Treatment approaches and antibiotic use for emergency dental treatment in Turkey

    Directory of Open Access Journals (Sweden)

    Kaptan RF

    2013-11-01

    Full Text Available Rabia Figen Kaptan,1 Faruk Haznedaroglu,2 Fatima Betul Basturk,3 Mehmet Baybora Kayahan11Department of Endodontics, Yeditepe University, 2Department of Endodontics, Istanbul University, 3Department of Endodontics, Marmara University, Istanbul, TurkeyAbstract: The purpose of this study was to gather information about Turkish general dental practitioners' treatment approaches towards endodontic emergencies, antibiotic-prescribing habits, and their participation in lifelong learning programs. Questionnaires were given to dentists who attended the 16th National Congress organized by the Turkish Dental Association. From 1,400 questionnaires distributed, 589 (43% were deemed usable in this study. This survey dealt with questions that were subdivided into two main topics: dental emergency treatment approaches, and antibiotic prescription and information on lifelong learning program participation. The statistical analysis was conducted with a Χ2 test at a significance level of P<0.05. For irreversible pulpitis cases in vital teeth, most of the dental practitioners (65.3% preferred single-visit root canal treatments. For teeth presenting a periapical lesion, the preferred treatment approach was root canal treatment (91.5%. The rate of prescription of analgesics and antibiotics was 21.7% in untreated acute apical periodontitis cases and 41% in acute apical abscess cases. Frequently prescribed antibiotics were amoxicillin–clavulanate (61.8% and amoxicillin (46.5%. There was a tendency for practitioners to attend congresses as their years of professional practice increased (P<0.0001. There have been discrepancies between taught and observed practice. Educational initiatives are needed to prevent inappropriate prescription of antibiotics.Keywords: antibiotic prescription, endodontic emergency, survey, Turkey

  9. Can ultrasound extended emergency (EFAST) replace the chest radiograph in the initial approach to trauma?

    International Nuclear Information System (INIS)

    Aguirre Jimenez, Marcela

    2010-01-01

    The sensitivity diagnosed between ultrasound Extended emergency (EFAST) and portable radiography was compared. Life-threatening pathologies are detected in the initial approach to trauma, through an analysis comparative between EFAST and portable chest radiography. So, the need or not both studies or if the use of EFAST as the only diagnostic method in primary evaluation of trauma can be limited. The study has concluded that the EFAST can be used as the only tool for polytrauma patients, although in this analysis the sample has been very small [es

  10. Uncharted territory: A complex systems approach as an emerging paradigm in applied linguistics

    Directory of Open Access Journals (Sweden)

    Weideman, Albert J

    2009-12-01

    Full Text Available Developing a theory of applied linguistics is a top priority for the discipline today. The emergence of a new paradigm - a complex systems approach - in applied linguistics presents us with a unique opportunity to give prominence to the development of a foundational framework for this design discipline. Far from being a mere philosophical exercise, such a framework will find application in the training and induction of new entrants into the discipline within the developing context of South Africa, as well as internationally.

  11. "Futile Care"-An Emergency Medicine Approach: Ethical and Legal Considerations.

    Science.gov (United States)

    Simon, Jeremy R; Kraus, Chadd; Rosenberg, Mark; Wang, David H; Clayborne, Elizabeth P; Derse, Arthur R

    2017-11-01

    Futility often serves as a proposed reason for withholding or withdrawing medical treatment, even in the face of patient and family requests. Although there is substantial literature describing the meaning and use of futility, little of it is specific to emergency medicine. Furthermore, the literature does not provide a widely accepted definition of futility, and thus is difficult if not impossible to apply. Some argue that even a clear concept of futility would be inappropriate to use. This article will review the origins of and meanings suggested for futility, specific challenges such cases create in the emergency department (ED), and the relevant legal background. It will then propose an approach to cases of perceived futility that is applicable in the ED and does not rely on unilateral decisions to withhold treatment, but rather on avoiding and resolving the conflicts that lead to physicians' believing that patients are asking them to provide "futile" care. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  12. Nanotechnology-based combinational drug delivery: an emerging approach for cancer therapy.

    Science.gov (United States)

    Parhi, Priyambada; Mohanty, Chandana; Sahoo, Sanjeeb Kumar

    2012-09-01

    Combination therapy for the treatment of cancer is becoming more popular because it generates synergistic anticancer effects, reduces individual drug-related toxicity and suppresses multi-drug resistance through different mechanisms of action. In recent years, nanotechnology-based combination drug delivery to tumor tissues has emerged as an effective strategy by overcoming many biological, biophysical and biomedical barriers that the body stages against successful delivery of anticancer drugs. The sustained, controlled and targeted delivery of chemotherapeutic drugs in a combination approach enhanced therapeutic anticancer effects with reduced drug-associated side effects. In this article, we have reviewed the scope of various nanotechnology-based combination drug delivery approaches and also summarized the current perspective and challenges facing the successful treatment of cancer. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Learning through Discussions

    Science.gov (United States)

    Ellis, Robert A.; Calvo, Rafael; Levy, David; Tan, Kelvin

    2004-01-01

    Students studying a third-year e-commerce subject experienced face-to-face and online discussions as an important part of their learning experience. The quality of the students' experiences of learning through those discussions is investigated in this study. This study uses qualitative approaches to investigate the variation in the students'…

  14. A scenario-based modeling approach for emergency evacuation management and risk analysis under multiple uncertainties

    Energy Technology Data Exchange (ETDEWEB)

    Lv, Y., E-mail: lvyying@hotmail.com [School of Traffic and Transportation, Beijing Jiaotong University, Beijing 100044 (China); Faculty of Engineering and Applied Science, University of Regina, Regina, Saskatchewan S4S 0A2 (Canada); Huang, G.H., E-mail: huang@iseis.org [Faculty of Engineering and Applied Science, University of Regina, Regina, Saskatchewan S4S 0A2 (Canada); Guo, L., E-mail: guoli8658@hotmail.com [Faculty of Engineering and Applied Science, University of Regina, Regina, Saskatchewan S4S 0A2 (Canada); Li, Y.P., E-mail: yongping.li@iseis.org [MOE Key Laboratory of Regional Energy and Environmental Systems Optimization, Resources and Environmental Research Academy, North China Electric Power University, Beijing 102206 (China); Dai, C., E-mail: daichao321@gmail.com [College of Environmental Sciences and Engineering, Peking University, Beijing 100871 (China); Wang, X.W., E-mail: wangxingwei0812@gamil.com [State Key Laboratory of Water Environment Simulation, School of Environment, Beijing Normal University, Beijing 100875 (China); Sun, W., E-mail: sunwei@iseis.org [Faculty of Engineering and Applied Science, University of Regina, Regina, Saskatchewan S4S 0A2 (Canada)

    2013-02-15

    Highlights: ► An interval-parameter joint-probabilistic integer programming method is developed. ► It is useful for nuclear emergency management practices under uncertainties. ► It can schedule optimal routes with maximizing evacuees during a finite time. ► Scenario-based analysis enhances robustness in controlling system risk. ► The method will help to improve the capability of disaster responses. -- Abstract: Nuclear emergency evacuation is important to prevent radioactive harms by hazardous materials and to limit the accidents’ consequences; however, uncertainties are involved in the components and processes of such a management system. In the study, an interval-parameter joint-probabilistic integer programming (IJIP) method is developed for emergency evacuation management under uncertainties. Optimization techniques of interval-parameter programming (IPP) and joint-probabilistic constrained (JPC) programming are incorporated into an integer linear programming framework, so that the approach can deal with uncertainties expressed as joint probability and interval values. The IJIP method can schedule the optimal routes to guarantee the maximum population evacuated away from the effected zone during a finite time. Furthermore, it can also facilitate post optimization analysis to enhance robustness in controlling system violation risk imposed on the joint-probabilistic constraints. The developed method has been applied to a case study of nuclear emergency management; meanwhile, a number of scenarios under different system conditions have been analyzed. It is indicated that the solutions are useful for evacuation management practices. The result of the IJIP method can not only help to raise the capability of disaster responses in a systematic manner, but also provide an insight into complex relationships among evacuation planning, resources utilizations, policy requirements and system risks.

  15. Recommendations for Nanomedicine Human Subjects Research Oversight: An Evolutionary Approach for an Emerging Field

    Science.gov (United States)

    Fatehi, Leili; Wolf, Susan M.; McCullough, Jeffrey; Hall, Ralph; Lawrenz, Frances; Kahn, Jeffrey P.; Jones, Cortney; Campbell, Stephen A.; Dresser, Rebecca S.; Erdman, Arthur G.; Haynes, Christy L.; Hoerr, Robert A.; Hogle, Linda F.; Keane, Moira A.; Khushf, George; King, Nancy M.P.; Kokkoli, Efrosini; Marchant, Gary; Maynard, Andrew D.; Philbert, Martin; Ramachandran, Gurumurthy; Siegel, Ronald A.; Wickline, Samuel

    2015-01-01

    The nanomedicine field is fast evolving toward complex, “active,” and interactive formulations. Like many emerging technologies, nanomedicine raises questions of how human subjects research (HSR) should be conducted and the adequacy of current oversight, as well as how to integrate concerns over occupational, bystander, and environmental exposures. The history of oversight for HSR investigating emerging technologies is a patchwork quilt without systematic justification of when ordinary oversight for HSR is enough versus when added oversight is warranted. Nanomedicine HSR provides an occasion to think systematically about appropriate oversight, especially early in the evolution of a technology, when hazard and risk information may remain incomplete. This paper presents the consensus recommendations of a multidisciplinary, NIH-funded project group, to ensure a science-based and ethically informed approach to HSR issues in nanomedicine, and integrate HSR analysis with analysis of occupational, bystander, and environmental concerns. We recommend creating two bodies, an interagency Human Subjects Research in Nanomedicine (HSR/N) Working Group and a Secretary’s Advisory Committee on Nanomedicine (SAC/N). HSR/N and SAC/N should perform 3 primary functions: (1) analysis of the attributes and subsets of nanomedicine interventions that raise HSR challenges and current gaps in oversight; (2) providing advice to relevant agencies and institutional bodies on the HSR issues, as well as federal and federal-institutional coordination; and (3) gathering and analyzing information on HSR issues as they emerge in nanomedicine. HSR/N and SAC/N will create a home for HSR analysis and coordination in DHHS (the key agency for relevant HSR oversight), optimize federal and institutional approaches, and allow HSR review to evolve with greater knowledge about nanomedicine interventions and greater clarity about attributes of concern. PMID:23289677

  16. Assessing offshore emergency evacuation behavior in a virtual environment using a Bayesian Network approach

    International Nuclear Information System (INIS)

    Musharraf, Mashrura; Smith, Jennifer; Khan, Faisal; Veitch, Brian; MacKinnon, Scott

    2016-01-01

    In the performance influencing factor (PIF) hierarchy, person-based influencing factors reside in the top level along with machine-based, team-based, organization-based and situation/stressor-based factors. Though person-based PIFs like morale, motivation, and attitude (MMA) play an important role in shaping performance, it is nearly impossible to assess such PIFs directly. However, it is possible to measure behavioral indicators (e.g. compliance, use of information) that can provide insight regarding the state of the unobservable person-based PIFs. One common approach to measuring these indicators is to carry out a self-reported questionnaire survey. Significant work has been done to make such questionnaires reliable, but the potential validity problem associated with any questionnaire is that the data are subjective and thus may bear a limited relationship to reality. This paper describes the use of a virtual environment to measure behavioral indicators, which in turn can be used as proxies to assess otherwise unobservable PIFs like MMA. A Bayesian Network (BN) model is first developed to define the relationship between person-based PIFs and measurable behavioral indicators. The paper then shows how these indicators can be measured using evidence collected from a virtual environment of an offshore petroleum installation. A study that focused on emergency evacuation scenarios was done with 36 participants. The participants were first assessed using a multiple choice test. They were then assessed based on their observed performance during simulated offshore emergency evacuation conditions. A comparison of the two assessments demonstrates the potential benefits and challenges of using virtual environments to assess behavioral indicators, and thus the person-based PIFs. - Highlights: • New approach to use virtual environment as measure of behavioral indicators. • New model to study morale, motivation, and attitude. • Bayesian Network model to define the

  17. Nuclear and Radiological Emergency Management and Rehabilitation Strategies: Towards a EU approach for decision support tools

    International Nuclear Information System (INIS)

    Raskob, W.; Gering, F.; Lochard, J.; Nisbet, A.; Starostova, V.; Tomic, B.

    2011-01-01

    Highlights: → European emergency management and rehabilitation was strengthened. → Development of generic European handbooks for urban and agricultural areas. → Decision support systems became more operational. → Harmonisation of tools in Europe has been promoted. - Abstract: The 5-year multi-national project EURANOS (European Approach to Nuclear and Radiological Emergency Management and Rehabilitation Strategies), funded by the European Commission and 23 European Member States, started in April 2004. Integrating 17 national emergency management organisations with 33 research institutes, it brings together best practices, knowledge and technology to enhance the preparedness for Europe's response to any radiation emergency and long term contamination. Key objectives of the project are to collate information on the likely effectiveness and consequences of a wide range of countermeasures, to provide guidance to emergency management organisations and decision makers on the establishment of an appropriate response strategy and to further enhance advanced decision support systems (DSS), in particular, RODOS (Real-time On-line Decisions Support) decision support system), through feedback from their operational use. Further, the project aims to create regional initiatives leading to information exchange based on state-of-the-art information technologies, to develop guidance which assists Member States in developing a framework for the sustainable rehabilitation of living conditions in contaminated areas and to maintain and enhance knowledge and competence through emergency exercises, training and education, thus fostering best practice in emergency response. The project is divided into three major research activities and a set of demonstration projects which are split in two phases lasting over two and three years, respectively. The research activities address specific issues previously identified by the users or by previous research in the area. They are focused

  18. Ethics, genetics and dynamics: an emerging systematic approach to radiation protection of the environment

    International Nuclear Information System (INIS)

    Pentreath, R.J.

    2004-01-01

    There is now a general consensus of opinion that an explicit approach is necessary to demonstrate radiation protection of the environment, and that this approach needs to be developed in a systematic way. The framework that is emerging links ethical and moral issues (anthropocentric, biocentric, and ecocentric) to broad-based principles and objectives of environmental protection (sustainable development, maintaining biological diversity, and habitat protection) and then links these, in turn, to the needs of current environmental management practices, such as environmental exploitation, pollution control, and nature conservation. The relevance of this to radiation is that its effects (such as causing early mortality, morbidity, reduced reproductive success, as well as resulting in observable (scorable) cytogenetic damage) are those that may have a bearing on these same environmental management practices. The devise that would appear to be most useful to bridge the gap between our disparate data on radiation effects and the needs of environmental management, is that of adding to the concept of Reference Man in the shape of a small set of Reference Animals and Plants. This approach has now been adopted by the ICRP, adding new dynamics--the motive forces, both moral and physical--to the subject. The way is now clear for rapid progress to be made on a number of fronts

  19. Green and Sustainable Separation of Natural Products from Agro-Industrial Waste: Challenges, Potentialities, and Perspectives on Emerging Approaches.

    Science.gov (United States)

    Zuin, Vânia G; Ramin, Luize Z

    2018-01-17

    New generations of biorefinery combine innovative biomass waste resources from different origins, chemical extraction and/or synthesis of biomaterials, biofuels, and bioenergy via green and sustainable processes. From the very beginning, identifying and evaluating all potentially high value-added chemicals that could be removed from available renewable feedstocks requires robust, efficient, selective, reproducible, and benign analytical approaches. With this in mind, green and sustainable separation of natural products from agro-industrial waste is clearly attractive considering both socio-environmental and economic aspects. In this paper, the concepts of green and sustainable separation of natural products will be discussed, highlighting the main studies conducted on this topic over the last 10 years. The principal analytical techniques (such as solvent, microwave, ultrasound, and supercritical treatments), by-products (e.g., citrus, coffee, corn, and sugarcane waste) and target compounds (polyphenols, proteins, essential oils, etc.) will be presented, including the emerging green and sustainable separation approaches towards bioeconomy and circular economy contexts.

  20. Open of chat rooms for discussing geological disposal issues and review of adequate approaches for offering the information using the internet

    International Nuclear Information System (INIS)

    Takizawa, Masayuki; Ito, Toshikazu; Yabuta, Naohiro; Yoshizawa, Nobuaki; Tsunoda, Hirokazu

    2001-03-01

    JNC is doing publicity work to let the technical reliability for geological disposal of high-level radioactive waste (HLW) comprehended widely. But the information about geological disposal of HLW itself and its technology has not been spread and recognized. It has been required to offer the opportunity to discuss the geological disposal and its technology as our own issue. Recently the internet, which has such characteristics as two-way, instant and open communication means, has become used on business and for pleasure commonly. So the opportunity for discussing the topics related to geological disposal of HLW has been offered on the internet web site so-called 'Internet Forum' by JNC since fiscal year 1999. 'Internet Forum' or an assembly of chat rooms is being run on the web server which is not operated by JNC in order to provide the place where discussion on the issue can be done as fairly and objectively as possible. In this report, the results of Internet Forum in fiscal year 2000 comparing with that in fiscal year 1999 were shown and the adequate approaches of operating 'Internet Forum' and offering the information about geological disposal of HLW were reviewed. (author)

  1. CO2 emissions and financial development in an emerging economy: An augmented VAR approach

    International Nuclear Information System (INIS)

    Abbasi, Faiza; Riaz, Khalid

    2016-01-01

    This paper explores the influence of economic and financial development on carbon emissions in a small emerging economy. The study employs ARDL approach to investigate the long run relationship between carbon emissions and a set of economic and financial variables, an Error Correction Model (ECM) to capture the short run dynamics, Granger causality in an augmented VAR framework to check the causality direction, and variance decomposition based on an estimated Vector Error Correction Model (VECM) to determine the relative contributions of economic and financial variables to the evolution of per capita carbon emissions. The periods considered were the full sample (1971–2011), and a reduced sample sub-period (1988–2011) that corresponded to greater liberalization and financial sector development. The financial variables played a role in emission mitigation only in the latter period where greater degree of liberalization and financial sector development occurred. Even then the relative magnitude of emissions mitigation attributable to financial variables was much smaller compared to the emissions raising impact of rising per capita incomes. This underscores the need for adopting other mitigation policies for reducing carbon footprints in those emerging economies where a sufficient degree of financial deepening and financial sector development has not yet taken place. - Highlights: • In economies where structural transformation of financial sector is in early stages. • Financial development does not aid in mitigating CO 2 emissions rather it increases it. • CO 2 emissions rise as per capita income rises. • Government should devise comprehensive and realistic mitigation strategies.

  2. SYSTEMIC APPROACH AND ROUGHNESS APPLICATION TO CAUSE EMERGING PROPERTIES IN THE RESTORATION OF DEGRADED SOILS

    Directory of Open Access Journals (Sweden)

    Juarês José Aumond

    2014-09-01

    Full Text Available http://dx.doi.org/10.5902/1980509815737Based on the general systems theory, an ecological model for the restoration of ecosystems has been developed, which soils are highly degraded, and treating the ecosystem as a complex dynamic system, hyper-sensitive to initial conditions of soil preparation. Assuming that degraded ecosystems are sensitive to initial conditions of soil preparation, the technique of roughness was evaluated (relief variations alternating between concave and convex surfaces to trigger over time emergent properties that accelerate the process of ecological restoration. The degraded ecosystems can be understood as organizationally open systems, as a dissipative structure, in which irreversibly matter and energy flow. The main task in ecological restoration in areas that had the soil degraded is to achieve the internalization of matter and energy to induce the system to organizational closure. The roughness, represented by soil micro-topography is an effective technique in the internalization of matter, retaining water, sediment, organic matter, nutrients and seeds. Variations of relief trigger environmental changes over time in a dynamic and heterogeneous way, which influence the interactions between solar radiation, moisture and nutrients, creating different opportunities for plants and animal species. There must be an oriented concentration to flow structures and processes between the degraded ecosystem (system and the environment (neighborhood. In this approach, a particular concentration on the interrelationships between the system and the environment is dedicated. For ecological restoration, whose area is with degraded soil, such as mining and ranching, a new integrative degraded systemic approach is proposed, in which the roughness of the soil might trigger spatial and temporal patterns and emergent environmental properties due to the hyper-sensitivity to initial conditions of the land preparation.

  3. The Emergence of Regional Immigrant Concentrations in USA and Australia: A Spatial Relatedness Approach

    Science.gov (United States)

    Novotny, Josef; Hasman, Jiri

    2015-01-01

    This paper examines the patterns of the US and Australian immigration geography and the process of regional population diversification and the emergence of new immigrant concentrations at the regional level. It presents a new approach in the context of human migration studies, focusing on spatial relatedness between individual foreign-born groups as revealed from the analysis of their joint spatial concentrations. The approach employs a simple assumption that the more frequently the members of two population groups concentrate in the same locations the higher is the probability that these two groups can be related. Based on detailed data on the spatial distribution of foreign-born groups in US counties (2000–2010) and Australian postal areas (2006–2011) we firstly quantify the spatial relatedness between all pairs of foreign-born groups and model the aggregate patterns of US and Australian immigration systems conceptualized as the undirected networks of foreign-born groups linked by their spatial relatedness. Secondly, adopting a more dynamic perspective, we assume that immigrant groups with higher spatial relatedness to those groups already concentrated in a region are also more likely to settle in this region in future. As the ultimate goal of the paper, we examine the power of spatial relatedness measures in projecting the emergence of new immigrant concentrations in the US and Australian regions. The results corroborate that the spatial relatedness measures can serve as useful instruments in the analysis of the patterns of population structure and prediction of regional population change. More generally, this paper demonstrates that information contained in spatial patterns (relatedness in space) of population composition has yet to be fully utilized in population forecasting. PMID:25966371

  4. Deriving a Framework for a Systems Approach to Agitated Patient Care in the Emergency Department.

    Science.gov (United States)

    Wong, Ambrose H; Ruppel, Halley; Crispino, Lauren J; Rosenberg, Alana; Iennaco, Joanne D; Vaca, Federico E

    2018-05-01

    The rising agitated patient population presenting to the emergency department (ED) has caused increasing safety threats for health care workers and patients. Development of evidence-based strategies has been limited by the lack of a structured framework to examine agitated patient care in the ED. In this study, a systems approach from the patient safety literature was used to derive a comprehensive theoretical framework for addressing ED patient agitation. A mixed-methods approach was used with ED staff members at an academic site and a community site of a regional health care network. Participants consisted of resident and attending physicians, physician assistants/nurse practitioners, nurses, technicians, and security officers. After a simulated agitated patient encounter to prime participants, uniprofessional and interprofessional focus groups were conducted, followed by a structured thematic analysis using a grounded theory approach. Quantitative data consisted of surveys of violence exposure and attitudes toward patient aggression and management. Data saturation was reached with 57 participants. Violence exposure was higher for technicians, nurses, and officers. Conflicting priorities and management challenges occurred due to four main interconnected elements: perceived complex patient motivations; a patient care paradox between professional duty and personal safety; discordant interprofessional dynamics mitigated by respect and trust; and logistical challenges impeding care delivery and long-term outcomes. Using a systems approach, five interconnected levels of ED agitated patient care delivery were identified: patient, staff, team, ED microsystem, and health care macrosystem. These care dimensions were synthesized to form a novel patient safety-based framework that can help guide future research, practice, and policy. Copyright © 2018 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  5. Permeable Reactive Barriers: a multidisciplinary approach of a new emerging sustainable groundwater treatment technology

    Energy Technology Data Exchange (ETDEWEB)

    Diels, L.; Bastiaens, L. [Vito, Mol (BL); O' Hannessin, S. [EnviroMetal Technologies Inc., Ontario (Canada); Cortina, J.L. [Univ. Politecnica de Catalunya, Barcelona (Spain). Dept. d' Enginyeria Quimica; Alvarez, P.J. [Univ. of Iowa, Iowa-City (United States). Center for Biocatalysis and Bioprocessing; Ebert, M. [Christian-Albrechts Univ. Kiel (Germany). Inst. fuer Geowissenschaften; Schad, H. [I.M.E.S. GmbH, Amtzell (Germany)

    2003-07-01

    Permeable reactive barriers or zones are becoming an interesting sustainable and cost-effective technology for in situ treatment of contaminated groundwater. The technology is based on chemical processes as the dehalogenating activity of zerovalent iron, biological processes in bioscreens or reactive zones and on sorption technology (e.g. heavy metal adsorption or adsorption on granular activated carbon). Three technical sessions will be devoted to this nowadays becoming mature technology. This special session intends to pay attention to the discussion about some questions related to PRBs. These include the sustainability (e.g. life time and clogging) especially for zerovalent iron barriers, the need and quality of feasibility tests, drawbacks and restrictions of PRBs. Combined with long term performance monitoring os these systems will be discussed. Further attention will be paid to cost evaluation and the relationship between zerovalent barriers and bacterial growth. Also attention will be paid to new reactive materials (e.g. activated carbon for organics and inorganic materials for heavy metals) and consequences (e.g. environmental impact). Finally the session will combine al these approaches in a discussion about combined barriers or multibarriers for treatment of mixed pollution (e.g. landfill leachates contaminated groundwater). Specialists involved in these subjects will introduce these topics and allow for a large and intensive discussion to improve future applications of this technology. (orig.)

  6. The regulatory approach to ensuring the adequacy of emergency planning for nuclear power stations in South Africa

    International Nuclear Information System (INIS)

    Metcalf, P.E.

    1986-01-01

    The first nuclear power station in South Africa became operational in 1984. The paper describes the basis on which emergency planning was required from a regulatory point of view. The extent of planning required and the associated facilities are described, together with the structure of the emergency response organization and associated responsibilities. The provisions in place to ensure ongoing readiness of the emergency response organization are discussed. These include training and retraining of operational staff, equipment and inventory checks and the conducting of an annual full-scale demonstration exercise. (author)

  7. The women in emergency medicine mentoring program: an innovative approach to mentoring.

    Science.gov (United States)

    Welch, Julie L; Jimenez, Heather L; Walthall, Jennifer; Allen, Sheryl E

    2012-09-01

    Women in medicine report many gender-specific barriers to their career success and satisfaction, including a lack of mentors and role models. The literature calls for innovative strategies to enhance mentorship for women in medicine. To describe the content, perceived value, and ongoing achievements of a mentoring program for women in emergency medicine. The program offered mentoring for female faculty and residents in an academic emergency medicine department. Volunteers participated in group mentoring sessions using a mosaic of vertical and peer mentoring. Sessions focused on topics specific to women in medicine. An anonymous, electronic survey was sent to women who participated during 2004-2010 to assess the perceived value of the program and to collect qualitative feedback. Preliminary achievements fulfilling the program's goals were tracked. A total of 46 women (64%) completed the survey. The results showed a positive perceived value of the program (average, 4.65 on a 5-point Likert scale) in providing mentors and role models (4.41), in offering a supportive environment (4.39), in providing discussions pertinent to both personal (4.22) and professional development (4.22), while expanding networking opportunities (4.07). Notable achievements included work on the creation of a family leave policy, establishing lactation space, collaboration on projects, awards, and academic advancement. This innovative model for mentoring women is perceived as a valuable asset to the academic department and residency. It offers the unique combination of expanding a female mentor pool by recruiting alumni and using a mosaic of vertical and peer mentoring.

  8. The Emergency Framing of Solar Geoengineering: Time for a Different Approach

    OpenAIRE

    Horton, Joshua

    2015-01-01

    Solar geoengineering has been proposed as a possible response measure in the event of a "climate emergency." Scientific evidence for climate emergencies in the form of tipping points, however, is contested and unsettled. Furthermore, declarations of emergency entail authoritarian political tendencies that historically have given rise to repression and abuse. By definition, an emergency must exhibit a combination of high risk, urgency and necessity; no plausible climatic tipping point display...

  9. Nano-Medicine as a Newly Emerging Approach to Combat Human Immunodeficiency Virus (HIV).

    Science.gov (United States)

    Saravanan, Muthupandian; Asmalash, Tsehaye; Gebrekidan, Atsebaha; Gebreegziabiher, Dawit; Araya, Tadele; Hilekiros, Haftamu; Barabadi, Hamed; Ramanathan, Kumaresan

    2018-01-01

    Human Immuno deficiency Virus (HIV) infection has attained pandemic level due to its complexity on both the HIV infection cycle and on the targets for drug delivery. This limits medication and consequently requires prominent and promising drug delivery systems to be invented. Notably, various nanomaterial have been studied to enhance effective delivery of the antiretroviral drugs for HIV prevention, diagnosis and cure. Some of these nanomaterials are liposomes, dendrimers, inorganic nanoparticles (NPs), polymeric micelles, natural and synthetic polymers. The present study aimed to review the recent progress in nanomedicine as a newly emerging approach to combat HIV. The scientific data bases reviewed carefully to find both in vitro and in vivo studies representing the role of nonomedicine to combat HIV. Impressively, nanomedicine drug delivery systems have been commendable in various models ranging from in vitro to in vivo. It gives notion about the application of nano-carrier systems for the delivery of anti-retroviral drugs which ideally should provide better distribution to surpass Blood- Brain Barrier (BBB) and other tissue or to overcome innate barriers such as mucus. Considerably, nanomaterials such as dendrimers and many other inorganic NPs such as silver, gold, iron, and zinc can be used for HIV treatment by interfering in varying stages of HIV life cycle. Furthermore, NPs could best act as adjuvants, convoys during vaccine delivery, as intra-vaginal microbicides and for the early detection of HIV-1 p24 antigen. Nanomedicine may be a proper approach in HIV/AIDS therapy by means of offering lower dosage and side effect, better patient-to-patient consistency, bioavailability, target specificity and improved sensitivity of HIV diagnosis. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  10. A systematic approach to novel virus discovery in emerging infectious disease outbreaks.

    Science.gov (United States)

    Sridhar, Siddharth; To, Kelvin K W; Chan, Jasper F W; Lau, Susanna K P; Woo, Patrick C Y; Yuen, Kwok-Yung

    2015-05-01

    The discovery of novel viruses is of great importance to human health-both in the setting of emerging infectious disease outbreaks and in disease syndromes of unknown etiology. Despite the recent proliferation of many efficient virus discovery methods, careful selection of a combination of methods is important to demonstrate a novel virus, its clinical associations, and its relevance in a timely manner. The identification of a patient or an outbreak with distinctive clinical features and negative routine microbiological workup is often the starting point for virus hunting. This review appraises the roles of culture, electron microscopy, and nucleic acid detection-based methods in optimizing virus discovery. Cell culture is generally slow but may yield viable virus. Although the choice of cell line often involves trial and error, it may be guided by the clinical syndrome. Electron microscopy is insensitive but fast, and may provide morphological clues to choice of cell line or consensus primers for nucleic acid detection. Consensus primer PCR can be used to detect viruses that are closely related to known virus families. Random primer amplification and high-throughput sequencing can catch any virus genome but cannot yield an infectious virion for testing Koch postulates. A systematic approach that incorporates carefully chosen combinations of virus detection techniques is required for successful virus discovery. Copyright © 2015 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

  11. A successful approach for the implementation of symptom-based emergency operating procedures for VVER reactors

    International Nuclear Information System (INIS)

    Lhoest, V.; Prior, R.; Pascal, G.

    2000-01-01

    The paper provides an overview of the organization, the progress and the results of the various Emergence Operating Procedure (EOP) development programs for VVER type reactors conducted by Westinghouse so far. The detailed working process is presented through the solutions to some major plant issues. The EOPs have been developed for the Temelin, Dukovany, Bohunice, Mochovce and Paks VVER nuclear power plants. The procedures are developed in working teams of experts from the utility and Westinghouse. The completion of the programs constitute an indication of the overall success of this approach. This is further reinforced by the general acceptance of the new procedures by the plant personnel, together with the good results obtained so far from procedure testing. This is also confirmed by a new PSA-level 1 analysis for Dukovany plant, which shows a significant improvement in the overall plant safety. This means a 20% reduction in the Core Damage Frequency due to the introduction of the new EOPs. The fact that some modifications have been implemented to the plants to solve design weaknesses identified in the course of this programs also constitute a positive result

  12. Bird's Eye View of a Neonatologist: Clinical Approach to Emergency Neonatal Infection

    Directory of Open Access Journals (Sweden)

    Fu-Kuei Huang

    2016-06-01

    Full Text Available Though the incidence of neonatal infection in term and near-term infants is relatively low, incidence of infection in preterm very low birth weight infants is as high as 20–30% and may result in neurodevelopmental impairment or mortality. Pediatricians should be familiar with recognition and emergency management of life-threatening neonatal infections, such as congenital pneumonia, early onset sepsis, late onset sepsis, bacterial and fungal meningitis, disseminated neonatal herpes simplex virus (HSV, and HSV meningoencephalitis. For the pediatrician, it is logical to approach the management of these infections by time of onset, i.e., early versus late onset of infection. Perinatal risk factors and simple laboratory tests, such as total white blood-cell count, immature/total ratio, and C-reactive protein are helpful in guiding the decision of antibiotics therapy. Successful management of these critical infections depends upon early diagnosis and timely administration of adequate antibiotics. Empiric antibiotic therapy must cover the most likely pathogens according to the risk factors of each individual neonate, and therapy duration is dependent upon culture results, clinical course, and the microorganism. Future research may focus on developing a practical neonatal sepsis score system based on risk factors and common biomarkers, which are readily available at bedside to make early accurate decisions and achieve better outcomes.

  13. Environmental emergency response plans (EERPs): A single plan approach to satisfy multiple regulations

    International Nuclear Information System (INIS)

    Muzyka, L.

    1995-01-01

    Conrail is a freight railroad operating in twelve northeast and midwestern states transporting goods and materials over 11,700 miles of railroad. To repair, maintain, rebuild, and manufacture locomotives and rail cars, and to maintain the track, right of way, bridges, tunnels and other structures, Conrail uses petroleum products, solvents and cleaners. These products are stored in hundreds of storage tanks in and around the yards and right of way. To power the trains, locomotives are fueled with diesel fuel. With large volumes of fuel, lubricants, solvents and cleaners, safe and efficient handling of petroleum and chemicals is crucial to avoid negative impacts on the environment. Conrail recently revisited the issue of environmental emergency response planning. In an attempt to assure full compliance with a myriad of federal, state, and local regulation, a ''single plan approach'' was chosen. Single plans for each facility, coined EERPs, were decided on after careful review of the regulations, and evaluation of the company's operational and organizational needs

  14. New Molecules and Old Drugs as Emerging Approaches to Selectively Target Human Glioblastoma Cancer Stem Cells

    Directory of Open Access Journals (Sweden)

    Roberto Würth

    2014-01-01

    Full Text Available Despite relevant progress obtained by multimodal treatment, glioblastoma (GBM, the most aggressive primary brain tumor, is still incurable. The most encouraging advancement of GBM drug research derives from the identification of cancer stem cells (CSCs, since these cells appear to represent the determinants of resistance to current standard therapies. The goal of most ongoing studies is to identify drugs able to affect CSCs biology, either inducing selective toxicity or differentiating this tumor cell population into nontumorigenic cells. Moreover, the therapeutic approach for GBM could be improved interfering with chemo- or radioresistance mechanisms, microenvironment signals, and the neoangiogenic process. During the last years, molecular targeted compounds such as sorafenib and old drugs, like metformin, displayed interesting efficacy in preclinical studies towards several tumors, including GBM, preferentially affecting CSC viability. In this review, the latest experimental results, controversies, and prospective application concerning these promising anticancer drugs will be discussed.

  15. Discussion about the use of the volume specific surface area (VSSA) as a criterion to identify nanomaterials according to the EU definition. Part two: experimental approach.

    Science.gov (United States)

    Lecloux, André J; Atluri, Rambabu; Kolen'ko, Yury V; Deepak, Francis Leonard

    2017-10-12

    The first part of this study was dedicated to the modelling of the influence of particle shape, porosity and particle size distribution on the volume specific surface area (VSSA) values in order to check the applicability of this concept to the identification of nanomaterials according to the European Commission Recommendation. In this second part, experimental VSSA values are obtained for various samples from nitrogen adsorption isotherms and these values were used as a screening tool to identify and classify nanomaterials. These identification results are compared to the identification based on the 50% of particles with a size below 100 nm criterion applied to the experimental particle size distributions obtained by analysis of electron microscopy images on the same materials. It is concluded that the experimental VSSA values are able to identify nanomaterials, without false negative identification, if they have a mono-modal particle size, if the adsorption data cover the relative pressure range from 0.001 to 0.65 and if a simple, qualitative image of the particles by transmission or scanning electron microscopy is available to define their shape. The experimental conditions to obtain reliable adsorption data as well as the way to analyze the adsorption isotherms are described and discussed in some detail in order to help the reader in using the experimental VSSA criterion. To obtain the experimental VSSA values, the BET surface area can be used for non-porous particles, but for porous, nanostructured or coated nanoparticles, only the external surface of the particles, obtained by a modified t-plot approach, should be considered to determine the experimental VSSA and to avoid false positive identification of nanomaterials, only the external surface area being related to the particle size. Finally, the availability of experimental VSSA values together with particle size distributions obtained by electron microscopy gave the opportunity to check the

  16. An Efficient Approach for Mars Sample Return Using Emerging Commercial Capabilities.

    Science.gov (United States)

    Gonzales, Andrew A; Stoker, Carol R

    2016-06-01

    Mars Sample Return is the highest priority science mission for the next decade as recommended by the 2011 Decadal Survey of Planetary Science [1]. This article presents the results of a feasibility study for a Mars Sample Return mission that efficiently uses emerging commercial capabilities expected to be available in the near future. The motivation of our study was the recognition that emerging commercial capabilities might be used to perform Mars Sample Return with an Earth-direct architecture, and that this may offer a desirable simpler and lower cost approach. The objective of the study was to determine whether these capabilities can be used to optimize the number of mission systems and launches required to return the samples, with the goal of achieving the desired simplicity. All of the major element required for the Mars Sample Return mission are described. Mission system elements were analyzed with either direct techniques or by using parametric mass estimating relationships. The analysis shows the feasibility of a complete and closed Mars Sample Return mission design based on the following scenario: A SpaceX Falcon Heavy launch vehicle places a modified version of a SpaceX Dragon capsule, referred to as "Red Dragon", onto a Trans Mars Injection trajectory. The capsule carries all the hardware needed to return to Earth Orbit samples collected by a prior mission, such as the planned NASA Mars 2020 sample collection rover. The payload includes a fully fueled Mars Ascent Vehicle; a fueled Earth Return Vehicle, support equipment, and a mechanism to transfer samples from the sample cache system onboard the rover to the Earth Return Vehicle. The Red Dragon descends to land on the surface of Mars using Supersonic Retropropulsion. After collected samples are transferred to the Earth Return Vehicle, the single-stage Mars Ascent Vehicle launches the Earth Return Vehicle from the surface of Mars to a Mars phasing orbit. After a brief phasing period, the Earth Return

  17. Regional and international approaches on prevention and control of animal transboundary and emerging diseases.

    Science.gov (United States)

    Domenech, J; Lubroth, J; Eddi, C; Martin, V; Roger, F

    2006-10-01

    Transboundary animal diseases pose a serious risk to the world animal agriculture and food security and jeopardize international trade. The world has been facing devastating economic losses from major outbreaks of transboundary animal diseases (TADs) such as foot-and-mouth disease, classical swine fever, rinderpest, peste des petits ruminants (PPR), and Rift Valley fever. Lately the highly pathogenic avian influenza (HPAI) due to H5N1 virus, has become an international crisis as all regions around the world can be considered at risk. In the past decades, public health authorities within industrialized countries have been faced with an increasing number of food safety issues. The situation is equally serious in developing countries. The globalization of food (and feed) trade, facilitated by the liberalization of world trade, while offering many benefits and opportunities, also represents new risks. The GF-TADs Global Secretariat has carried out several regional consultations for the identification of priority diseases and best ways for their administration, prevention and control. In the questionnaires carried out and through the consultative process, it was noted that globally, FMD was ranked as the first and foremost priority. Rift Valley fever, and today highly pathogenic avian influenza, are defined as major animal diseases which also affect human health. PPR and CBPP, a disease which is particularly serious in Africa and finally, African swine fever (ASF) and classical swine fever (CSF) are also regionally recognised as top priorities on which the Framework is determined to work. The FAO philosophy--shared by the OIE--embraces the need to prevent and control TADs and emerging diseases at their source, which is most of the time in developing countries. Regional and international approaches have to be followed, and the FAO and OIE GF-TADs initiative provides the appropriate concepts and objectives as well as an organizational framework to link international and

  18. A Review of Cyber Threats and Defence Approaches in Emergency Management

    OpenAIRE

    Tuan Vuong; Diane Gan; George Loukas

    2013-01-01

    Emergency planners, first responders and relief workers increasingly rely on computational and communication systems that support all aspects of emergency management, from mitigation and preparedness to response and recovery. Failure of these systems, whether accidental or because of malicious action, can have severe implications for emergency management. Accidental failures have been extensively documented in the past and significant effort has been put into the development and introduction ...

  19. The approach of prehospital health care personnel working at emergency stations towards forensic cases

    OpenAIRE

    Ozlem Asci; Guleser Hazar; Isa Sercan

    2015-01-01

    Objectives: The objective of this study is to determine the states of health care personnel, working at 112 emergency stations in the province of Artvin, to encounter with regarding forensic cases and determine their practices aimed at recognizing, protecting, and reporting the evidences that may affect the forensic process. Materials and methods: This descriptive study was conducted with nurses and emergency medicine technicians working at 112 emergency stations in Artvin between January 201...

  20. Pro-active approaches to the identification of emerging risks in the food chain: Retrospective case studies.

    NARCIS (Netherlands)

    Hagenaars, T.H.J.; Elbers, A.R.W.; Kleter, G.A.; Kreft, F.; Leeuwen, van P.; Waalwijk, C.; Hoogenboom, L.A.P.; Marvin, H.J.P.

    2006-01-01

    In this report six case studies are carried out on food-safety and animal-health crises that have occurred in the recent past. The aim is to learn from these cases if and how the identification of emerging food-safety (and animal-health) risks can be improved by adopting a (more) pro-active approach

  1. The Emergence of Cambodian Civil Society within Global Educational Governance: A Morphogenetic Approach to Agency and Structure

    Science.gov (United States)

    Edwards, D. Brent, Jr.; Brehm, William C.

    2015-01-01

    This paper uses Margaret Archer's morphogenetic approach to analyze the emergence of civil society within global educational governance. The purpose is to understand the intersection of historical structures with global actors and spaces that have accompanied the globalization of education. Based on findings from a study on the impact in Cambodia…

  2. Estudo de caso discutido à luz das diferentes abordagens para a terapia da gagueira Case study discussed under the light of different stuttering therapy approaches

    Directory of Open Access Journals (Sweden)

    Larissa Severa da Silva

    2011-01-01

    Full Text Available TEMA: na atualidade, a gagueira pode apresentar definições distintas de acordo com a abordagem defendida pelos autores para fundamentar tal distúrbio. O trabalho tem como objetivo discutir tais abordagens na terapia do caso em questão, aplicando suas técnicas terapêuticas e adequando-as conforme o contexto em questão e a aceitação do indivíduo para com as atividades, promovendo o desenvolvimento dos objetivos, procedimentos e técnicas utilizados na terapêutica para a gagueira. PROCEDIMENTOS: estudo longitudinal de um paciente de 14 anos, atendido em dois momentos: entre 2005/2006, ano em que recebeu alta com indicação de monitoramento, e 2008/2009 época em que retorna ao atendimento devido à recidiva. No estudo, são consideradas as diferentes abordagens: psicolinguística da fluência, neurolinguística e motora da gagueira, vertente contextualizada e abordagem fenomenológica da gagueira. RESULTADOS: na evolução, observou-se a diminuição considerável da gagueira e dos movimentos compensatórios, bem como, comportamento e postura adequados e uma melhor socialização. CONCLUSÃO: o estudo das abordagens consideradas na terapia propiciou a realização do atendimento que atingiu os objetivos propostos. Além disso, o paciente contribuiu no direcionamento da terapia conforme sua aceitação e aplicação em sua vida, revelando, dessa forma, quais condutas foram mais efetivas e puderam contribuir de forma mais direta com a sua qualidade de vida e sua evolução.BACKGROUND: stuttering may currently have different definitions according to the approach advocated by the authors to substantiate such a disorder. The paper aims to discuss such approaches in the therapy of the case, applying its therapeutic techniques and adapting them according to the context at issue and take the individual to activities, promoting the development of goals, procedures and techniques used in the stuttering therapy. PROCEDURES: a longitudinal study of

  3. Estudo de caso discutido à luz das diferentes abordagens para a terapia da gagueira Case study discussed under the light of different stuttering therapy approaches

    Directory of Open Access Journals (Sweden)

    Larissa Severa da Silva

    2013-02-01

    Full Text Available TEMA: na atualidade, a gagueira pode apresentar definições distintas de acordo com a abordagem defendida pelos autores para fundamentar tal distúrbio. O trabalho tem como objetivo discutir tais abordagens na terapia do caso em questão, aplicando suas técnicas terapêuticas e adequando-as conforme o contexto em questão e a aceitação do indivíduo para com as atividades, promovendo o desenvolvimento dos objetivos, procedimentos e técnicas utilizados na terapêutica para a gagueira. PROCEDIMENTOS: estudo longitudinal de um paciente de 14 anos, atendido em dois momentos: entre 2005/2006, ano em que recebeu alta com indicação de monitoramento, e 2008/2009 época em que retorna ao atendimento devido à recidiva. No estudo, são consideradas as diferentes abordagens: psicolinguística da fluência, neurolinguística e motora da gagueira, vertente contextualizada e abordagem fenomenológica da gagueira. RESULTADOS: na evolução, observou-se a diminuição considerável da gagueira e dos movimentos compensatórios, bem como, comportamento e postura adequados e uma melhor socialização. CONCLUSÃO: o estudo das abordagens consideradas na terapia propiciou a realização do atendimento que atingiu os objetivos propostos. Além disso, o paciente contribuiu no direcionamento da terapia conforme sua aceitação e aplicação em sua vida, revelando, dessa forma, quais condutas foram mais efetivas e puderam contribuir de forma mais direta com a sua qualidade de vida e sua evolução.BACKGROUND: stuttering may currently have different definitions according to the approach advocated by the authors to substantiate such a disorder. The paper aims to discuss such approaches in the therapy of the case, applying its therapeutic techniques and adapting them according to the context at issue and take the individual to activities, promoting the development of goals, procedures and techniques used in the stuttering therapy. PROCEDURES: a longitudinal study of

  4. Clinical governance implementation in a selected teaching emergency department: a systems approach

    Science.gov (United States)

    2012-01-01

    Background Clinical governance (CG) is among the different frameworks proposed to improve the quality of healthcare. Iran, like many other countries, has put healthcare quality improvement in its top health policy priorities. In November 2009, implementation of CG became a task for all hospitals across the country. However, it has been a challenge to clarify the notion of CG and the way to implement it in Iran. The purpose of this action research study is to understand how CG can be defined and implemented in a selected teaching emergency department (ED). Methods/design We will use Soft Systems Methodology for both designing the study and inquiring into its content. As we considered a complex problem situation regarding the quality of care in the selected ED, we initially conceptualized CG as a cyclic set of purposeful activities designed to explore the situation and find relevant changes to improve the quality of care. Then, implementation of CG will conceptually be to carry out that set of purposeful activities. The activities will be about: understanding the situation and finding out relevant issues concerning the quality of care; exploring different stakeholders’ views and ideas about the situation and how it can be improved; and defining actions to improve the quality of care through structured debates and development of accommodations among stakeholders. We will flexibly use qualitative methods of data collection and analysis in the course of the study. To ensure the study rigor, we will use different strategies. Discussion Successful implementation of CG, like other quality improvement frameworks, requires special consideration of underlying complexities. We believe that addressing the complex situation and reflections on involvement in this action research will make it possible to understand the concept of CG and its implementation in the selected setting. By describing the context and executed flexible methods of implementation, the results of this study

  5. Text mining approach to predict hospital admissions using early medical records from the emergency department.

    Science.gov (United States)

    Lucini, Filipe R; S Fogliatto, Flavio; C da Silveira, Giovani J; L Neyeloff, Jeruza; Anzanello, Michel J; de S Kuchenbecker, Ricardo; D Schaan, Beatriz

    2017-04-01

    Emergency department (ED) overcrowding is a serious issue for hospitals. Early information on short-term inward bed demand from patients receiving care at the ED may reduce the overcrowding problem, and optimize the use of hospital resources. In this study, we use text mining methods to process data from early ED patient records using the SOAP framework, and predict future hospitalizations and discharges. We try different approaches for pre-processing of text records and to predict hospitalization. Sets-of-words are obtained via binary representation, term frequency, and term frequency-inverse document frequency. Unigrams, bigrams and trigrams are tested for feature formation. Feature selection is based on χ 2 and F-score metrics. In the prediction module, eight text mining methods are tested: Decision Tree, Random Forest, Extremely Randomized Tree, AdaBoost, Logistic Regression, Multinomial Naïve Bayes, Support Vector Machine (Kernel linear) and Nu-Support Vector Machine (Kernel linear). Prediction performance is evaluated by F1-scores. Precision and Recall values are also informed for all text mining methods tested. Nu-Support Vector Machine was the text mining method with the best overall performance. Its average F1-score in predicting hospitalization was 77.70%, with a standard deviation (SD) of 0.66%. The method could be used to manage daily routines in EDs such as capacity planning and resource allocation. Text mining could provide valuable information and facilitate decision-making by inward bed management teams. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  6. Executing A Customer Relationship Management Programme In An Emerging Market: An Empirical Approach

    Directory of Open Access Journals (Sweden)

    Akinyele Samuel

    2013-05-01

    Full Text Available Retail financial services in all markets, including emerging markets, are undergoing major transaction, driven by change, deregulation and customer sophistication. Customer service and specifically relationship management in particular, are crucial to attaining a sustainable competitive advantage in the marketplace. The execution of a one- to- one programme within an emerging economy is the focus of this paper, specifically in the financial services environment. The steps in the execution of customer relationship management (CRM as proposed by Peppers, Rogers and Dorf (1999b are examined and the effect on customer service in an emerging market is investigated. The findings indicates that there are positive associations with these steps and customer service.

  7. Emerging Targets and Novel Approaches to Ebola Virus Prophylaxis and Treatment

    Science.gov (United States)

    Choi, Jin Huk; Croyle, Maria A.

    2013-01-01

    Ebola is a highly virulent pathogen causing severe hemorrhagic fever with a high case fatality rate in humans and non-human primates (NHPs). Although safe and effective vaccines or other medicinal agents to block Ebola infection are currently unavailable, a significant effort has been put forth to identify several promising candidates for the treatment and prevention of Ebola hemorrhagic fever. Among these, recombinant-virus based vectors have been identified as potent vaccine candidates with some affording both pre- and post-exposure protection from the virus. Recently, Investigational New Drug (IND) applications have been approved by the United States (U.S.) Food and Drug Administration (FDA) and Phase I clinical trials initiated for two small molecule therapeutics, 1) anti-sense phosphorodiamidate morphino oligomers (PMOs: AVI-6002, AVI-6003), and 2) lipid-nanoparticle/small interfering RNA (LNP/siRNA: TKM-Ebola). These potential alternatives to vector-based vaccines require multiple doses to achieve therapeutic efficacy which is not ideal with regard to patient compliance and outbreak scenarios. These concerns have fueled a quest for even better vaccination and treatment strategies. Here, we summarize recent advances in vaccines or post-exposure therapeutics for prevention of Ebola hemorrhagic fever. The utility of novel pharmaceutical approaches to refine and overcome barriers associated with the most promising therapeutic platforms will also be discussed. PMID:23813435

  8. Emergency First Response to a Crisis Event: A Multi-Agent Simulation Approach

    National Research Council Canada - National Science Library

    Roginski, Jonathan W

    2006-01-01

    .... This process led to the development of a multi-agent simulation methodology for emergency first response specifically applied to analyze a notional vehicle bomb attack during a festival in the Baltimore Inner Harbor...

  9. Systems approach to detect and evaluate contaminants of emerging concern in the Great Lakes

    Science.gov (United States)

    The release of chemicals of emerging concern threatens near shore health in the Great Lakes, particularly in regions already suffering from degradation of water and environmental quality due to past and present anthropogenic activities. Critical issues remain in delisting Areas ...

  10. A multivariate time series approach to forecasting daily attendances at hospital emergency department

    KAUST Repository

    Kadri, Farid; Harrou, Fouzi; Sun, Ying

    2018-01-01

    Efficient management of patient demands in emergency departments (EDs) has recently received increasing attention by most healthcare administrations. Forecasting ED demands greatly helps ED's managers to make suitable decisions by optimally

  11. Clinical governance implementation in a selected teaching emergency department: a systems approach

    Directory of Open Access Journals (Sweden)

    Heyrani Ali

    2012-09-01

    Full Text Available Abstract Background Clinical governance (CG is among the different frameworks proposed to improve the quality of healthcare. Iran, like many other countries, has put healthcare quality improvement in its top health policy priorities. In November 2009, implementation of CG became a task for all hospitals across the country. However, it has been a challenge to clarify the notion of CG and the way to implement it in Iran. The purpose of this action research study is to understand how CG can be defined and implemented in a selected teaching emergency department (ED. Methods/design We will use Soft Systems Methodology for both designing the study and inquiring into its content. As we considered a complex problem situation regarding the quality of care in the selected ED, we initially conceptualized CG as a cyclic set of purposeful activities designed to explore the situation and find relevant changes to improve the quality of care. Then, implementation of CG will conceptually be to carry out that set of purposeful activities. The activities will be about: understanding the situation and finding out relevant issues concerning the quality of care; exploring different stakeholders’ views and ideas about the situation and how it can be improved; and defining actions to improve the quality of care through structured debates and development of accommodations among stakeholders. We will flexibly use qualitative methods of data collection and analysis in the course of the study. To ensure the study rigor, we will use different strategies. Discussion Successful implementation of CG, like other quality improvement frameworks, requires special consideration of underlying complexities. We believe that addressing the complex situation and reflections on involvement in this action research will make it possible to understand the concept of CG and its implementation in the selected setting. By describing the context and executed flexible methods of implementation

  12. Mature and emerging organic markets: Modelling consumer attitude and behaviour with Partial Least Square Approach

    OpenAIRE

    von Meyer-Höfer, Marie; von der Wense, Vera; Padilla Bravo, Carlos; Spiller, Achim

    2013-01-01

    Although the organic food sector has been the subject of research for around 20 years, little is known about consumer behaviour when comparing developed and emerging organic food markets using causal research models. Thus, by developing a behavioural model based on the Theory of Planned Behaviour (TPB), the aim of this research article is to investigate the main determinants of organic food consumption in a mature (Germany) and an emerging (Chile) organic market. Subjects aged 18 or above wer...

  13. A Review of Cyber Threats and Defence Approaches in Emergency Management

    Directory of Open Access Journals (Sweden)

    Tuan Vuong

    2013-05-01

    Full Text Available Emergency planners, first responders and relief workers increasingly rely on computational and communication systems that support all aspects of emergency management, from mitigation and preparedness to response and recovery. Failure of these systems, whether accidental or because of malicious action, can have severe implications for emergency management. Accidental failures have been extensively documented in the past and significant effort has been put into the development and introduction of more resilient technologies. At the same time researchers have been raising concerns about the potential of cyber attacks to cause physical disasters or to maximise the impact of one by intentionally impeding the work of the emergency services. Here, we provide a review of current research on the cyber threats to communication, sensing, information management and vehicular technologies used in emergency management. We emphasise on open issues for research, which are the cyber threats that have the potential to affect emergency management severely and for which solutions have not yet been proposed in the literature.

  14. Analisi dell'Interazione Verbale Nella Discussione Matematica: Un Approccio Vygotskiano (A Verbal Analysis of Interaction in Mathematics Discussion: The Vygotskiano Approach).

    Science.gov (United States)

    Bussi, Maria G. Bartolini; Boni, Mara

    1995-01-01

    Presents a methodology for analyzing verbal interaction in mathematical discussion which is both a product and an instrument of a research project in grades one through eight. Analyzes an example of discussion from a first-grade classroom about point of view. (Author/MKR)

  15. Newspaper reporting and the emergence of charcoal burning suicide in Taiwan: A mixed methods approach.

    Science.gov (United States)

    Chen, Ying-Yeh; Tsai, Chi-Wei; Biddle, Lucy; Niederkrotenthaler, Thomas; Wu, Kevin Chien-Chang; Gunnell, David

    2016-03-15

    It has been suggested that extensive media reporting of charcoal burning suicide was a key factor in the rapid spread of this novel method in many East Asian countries. But very few empirical studies have explored the relationship between media reporting and the emergence of this new method of suicide. We investigated the changing pattern of media reporting of charcoal burning suicides in Taiwan during 1998-2002 when this method of suicide increased most rapidly, assessing whether the characteristics of media reporting were associated with the changing incidence of suicide using this method. A mixed method approach, combining quantitative and qualitative analysis of newspaper content during 1998-2002 was used. We compared differences in reporting characteristics before and after the rapid increase in charcoal burning suicide. Point-biserial and Pearson correlation coefficients were calculated to quantify the associations between the media item content and changes in suicide rates. During the period when charcoal burning suicide increased rapidly, the number of reports per suicide was considerably higher than during the early stage (0.31 vs. 0.10). Detailed reporting of this new method was associated with a post-reporting increase in suicides using the method. Qualitative analysis of news items revealed that the content of reports of suicide by charcoal burning changed gradually; in the early stages of the epidemic (1999-2000) there was convergence in the terminology used to report charcoal burning deaths, later reports gave detailed descriptions of the setting in which the death occurred (2001) and finally the method was glamourized and widely publicized (2001-2002). Our analysis was restricted to newspaper reports and did not include TV or the Internet. Newspaper reporting was associated with the evolution and establishment of charcoal burning suicide. Working with media and close monitoring of changes in the incidence of suicide using a new method might help

  16. Investigating the effect of clinical governess approach on patients' length of stay in emergency department: an action research study.

    Directory of Open Access Journals (Sweden)

    Tahmine Salehi

    2014-02-01

    Full Text Available Over the past decade, clinical governance approach with aims to improve the quality of health services has been proposed in Iran. Considering the obvious problems especially patients' length of stay (LOS in the emergency departments (EDs; the present study has been carried out with the purpose of Investigating the effect of clinical governess approach on patients' LOS in the one of the largest medical centers in the country. After the problem was specified by the 17 interviews with employees and managers of the ED; the emergency clinical governance committee was formed by two academic researchers and seven ED staff (key participants that had the most involvement with the subject of study. The activities of the committee, including planning, acting, observing and reflecting, was organized by using participatory action research approach and action research cycle (Kemmis 1995. During this time, three formal meetings with key participants were held in 6-month intervals. Monthly records of patients' average LOS and interview with ED staff were used to analyze the findings. The research was completed with two cycles in one year. Committee members took the following actions. As a result, the patients' LOS reduced from 2.68 days to 1.73 days. Make regular patients visits by medical groups especially orthopedists and neurologists; Decision making about patients situation by emergency physicians and transferring patients to the relevant units by bed managers; Refusing to admit elective patients during overcrowding times; to regulate the list of patients requiring ICU by anesthesiologists. Prolonged LOS can be due to various causes and a team approach, which is one of the requirements of clinical governance approach, is needed to manage it. The results showed that the multidisciplinary team could make positive changes and reduce LOS in emergency setting.

  17. Using the Grade Approach to Support the Development of Recommendations for Public Health Interventions in Radiation Emergencies

    International Nuclear Information System (INIS)

    Carr, Z.; Clarke, M.; Akl, E.A.; Schneider, R.; Murith, C.; Li, C.; Parrish-Sprowl, J.; Stenke, L.; Cui-Ping, L.; Bertrand, S.; Miller, C.

    2016-01-01

    The World Health Organization (WHO) guideline development policy requires that WHO guidelines be developed in a manner that is transparent and based on all available evidences, which must be synthesised and formally assessed for quality. To fulfil this requirement, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach of rating quality of evidence and grading strength of recommendations was applied when developing the WHO recommendations on public health interventions in radiation emergencies. The guideline development group (GDG) formulated 10 PICO (P: population; I: intervention; C: comparator; O: outcomes) questions to guide the development of recommendations on response interventions during the early/intermediate and late emergency phases and on risk communications for mitigating psycho-social impact of radiation emergencies. For each PICO question, an extensive evidence search and systematic review was conducted. The GDG then formulated the recommendations using the evidence to recommendation (E-2-R) decision-making matrix and evaluated the strength of each recommendation. (authors)

  18. A System Dynamics Approach to Modeling the Sensitivity of Inappropriate Emergency Department Utilization

    Science.gov (United States)

    Behr, Joshua G.; Diaz, Rafael

    Non-urgent Emergency Department utilization has been attributed with increasing congestion in the flow and treatment of patients and, by extension, conditions the quality of care and profitability of the Emergency Department. Interventions designed to divert populations to more appropriate care may be cautiously received by operations managers due to uncertainty about the impact an adopted intervention may have on the two values of congestion and profitability. System Dynamics (SD) modeling and simulation may be used to measure the sensitivity of these two, often-competing, values of congestion and profitability and, thus, provide an additional layer of information designed to inform strategic decision making.

  19. [Emergency department as final destination: perception and reception of the palliative patient" concept as well as approach toward improving interdisciplinary collaboration - a survey of emergency personnel of a Swiss emergency department].

    Science.gov (United States)

    Klenk, Laurence; Iucolano, Nicoletta M; Braun, Christian Tasso; Exadaktylos, Aristomenis K; Eychmüller, Steffen

    2015-01-02

    As the demand for palliative care (PC) in emergency wards continues to increase, emergency medicine is increasingly focusing on the care of extremely ill patients with incurable, chronic and/or advanced diseases. There is no consistent definition of the profile of PC or understanding of what PC involves. The mistake is often made of confusing PC with end-of-life or terminal care. The present study was intended to assess the situation at the Department of Emergency Medicine, Inselspital, Bern University Hospital (UNZ), which cares for about 32 400 patients annually. The plan was to find out how much staff members knew about PC and to survey their personal attitudes. The employees of the UNZ were surveyed with an online questionnaire by a special institution outside the hospital. This is based on an instrument [1] developed in a comparative study in an emergency ward in the USA and used for physicians. 60 of 154 staff members (physicians and nurses) completed the questionnaire, corresponding to a response rate of 39%. The definition of palliative care (n=60) was very mixed and could be classified into 6 areas. In response to questions about specific services, the staff members mentioned that their access to existing patient data should be facilitated. They also expressed the wish for a 24 h palliative consultation service and thought that, during normal working days, more time should be allotted to discussing issues related to palliative care. It has been confirmed that the definition of palliative care is not consistent. Within the UNZ, there is no clear procedure, but lack of time for detailed discussions with patients needing palliative care. Patient wishes or living wills with the DNR/DNI procedure do not contradict the personal ethics of most staff members. UNZ staff members would welcome the 24 h availability of a specialized PC team, as well as the development of guidelines and increased training in PC.

  20. Panel discussion: Nuclear cardiology

    International Nuclear Information System (INIS)

    Schwaiger, M.

    1991-01-01

    The panel discussion opened with a question concerning whether true quantification of myocardial sympathetic presynaptic function or receptor density can be obtained with currently available radiopharmaceuticals. What are the relative advantages of the two general approaches that have been proposed for quantification: (1) The assessment of tracer distribution volume in tissue following bolus injection and (2) quantification based on tracer displacement kinetics following administration of excess unlabeled tracer. It was pointed out that tracer kinetics for the delineation of presynaptic and postsynaptic binding sites by radiopharmaceuticals or radiolabeled receptor antagonists are rather complex, reflecting several physiologic processes that are difficult to separate. Several approaches were examined. The possibility of regional definition of receptor density by PET was questioned and it was noted that regions of interest can be applied to calculate regional receptor kinetics. However, due to the limited spatial resolution of PET, only average transmural values can be determined. The discussion then turned to the discrepancy between the known sparse parasympathetic innervation of the heart and the high density of muscarinic receptors observed with PET. Experiences with MIBG imaging were reported, including uptake in the transplanted heart and interaction of drugs with MIBG uptake

  1. European approach to nuclear and radiological emergency management and rehabilitation strategies (EURANOS)

    International Nuclear Information System (INIS)

    Raskob, W.

    2007-01-01

    The 5-year multi-national project EURANOS, funded by the European Commission and 23 European Member States, started in April 2004. Integrating 17 national emergency management organisations with 33 research institutes, it brings together best practice, knowledge and technology to enhance the preparedness for Europe's response to any radiation emergency and long-term contamination. Key objectives of the project are to collate information on the likely effectiveness and consequences of a wide range of countermeasures, to provide guidance to emergency management organisations and decision makers on the establishment of an appropriate response strategy and to further enhance advanced decision support systems, in particular, RODOS (Real-time On-Line DecisiOn Support), through feedback from their operational use. The research activities focused on emergency actions and countermeasures, the enhancement of decision support systems for operational application and the development of strategies for the sustainable rehabilitation of contaminated territories. The demonstration activities exercise the developed methods and tools in the actual operational environment. (orig.)

  2. Emerging Late Adolescent Friendship Networks and Big Five Personality Traits: A Social Network Approach

    NARCIS (Netherlands)

    Selfhout, M.; Burk, W.J.; Branje, S.J.T.; Denissen, J.J.A.; Aken, M.A.G. van; Meeus, W.H.J.

    2010-01-01

    The current study focuses on the emergence of friendship networks among just-acquainted individuals, investigating the effects of Big Five personality traits on friendship selection processes. Sociometric nominations and self-ratings on personality traits were gathered from 205 late adolescents

  3. Planning Emergency Shelters for Urban Disaster Resilience: An Integrated Location-Allocation Modeling Approach

    Directory of Open Access Journals (Sweden)

    Laijun Zhao

    2017-11-01

    Full Text Available In recent years, extreme natural hazards threaten cities more than ever due to contemporary society’s high vulnerability in cities. Hence, local governments need to implement risk mitigation and disaster operation management to enhance disaster resilience in cities. Transforming existing open spaces within cities into emergency shelters is an effective method of providing essential life support and an agent of recovery in the wake of disasters. Emergency shelters planning must identify suitable locations for shelters and reasonably allocate evacuees to those shelters. In this paper, we first consider both the buildings’ post-disaster condition and the human choice factor that affect evacuees’ decision, and propose a forecasting method to estimate the time-varying shelter demand. Then we formulate an integrated location-allocation model that is used sequentially: an emergency shelter location model to satisfy the time-varying shelter demand in a given urban area with a goal of minimizing the total setup cost of locating the shelters and an allocation model that allocates the evacuees to shelters with a goal of minimizing their total evacuation distance. We also develop an efficient algorithm to solve the model. Finally, we propose an emergency shelters planning based on a case study of Shanghai, China.

  4. Being a Modern Human: essentialist and hierarchical approaches to the emergence of 'modern human behaviour'

    Directory of Open Access Journals (Sweden)

    Terry Hopkinson

    2013-06-01

    Full Text Available The emergence of the modern human mind and modern human behaviour is a prominent issue in palaeolithic archaeology. The consensus has been that modernity, understood in terms of increased rates of innovation and the emergence of symbolism, is enabled by a heritable neurophysiology unique to Homo sapiens. This consensus is characterised as biological essentialist in that it understands modernity as genotypically specified and unique to Homo sapiens. 'Archaic' hominins such as the Neanderthals are understood to have lacked the modern neuroanatomical genotype and therefore to have been innately incapable of modern cognition and behaviour. The biological-essentialist programme, however, is facing a serious challenge as evidence for innovation and symbolism is found in the archaeological records of the Eurasian Middle Palaeolithic and the African Middle Stone Age. An alternative programme is emerging that understands modern human behaviour as an emergent property of social, demographic and ecological dynamics. It is argued that this programme is currently inadequate since it cannot explain the emergence of symbolically charged material culture and relies on inexorable long-term population growth. It is suggested here that the problem is better understood in terms of hierarchy theory, a body of ideas concerned with systems organised on multiple scales. Palaeolithic behaviour is reconceptualised as social practice emerging from a multi-scale knowledge system. It is shown that enhancements in the rate at which knowledgeable practices disseminate through social fields – the social transmission of knowledge - will have the effect of increasing the likelihood that novel practices will be incorporated into long-term structuring principles and thus become persistent practices. They will also effect a scalar convergence of domains of knowledgeability such that technical practices become incorporated into the construction of personhood as meaningful or

  5. Multiport Combined Endoscopic Approach to Nonembolized Juvenile Nasopharyngeal Angiofibroma with Parapharyngeal Extension: An Emerging Concept

    Directory of Open Access Journals (Sweden)

    Tiruchy Narayanan Janakiram

    2016-01-01

    Full Text Available Background. Surgical approaches to the parapharyngeal space (PPS are challenging by virtue of deep location and neurovascular content. Juvenile Nasopharyngeal Angiofibroma (JNA is a formidable hypervascular tumor that involves multiple compartments with increase in size. In tumors with extension to parapharyngeal space, the endonasal approach was observed to be inadequate. Combined Endoscopic Endonasal Approaches and Endoscopic Transoral Surgery (EEA-ETOS approach has provided a customized alternative of multicorridor approach to access JNA for its safe and efficient resection. Methods. The study demonstrates a case series of patients of JNA with prestyloid parapharyngeal space extension operated by endoscopic endonasal and endoscopic transoral approach for tumor excision. Results. The multiport EEA-ETOS approach was used to provide wide exposure to access JNA in parapharyngeal space. No major complications were observed. No conversion to external approach was required. Postoperative morbidity was low and postoperative scans showed no residual tumor. A one-year follow-up was maintained and there was no evidence of disease recurrence. Conclusion. Although preliminary, our experience demonstrates safety and efficacy of multiport approach in providing access to multiple compartments, facilitating total excision of JNA in selected cases.

  6. Blended Learning Model on Hands-On Approach for In-Service Secondary School Teachers: Combination of E-Learning and Face-to-Face Discussion

    Science.gov (United States)

    Ho, Vinh-Thang; Nakamori, Yoshiteru; Ho, Tu-Bao; Lim, Cher Ping

    2016-01-01

    The purpose of this study was to examine the effectiveness of a blended learning model on hands-on approach for in-service secondary school teachers using a quasi-experimental design. A 24-h teacher-training course using the blended learning model was administered to 117 teachers, while face-to-face instruction was given to 60 teachers. The…

  7. Westgate Shootings: An Emergency Department Approach to a Mass-casualty Incident.

    Science.gov (United States)

    Wachira, Benjamin W; Abdalla, Ramadhani O; Wallis, Lee A

    2014-10-01

    At approximately 12:30 pm on Saturday September 21, 2013, armed assailants attacked the upscale Westgate shopping mall in the Westlands area of Nairobi, Kenya. Using the seven key Major Incident Medical Management and Support (MIMMS) principles, command, safety, communication, assessment, triage, treatment, and transport, the Aga Khan University Hospital, Nairobi (AKUH,N) emergency department (ED) successfully coordinated the reception and care of all the casualties brought to the hospital. This report describes the AKUH,N ED response to the first civilian mass-casualty shooting incident in Kenya, with the hope of informing the development and implementation of mass-casualty emergency preparedness plans by other EDs and hospitals in Kenya, appropriate for the local health care system.

  8. In vitro protein expression: an emerging alternative to cell-based approaches.

    Science.gov (United States)

    He, Mingyue

    2011-04-30

    Protein expression remains a bottleneck in the production of proteins. Owing to several advantages, cell-free translation is emerging as an alternative to cell-based methods for the generation of proteins. Recent advances have led to many novel applications of cell-free systems in biotechnology, proteomics and fundamental biological research. This special issue of New Biotechnology describes recent advances in cell-free protein expression systems and their applications. Copyright © 2010 Elsevier B.V. All rights reserved.

  9. 'REACTS'. A pragmatic approach for providing medical care and physician education for radiation emergencies

    International Nuclear Information System (INIS)

    Lushbaugh, C.C.; Andrews, G.A.; Huebner, K.F.; Cloutier, R.J.; Beck, W.L.; Berger, J.D.

    1976-01-01

    Because serious radiation incidents have been rare, few medical personnel (notably only some in France, Russia, Belgium, Canada, Yugoslavia, Japan, Great Britain and the United States) have first-hand experience in radiation-accident management. The generation of physicians who participated in those accidents now needs to pass on the bits of knowledge that were gleaned from them. These case histories are difficult for the local, non-radiology physician to obtain when he is called upon to help formulate the medical-emergency response plan required everywhere for licensing power reactors. The Radiation Emergency Assistance Center and Training Site (REACTS) in Oak Ridge, Tennessee, supported by the US Energy Research and Development Administration, is designed to meet these medical and educational needs. REACTS, located in the Oak Ridge Hospital of the Methodist Church, is not involved in the hospital's daily community functions except insofar as REACTS is the radiation emergency arm of the area's major disaster plan. Its dual mission is training physicians, nurses, and paramedical emergency personnel in radiation-accident management, and treating irradiated and contaminated persons. Its training activities are carried out by the Special Training Division of Oak Ridge Associated Universities. Formal courses in radiation medicine and health physics and practical laboratory experience are now conducted twice a year for physicians. They will be expanded in the future to include training of paramedical personnel. Follow-up studies of radiation-accident survivors are carried out in REACTS to ensure the preservation of valuable human data and radiation-accident experiences. This unique facility and its staff are dedicated to meet the needs of the far-flung public and private medical domains in the United States for nuclear-production energy

  10. Alien plant invasions--incorporating emerging invaders in regional prioritization: a pragmatic approach for Southern Africa.

    Science.gov (United States)

    Mgidi, Theresa N; Le Maitre, David C; Schonegevel, Lucille; Nel, Jeanne L; Rouget, Mathieu; Richardson, David M

    2007-07-01

    Plant invasions are a serious threat to natural and semi-natural ecosystems worldwide. Most management-orientated research on invasions focuses on invaders that are already widespread and often have major impacts. This paper deals with "emerging" invaders-those alien species with the potential to become important problems without timely intervention. A climate matching procedure was developed to define areas of South Africa, Lesotho and Swaziland that could be invaded by 28 plant species that had previously been classified as emerging invaders. Information on the location of populations of these species in the study area was combined with information on their distributions (as native or alien) in parts of Australia and the United States of America. These two countries had the best available distribution data for this study. They also share many invasive alien plant species with South Africa. Climatic data obtained for weather stations near points of known occurrence in these countries were used to define the climatically suitable areas for each species in the study area. Almost 80% of the remaining natural environment in southern Africa was found to be vulnerable to invasion by at least one of these species, 50% by six or more and 24% by 16 or more species. The most vulnerable areas are the highveld grasslands and the eastern escarpment. The emerging invaders with the greatest potential range included Acacia podalyriifolia and Cortaderia selloana. The globally important invaders Ulex europaeus and Lythrum salicaria had a more limited invasion potential but could still become major invaders. There was no relationship between the extent of the climatically suitable areas for the different species and an expert ranking of their invasion potential, emphasising the uncertainties inherent in making expert assessments based on very little information. The methods used in this analysis establish a protocol for future modelling exercises to assess the invasion potential of

  11. Heterogeneity of growth in the west Balkans and emerging Europe: A dynamic panel data model approach

    Directory of Open Access Journals (Sweden)

    Josifidis Kosta

    2012-01-01

    Full Text Available This paper explores the heterogeneity of growth in the Western Balkan and Emerging European economies. For that purpose, growth determinants are estimated in the period 1997-2009 by dynamic panel data models. The chosen period provides a comparison for the model results with those estimated for the period up to 2007 in order to analyze changes caused by the global instability. According to the main findings of the paper, macroeconomic stabilization and structural reforms still matter in determining economic growth, but foreign direct investments and economic integrations seem to have the most important role in stimulating growth in the observed countries. Moreover, significant positive effects of foreign direct investments and economic integrations produce differences in growth paths between Emerging European and Western Balkan economies. Sharp decrease of foreign inflows in 2008 determined contractions of growth rates firstly in Emerging European economies with subsequent spill-over on the Western Balkan economies during 2009. Consequently, in the period of global instability, differences between two groups of economies become even more obvious.

  12. THE HYBRID APPROACH OF INFLATION TARGETING: WHAT OPPORTUNITIES FOR AN EMERGING ECONOMY LIKE TUNISIA?

    Directory of Open Access Journals (Sweden)

    Hella Guerchi Mehri

    2016-07-01

    Full Text Available After economic crises happening in many emerging countries, flexible exchange rates became a required theoretical condition helping to target inflation. Many countries stopped using exchange rate as an anchor for monetary policy and started using inflation targeting framework. In emerging countries, monetary authorities work to stabilize the exchange rate because of their “fear of floating”. They are against high volatility of interest rate allowing speculative attacks and causing free fluctuations of their national currency. To avoid uncontrolled market movements, they have to choose between active and public exchange rate management and tight inflation targeting. In the same vein, Central bank of Tunisia follows financial measures linked closely to inflation without focusing especially on monetary aggregates in order to study a possible transition to targeting inflation strategy. It uses a simple Taylor rule where interest rates adjustment are guided by the anticipated inflation deviation from its original target and also by the gap between observed and potential GDP.As an emerging economy with a high degree of financial vulnerability, and facing different shocks, Tunisia should adopt a hybrid rule of inflation targeting in an open economy. This hybrid rule explicitly takes into account the evolution of the exchange rate in the reaction function of the central bank.

  13. Metaphor and the 'Emergent Property' Problem: A Relevance-Theoretic Approach

    Directory of Open Access Journals (Sweden)

    Robyn Carston

    2008-08-01

    Full Text Available The interpretation of metaphorical utterances often results in the attribution of emergent properties; these are properties which are neither standardly associated with the individual constituents of the utterance in isolation nor derivable by standard rules of semantic composition. For example, an utterance of ‘Robert is a bulldozer’ may be understood as attributing to Robert such properties as single-mindedness, insistence on having things done in his way, and insensitivity to the opinions/feelings of others, although none of these is included in the encyclopaedic information associated with bulldozers (earth-clearing machines. An adequate pragmatic account of metaphor interpretation must provide an explanation of the processes through which emergent properties are derived. In this paper, we attempt to develop an explicit account of the derivation process couched within the framework of relevance theory. The key features of our account are: (a metaphorical language use is taken to lie on a continuum with other cases of loose use, including hyperbole; (b metaphor interpretation is a wholly inferential process, which does not require associative mappings from one domain (e.g. machines to another (e.g. human beings; (c the derivation of emergent properties involves no special interpretive mechanisms not required for the interpretation of ordinary, literal utterances.

  14. Attending to scalar ethical issues in emerging approaches to environmental health research and practice.

    Science.gov (United States)

    Buse, Chris G; Smith, Maxwell; Silva, Diego S

    2018-06-04

    Accelerated changes to the planet have created novel spaces to re-imagine the boundaries and foci of environmental health research. Climate change, mass species extinction, ocean acidification, biogeochemical disturbance, and other emergent environmental issues have precipitated new population health perspectives, including, but not limited to, one health, ecohealth, and planetary health. These perspectives, while nuanced, all attempt to reconcile broad global challenges with localized health impacts by attending to the reciprocal relationships between the health of ecosystems, animals, and humans. While such innovation is to be encouraged, we argue that a more comprehensive engagement with the ethics of these emerging fields of inquiry will add value in terms of the significance and impact of associated interventions. In this contribution, we highlight how the concept of spatial and temporal scale can be usefully deployed to shed light on a variety of ethical issues common to emerging environmental health perspectives, and that the potential of scalar analysis implicit to van Potter's conceptualization of bioethics has yet to be fully appreciated. Specifically, we identify how scale interacts with key ethical issues that require consideration and clarification by one health, ecohealth, and planetary health researchers and practitioners to enhance the effectiveness of research and practice, including justice and governance.

  15. The Usage of Authority in Management Process and Evaluation of Emerged Problems: A Critical Approach

    Directory of Open Access Journals (Sweden)

    Salih ARSLAN

    2018-01-01

    Full Text Available This study aims to discuss the role, effect and the problems of ‘authority’ in the management process from a critical perspective. Firstly, the concept of authority is evaluated as a term in social science, then the role and effect of authority in management process is emphasized. The concept of authority is discussed not only in terms of its practical issues in management discipline but also the psychological, political and philosophical aspects of the term are included in discussion. Therefore, it is underlined that the usage of authority causes not only managerial problems but also some humane issues. So, the study professes that a moral authority is required besides other types of authority in management process. In this context, the study aims to test the accordance between theory and practice by comparing the results of the survey, which is implemented on public officers about their perception of authority, with the theoretical discussions.

  16. Exploring the relationship between child physical abuse and adult dating violence using a causal inference approach in an emerging adult population in South Korea.

    Science.gov (United States)

    Jennings, Wesley G; Park, MiRang; Richards, Tara N; Tomsich, Elizabeth; Gover, Angela; Powers, Ráchael A

    2014-12-01

    Child maltreatment is one of the most commonly examined risk factors for violence in dating relationships. Often referred to as the intergenerational transmission of violence or cycle of violence, a fair amount of research suggests that experiencing abuse during childhood significantly increases the likelihood of involvement in violent relationships later, but these conclusions are primarily based on correlational research designs. Furthermore, the majority of research linking childhood maltreatment and dating violence has focused on samples of young people from the United States. Considering these limitations, the current study uses a rigorous, propensity score matching approach to estimate the causal effect of experiencing child physical abuse on adult dating violence among a large sample of South Korean emerging adults. Results indicate that the link between child physical abuse and adult dating violence is spurious rather than causal. Study limitations and implications are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Empowerment: a conceptual discussion.

    Science.gov (United States)

    Tengland, Per-Anders

    2008-06-01

    The concept of 'empowerment' is used frequently in a number of professional areas, from psychotherapy to social work. But even if the same term is used, it is not always clear if the concept denotes the same goals or the same practice in these various fields. The purpose of this paper is to clarify the discussion and to find a plausible and useful definition of the concept that is suitable for work in various professions. Several suggestions are discussed in the paper, for example control over life or health, autonomy, ability, self-efficacy, self-esteem, and freedom, and it is concluded that there are two plausible complementary uses, one as a goal and one as a process or approach. Empowerment as a goal is to have control over the determinants of one's quality of life, and empowerment as a process is to create a professional relation where the client or community takes control over the change process, determining both the goals of this process and the means to use.

  18. Geophysical approach for emergency management of landslide: the experience of Basilicata Civil Protection (southern Italy)

    Science.gov (United States)

    Colangelo, G.; Lapenna, V.; Perrone, A.; Loperte, A.

    2009-04-01

    The Basilicata region (Southern Italy), being dissected by numerous and often significant rivers and characterized by the outcrop of terrains with bad mechanical properties, is one of the more exposed regions of the southern Apennine chain to hydrogeologic hazard and shows a complete panorama of mass movements. During the last years, after strong precipitations, this region has been affected by the reactivation of many quiescent landslides that involved buildings and infrastructures constructed on the slopes. The risk for people and assets needed the intervention of the end users involved in the risk management and, in particular, the inspection of Regional Department of Infrastructure and Civil Protection (RDICP). In many involved areas and for many families evacuation decrees have been issued in order to allow the damage valuation. An important contribution has been provided by the geophysical data and, in particular, by the 2D electrical resistivity tomographies (ERTs) that have been carried out in the areas some days after the event by IMAA-CNR. In this work we present the results regarding the application of unconventional geoelectrical techniques used for the emergency management of landslide in Basilicata Region (southern Italy). The information obtained by the application of indirect surveys appeared to be particularly useful for the end users involved in the risks management. In particular, taking into account the cycle of landslides emergency, the obtained data could give a valid contribution during the post-event phase which mainly regards the damage valuation. Indeed, only a corrected assessment of the damage and a precise geometric reconstruction of the landslide body, can direct the intervention actions of the end users. The results represent a valid cognitive support to choose the most appropriate technical solution for strengthening of the slopes and an example of best practice for the cooperation between the research activity (IMAA-CNR) and field

  19. Assigning Oxidation States to Organic Compounds via Predictions from X-ray Photoelectron Spectroscopy: A Discussion of Approaches and Recommended Improvements

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Vipul; Ganegoda, Hasitha; Engelhard, Mark H.; Terry, Jeff H.; Linford, Matthew R.

    2014-02-11

    The traditional assignment of oxidation numbers to organic molecules is problematic. Accordingly, in 1999, Calzaferri proposed a simple and elegant solution that is based on the similar electronegativities of carbon and hydrogen: hydrogen would be assigned an oxidation number of zero when bonded to carbon. Here we show that X-ray photoelectron spectroscopy (XPS), a core electron spectroscopy that is sensitive to oxidation states of elements, confirms his suggestion. In particular, in this work we: (i) list the typical rules for assigning oxidation numbers, (ii) discuss the traditional assignment of oxidation numbers to organic molecules, (iii) review Calzaferri’s solution, (iv) introduce X-ray photoelectron spectroscopy (XPS), (v) show the consistency of Calzaferri’s suggestion with XPS results, (vi) provide supporting examples from the literature, (vii) provide examples from our own research, and (viii) further confirm the Calzaferri suggestion/photoelectron spectroscopy results by discussing two organic well-known reactions. We end by reechoing Calzaferri’s suggestion that the traditional rules for assigning oxidation numbers to organic molecules be modified.

  20. [The liaison psychiatry approach of the psychiatric crisis, urgencies and emergencies].

    Science.gov (United States)

    Tenconi, Juan Cristóbal

    2003-01-01

    The purpose of this paper is to differentiate crisis, emergencies and urgencies within the frame of Liaison psychiatry. It begins with the definition of each one of the terms, later the emphasis is put in the clinical characteristics of each one of these situations. These characteristics are determined by the patient and the therapeutic team. At last therapeutic guidelines are stated, which allow more precision in the intervention, in function of the direct involvement of these situations in the development and evolution of the patients.

  1. Testing Weak Form Market Efficiency for Emerging Economies: A Nonlinear Approach

    OpenAIRE

    Omay, Nazli C.; Karadagli, Ece C.

    2010-01-01

    In this paper, we address weak form stock market efficiency of Emerging Economies, by testing whether the price series of these markets contain unit root. Nonlinear behavior of stock prices is well documented in the literature, and thus linear unit root tests may not be appropriate in this case. For this purpose, we employ the nonlinear unit root test procedure recently developed by Kapetanios et al. (2003) and nonlinear panel unit root test Ucar and Omay (2009) that has a better power than s...

  2. A Simulation-based Approach to Measuring Team Situational Awareness in Emergency Medicine: A Multicenter, Observational Study.

    Science.gov (United States)

    Rosenman, Elizabeth D; Dixon, Aurora J; Webb, Jessica M; Brolliar, Sarah; Golden, Simon J; Jones, Kerin A; Shah, Sachita; Grand, James A; Kozlowski, Steve W J; Chao, Georgia T; Fernandez, Rosemarie

    2018-02-01

    Team situational awareness (TSA) is critical for effective teamwork and supports dynamic decision making in unpredictable, time-pressured situations. Simulation provides a platform for developing and assessing TSA, but these efforts are limited by suboptimal measurement approaches. The objective of this study was to develop and evaluate a novel approach to TSA measurement in interprofessional emergency medicine (EM) teams. We performed a multicenter, prospective, simulation-based observational study to evaluate an approach to TSA measurement. Interprofessional emergency medical teams, consisting of EM resident physicians, nurses, and medical students, were recruited from the University of Washington (Seattle, WA) and Wayne State University (Detroit, MI). Each team completed a simulated emergency resuscitation scenario. Immediately following the simulation, team members completed a TSA measure, a team perception of shared understanding measure, and a team leader effectiveness measure. Subject matter expert reviews and pilot testing of the TSA measure provided evidence of content and response process validity. Simulations were recorded and independently coded for team performance using a previously validated measure. The relationships between the TSA measure and other variables (team clinical performance, team perception of shared understanding, team leader effectiveness, and team experience) were explored. The TSA agreement metric was indexed by averaging the pairwise agreement for each dyad on a team and then averaging across dyads to yield agreement at the team level. For the team perception of shared understanding and team leadership effectiveness measures, individual team member scores were aggregated within a team to create a single team score. We computed descriptive statistics for all outcomes. We calculated Pearson's product-moment correlations to determine bivariate correlations between outcome variables with two-tailed significance testing (p teams (n = 41

  3. Minimizing patient waiting time in emergency department of public hospital using simulation optimization approach

    Science.gov (United States)

    Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

    2017-04-01

    Emergency department (ED) is the main unit of a hospital that provides emergency treatment. Operating 24 hours a day with limited number of resources invites more problems to the current chaotic situation in some hospitals in Malaysia. Delays in getting treatments that caused patients to wait for a long period of time are among the frequent complaints against government hospitals. Therefore, the ED management needs a model that can be used to examine and understand resource capacity which can assist the hospital managers to reduce patients waiting time. Simulation model was developed based on 24 hours data collection. The model developed using Arena simulation replicates the actual ED's operations of a public hospital in Selangor, Malaysia. The OptQuest optimization in Arena is used to find the possible combinations of a number of resources that can minimize patients waiting time while increasing the number of patients served. The simulation model was modified for improvement based on results from OptQuest. The improvement model significantly improves ED's efficiency with an average of 32% reduction in average patients waiting times and 25% increase in the total number of patients served.

  4. Methodological Proposal for Optimal Location of Emergency Operation Centers through Multi-Criteria Approach

    Directory of Open Access Journals (Sweden)

    Umberto Di Matteo

    2016-01-01

    Full Text Available Territorial vulnerability and risk analysis play a fundamental role in urban planning and emergency management. Requirements analysis of such aspects are possible to define more and more effective risk mitigation strategies providing efficient response plans to events. Many mitigation strategies as well as many response plans have in common the purpose of minimizing response time in order to decrease the level of vulnerability of the concerning area. The response time to a perturbing event is in fact an essential parameter to define the hazard of the considered site and literature is unanimous in considering it. In this context, the article proposes a methodology for the optimization of the location on the territory of emergency operation centers (EOCs, reducing response times and mitigating in this way the vulnerability of the area. The proposed methodology is based on a multi-criteria decision making (MCDM hybrid type AHP (Analytic Hierarchy Process-Electre. This method has been applied in the territory of Bressanone and Vipiteno (Bolzano-Italy, simulating the need to build a new barrack of Fire Department. A campaign of interviews with operators and industry experts and the collection of spatial data from the portals of the concerned authorities has been carried out in order to get the number of necessary data for the implementation of the proposed methodology.

  5. City housing atmospheric pollutant impact on emergency visit for asthma: A classification and regression tree approach.

    Science.gov (United States)

    Mazenq, Julie; Dubus, Jean-Christophe; Gaudart, Jean; Charpin, Denis; Viudes, Gilles; Noel, Guilhem

    2017-11-01

    Particulate matter, nitrogen dioxide (NO 2 ) and ozone are recognized as the three pollutants that most significantly affect human health. Asthma is a multifactorial disease. However, the place of residence has rarely been investigated. We compared the impact of air pollution, measured near patients' homes, on emergency department (ED) visits for asthma or trauma (controls) within the Provence-Alpes-Côte-d'Azur region. Variables were selected using classification and regression trees on asthmatic and control population, 3-99 years, visiting ED from January 1 to December 31, 2013. Then in a nested case control study, randomization was based on the day of ED visit and on defined age groups. Pollution, meteorological, pollens and viral data measured that day were linked to the patient's ZIP code. A total of 794,884 visits were reported including 6250 for asthma and 278,192 for trauma. Factors associated with an excess risk of emergency visit for asthma included short-term exposure to NO 2 , female gender, high viral load and a combination of low temperature and high humidity. Short-term exposures to high NO 2 concentrations, as assessed close to the homes of the patients, were significantly associated with asthma-related ED visits in children and adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Backscattered electron imaging at low emerging angles: A physical approach to contrast in LVSEM

    Energy Technology Data Exchange (ETDEWEB)

    Cazaux, J., E-mail: jacques.cazaux@univ-reims.fr [LISM, EA 4695 Faculty of Sciences, BP 1039, 51687 Reims Cedex 2 (France); Kuwano, N. [Malaysia–Japan International Institute of Technology, Universiti Teknologi Malaysia, Jalan Semarak, 54100 Kuala Lumpur (Malaysia); Sato, K. [Steel Research Laboratory, JFE Steel Corporation, 1 Kawasaki-cho, Chuo-ku, Chiba 260-0835 (Japan)

    2013-12-15

    Due to the influence of refraction effects on the escape probability of the Back-Scattered Electrons (BSE), an expression of the fraction of these BSE is given as a function of the beam energy, E°, and emission angle (with respect to the normal) α. It has been shown that these effects are very sensitive to a local change of the work function in particular for low emerging angles. This sensitivity suggests a new type of contrast in Low Voltage Scanning Electron Microscopy (LVSEM for E°<2 keV): the work function contrast. Involving the change of ϕ with crystalline orientation, this possibility is supported by a new interpretation of a few published images. Some other correlated contrasts are also suggested. These are topographical contrasts or contrasts due to subsurface particles and cracks. Practical considerations of the detection system and its optimization are indicated. - Highlights: • Refraction effects experienced by Back-Scattered Electrons at sample/vacuum interfaces are evaluated as a function of energy and angles. • Sensitive to local work function changes with crystalline orientation these effects concern mainly keV-electrons at low emerging angles. • A new type of contrast in SEM is thus deduced and illustrated. • Some other correlated contrasts, topographical contrasts or contrasts due to subsurface particles and cracks are also suggested.

  7. Integrating emerging earth science technologies into disaster risk management: an enterprise architecture approach

    Science.gov (United States)

    Evans, J. D.; Hao, W.; Chettri, S. R.

    2014-12-01

    Disaster risk management has grown to rely on earth observations, multi-source data analysis, numerical modeling, and interagency information sharing. The practice and outcomes of disaster risk management will likely undergo further change as several emerging earth science technologies come of age: mobile devices; location-based services; ubiquitous sensors; drones; small satellites; satellite direct readout; Big Data analytics; cloud computing; Web services for predictive modeling, semantic reconciliation, and collaboration; and many others. Integrating these new technologies well requires developing and adapting them to meet current needs; but also rethinking current practice to draw on new capabilities to reach additional objectives. This requires a holistic view of the disaster risk management enterprise and of the analytical or operational capabilities afforded by these technologies. One helpful tool for this assessment, the GEOSS Architecture for the Use of Remote Sensing Products in Disaster Management and Risk Assessment (Evans & Moe, 2013), considers all phases of the disaster risk management lifecycle for a comprehensive set of natural hazard types, and outlines common clusters of activities and their use of information and computation resources. We are using these architectural views, together with insights from current practice, to highlight effective, interrelated roles for emerging earth science technologies in disaster risk management. These roles may be helpful in creating roadmaps for research and development investment at national and international levels.

  8. How to improve communication for the safe use of medicines?: Discussions on social marketing and patient-tailored approaches at the annual meetings of the WHO Programme for International Drug Monitoring.

    Science.gov (United States)

    Bahri, Priya; Harrison-Woolrych, Mira

    2012-12-01

    Over the past decade, the annual meetings of national centres participating in the WHO Programme for International Drug Monitoring have increasingly included discussions on how to improve communication between national pharmacovigilance centres, patients, healthcare professionals, policy makers and the general public, with the aim of promoting the safe use of medicines. At the most recent meetings, working groups were dedicated to discuss possible applications and implementation of social marketing and patient-tailored approaches. This article provides the history and a summary of the recent discussions and recommendations to support progress in this respect at national and global level. Recommendations are made to investigate and pilot these approaches in small-scale projects at national pharmacovigilance centres. Applying elements from the social marketing and patient-tailored approaches to support behaviours of safe medicines use in patients and healthcare professionals should give the pharmacovigilance community new tools to achieve their goal to minimize risks with medicines and improve patient safety.

  9. Resilience in Emergency Medical Responders: A Pilot Study of a Reflective Journal Intervention Using a Mixed Methods Approach

    Directory of Open Access Journals (Sweden)

    Gail Rowntree

    2015-07-01

    Full Text Available Emergency Medical Responders (EMRs work in potentially traumatic situations as part of their job. To enable them to do so requires a degree of resilience (i.e., the ability to bounce back from exposure to disruptive events. Taking a mixed-methods approach, the proposed study addresses the question of whether a reflective journal intervention will impact EMRs’ resilience to support positive outcomes. Data will be collected in four EU countries. The Connor-Davidson Resilience Scale will be administered for pre- and post-intervention assessment, while qualitative data will be collected for further analysis.

  10. #fitspo on Instagram: A mixed-methods approach using Netlytic and photo analysis, uncovering the online discussion and author/image characteristics.

    Science.gov (United States)

    Santarossa, Sara; Coyne, Paige; Lisinski, Carly; Woodruff, Sarah J

    2016-11-01

    The #fitspo 'tag' is a recent trend on Instagram, which is used on posts to motivate others towards a healthy lifestyle through exercise/eating habits. This study used a mixed-methods approach consisting of text and network analysis via the Netlytic program ( N = 10,000 #fitspo posts), and content analysis of #fitspo images ( N = 122) was used to examine author and image characteristics. Results suggest that #fitspo posts may motivate through appearance-mediated themes, as the largest content categories (based on the associated text) were 'feeling good' and 'appearance'. Furthermore, #fitspo posts may create peer influence/support as personal (opposed to non-personal) accounts were associated with higher popularity of images (i.e. number of likes/followers). Finally, most images contained posed individuals with some degree of objectification.

  11. A combined periodontal - prosthetic treatment approach to manage unusual gingival visibility in resting lip position and inversely inclined upper anterior teeth: a case report with discussion.

    Science.gov (United States)

    Biniraj, K R; Janardhanan, Mahija; Sunil, M M; Sagir, Mohammed; Hariprasad, A; Paul, Tony P; Emmatty, Rishi

    2015-03-01

    Excessive gingival visibility during smile is a common esthetic complaint in dentistry, but excessive gingival visibility in resting lip position is relatively uncommon condition. Several exclusive radical to conservative surgical treatment or its combination with orthodontic therapy to treat this condition are within the reach of every patient nowadays. A case report of an excessive gingival visibility because of altered passive eruption along with inversely inclined maxillary anterior teeth is presented here. A relatively simple treatment approach combining periodontal and restorative therapy is used here to achieve the desirable aesthetic results. The gingival exposure resulting from altered passive eruption was completely managed by a gingivectomy, but the inclined appearance of teeth was still an aesthetic complaint. After complete healing of gingivectomy surgery, appropriately designed crowns were given to rectify the inversely inclined appearance. A complete rehabilitation of patient's smile could be achieved, the case was followed up for 3 years and the condition was found satisfactory.

  12. A Combined Periodontal – Prosthetic Treatment Approach to Manage Unusual Gingival Visibility in Resting Lip Position and Inversely Inclined Upper Anterior Teeth: A Case Report with Discussion

    Science.gov (United States)

    Biniraj, K R; Janardhanan, Mahija; Sunil, M M; Sagir, Mohammed; Hariprasad, A; Paul, Tony P; Emmatty, Rishi

    2015-01-01

    Excessive gingival visibility during smile is a common esthetic complaint in dentistry, but excessive gingival visibility in resting lip position is relatively uncommon condition. Several exclusive radical to conservative surgical treatment or its combination with orthodontic therapy to treat this condition are within the reach of every patient nowadays. A case report of an excessive gingival visibility because of altered passive eruption along with inversely inclined maxillary anterior teeth is presented here. A relatively simple treatment approach combining periodontal and restorative therapy is used here to achieve the desirable aesthetic results. The gingival exposure resulting from altered passive eruption was completely managed by a gingivectomy, but the inclined appearance of teeth was still an aesthetic complaint. After complete healing of gingivectomy surgery, appropriately designed crowns were given to rectify the inversely inclined appearance. A complete rehabilitation of patient’s smile could be achieved, the case was followed up for 3 years and the condition was found satisfactory. PMID:25878482

  13. Identification of Emergency Department Visits in Medicare Administrative Claims: Approaches and Implications.

    Science.gov (United States)

    Venkatesh, Arjun K; Mei, Hao; Kocher, Keith E; Granovsky, Michael; Obermeyer, Ziad; Spatz, Erica S; Rothenberg, Craig; Krumholz, Harlan M; Lin, Zhenqui

    2017-04-01

    Administrative claims data sets are often used for emergency care research and policy investigations of healthcare resource utilization, acute care practices, and evaluation of quality improvement interventions. Despite the high profile of emergency department (ED) visits in analyses using administrative claims, little work has evaluated the degree to which existing definitions based on claims data accurately captures conventionally defined hospital-based ED services. We sought to construct an operational definition for ED visitation using a comprehensive Medicare data set and to compare this definition to existing operational definitions used by researchers and policymakers. We examined four operational definitions of an ED visit commonly used by researchers and policymakers using a 20% sample of the 2012 Medicare Chronic Condition Warehouse (CCW) data set. The CCW data set included all Part A (hospital) and Part B (hospital outpatient, physician) claims for a nationally representative sample of continuously enrolled Medicare fee-for-services beneficiaries. Three definitions were based on published research or existing quality metrics including: 1) provider claims-based definition, 2) facility claims-based definition, and 3) CMS Research Data Assistance Center (ResDAC) definition. In addition, we developed a fourth operational definition (Yale definition) that sought to incorporate additional coding rules for identifying ED visits. We report levels of agreement and disagreement among the four definitions. Of 10,717,786 beneficiaries included in the sample data set, 22% had evidence of ED use during the study year under any of the ED visit definitions. The definition using provider claims identified a total of 4,199,148 ED visits, the facility definition 4,795,057 visits, the ResDAC definition 5,278,980 ED visits, and the Yale definition 5,192,235 ED visits. The Yale definition identified a statistically different (p < 0.05) collection of ED visits than all other

  14. Emerging systems biology approaches in nanotoxicology: Towards a mechanism-based understanding of nanomaterial hazard and risk

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Pedro M.; Fadeel, Bengt, E-mail: Bengt.Fadeel@ki.se

    2016-05-15

    Engineered nanomaterials are being developed for a variety of technological applications. However, the increasing use of nanomaterials in society has led to concerns about their potential adverse effects on human health and the environment. During the first decade of nanotoxicological research, the realization has emerged that effective risk assessment of the multitudes of new nanomaterials would benefit from a comprehensive understanding of their toxicological mechanisms, which is difficult to achieve with traditional, low-throughput, single end-point oriented approaches. Therefore, systems biology approaches are being progressively applied within the nano(eco)toxicological sciences. This novel paradigm implies that the study of biological systems should be integrative resulting in quantitative and predictive models of nanomaterial behaviour in a biological system. To this end, global ‘omics’ approaches with which to assess changes in genes, proteins, metabolites, etc. are deployed allowing for computational modelling of the biological effects of nanomaterials. Here, we highlight omics and systems biology studies in nanotoxicology, aiming towards the implementation of a systems nanotoxicology and mechanism-based risk assessment of nanomaterials. - Highlights: • Systems nanotoxicology is a multi-disciplinary approach to quantitative modelling. • Transcriptomics, proteomics and metabolomics remain the most common methods. • Global “omics” techniques should be coupled to computational modelling approaches. • The discovery of nano-specific toxicity pathways and biomarkers is a prioritized goal. • Overall, experimental nanosafety research must endeavour reproducibility and relevance.

  15. Emerging systems biology approaches in nanotoxicology: Towards a mechanism-based understanding of nanomaterial hazard and risk

    International Nuclear Information System (INIS)

    Costa, Pedro M.; Fadeel, Bengt

    2016-01-01

    Engineered nanomaterials are being developed for a variety of technological applications. However, the increasing use of nanomaterials in society has led to concerns about their potential adverse effects on human health and the environment. During the first decade of nanotoxicological research, the realization has emerged that effective risk assessment of the multitudes of new nanomaterials would benefit from a comprehensive understanding of their toxicological mechanisms, which is difficult to achieve with traditional, low-throughput, single end-point oriented approaches. Therefore, systems biology approaches are being progressively applied within the nano(eco)toxicological sciences. This novel paradigm implies that the study of biological systems should be integrative resulting in quantitative and predictive models of nanomaterial behaviour in a biological system. To this end, global ‘omics’ approaches with which to assess changes in genes, proteins, metabolites, etc. are deployed allowing for computational modelling of the biological effects of nanomaterials. Here, we highlight omics and systems biology studies in nanotoxicology, aiming towards the implementation of a systems nanotoxicology and mechanism-based risk assessment of nanomaterials. - Highlights: • Systems nanotoxicology is a multi-disciplinary approach to quantitative modelling. • Transcriptomics, proteomics and metabolomics remain the most common methods. • Global “omics” techniques should be coupled to computational modelling approaches. • The discovery of nano-specific toxicity pathways and biomarkers is a prioritized goal. • Overall, experimental nanosafety research must endeavour reproducibility and relevance.

  16. Aorta Balloon Occlusion in Trauma: Three Cases Demonstrating Multidisciplinary Approach Already on Patient’s Arrival to the Emergency Room

    International Nuclear Information System (INIS)

    Hörer, Tal M.; Hebron, Dan; Swaid, Forat; Korin, Alexander; Galili, Offer; Alfici, Ricardo; Kessel, Boris

    2016-01-01

    PurposeTo describe the usage of aortic balloon occlusion (ABO), based on a multidisciplinary approach in severe trauma patients, emphasizing the role of the interventional radiologist in primary trauma care.MethodsWe briefly discuss the relevant literature, the technical aspects of ABO in trauma, and a multidisciplinary approach to the bleeding trauma patient. We describe three severely injured trauma patients for whom ABO was part of initial trauma management.ResultsThree severely injured multi-trauma patients were treated by ABO as a bridge to surgery and embolization. The procedures were performed by an interventional radiologist in the early stages of trauma management.ConclusionsThe interventional radiologist and the multidisciplinary team approach can be activated already on severe trauma patient arrival. ABO usage and other endovascular methods are becoming more widely spread, and can be used early in trauma management, without delay, thus justifying the early activation of this multidisciplinary approach

  17. Aorta Balloon Occlusion in Trauma: Three Cases Demonstrating Multidisciplinary Approach Already on Patient’s Arrival to the Emergency Room

    Energy Technology Data Exchange (ETDEWEB)

    Hörer, Tal M., E-mail: tal.horer@orebroll.se [Örebro University, Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital (Sweden); Hebron, Dan [Hillel Yaffe Medical Center, Department of Radiology (Israel); Swaid, Forat [Bnai-Zion Medical Center, Department of General Surgery (Israel); Korin, Alexander [Hillel Yaffe Medical Center, Trauma Unit (Israel); Galili, Offer [Hillel Yaffe Medical Center, Department of Vascular Surgery (Israel); Alfici, Ricardo [Hillel Yaffe Medical Center, Surgical Division (Israel); Kessel, Boris [Hillel Yaffe Medical Center, Trauma Unit (Israel)

    2016-02-15

    PurposeTo describe the usage of aortic balloon occlusion (ABO), based on a multidisciplinary approach in severe trauma patients, emphasizing the role of the interventional radiologist in primary trauma care.MethodsWe briefly discuss the relevant literature, the technical aspects of ABO in trauma, and a multidisciplinary approach to the bleeding trauma patient. We describe three severely injured trauma patients for whom ABO was part of initial trauma management.ResultsThree severely injured multi-trauma patients were treated by ABO as a bridge to surgery and embolization. The procedures were performed by an interventional radiologist in the early stages of trauma management.ConclusionsThe interventional radiologist and the multidisciplinary team approach can be activated already on severe trauma patient arrival. ABO usage and other endovascular methods are becoming more widely spread, and can be used early in trauma management, without delay, thus justifying the early activation of this multidisciplinary approach.

  18. Computational Paradigm to Elucidate the Effects of Arts-Based Approaches and Interventions: Individual and Collective Emerging Behaviors in Artwork Construction.

    Directory of Open Access Journals (Sweden)

    Billie Sandak

    Full Text Available Art therapy, as well as other arts-based therapies and interventions, is used to reduce pain, stress, depression, breathlessness and other symptoms in a wide variety of serious and chronic diseases, such as cancer, Alzheimer and schizophrenia. Arts-based approaches are also known to contribute to one's well-being and quality of life. However, much research is required, since the mechanisms by which these non-pharmacological treatments exert their therapeutic and psychosocial effects are not adequately understood. A typical clinical setting utilizing the arts consists of the creation work itself, such as the artwork, as well as the therapist and the patient, all of which constitute a rich and dynamic environment of occurrences. The underlying complex, simultaneous and interwoven processes of this setting are often considered intractable to human observers, and as a consequence are usually interpreted subjectively and described verbally, which affect their subsequent analyses and understanding. We introduce a computational research method for elucidating and analyzing emergent expressive and social behaviors, aiming to understand how arts-based approaches operate. Our methodology, which centers on the visual language of Statecharts and tools for its execution, enables rigorous qualitative and quantitative tracking, analysis and documentation of the underlying creation and interaction processes. Also, it enables one to carry out exploratory, hypotheses-generating and knowledge discovery investigations, which are empirical-based. Furthermore, we illustrate our method's use in a proof-of-principle study, applying it to a real-world artwork investigation with human participants. We explore individual and collective emergent behaviors impacted by diverse drawing tasks, yielding significant gender and age hypotheses, which may account for variation factors in response to art use. We also discuss how to gear our research method to systematic and

  19. Holistic Experimentation for Emergence: A Creative Approach to Postgraduate Entrepreneurship Education and Training

    Science.gov (United States)

    Mitra, Jay

    2017-01-01

    This article explores the development of a comprehensive and systemic approach to entrepreneurship education at a research-intensive university in the United Kingdom. The exploration is based on two key conceptual challenges: (a) taking entrepreneurship to mean something more than new business creation and (b) differentiating between…

  20. The emergence of psychopathy: implications for the neuropsychological approach to developmental disorders.

    Science.gov (United States)

    Blair, R J R

    2006-09-01

    In this paper, I am going to examine the disorder of psychopathy and consider how genetic anomalies could give rise to the relatively specific neuro-cognitive impairments seen in individuals with this disorder. I will argue that genetic anomalies in psychopathy reduce the salience of punishment information (perhaps as a function of noradrenergic disturbance). I will argue that the ability of the amygdala to form the stimulus-punishment associations necessary for successful socialization is disrupted and that because of this, individuals with psychopathy do not learn to avoid actions that will harm others. It is noted that this model follows the neuropsychological approach to the study of developmental disorders, an approach that has been recently criticized. I will argue that these criticisms are less applicable to psychopathy. Indeed, animal work on the development of the neural systems necessary for emotion, does not support a constructivist approach with respect to affect. Importantly, such work indicates that while environmental effects can alter the responsiveness of the basic neural architecture mediating emotion, environmental effects do not construct this architecture. However, caveats to the neuropsychological approach with reference to this disorder are noted.

  1. The Emergence of the Skills Approach in Industry and Its Consequences for the Training of Engineers

    Science.gov (United States)

    Pascail, Laurent

    2006-01-01

    It is striking to notice that the notion of skill is not only used in industry but also in higher education in most major industrialized countries. If a significant number of companies have taken a skills approach, one notices that this term is also used in higher education to determine teaching programmes according to a simple idea: higher…

  2. Emulating natural disturbance regimes: an emerging approach for sustainable forest management

    Science.gov (United States)

    M. North; W Keeton

    2008-01-01

    Sustainable forest management integrates ecological, social, and economic objectives. To achieve the former, researchers and practitioners are modifying silvicultural practices based on concepts from successional and landscape ecology to provide a broader array of ecosystem functions than is associated with conventional approaches. One...

  3. Temperamental, Parental, and Contextual Contributors to Early-Emerging Internalizing Problems: A New Integrative Analysis Approach

    Science.gov (United States)

    Mills, Rosemary S. L.; Hastings, Paul D.; Helm, Jonathan; Serbin, Lisa A.; Etezadi, Jamshid; Stack, Dale M.; Schwartzman, Alex E.; Li, Hai Hong

    2012-01-01

    This study evaluated a comprehensive model of factors associated with internalizing problems (IP) in early childhood, hypothesizing direct, mediated, and moderated pathways linking child temperamental inhibition, maternal overcontrol and rejection, and contextual stressors to IP. In a novel approach, three samples were integrated to form a large…

  4. Emerging late adolescent friendship networks and Big Five personality traits: a social network approach.

    Science.gov (United States)

    Selfhout, Maarten; Burk, William; Branje, Susan; Denissen, Jaap; van Aken, Marcel; Meeus, Wim

    2010-04-01

    The current study focuses on the emergence of friendship networks among just-acquainted individuals, investigating the effects of Big Five personality traits on friendship selection processes. Sociometric nominations and self-ratings on personality traits were gathered from 205 late adolescents (mean age=19 years) at 5 time points during the first year of university. SIENA, a novel multilevel statistical procedure for social network analysis, was used to examine effects of Big Five traits on friendship selection. Results indicated that friendship networks between just-acquainted individuals became increasingly more cohesive within the first 3 months and then stabilized. Whereas individuals high on Extraversion tended to select more friends than those low on this trait, individuals high on Agreeableness tended to be selected more as friends. In addition, individuals tended to select friends with similar levels of Agreeableness, Extraversion, and Openness.

  5. A multivariate time series approach to modeling and forecasting demand in the emergency department.

    Science.gov (United States)

    Jones, Spencer S; Evans, R Scott; Allen, Todd L; Thomas, Alun; Haug, Peter J; Welch, Shari J; Snow, Gregory L

    2009-02-01

    The goals of this investigation were to study the temporal relationships between the demands for key resources in the emergency department (ED) and the inpatient hospital, and to develop multivariate forecasting models. Hourly data were collected from three diverse hospitals for the year 2006. Descriptive analysis and model fitting were carried out using graphical and multivariate time series methods. Multivariate models were compared to a univariate benchmark model in terms of their ability to provide out-of-sample forecasts of ED census and the demands for diagnostic resources. Descriptive analyses revealed little temporal interaction between the demand for inpatient resources and the demand for ED resources at the facilities considered. Multivariate models provided more accurate forecasts of ED census and of the demands for diagnostic resources. Our results suggest that multivariate time series models can be used to reliably forecast ED patient census; however, forecasts of the demands for diagnostic resources were not sufficiently reliable to be useful in the clinical setting.

  6. Cost-Benefit Analysis of an Otolaryngology Emergency Room Using a Contingent Valuation Approach.

    Science.gov (United States)

    Naunheim, Matthew R; Kozin, Elliot D; Sethi, Rosh K; Ota, H Gregory; Gray, Stacey T; Shrime, Mark G

    2015-10-01

    Dedicated otolaryngology emergency rooms (ERs) provide a unique mechanism of health care delivery. Relative costs and willingness to pay (WTP) for these services have not been studied. This study aims to provide a cost-benefit analysis of otolaryngology-specific ER care. Cost-benefit analysis based on contingent valuation surveys. An otolaryngology-specific ER in a tertiary care academic medical center. Adult English-speaking patients presenting to an otolaryngology ER were included. WTP questions were used to assess patient valuations of specialty emergency care. Sociodemographic data, income, and self-reported levels of distress were assessed. State-level and institution-specific historical cost data were merged with WTP data within a cost-benefit analysis framework. The response rate was 75.6%, and 199 patients were included in the final analysis. Average WTP for otolaryngology ER services was $319 greater than for a general ER (95% CI: $261 to $377), with a median value of $200. The historical mean cost per visit at a general ER was $575, and mean cost at the specialty ER was $551 (95% CI: $529 to $574). Subtracting incremental cost from incremental WTP yielded a net benefit of $343. Dedicated otolaryngology ER services are valued by patients for acute otolaryngologic problems and have a net benefit of $343 per patient visit. They appear to be a cost-beneficial method for addressing acute otolaryngologic conditions. This study has implications for ER-based otolaryngologic care and direct-to-specialist services. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

  7. Evolutionary Steps in the Emergence of Life Deduced from the Bottom-Up Approach and GADV Hypothesis (Top-Down Approach).

    Science.gov (United States)

    Ikehara, Kenji

    2016-01-26

    It is no doubt quite difficult to solve the riddle of the origin of life. So, firstly, I would like to point out the kinds of obstacles there are in solving this riddle and how we should tackle these difficult problems, reviewing the studies that have been conducted so far. After that, I will propose that the consecutive evolutionary steps in a timeline can be rationally deduced by using a common event as a juncture, which is obtained by two counter-directional approaches: one is the bottom-up approach through which many researchers have studied the origin of life, and the other is the top-down approach, through which I established the [GADV]-protein world hypothesis or GADV hypothesis on the origin of life starting from a study on the formation of entirely new genes in extant microorganisms. Last, I will describe the probable evolutionary process from the formation of Earth to the emergence of life, which was deduced by using a common event-the establishment of the first genetic code encoding [GADV]-amino acids-as a juncture for the results obtained from the two approaches.

  8. Evolutionary Steps in the Emergence of Life Deduced from the Bottom-Up Approach and GADV Hypothesis (Top-Down Approach

    Directory of Open Access Journals (Sweden)

    Kenji Ikehara

    2016-01-01

    Full Text Available It is no doubt quite difficult to solve the riddle of the origin of life. So, firstly, I would like to point out the kinds of obstacles there are in solving this riddle and how we should tackle these difficult problems, reviewing the studies that have been conducted so far. After that, I will propose that the consecutive evolutionary steps in a timeline can be rationally deduced by using a common event as a juncture, which is obtained by two counter-directional approaches: one is the bottom-up approach through which many researchers have studied the origin of life, and the other is the top-down approach, through which I established the [GADV]-protein world hypothesis or GADV hypothesis on the origin of life starting from a study on the formation of entirely new genes in extant microorganisms. Last, I will describe the probable evolutionary process from the formation of Earth to the emergence of life, which was deduced by using a common event—the establishment of the first genetic code encoding [GADV]-amino acids—as a juncture for the results obtained from the two approaches.

  9. One Health approach: A platform for intervention in emerging public health challenges of Kerala state

    Directory of Open Access Journals (Sweden)

    A. Sukumaran

    2015-05-01

    Full Text Available The authors, key functionaries in the Kerala state public health system, review the communicable disease scenario of the state for the past 4 years, and in the background of the One Health concept, opines that the re-emerged discipline is perfectly in tune with the current challenges of the state. The unique model of Kerala state is witnessing newer challenges in its public health arena: The rapidly increasing migrant workforce from relatively poorer states of India, rapid urbanization and its consequent stress on public health, unsolved issues of urban waste disposal, reemergence of many communicable diseases like malaria, more so, the falciparum type, emergence of many zoonotic diseases like Lyme disease, scrub typhus, and Kyasanur forest disease etc. Conventional zoonotic infections such as anthrax and brucellosis remain potential threat for human health as well. Rabies continued to cause major concern from mortality point of view, as well as major drainer of state’s budget every year. Leptospirosis has remained major burden among the communicable disease for the past 10 years, and the annual incidence ranged from 2 to 7 per 100,000 population. Having a large section of its people working in various agriculture and animal rearing occupations, the state has all risk factors for propagation of Leptospirosis, but lacks interdisciplinary collaboration in its control and prevention area, the author highlights major avenues for collaboration. Japanese encephalitis appeared as an epidemic in 2011 in two of the southern districts in Kerala, one of the districts being famous tourist spot for both humans, as well as migrant birds. There is ample scope for collaborative research on the source of the virus, and in the subsequent years, the disease had been detected in more districts. Lyme disease was reported for the first time in India, from one of the districts in Kerala, promptly investigated by a joint team from Human Public Health and Veterinary

  10. Using omics and integrated multi-omics approaches to guide probiotic selection to mitigate chytridiomycosis and other emerging infectious diseases

    Directory of Open Access Journals (Sweden)

    Eria Alaide Rebollar

    2016-02-01

    Full Text Available Emerging infectious diseases in wildlife are responsible for massive population declines. In amphibians, chytridiomycosis caused by Batrachochytrium dendrobatidis, Bd, has severely affected many amphibian populations and species around the world. One promising management strategy is probiotic bioaugmentation of antifungal bacteria on amphibian skin. In vivo experimental trials using bioaugmentation strategies have had mixed results, and therefore a more informed strategy is needed to select successful probiotic candidates. Metagenomic, transcriptomic, and metabolomic methods, colloquially called omics, are approaches that can better inform probiotic selection and optimize selection protocols. The integration of multiple omic data using bioinformatic and statistical tools and in silico models that link bacterial community structure with bacterial defensive function can allow the identification of species involved in pathogen inhibition. We recommend using 16S rRNA gene amplicon sequencing and methods such as indicator species analysis, the K-S Measure, and co-occurrence networks to identify bacteria that are associated with pathogen resistance in field surveys and experimental trials. In addition to 16S amplicon sequencing, we recommend approaches that give insight into symbiont function such as shotgun metagenomics, metatranscriptomics or metabolomics to maximize the probability of finding effective probiotic candidates, which can then be isolated in culture and tested in persistence and clinical trials. An effective mitigation strategy to ameliorate chytridiomycosis and other emerging infectious diseases is necessary; the advancement of omic methods and the integration of multiple omic data provide a promising avenue toward conservation of imperiled species.

  11. A Multi-Element Approach to Location Inference of Twitter: A Case for Emergency Response

    Directory of Open Access Journals (Sweden)

    Farhad Laylavi

    2016-04-01

    Full Text Available Since its inception, Twitter has played a major role in real-world events—especially in the aftermath of disasters and catastrophic incidents, and has been increasingly becoming the first point of contact for users wishing to provide or seek information about such situations. The use of Twitter in emergency response and disaster management opens up avenues of research concerning different aspects of Twitter data quality, usefulness and credibility. A real challenge that has attracted substantial attention in the Twitter research community exists in the location inference of twitter data. Considering that less than 2% of tweets are geotagged, finding location inference methods that can go beyond the geotagging capability is undoubtedly the priority research area. This is especially true in terms of emergency response, where spatial aspects of information play an important role. This paper introduces a multi-elemental location inference method that puts the geotagging aside and tries to predict the location of tweets by exploiting the other inherently attached data elements. In this regard, textual content, users’ profile location and place labelling, as the main location-related elements, are taken into account. Location-name classes in three granularity levels are defined and employed to look up the location references from the location-associated elements. The inferred location of the finest granular level is assigned to a tweet, based on a novel location assignment rule. The location assigned by the location inference process is considered to be the inferred location of a tweet, and is compared with the geotagged coordinates as the ground truth of the study. The results show that this method is able to successfully infer the location of 87% of the tweets at the average distance error of 12.2 km and the median distance error of 4.5 km, which is a significant improvement compared with that of the current methods that can predict the location

  12. New strategies based on biomedical approaches for developing countermeasures against radiation and nuclear emergency

    International Nuclear Information System (INIS)

    Mishra, K. P.

    2009-01-01

    Biomedical and radiological research projects are essentially aimed to understanding, evaluation and modification of ionizing radiation induced effects on microorganisms, plants, animals and humans. It is widely recognized that control and management of radiation injury are central to safety assurances for peaceful applications of nuclear energy and radiation technology. Extensive radiobiological research in the past decades have allowed gaining the deeper insight of molecular mechanisms of radiation damage in vital cellular targets, namely, DNA, membrane, proteins and signaling cascades. The radiation induced damaging events in living cells are believed to be mediated by direct as well as indirect effects of radiation on the components of cells involving highly reactive free radicals which has provided basis for developing protocols for radioprotection and cancer radiotherapy. Cellular responses are subject to nature and dose/dose rates of radiation which are eventually reflected in the severity of health effects of population. Radiobiology research has a long-standing goal in understanding the risk, prevention, and treatment of damage to normal tissue after radiation exposure of healthy populations and also, in cancer treatment. However, much remains to be learned in terms of underlying molecular process and factors controlling the radiation injury. Developing high through put diagnostic tools for detection and bio markers for assessing radiation exposures are immediate challenges for policy planners, administrators, medical experts and safety officials in the management and control of mass exposures from nuclear radiation. Present world is faced with a rather new threat scenario from radiological and nuclear attack using radiation and radioisotope material by so called determined groups. To address the threat, new research efforts are required in developing safe and effective countermeasures against radiation emergency. It has become urgent to identify the

  13. Identification of Emergency Department Visits in Medicare Administrative Claims: Approaches and Implications

    Science.gov (United States)

    Venkatesh, Arjun K.; Mei, Hao; Kocher, Keith E.; Granovsky, Michael; Obermeyer, Ziad; Spatz, Erica S.; Rothenberg, Craig; Krumholz, Harlan M.; Lin, Zhenqui

    2018-01-01

    Objectives Administrative claims data sets are often used for emergency care research and policy investigations of healthcare resource utilization, acute care practices, and evaluation of quality improvement interventions. Despite the high profile of emergency department (ED) visits in analyses using administrative claims, little work has evaluated the degree to which existing definitions based on claims data accurately captures conventionally defined hospital-based ED services. We sought to construct an operational definition for ED visitation using a comprehensive Medicare data set and to compare this definition to existing operational definitions used by researchers and policymakers. Methods We examined four operational definitions of an ED visit commonly used by researchers and policymakers using a 20% sample of the 2012 Medicare Chronic Condition Warehouse (CCW) data set. The CCW data set included all Part A (hospital) and Part B (hospital outpatient, physician) claims for a nationally representative sample of continuously enrolled Medicare fee-for-services beneficiaries. Three definitions were based on published research or existing quality metrics including: 1) provider claims–based definition, 2) facility claims–based definition, and 3) CMS Research Data Assistance Center (ResDAC) definition. In addition, we developed a fourth operational definition (Yale definition) that sought to incorporate additional coding rules for identifying ED visits. We report levels of agreement and disagreement among the four definitions. Results Of 10,717,786 beneficiaries included in the sample data set, 22% had evidence of ED use during the study year under any of the ED visit definitions. The definition using provider claims identified a total of 4,199,148 ED visits, the facility definition 4,795,057 visits, the ResDAC definition 5,278,980 ED visits, and the Yale definition 5,192,235 ED visits. The Yale definition identified a statistically different (p services in the

  14. A cost sensitive inpatient bed reservation approach to reduce emergency department boarding times.

    Science.gov (United States)

    Qiu, Shanshan; Chinnam, Ratna Babu; Murat, Alper; Batarse, Bassam; Neemuchwala, Hakimuddin; Jordan, Will

    2015-03-01

    Emergency departments (ED) in hospitals are experiencing severe crowding and prolonged patient waiting times. A significant contributing factor is boarding delays where admitted patients are held in ED (occupying critical resources) until an inpatient bed is identified and readied in the admit wards. Recent research has suggested that if the hospital admissions of ED patients can be predicted during triage or soon after, then bed requests and preparations can be triggered early on to reduce patient boarding time. We propose a cost sensitive bed reservation policy that recommends optimal bed reservation times for patients. The policy relies on a classifier that estimates the probability that the ED patient will be admitted using the patient information collected and readily available at triage or right after. The policy is cost sensitive in that it accounts for costs associated with patient admission prediction misclassification as well as costs associated with incorrectly selecting the reservation time. Results from testing the proposed bed reservation policy using data from a VA Medical Center are very promising and suggest significant cost saving opportunities and reduced patient boarding times.

  15. Linear programming: an alternative approach for developing formulations for emergency food products.

    Science.gov (United States)

    Sheibani, Ershad; Dabbagh Moghaddam, Arasb; Sharifan, Anousheh; Afshari, Zahra

    2018-03-01

    To minimize the mortality rates of individuals affected by disasters, providing high-quality food relief during the initial stages of an emergency is crucial. The goal of this study was to develop a formulation for a high-energy, nutrient-dense prototype using linear programming (LP) model as a novel method for developing formulations for food products. The model consisted of the objective function and the decision variables, which were the formulation costs and weights of the selected commodities, respectively. The LP constraints were the Institute of Medicine and the World Health Organization specifications of the content of nutrients in the product. Other constraints related to the product's sensory properties were also introduced to the model. Nonlinear constraints for energy ratios of nutrients were linearized to allow their use in the LP. Three focus group studies were conducted to evaluate the palatability and other aspects of the optimized formulation. New constraints were introduced to the LP model based on the focus group evaluations to improve the formulation. LP is an appropriate tool for designing formulations of food products to meet a set of nutritional requirements. This method is an excellent alternative to the traditional 'trial and error' method in designing formulations. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  16. The emergence of learning-teaching trajectories in education: a complex dynamic systems approach.

    Science.gov (United States)

    Steenbeek, Henderien; van Geert, Paul

    2013-04-01

    In this article we shall focus on learning-teaching trajectories ='successful' as well as 'unsuccessful' ones - as emergent and dynamic phenomena resulting from the interactions in the entire educational context, in particular the interaction between students and teachers viewed as processes of intertwining self-, other- and co-regulation. The article provides a review of the educational research literature on action regulation in learning and teaching, and interprets this literature in light of the theory of complex dynamic systems. Based on this reinterpretation of the literature, two dynamic models are proposed, one focusing on the short-term dynamics of learning-teaching interactions as they take place in classrooms, the other focusing on the long-term dynamics of interactions in a network of variables encompassing concerns, evaluations, actions and action effects (such as learning) students and teachers. The aim of presenting these models is to demonstrate, first, the possibility of transforming existing educational theory into dynamic models and, second, to provide some suggestions as to how such models can be used to further educational theory and practice.

  17. Muscle–Bone Crosstalk: Emerging Opportunities for Novel Therapeutic Approaches to Treat Musculoskeletal Pathologies

    Directory of Open Access Journals (Sweden)

    Delphine B. Maurel

    2017-10-01

    Full Text Available Osteoporosis and sarcopenia are age-related musculoskeletal pathologies that often develop in parallel. Osteoporosis is characterized by a reduced bone mass and an increased fracture risk. Sarcopenia describes muscle wasting with an increasing risk of injuries due to falls. The medical treatment of both diseases costs billions in health care per year. With the impact on public health and economy, and considering the increasing life expectancy of populations, more efficient treatment regimens are sought. The biomechanical interaction between both tissues with muscle acting on bone is well established. Recently, both tissues were also determined as secretory endocrine organs affecting the function of one another. New exciting discoveries on this front are made each year, with novel signaling molecules being discovered and potential controversies being described. While this review does not claim completeness, it will summarize the current knowledge on both the biomechanical and the biochemical link between muscle and bone. The review will highlight the known secreted molecules by both tissues affecting the other and finish with an outlook on novel therapeutics that could emerge from these discoveries.

  18. A trait based dynamic energy budget approach to explore emergent microalgal community structure

    Science.gov (United States)

    Cheng, Y.; Bouskill, N.; Karaoz, U.; Geng, H.; Lane, T.; Pett-Ridge, J.; Mayali, X.; Brodie, E.

    2015-12-01

    Microalgae play important roles in the global carbon budget. Phytoplankton, including microalgae, are responsible for around 50% of global primary production, and also hold promise as a viable renewable biofuel source. Research has been underway for decades to realize the full potential of algal biofuels at the commercial scale, however, uni-algal ponds are typically threatened by collapse due to microalgal grazing and parasite invasions. Recently, it has been proposed that functionally diverse microalgal-bacterial communities can achieve high biomass and/or lipid yields, and are more stable (less susceptible to invasion) than a monoculture. Similar positive diversity-productivity relationships have been observed in a wide range of ecosystem studies, but the purposeful maintenance of a diverse microbiome is less common in managed systems. In our work, a trait based dynamic energy budget model was developed to explore emergent microalgal community structure under various environmental (e.g. light, temperature, nutrient availability) conditions. The complex algal community can be reduced into functional groups (guilds). Each guild (algae or bacteria) is characterized by distinct physiological traits (e.g. nutrient requirement, growth rate, substrate affinity, lipid production) constrained by biochemical trade-offs. These trait values are derived from literature and information encoded in genomic data. Metabolism of the algae and the bacterial species (symbiotic or non-symbiotic) are described within a dynamic energy budget framework. The model offers a mechanistic framework to predict the optimal microalgal community assemblage towards high productivity and resistance to invasion under prevailing environmental conditions.

  19. Hemoperitoneum from Corpus Luteal Cyst Rupture: A Practical Approach in Emergency Room

    Directory of Open Access Journals (Sweden)

    Valeria Fiaschetti

    2014-01-01

    Full Text Available Corpus luteum cyst rupture with consequent hemoperitoneum is a common disorder in women in their reproductive age. This condition should be promptly recognized and treated because a delayed diagnosis may significantly reduce women’s fertility and intra-abdominal bleeding may be life-threatening. Many imaging modalities play a key role in the diagnosis of acute pelvic pain from gynecological causes. Ultrasound study (USS is usually the first imaging technique for initial evaluation. USS is used to confirm or to exclude the presence of intraperitoneal fluid but it has some limitations in the identification of the bleeding source. Contrast-enhanced computed tomography (CT is the imaging modality which could be used in the acute setting in order to recognize gynecological emergencies and to establish a correct management. Magnetic resonance imaging (MRI nowadays is the most useful technique for studying the pelvis but its low availability and the long acquisition time of the images limit its usefulness in characterization of acute gynecological complications. We report a case of a young patient with hemoperitoneum from hemorrhagic corpus luteum correctly identified by transabdominal USS and contrast-enhanced CT.

  20. Muscle-Bone Crosstalk: Emerging Opportunities for Novel Therapeutic Approaches to Treat Musculoskeletal Pathologies.

    Science.gov (United States)

    Maurel, Delphine B; Jähn, Katharina; Lara-Castillo, Nuria

    2017-10-24

    Osteoporosis and sarcopenia are age-related musculoskeletal pathologies that often develop in parallel. Osteoporosis is characterized by a reduced bone mass and an increased fracture risk. Sarcopenia describes muscle wasting with an increasing risk of injuries due to falls. The medical treatment of both diseases costs billions in health care per year. With the impact on public health and economy, and considering the increasing life expectancy of populations, more efficient treatment regimens are sought. The biomechanical interaction between both tissues with muscle acting on bone is well established. Recently, both tissues were also determined as secretory endocrine organs affecting the function of one another. New exciting discoveries on this front are made each year, with novel signaling molecules being discovered and potential controversies being described. While this review does not claim completeness, it will summarize the current knowledge on both the biomechanical and the biochemical link between muscle and bone. The review will highlight the known secreted molecules by both tissues affecting the other and finish with an outlook on novel therapeutics that could emerge from these discoveries.

  1. Application of risk-informed in-service inspection approach. Pilot study on low pressure emergency core cooling system of NPP Temelin

    International Nuclear Information System (INIS)

    Horacek, L.; Palyza, J.; Zdarek, J.; Vizina, M.

    2004-01-01

    In-service inspection (ISI) programme of piping systems based on Riskinformed In-service Inspections (RI-ISI) approach represents for the WWER NPP licensee first overall systematic conceptual solution of the problems associated with design and design modifications of ISI programme for piping systems. The approach enables to consider possible savings and comparison of in-service inspection programmes according to more objective criteria including those calculated in PSA, in contrast to present much empiric experience collected by manufacturers, operators and ISI vendors in the past. Service experience has shown limited correlation between the deterministic ISI requirements and actual field failures or degradation mechanisms. Where field failures have been observed in piping, they have generally been due to either material concerns (e.g., Intergranular Stress Corrosion Cracking) or stress/cycling mechanisms not identified in the original design basis documents (e.g., thermal stratification), and therefore would not be selected for inspection under current requirements. Risk-informed in-service inspections represent integrated multidisciplinary approach to the in-service inspection programme fulfilling the enhanced requirements of the Czech Regulatory Body (SUJB) for defence in depth concept applied to weld joints of safety related components, application of qualified NDT methods/techniques and introducing of inspections for cause approach. Inspections for cause take into account analysis of both active and potential degradation mechanisms specific to piping system concerned. Simultaneously, this approach enables the licensee to reach, in cases justified from safety point of view, economic savings resulting from lowering of both number and extent of performed in-service inspections and optimisation of their performance. RI ISI pilot study based in majority on EPRI methodology implemented for WWER type reactors has been performed for LP ECCS (Low Pressure Emergency

  2. Emerging Approach of Natural Language Processing in Opinion Mining: A Review

    Science.gov (United States)

    Kim, Tai-Hoon

    Natural language processing (NLP) is a subfield of artificial intelligence and computational linguistics. It studies the problems of automated generation and understanding of natural human languages. This paper outlines a framework to use computer and natural language techniques for various levels of learners to learn foreign languages in Computer-based Learning environment. We propose some ideas for using the computer as a practical tool for learning foreign language where the most of courseware is generated automatically. We then describe how to build Computer Based Learning tools, discuss its effectiveness, and conclude with some possibilities using on-line resources.

  3. Recent Development in Pulmonary Valve Replacement after Tetralogy of Fallot Repair: The Emergence of Hybrid Approaches

    Directory of Open Access Journals (Sweden)

    Tariq eSuleiman

    2015-06-01

    Full Text Available In the current era approximately 90% of infants born with tetralogy of Fallot (ToF are expected to live beyond 40 years of age making it the fastest growing population amongst patients with congenital heart disease. One of the most common late consequences after repair of ToF, is pulmonary valve regurgitation (PVR. Significant PVR results in progressive dilatation and dysfunction of the right ventricle, decrease in exercise tolerance, arrhythmias, heart failure, and increased risk of sudden death. The conventional approach of dealing with this problem is to perform pulmonary valve replacement using cardiopulmonary bypass (CPB and cardioplegic arrest. However, this approach is associated not only with long operative times but also side effects related to the use of CPB. Development of percutaneous approaches to valve disease is one of the most exciting areas of research and clinical innovation in cardiovascular research. The main development has been that of transcatheter pulmonary valve replacement for the rehabilitation of conduits between the right ventricle and pulmonary artery in patients after surgery for ToF. However, with the percutaneous technique, a limited size of prosthesis can be inserted. Moreover, the technique does not offer the opportunity of treating additional defects that are frequently associated with severe PR, such as pulmonary artery dilatation, and it cannot be used in the significantly dilated native right ventricular outlet tract (RVOT. The advent of the hybrid surgical options for treating cardiac disease has integrated the techniques of interventional cardiology with the techniques of cardiac surgery to provide a form of therapy that combines the respective strengths of both fields.In this review, we present and compare recent advances in procedures to replace the pulmonary valve in patients with ToF presenting with severe PVR and dilated RVOT.

  4. Partnership for Diversity: A Multidisciplinary Approach to Nurturing Cultural Competence at an Emerging Medical School.

    Science.gov (United States)

    Swanberg, Stephanie M; Abuelroos, Dena; Dabaja, Emman; Jurva, Stephanie; Martin, Kimberly; McCarron, Joshua; Reed-Hendon, Caryn; Yeow, Raymond Y; Harriott, Melphine M

    2015-01-01

    Fostering cultural competence in higher education institutions is essential, particularly in training future health care workers to care for diverse populations. The opportunity to explore techniques to address diversity and cultural competence at a new medical school was undertaken by a multidisciplinary team of librarians, faculty, staff, and medical students. From 2011 to 2015, the team sponsored a voluntary programming series to promote cultural competence and raise awareness of health care disparities for the medical school. Thirteen events were hosted with 562 participants across all. This approach to diversity proved effective and could be adapted in any higher education setting.

  5. Qualitative discussion of quantitative radiography

    International Nuclear Information System (INIS)

    Berger, H.; Motz, J.W.

    1975-01-01

    Since radiography yields an image that can be easily related to the tested object, it is superior to many nondestructive testing techniques in revealing the size, shape, and location of certain types of discontinuities. The discussion is limited to a description of the radiographic process, examination of some of the quantitative aspects of radiography, and an outline of some of the new ideas emerging in radiography. The advantages of monoenergetic x-ray radiography and neutron radiography are noted

  6. Causal inference as an emerging statistical approach in neurology: an example for epilepsy in the elderly

    Directory of Open Access Journals (Sweden)

    Moura LMVR

    2016-12-01

    Full Text Available Lidia MVR Moura,1,2 M Brandon Westover,1,2 David Kwasnik,1 Andrew J Cole,1,2 John Hsu3–5 1Massachusetts General Hospital, Department of Neurology, Epilepsy Service, Boston, MA, USA; 2Harvard Medical School, Boston, MA, USA; 3Massachusetts General Hospital, Mongan Institute, Boston, MA, USA; 4Harvard Medical School, Department of Medicine, Boston, MA, USA; 5Harvard Medical School, Department of Health Care Policy, Boston, MA, USA Abstract: The elderly population faces an increasing number of cases of chronic neurological conditions, such as epilepsy and Alzheimer’s disease. Because the elderly with epilepsy are commonly excluded from randomized controlled clinical trials, there are few rigorous studies to guide clinical practice. When the elderly are eligible for trials, they either rarely participate or frequently have poor adherence to therapy, thus limiting both generalizability and validity. In contrast, large observational data sets are increasingly available, but are susceptible to bias when using common analytic approaches. Recent developments in causal inference-analytic approaches also introduce the possibility of emulating randomized controlled trials to yield valid estimates. We provide a practical example of the application of the principles of causal inference to a large observational data set of patients with epilepsy. This review also provides a framework for comparative-effectiveness research in chronic neurological conditions. Keywords: epilepsy, epidemiology, neurostatistics, causal inference

  7. Remediation approaches for polycyclic aromatic hydrocarbons (PAHs) contaminated soils: Technological constraints, emerging trends and future directions.

    Science.gov (United States)

    Kuppusamy, Saranya; Thavamani, Palanisami; Venkateswarlu, Kadiyala; Lee, Yong Bok; Naidu, Ravi; Megharaj, Mallavarapu

    2017-02-01

    For more than a decade, the primary focus of environmental experts has been to adopt risk-based management approaches to cleanup PAH polluted sites that pose potentially destructive ecological consequences. This focus had led to the development of several physical, chemical, thermal and biological technologies that are widely implementable. Established remedial options available for treating PAH contaminated soils are incineration, thermal conduction, solvent extraction/soil washing, chemical oxidation, bioaugmentation, biostimulation, phytoremediation, composting/biopiles and bioreactors. Integrating physico-chemical and biological technologies is also widely practiced for better cleanup of PAH contaminated soils. Electrokinetic remediation, vermiremediation and biocatalyst assisted remediation are still at the development stage. Though several treatment methods to remediate PAH polluted soils currently exist, a comprehensive overview of all the available remediation technologies to date is necessary so that the right technology for field-level success is chosen. The objective of this review is to provide a critical overview in this respect, focusing only on the treatment options available for field soils and ignoring the spiked ones. The authors also propose the development of novel multifunctional green and sustainable systems like mixed cell culture system, biosurfactant flushing, transgenic approaches and nanoremediation in order to overcome the existing soil- contaminant- and microbial-associated technological limitations in tackling high molecular weight PAHs. The ultimate objective is to ensure the successful remediation of long-term PAH contaminated soils. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Emergence of Landauer transport from quantum dynamics: A model Hamiltonian approach.

    Science.gov (United States)

    Pal, Partha Pratim; Ramakrishna, S; Seideman, Tamar

    2018-04-14

    The Landauer expression for computing current-voltage characteristics in nanoscale devices is efficient but not suited to transient phenomena and a time-dependent current because it is applicable only when the charge carriers transition into a steady flux after an external perturbation. In this article, we construct a very general expression for time-dependent current in an electrode-molecule-electrode arrangement. Utilizing a model Hamiltonian (consisting of the subsystem energy levels and their electronic coupling terms), we propagate the Schrödinger wave function equation to numerically compute the time-dependent population in the individual subsystems. The current in each electrode (defined in terms of the rate of change of the corresponding population) has two components, one due to the charges originating from the same electrode and the other due to the charges initially residing at the other electrode. We derive an analytical expression for the first component and illustrate that it agrees reasonably with its numerical counterpart at early times. Exploiting the unitary evolution of a wavefunction, we construct a more general Landauer style formula and illustrate the emergence of Landauer transport from our simulations without the assumption of time-independent charge flow. Our generalized Landauer formula is valid at all times for models beyond the wide-band limit, non-uniform electrode density of states and for time and energy-dependent electronic coupling between the subsystems. Subsequently, we investigate the ingredients in our model that regulate the onset time scale of this steady state. We compare the performance of our general current expression with the Landauer current for time-dependent electronic coupling. Finally, we comment on the applicability of the Landauer formula to compute hot-electron current arising upon plasmon decoherence.

  9. Optimizing cardiology capacity to reduce emergency department boarding: a systems engineering approach.

    Science.gov (United States)

    Levin, Scott R; Dittus, Robert; Aronsky, Dominik; Weinger, Matthew B; Han, Jin; Boord, Jeffrey; France, Daniel

    2008-12-01

    Patient safety and emergency department (ED) functionality are compromised when inefficient coordination between hospital departments impedes ED patients' access to inpatient cardiac care. The objective of this study was to determine how bed demand from competing cardiology admission sources affects ED patients' access to inpatient cardiac care. A stochastic discrete event simulation of hospital patient flow predicted ED patient boarding time, defined as the time interval between cardiology admission request to inpatient bed placement, as the primary outcome measure. The simulation was built and tested from 1 year of patient flow data and was used to examine prospective strategies to reduce cardiology patient boarding time. Boarding time for the 1,591 ED patients who were admitted to the cardiac telemetry unit averaged 5.3 hours (median 3.1, interquartile range 1.5-6.9). Demographic and clinical patient characteristics were not significant predictors of boarding time. Measurements of bed demand from competing admission sources significantly predicted boarding time, with catheterization laboratory demand levels being the most influential. Hospital policy required that a telemetry bed be held for each electively scheduled catheterization patient, yet the analysis revealed that 70.4% (95% CI 51.2-92.5) of these patients did not transfer to a telemetry bed and were discharged home each day. Results of simulation-based analyses showed that moving one afternoon scheduled elective catheterization case to before noon resulted in a 20-minute reduction in average boarding time compared to a 9-minute reduction achieved by increasing capacity by one additional telemetry bed. Scheduling and bed management practices based on measured patient transfer patterns can reduce inpatient bed blocking, optimize hospital capacity, and improve ED patient access.

  10. Which Patients in the Emergency Department Should Receive Preexposure Prophylaxis? Implementation of a Predictive Analytics Approach.

    Science.gov (United States)

    Ridgway, Jessica P; Almirol, Ellen A; Bender, Alvie; Richardson, Andrew; Schmitt, Jessica; Friedman, Eleanor; Lancki, Nicola; Leroux, Ivan; Pieroni, Nina; Dehlin, Jessica; Schneider, John A

    2018-04-19

    Emergency Departments (EDs) have the potential to play a crucial role in HIV prevention by identifying and linking high-risk HIV-negative clients to preexposure prophylaxis (PrEP) care, but it is difficult to perform HIV risk assessment for all ED patients. We aimed to develop and implement an electronic risk score to identify ED patients who are potential candidates for PrEP. Using electronic medical record (EMR) data, we used logistic regression to model the outcome of PrEP eligibility. We converted the model into an electronic risk score and incorporated it into the EMR. The risk score is automatically calculated at triage. For patients whose risk score is above a given threshold, an automated electronic alert is sent to an HIV prevention counselor who performs real time HIV prevention counseling, risk assessment, and PrEP linkage as appropriate. The electronic risk score includes the following EMR variables: age, gender, gender of sexual partner, chief complaint, and positive test for sexually transmitted infection in the prior 6 months. A risk score ≥21 has specificity of 80.6% and sensitivity of 50%. In the first 5.5 months of implementation, the alert fired for 180 patients, 34.4% (62/180) of whom were women. Of the 51 patients who completed risk assessment, 68.6% (35/51) were interested in PrEP, 17.6% (9/51) scheduled a PrEP appointment, and 7.8% (4/51) successfully initiated PrEP. The measured number of successful PrEP initiations is likely an underestimate, as it does include patients who initiated PrEP with outside providers or referred acquaintances for PrEP care.

  11. The emerging role of immune checkpoint based approaches in AML and MDS.

    Science.gov (United States)

    Boddu, Prajwal; Kantarjian, Hagop; Garcia-Manero, Guillermo; Allison, James; Sharma, Padmanee; Daver, Naval

    2018-04-01

    The development of immune checkpoint inhibitors represents a major breakthrough in the field of cancer therapeutics. Pursuant to their success in melanoma and numerous solid tumor malignancies, these agents are being investigated in hematological malignancies including acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS). Although AML/MDS have traditionally been considered to be less immunogenic than solid tumor malignancies, recent pre-clinical models suggest a therapeutic role for immune checkpoint inhibition in these diseases. CTLA-4 inhibition may be especially effective in treating late post-allogeneic stem cell transplant relapse of AML in patients with limited or no graft versus host disease. Immune checkpoint inhibition, specifically PD-1 inhibition, demonstrated limited single agent efficacy in patients with relapsed AML and with MDS post-hypomethylating therapy. Rationally designed combinations of PD-1 inhibitors with standard anti-leukemic therapy are needed. Hypomethylating agents such as azacitidine, up-regulate PD-1, PD-L1, and PD-L2 in patients with AML/MDS and up-regulation of these genes was associated with the emergence of resistance. The combination of azacitidine and PD-1/PD-L1 inhibition may be a potential mechanism to prevent or overcome resistance to 5-azacitidine. A number of such combinations are being evaluated in clinical trials with early encouraging results. Immune checkpoint inhibition is also an attractive option to improve relapse-free survival or eliminate minimal residual disease post induction and consolidation by enhancing T-cell surveillance in patients with high-risk AML. The ongoing clinical trials with checkpoint inhibitors in AML/MDS will improve our understanding of the immunobiology of these diseases and guide us to the most appropriate application of these agents in the therapy of AML/MDS.

  12. Neuroimaging mechanisms of change in psychotherapy for addictive behaviors: emerging translational approaches that bridge biology and behavior.

    Science.gov (United States)

    Feldstein Ewing, Sarah W; Chung, Tammy

    2013-06-01

    Research on mechanisms of behavior change provides an innovative method to improve treatment for addictive behaviors. An important extension of mechanisms of change research involves the use of translational approaches, which examine how basic biological (i.e., brain-based mechanisms) and behavioral factors interact in initiating and sustaining positive behavior change as a result of psychotherapy. Articles in this special issue include integrative conceptual reviews and innovative empirical research on brain-based mechanisms that may underlie risk for addictive behaviors and response to psychotherapy from adolescence through adulthood. Review articles discuss hypothesized mechanisms of change for cognitive and behavioral therapies, mindfulness-based interventions, and neuroeconomic approaches. Empirical articles cover a range of addictive behaviors, including use of alcohol, cigarettes, marijuana, cocaine, and pathological gambling and represent a variety of imaging approaches including fMRI, magneto-encephalography, real-time fMRI, and diffusion tensor imaging. Additionally, a few empirical studies directly examine brain-based mechanisms of change, whereas others examine brain-based indicators as predictors of treatment outcome. Finally, two commentaries discuss craving as a core feature of addiction, and the importance of a developmental approach to examining mechanisms of change. Ultimately, translational research on mechanisms of behavior change holds promise for increasing understanding of how psychotherapy may modify brain structure and functioning and facilitate the initiation and maintenance of positive treatment outcomes for addictive behaviors. 2013 APA, all rights reserved

  13. Meeting report on the Bellagio Conference 'prevention of vascular diseases in the emerging world: An approach to global health equity'.

    Science.gov (United States)

    Dirks, J H; Robinson, S W; Alderman, M; Couser, W G; Grundy, S M; Smith, S C; Remuzzi, G; Unwin, N

    2006-10-01

    Representatives from five international organizations (International Society of Nephrology, World Heart Federation, International Diabetes Federation, International Atherosclerosis Federation, and International Society of Hypertension) participated in a strategic planning workshop in December 2005 in Bellagio, Italy sponsored by the Rockefeller Foundation. There were equal representatives from developed and developing countries. Global perspectives on diabetes and cardiovascular and renal diseases were presented, with special emphasis on China, India, Latin America, and Africa. The rationale and effectiveness of preventive measures were discussed. It was apparent that measures for primary prevention and early intervention for all the chronic vascular diseases are similar. The five organizations agreed that an integrated global approach to chronic vascular diseases is needed. They resolved to collaborate and work towards an integrated approach to chronic vascular diseases with the establishment of a 5-year plan for the prevention and treatment of chronic vascular diseases, including public advocacy, advising international and national agencies, and improving education and the practice of established approaches.

  14. Open, aware, and active: contextual approaches as an emerging trend in the behavioral and cognitive therapies.

    Science.gov (United States)

    Hayes, Steven C; Villatte, Matthieu; Levin, Michael; Hildebrandt, Mikaela

    2011-01-01

    A wave of new developments has occurred in the behavioral and cognitive therapies that focuses on processes such as acceptance, mindfulness, attention, or values. In this review, we describe some of these developments and the data regarding them, focusing on information about components, moderators, mediators, and processes of change. These "third wave" methods all emphasize the context and function of psychological events more so than their validity, frequency, or form, and for these reasons we use the term "contextual cognitive behavioral therapy" to describe their characteristics. Both putative processes, and component and process evidence, indicate that they are focused on establishing a more open, aware, and active approach to living, and that their positive effects occur because of changes in these processes. © 2011 by Annual Reviews. All rights reserved

  15. Emotional and interactional prosody across animal communication systems: A comparative approach to the emergence of language

    Directory of Open Access Journals (Sweden)

    Piera Filippi

    2016-09-01

    Full Text Available Across a wide range of animal taxa, prosodic modulation of the voice can express emotional information and is used to coordinate vocal interactions between multiple individuals. Within a comparative approach to animal communication systems, I hypothesize that the ability for emotional and interactional prosody (EIP paved the way for the evolution of linguistic prosody - and perhaps also of music, continuing to play a vital role in the acquisition of language. In support of this hypothesis, I review three research fields: i empirical studies on the adaptive value of EIP in nonhuman primates, mammals, songbirds, anurans and insects; ii the beneficial effects of EIP in scaffolding language learning and social development in human infants; iii the cognitive relationship between linguistic prosody and the ability for music, which has often been identified as the evolutionary precursor of language.

  16. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches.

    Science.gov (United States)

    Redwood-Campbell, Lynda; Pakes, Barry; Rouleau, Katherine; MacDonald, Colla J; Arya, Neil; Purkey, Eva; Schultz, Karen; Dhatt, Reena; Wilson, Briana; Hadi, Abdullahel; Pottie, Kevin

    2011-07-22

    Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes) for Canadian Family Medicine training. The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS) competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the framework. The process used to develop this framework can be applied

  17. Strategic management of keloid disease in ethnic skin: a structured approach supported by the emerging literature.

    Science.gov (United States)

    Ud-Din, S; Bayat, A

    2013-10-01

    Keloid disease (KD) is a common, benign, dermal fibroproliferative growth of unknown aetiology. Lesions tend to grow over time; they often recur following therapy and do not regress spontaneously. KD causes considerable discomfort due to pain, pruritus and inflammation, and a significant psychosocial impact with reduced quality of life. It is unique to humans and occurrence is higher in individuals with dark, pigmented, ethnic skin. There is a strong familial heritability, with a high ethnic predisposition in individuals of African, Asian and Hispanic descent. High recurrence rates and unknown resolution rates present a major problem for both the patient and clinician. Many treatment modalities exist; however, there is no single advocated therapy. Therefore, the aim of this review was to explore the most current literature regarding the range of treatment options for KD and to offer a structured approach in the management of KD, based on evidence and experience, to aid clinicians in their current practice. A focused history involving careful evaluation of the patient's symptoms, signs, quality of life and psychosocial well-being should direct targeted therapy, complemented with regular follow-up and re-evaluation. Many treatment modalities, such as intralesional steroid injection, silicone gel application, cryotherapy, lasers, 5-fluorouracil and, relatively recently, photodynamic therapy, are currently being used in clinical practice for the management of KD. Combination therapies have also been shown to be beneficial. However, there is a lack of robust, randomized, level-one, evidence-controlled trials evaluating these treatment options. Management of KD in ethnic pigmented skin remains a clinical challenge. Thus, a strategic approach with structured assessment, targeted therapy and focus on prevention of recurrence is highly recommended. Quality evidence is essential in order to tailor treatment effectively for the ethnic patient presenting with KD. © 2013 The

  18. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches

    Directory of Open Access Journals (Sweden)

    Wilson Briana

    2011-07-01

    Full Text Available Abstract Background Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. Methods A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes for Canadian Family Medicine training. Results The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. Conclusions The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the

  19. Efficient Machine Learning Approach for Optimizing Scientific Computing Applications on Emerging HPC Architectures

    Energy Technology Data Exchange (ETDEWEB)

    Arumugam, Kamesh [Old Dominion Univ., Norfolk, VA (United States)

    2017-05-01

    the parallel implementation challenges of such irregular applications on different HPC architectures. In particular, we use supervised learning to predict the computation structure and use it to address the control-ow and memory access irregularities in the parallel implementation of such applications on GPUs, Xeon Phis, and heterogeneous architectures composed of multi-core CPUs with GPUs or Xeon Phis. We use numerical simulation of charged particles beam dynamics simulation as a motivating example throughout the dissertation to present our new approach, though they should be equally applicable to a wide range of irregular applications. The machine learning approach presented here use predictive analytics and forecasting techniques to adaptively model and track the irregular memory access pattern at each time step of the simulation to anticipate the future memory access pattern. Access pattern forecasts can then be used to formulate optimization decisions during application execution which improves the performance of the application at a future time step based on the observations from earlier time steps. In heterogeneous architectures, forecasts can also be used to improve the memory performance and resource utilization of all the processing units to deliver a good aggregate performance. We used these optimization techniques and anticipation strategy to design a cache-aware, memory efficient parallel algorithm to address the irregularities in the parallel implementation of charged particles beam dynamics simulation on different HPC architectures. Experimental result using a diverse mix of HPC architectures shows that our approach in using anticipation strategy is effective in maximizing data reuse, ensuring workload balance, minimizing branch and memory divergence, and in improving resource utilization.

  20. Below the radar innovations and emerging property right approaches in Tibetan medicine.

    Science.gov (United States)

    Madhavan, Harilal

    2017-11-01

    Outside the established legal framework of intellectual property rights, countries have pursued multiple pathways to protect and promote traditional medicine. As Tibetan medicine is a late entrant into commercialization, the proposals to propertize generally fall within the rationale of existing sui-generis paradigms of Intellectual property. In this context, the article enquires the state of innovations in this sector viz-a-viz the property right approaches in place especially in India and China. It argues that beyond the usual complex medical science and technology led-innovations, the pathways of cumulative processes and creative additions through informal experiential learning platforms, where the transfers of knowledge become part of livelihood and social benefits (we call them "below the radar innovations") is ubiquitous in Tibetan medicine. The trends and politics in two recent strategies of protection, that is, Tibetan medicine as economic property (emphasizing patents here among many others) and as a cultural property (intangible cultural heritage) are juxtaposed with these informal innovative attempts. The paper underlines that the productivity-based economic rationale of these protection mechanisms should not obscure sustainability alternatives of "below the radar" (BtR) innovations in Tibetan medicine.

  1. A fully digital approach to replicate peri-implant soft tissue contours and emergence profile in the esthetic zone.

    Science.gov (United States)

    Monaco, Carlo; Evangelisti, Edoardo; Scotti, Roberto; Mignani, Giuseppe; Zucchelli, Giovanni

    2016-12-01

    This short communication reports on a novel digital technique designated - the "Fully Digital Technique (FDT)" - to take the impression of the peri-implant soft tissue and emergence profile with an intraoral scanner, digitally capturing both the three dimensional position of the implant platform and the coronal and gingival parts of the provisional retained restoration. A first intraoral digital impression, which generated a standard triangulation language file (STL1), was taken using a standardized implant scanbody to detect the position of the implant. A second digital impression (STL2) with the provisional retained restoration in situ was performed in two steps: the first part of the scan captured all details of the vestibular and palatal sides of the provisional retained restoration and the adjacent teeth. The provisional retained restoration was then unscrewed, and the subgingival part of the restoration was scanned directly out of the mouth to determine its subgingival shape. STL1 and STL2 were imported into imaging software and superimposed using the "best fit" algorithm to achieve a new merged file (STL3) with the 3D implant position, the peri-implant mucosa, and emergence profile. The merged file was used to design the CAD/CAM customized abutment and to realize a stereolithographic model by 3D printing. The STL superimposition of digital impressions of the implant position and the provisional retained restoration constitute a novel technique to obtain a single STL file with the implant position and its peri-implant mucosal architecture. FDT is a rapid digital approach for achieving all information of the peri-implant soft tissue and emergence profile directly from the provisional retained restoration. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Discussion in Postsecondary Classrooms

    Directory of Open Access Journals (Sweden)

    Curt Dudley-Marling

    2013-11-01

    Full Text Available Spoken language is, arguably, the primary means by which teachers teach and students learn. Much of the literature on language in classrooms has focused on discussion that is seen as both a method of instruction and a curricular outcome. While much of the research on discussion has focused on K-12 classrooms, there is also a body of research examining the efficacy of discussion in postsecondary settings. This article provides a review of this literature in order to consider the effect of discussion on student learning in college and university classrooms, the prevalence of discussion in postsecondary settings, and the quality of discussion in these settings. In general, the results of research on the efficacy of discussion in postsecondary settings are mixed. More seriously, researchers have not been explicit about the meaning of discussion and much of what is called discussion in this body of research is merely recitation with minimal levels of student participation. Although the research on discussion in college and university classrooms is inconclusive, some implications can be drawn from this review of the research including the need for future researchers to clearly define what they mean by “discussion.”

  3. Identifying Work Skills: International Approaches. Discussion Paper

    Science.gov (United States)

    Siekmann, Gitta; Fowler, Craig

    2017-01-01

    The digital revolution and automation are accelerating changes in the labour market and in workplace skills, changes that are further affected by fluctuations in international and regional economic cycles and employment opportunity. These factors pose a universal policy challenge for all advanced economies and governments. In the workplace, people…

  4. A triangular fuzzy TOPSIS-based approach for the application of water technologies in different emergency water supply scenarios.

    Science.gov (United States)

    Qu, Jianhua; Meng, Xianlin; Yu, Huan; You, Hong

    2016-09-01

    Because of the increasing frequency and intensity of unexpected natural disasters, providing safe drinking water for the affected population following a disaster has become a global challenge of growing concern. An onsite water supply technology that is portable, mobile, or modular is a more suitable and sustainable solution for the victims than transporting bottled water. In recent years, various water techniques, such as membrane-assisted technologies, have been proposed and successfully implemented in many places. Given the diversity of techniques available, the current challenge is how to scientifically identify the optimum options for different disaster scenarios. Hence, a fuzzy triangular-based multi-criteria, group decision-making tool was developed in this research. The approach was then applied to the selection of the most appropriate water technologies corresponding to the different emergency water supply scenarios. The results show this tool capable of facilitating scientific analysis in the evaluation and selection of emergency water technologies for enduring security drinking water supply in disaster relief.

  5. Methodology to explore emergent behaviours of the interactions between water resources and ecosystem under a pluralistic approach

    Science.gov (United States)

    García-Santos, Glenda; Madruga de Brito, Mariana; Höllermann, Britta; Taft, Linda; Almoradie, Adrian; Evers, Mariele

    2018-06-01

    Understanding the interactions between water resources and its social dimensions is crucial for an effective and sustainable water management. The identification of sensitive control variables and feedback loops of a specific human-hydro-scape can enhance the knowledge about the potential factors and/or agents leading to the current water resources and ecosystems situation, which in turn supports the decision-making process of desirable futures. Our study presents the utility of a system dynamics modeling approach for water management and decision-making for the case of a forest ecosystem under risk of wildfires. We use the pluralistic water research concept to explore different scenarios and simulate the emergent behaviour of water interception and net precipitation after a wildfire in a forest ecosystem. Through a case study, we illustrate the applicability of this new methodology.

  6. Encouraging Classroom Discussion

    Directory of Open Access Journals (Sweden)

    Robert Joseph McKee

    2014-10-01

    Full Text Available Classroom discussion has the potential to enhance the learning environment and encourages students to become active participants in the educational process. Student participation in classroom discussion has been shown to significantly improve the student learning experience. Research suggests that classroom discussion is an effective method for encouraging student classroom participation and for motivating student learning beyond the classroom. Participation in classroom discussion encourages students to become active collaborators in the learning process, while at the same time providing instructors with a practical method of assessing student learning. Classroom discussion is an effective tool for developing higher-level cognitive skills like critical thinking. Despite the potential discussion holds for student learning, many in academia lament the lack of participation in the classroom. The lack of student participation in classroom discussion is not a recent problem; it is one that has frustrated instructors for decades. Instructors report that some of the more current methods for encouraging classroom discussion can be exasperating and at times non-productive. This two-year study of 510 college and university students provides insight into the reasons why some students do not participate in classroom discussion. This study, which also elicited input from sixteen college and university professors and two high school teachers, offers some suggestions for creating and encouraging an environment conducive to student participation in the classroom.

  7. Nanoparticles and self-organisation: the emergence of hierarchical properties from the nanoparticle soup (i.e., the small is getting bigger). Concluding remarks for Faraday Discussion: Nanoparticle Synthesis and Assembly.

    Science.gov (United States)

    Schiffrin, David J

    2015-01-01

    Some four years ago, one of the participants in this Discussion (Prof. Nicholas Kotov) predicted that: "within five years we shall see multiple examples of electronic, sensor, optical and other devices utilizing self-assembled superstructures" (N. A. Kotov, J. Mater. Chem., 2011, 21, 16673-16674). Although this prediction came partially to fruition, we have witnessed an unprecedented interest in the properties of materials at the nanoscale. The point highlighted by Kotov, however, was the importance of self-assembly of structures from well characterised building blocks to yield hierarchical structures, hopefully with predictable properties, a concept that is an everyday pursuit of synthetic chemists. This Discussion has brought together researchers from a wide range of disciplines, i.e., colloid science, modelling, nanoparticle synthesis and organisation, magnetic and optical materials, and new imaging methods, within the excellent traditional Faraday Discussion format, to discuss advances in areas relevant to the main theme of the meeting.

  8. Opinion paper on innovative approach of biomarkers for infectious diseases and sepsis management in the emergency department.

    Science.gov (United States)

    Di Somma, Salvatore; Magrini, Laura; Travaglino, Francesco; Lalle, Irene; Fiotti, Nicola; Cervellin, Grianfranco; Avanzi, Gian Carlo; Lupia, Enrico; Maisel, Alan; Hein, Frauke; Wagner, Florian; Lippi, Giuseppe

    2013-06-01

    Sepsis is a leading healthcare problem, accounting for the vast majority of fatal events in critically ill patients. Beyond early diagnosis and appropriate treatment, this condition requires a multifaceted approach for monitoring the severity, the potential organ failure as well as the risk of death. Monitoring of the efficacy of treatment is also a major issue in the emergency department (ED). The assessment of critically ill conditions and the prognosis of patients with sepsis is currently based on some scoring systems, which are, however, inefficient to provide definite clues about organ failure and prognosis in general. The discretionary and appropriate use of some selected biomarkers such as procalcitonin, inducible protein 10 (IP10), Group IV phospholipase A2 type II (PLA2 II), neutrophil gelatinase-associated lipocalin (NGAL), natriuretic peptides, mature adrenomedullin (ADM), mid-regional pro-adrenomedullin (MR-proADM), copeptin, thrombopoietin, Mer receptor and even red blood cell distribution width (RDW) represent thereby an appealing perspective in the diagnosis and management of patients with sepsis. Nevertheless, at the moment, it is not still clear if it is better to use a multimarkers approach or if a single, most appropriate, biomarker exists. This collective opinion paper is aimed at providing an overview about the potential clinical usefulness of some innovative biomarkers of sepsis in its diagnosis and prognosis, but also in the treatment management of the disease. This manuscript represents a synopsis of the lectures of Third Italian GREAT Network Congress, that was hold in Rome, 15-19 October 2012.

  9. The emergence of international food safety standards and guidelines: understanding the current landscape through a historical approach.

    Science.gov (United States)

    Ramsingh, Brigit

    2014-07-01

    Following the Second World War, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) teamed up to construct an International Codex Alimentarius (or 'food code') which emerged in 1963. The Codex Committee on Food Hygiene (CCFH) was charged with the task of developing microbial hygiene standards, although it found itself embroiled in debate with the WHO over the nature these standards should take. The WHO was increasingly relying upon the input of biometricians and especially the International Commission on Microbial Specifications for Foods (ICMSF) which had developed statistical sampling plans for determining the microbial counts in the final end products. The CCFH, however, was initially more focused on a qualitative approach which looked at the entire food production system and developed codes of practice as well as more descriptive end-product specifications which the WHO argued were 'not scientifically correct'. Drawing upon historical archival material (correspondence and reports) from the WHO and FAO, this article examines this debate over microbial hygiene standards and suggests that there are many lessons from history which could shed light upon current debates and efforts in international food safety management systems and approaches.

  10. Emerging zoonotic viral diseases.

    Science.gov (United States)

    Wang, L-F; Crameri, G

    2014-08-01

    Zoonotic diseases are infectious diseases that are naturally transmitted from vertebrate animals to humans and vice versa. They are caused by all types of pathogenic agents, including bacteria, parasites, fungi, viruses and prions. Although they have been recognised for many centuries, their impact on public health has increased in the last few decades due to a combination of the success in reducing the spread of human infectious diseases through vaccination and effective therapies and the emergence of novel zoonotic diseases. It is being increasingly recognised that a One Health approach at the human-animal-ecosystem interface is needed for effective investigation, prevention and control of any emerging zoonotic disease. Here, the authors will review the drivers for emergence, highlight some of the high-impact emerging zoonotic diseases of the last two decades and provide examples of novel One Health approaches for disease investigation, prevention and control. Although this review focuses on emerging zoonotic viral diseases, the authors consider that the discussions presented in this paper will be equally applicable to emerging zoonotic diseases of other pathogen types.

  11. Emergency Department Query for Patient-Centered Approaches to Sexual Orientation and Gender Identity : The EQUALITY Study.

    Science.gov (United States)

    Haider, Adil H; Schneider, Eric B; Kodadek, Lisa M; Adler, Rachel R; Ranjit, Anju; Torain, Maya; Shields, Ryan Y; Snyder, Claire; Schuur, Jeremiah D; Vail, Laura; German, Danielle; Peterson, Susan; Lau, Brandyn D

    2017-06-01

    The Institute of Medicine and The Joint Commission recommend routine documentation of patients' sexual orientation in health care settings. Currently, very few health care systems collect these data since patient preferences and health care professionals' support regarding collection of data about patient sexual orientation are unknown. To identify the optimal patient-centered approach to collect sexual orientation data in the emergency department (ED) in the Emergency Department Query for Patient-Centered Approaches to Sexual Orientation and Gender Identity study. An exploratory, sequential, mixed-methods design was used first to evaluate qualitative interviews conducted in the Baltimore, Maryland, and Washington, DC, areas. Fifty-three patients and 26 health care professionals participated in the qualitative interviews. Interviews were followed by a national online survey, in which 1516 (potential) patients (244 lesbian, 289 gay, 179 bisexual, and 804 straight) and 429 ED health care professionals (209 physicians and 220 nurses) participated. Survey participants were recruited using random digit dialing and address-based sampling techniques. Qualitative interviews were used to obtain the perspectives of patients and health care professionals on sexual orientation data collection, and a quantitative survey was used to gauge patients' and health care professionals' willingness to provide or obtain sexual orientation information. Mean (SD) age of patient and clinician participants was 49 (16.4) and 51 (9.4) years, respectively. Qualitative interviews suggested that patients were less likely to refuse to provide sexual orientation than providers expected. Nationally, 154 patients (10.3%) reported that they would refuse to provide sexual orientation; however, 333 (77.8%) of all clinicians thought patients would refuse to provide sexual orientation. After adjustment for demographic characteristics, only bisexual patients had increased odds of refusing to provide sexual

  12. Axelrod model: accepting or discussing

    Science.gov (United States)

    Dybiec, Bartlomiej; Mitarai, Namiko; Sneppen, Kim

    2012-10-01

    Agents building social systems are characterized by complex states, and interactions among individuals can align their opinions. The Axelrod model describes how local interactions can result in emergence of cultural domains. We propose two variants of the Axelrod model where local consensus is reached either by listening and accepting one of neighbors' opinion or two agents discuss their opinion and achieve an agreement with mixed opinions. We show that the local agreement rule affects the character of the transition between the single culture and the multiculture regimes.

  13. 33 CFR 214.6 - Discussion.

    Science.gov (United States)

    2010-07-01

    ... providing emergency supplies of clean drinking water. Sewage treatment and disposal, and other sanitary... with contamination of water used in its process is not eligible. The drinking water used by the people... SUPPLIES OF DRINKING WATER § 214.6 Discussion. (a) The amendment provides for furnishing emergency supplies...

  14. A quantitative risk assessment approach for mosquito-borne diseases: malaria re-emergence in southern France

    Directory of Open Access Journals (Sweden)

    Luty Adrian JF

    2008-08-01

    Full Text Available Abstract Background The Camargue region is a former malaria endemic area, where potential Anopheles vectors are still abundant. Considering the importation of Plasmodium due to the high number of imported malaria cases in France, the aim of this article was to make some predictions regarding the risk of malaria re-emergence in the Camargue. Methods Receptivity (vectorial capacity and infectivity (vector susceptibility were inferred using an innovative probabilistic approach and considering both Plasmodium falciparum and Plasmodium vivax. Each parameter of receptivity (human biting rate, anthropophily, length of trophogonic cycle, survival rate, length of sporogonic cycle and infectivity were estimated based on field survey, bibliographic data and expert knowledge and fitted with probability distributions taking into account the variability and the uncertainty of the estimation. Spatial and temporal variations of the parameters were determined using environmental factors derived from satellite imagery, meteorological data and entomological field data. The entomological risk (receptivity/infectivity was calculated using 10,000 different randomly selected sets of values extracted from the probability distributions. The result was mapped in the Camargue area. Finally, vulnerability (number of malaria imported cases was inferred using data collected in regional hospitals. Results The entomological risk presented large spatial, temporal and Plasmodium species-dependent variations. The sensitivity analysis showed that susceptibility, survival rate and human biting rate were the three most influential parameters for entomological risk. Assessment of vulnerability showed that among the imported cases in the region, only very few were imported in at-risk areas. Conclusion The current risk of malaria re-emergence seems negligible due to the very low number of imported Plasmodium. This model demonstrated its efficiency for mosquito-borne diseases risk

  15. Session 1 - discussion

    International Nuclear Information System (INIS)

    Wells, C.; Richards, K.M.; McKerrow, J.F.

    1991-01-01

    This discussion session of the Landfill Gas-Energy and Environment 90 Conference covered the landfill gas potential, the setting up of the Non-Fossil Fuel Obligation; anticipated developments in the post 1998 period, the problem of smell for those who live near a landfill, and the length of time a landfill site is productive in terms of gas evolution. Relevant regulations in California are briefly discussed. (author)

  16. Approach to Integrate Global-Sun Models of Magnetic Flux Emergence and Transport for Space Weather Studies

    Science.gov (United States)

    Mansour, Nagi N.; Wray, Alan A.; Mehrotra, Piyush; Henney, Carl; Arge, Nick; Godinez, H.; Manchester, Ward; Koller, J.; Kosovichev, A.; Scherrer, P.; hide

    2013-01-01

    The Sun lies at the center of space weather and is the source of its variability. The primary input to coronal and solar wind models is the activity of the magnetic field in the solar photosphere. Recent advancements in solar observations and numerical simulations provide a basis for developing physics-based models for the dynamics of the magnetic field from the deep convection zone of the Sun to the corona with the goal of providing robust near real-time boundary conditions at the base of space weather forecast models. The goal is to develop new strategic capabilities that enable characterization and prediction of the magnetic field structure and flow dynamics of the Sun by assimilating data from helioseismology and magnetic field observations into physics-based realistic magnetohydrodynamics (MHD) simulations. The integration of first-principle modeling of solar magnetism and flow dynamics with real-time observational data via advanced data assimilation methods is a new, transformative step in space weather research and prediction. This approach will substantially enhance an existing model of magnetic flux distribution and transport developed by the Air Force Research Lab. The development plan is to use the Space Weather Modeling Framework (SWMF) to develop Coupled Models for Emerging flux Simulations (CMES) that couples three existing models: (1) an MHD formulation with the anelastic approximation to simulate the deep convection zone (FSAM code), (2) an MHD formulation with full compressible Navier-Stokes equations and a detailed description of radiative transfer and thermodynamics to simulate near-surface convection and the photosphere (Stagger code), and (3) an MHD formulation with full, compressible Navier-Stokes equations and an approximate description of radiative transfer and heating to simulate the corona (Module in BATS-R-US). CMES will enable simulations of the emergence of magnetic structures from the deep convection zone to the corona. Finally, a plan

  17. Lignin Valorization: Emerging Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Beckham, Gregg T [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2018-04-03

    Lignin, an aromatic biopolymer found in plant cell walls, is a key component of lignocellulosic biomass and generally utilized for heat and power. However, lignin's chemical composition makes it an attractive source for biological and catalytic conversion to fuels and chemicals. Bringing together experts from biology, catalysis, engineering, analytical chemistry, and techno-economic/life-cycle analysis, Lignin Valorization presents a comprehensive, interdisciplinary picture of how lignocellulosic biorefineries could potentially employ lignin valorization technologies. Chapters will specifically focus on the production of fuels and chemicals from lignin and topics covered include (i) methods for isolating lignin in the context of the lignocellulosic biorefinery, (ii) thermal, chemo-catalytic, and biological methods for lignin depolymerization, (iii) chemo-catalytic and biological methods for upgrading lignin, (iv) characterization of lignin, and (v) techno-economic and life-cycle analysis of integrated processes to utilize lignin in an integrated biorefinery. The book provides the latest breakthroughs and challenges in upgrading lignin to fuels and chemicals for graduate students and researchers in academia, governmental laboratories, and industry interested in biomass conversion.

  18. Emerging Infectious Diseases Cover Art

    Centers for Disease Control (CDC) Podcasts

    2017-07-26

    Byron Breedlove, managing editor of the EID Journal, discusses his approach to cover art.  Created: 7/26/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 7/26/2017.

  19. Summary of group discussions

    International Nuclear Information System (INIS)

    2009-01-01

    A key aspect of the workshop was the interaction and exchange of ideas and information among the 40 participants. To facilitate this activity the workshop participants were divided into five discussions groups. These groups reviewed selected subjects and reported back to the main body with summaries of their considerations. Over the 3 days the 5 discussion groups were requested to focus on the following subjects: the characteristics and capabilities of 'good' organisations; how to ensure sufficient resources; how to ensure competence within the organisation; how to demonstrate organisational suitability; the regulatory oversight processes - including their strengths and weaknesses. A list of the related questions that were provided to the discussion groups can be found in Appendix 3. Also included in Appendix 3 are copies of the slides the groups prepared that summarised their considerations

  20. Focus group discussions

    CERN Document Server

    Hennink, Monique M

    2014-01-01

    The Understanding Research series focuses on the process of writing up social research. The series is broken down into three categories: Understanding Statistics, Understanding Measurement, and Understanding Qualitative Research. The books provide researchers with guides to understanding, writing, and evaluating social research. Each volume demonstrates how research should be represented, including how to write up the methodology as well as the research findings. Each volume also reviews how to appropriately evaluate published research. Focus Group Discussions addresses the challenges associated with conducting and writing focus group research. It provides detailed guidance on the practical and theoretical considerations in conducting focus group discussions including: designing the discussion guide, recruiting participants, training a field team, moderating techniques and ethical considerations. Monique Hennink describes how a methodology section is read and evaluated by others, such as journal reviewers or ...

  1. Plutonium roundtable discussion

    International Nuclear Information System (INIS)

    Penneman, R.A.

    1982-01-01

    The roundtable discussion began with remarks by the chairman who pointed out the complicated nature of plutonium chemistry. Judging from the papers presented at this symposium, he noticed a pattern which indicated to him the result of diminished funding for investigation of basic plutonium chemistry and funding focused on certain problem areas. Dr. G.L. silver pointed to plutonium chemists' erroneous use of a simplified summary equation involving the disproportionation of Pu(EV) and their each of appreciation of alpha coefficients. To his appreciation of alpha coefficients. To his charges, Dr. J.T. Bell spoke in defense of the chemists. This discussion was followed by W.W. Schulz's comments on the need for experimental work to determine solubility data for plutonium in its various oxidation states under geologic repository conditions. Discussion then turned to plutonium pyrachemical process with Dana C. Christensen as the main speaker. This paper presents edited versions of participants' written version

  2. When death approaches: reverting or exploiting emergent inequity in a complex land-use table-board game

    Directory of Open Access Journals (Sweden)

    Luís García-Barrios

    2015-06-01

    Full Text Available The lives of poor landowners in tropical mountains depend upon their collective capacity to create and coordinate social preferences derived from their interacting communalistic, hierarchical, and reciprocal exchanges. External actors currently contend for these territories under market rules that are modifying such preferences. We present the design, experimental implementation, and analysis of results of a four-player, land-use board game with stark resource and livelihood limits and coordination/cooperation challenges, as played (separately by 116 farmers and 108 academics, mainly in the tropical mountains of Chiapas, Mexico. In game session one, we trained and framed players in moral economy, a human core feeling and communalistic norm of solidarity and mutual obligation, which translates into "all players must survive." In session two, we explored to what extent moral economy resisted as a social preference under a hypothetical external monetary incentive scheme unfavorable to it. Using an approach that combines spot game analysis and experimental work, we studied the social preferences that emerged during session two among advantaged and disadvantaged players to deal with inequity in land appropriation and use when imminent "death" approaches. We make comparisons between farmers and academics. Players evolved moral economy, competitive domination, i.e., let competition decide, and coalition, i.e., advantaged players ask the dying to surrender land and die prematurely in exchange for a share of the dismal profits. Farmers basically stuck to the first two preferences in similar proportions whereas academics clearly shifted to coalition, a last-resort choice, which allowed disadvantaged players some final leverage and advantaged players use of liberated resources to improve efficiency. Coalition as strategic cooperation among the unequal is part of the culture in which academics are being educated as sustainability professionals and toward

  3. Source Apportionment and Risk Assessment of Emerging Contaminants: An Approach of Pharmaco-Signature in Water Systems

    Science.gov (United States)

    Jiang, Jheng Jie; Lee, Chon Lin; Fang, Meng Der; Boyd, Kenneth G.; Gibb, Stuart W.

    2015-01-01

    This paper presents a methodology based on multivariate data analysis for characterizing potential source contributions of emerging contaminants (ECs) detected in 26 river water samples across multi-scape regions during dry and wet seasons. Based on this methodology, we unveil an approach toward potential source contributions of ECs, a concept we refer to as the “Pharmaco-signature.” Exploratory analysis of data points has been carried out by unsupervised pattern recognition (hierarchical cluster analysis, HCA) and receptor model (principal component analysis-multiple linear regression, PCA-MLR) in an attempt to demonstrate significant source contributions of ECs in different land-use zone. Robust cluster solutions grouped the database according to different EC profiles. PCA-MLR identified that 58.9% of the mean summed ECs were contributed by domestic impact, 9.7% by antibiotics application, and 31.4% by drug abuse. Diclofenac, ibuprofen, codeine, ampicillin, tetracycline, and erythromycin-H2O have significant pollution risk quotients (RQ>1), indicating potentially high risk to aquatic organisms in Taiwan. PMID:25874375

  4. Application of modelling and nanotechnology-based approaches: The emergence of breakthroughs in theranostics of central nervous system disorders.

    Science.gov (United States)

    Hassanzadeh, Parichehr; Atyabi, Fatemeh; Dinarvand, Rassoul

    2017-08-01

    The limited efficiency of the current treatment options against the central nervous system (CNS) disorders has created increasing demands towards the development of novel theranostic strategies. The enormous research efforts in nanotechnology have led to the production of highly-advanced nanodevices and biomaterials in a variety of geometries and configurations for targeted delivery of genes, drugs, or growth factors across the blood-brain barrier. Meanwhile, the richness or reliability of data, drug delivery methods, therapeutic effects or potential toxicity of nanoparticles, occurrence of the unexpected phenomena due to the polydisperse or polymorphic nature of nanomaterials, and personalized theranostics have remained as challenging issues. In this respect, computational modelling has emerged as a powerful tool for rational design of nanoparticles with optimized characteristics including the selectivity, improved bioactivity, and reduced toxicity that might lead to the effective delivery of therapeutic agents. High-performance simulation techniques by shedding more light on the dynamical behaviour of neural networks and pathomechanisms of CNS disorders may provide imminent breakthroughs in nanomedicine. In the present review, the importance of integration of nanotechnology-based approaches with computational techniques for targeted delivery of theranostics to the CNS has been highlighted. Copyright © 2017. Published by Elsevier Inc.

  5. Discussion on nuclear issues

    International Nuclear Information System (INIS)

    Andrlova, Z.

    2012-01-01

    Treatment of the radioactive waste and utilisation of the ionisation radiation. Interesting contributions to two topics appeared in conference of Slovak Nuclear Society in Casta-Papiernicka in May 2012. The members from the female section 'Women in nuclear sector; were discussing in particular of the mind-set of Europeans to radioactive waste and novelties in nuclear medicine. (author)

  6. Summary of discussion

    International Nuclear Information System (INIS)

    2006-01-01

    This document provides summaries of the discussions occurred during the second international workshop on the indemnification of nuclear damage. It concerns the second accident scenario: a fire on board of a ship transporting enriched uranium hexafluoride along the Danube River. (A.L.B.)

  7. Discussion 2: David Dobbs

    OpenAIRE

    Dobbs, David; Murray-Rust, Peter; Hatcher, Jordan; Pollock, Rufus

    2010-01-01

    David Dobbs writes on science, medicine and culture. He has contributed to a diversity of publications, including Scientific American, Slate magazine, Wired, Audubon, Atlantic Monthly, and the New York Times magazine. He has also authored a number of books. Other participants in this discussion were Peter Murray-Rust, Jordan Hatcher, and Rufus Pollock.

  8. Summary and Discussion.

    Science.gov (United States)

    Hetherington, E. Mavis

    1992-01-01

    Summarizes and discusses results of the longitudinal study that comprises this monograph issue. Results concern: (1) marital, parent-child, and sibling relationships in families with single and remarried mothers; (2) the relationship between parenting style and adolescent adjustment; and (3) the relationship between marital transitions and…

  9. WORKSHOP: Discussion, debate, deliberation

    NARCIS (Netherlands)

    Jeliazkova, Margarita I.

    2014-01-01

    Discussing, deliberating and debating are a core part of any democratic process. To organise these processes well, a great deal of knowledge and skill is required. It is not simple to find a good balance between a number of elements: appropriate language and terminology; paying attention to solid

  10. Panel discussion : contract design

    Energy Technology Data Exchange (ETDEWEB)

    Vallas, A. [Sempra Energy Trading, Toronto, ON (Canada); Vegh, G. [MacLeod Dixon, Toronto, ON (Canada); McGee, M. [Energy Profiles Ltd., Etobicoke, ON (Canada); Zaremba, T. [Direct Energy Marketing, Calgary, AB (Canada); Seshan, A. [Larson and Toubro Information Technology, Toronto, ON (Canada); Harricks, P. [Gowlings, Toronto, ON (Canada); Bertoldi, L. [Borden Ladner Gervais, Toronto, ON (Canada); Taylor, R. [Hydro One Networks Inc., Markham, ON (Canada)

    2003-05-01

    This session presented highlights of the comments of 8 panelists who discussed the issue of contract design. The new electricity market in Ontario has introduced the energy trader, who enters into a contract with the consumer, based on the spot price set by the Independent Electricity Market Operator. Every contract has a fixed price payer as well as floating-price payers. If the floating price for a given amount of energy is higher than the fixed price, then the consumer gets the difference. Confusion, however, arises with the purchase of retail physical power in the market, particularly in deciding a fixed rate that the consumer will be paying. Different billing options were also discussed with emphasis on mid to large retail customers that have portfolios in the tens of MW and up to 100 MW or more. figs.

  11. Panel discussion : contract design

    International Nuclear Information System (INIS)

    Vallas, A.; Vegh, G.; McGee, M.; Zaremba, T.; Seshan, A.; Harricks, P.; Bertoldi, L.; Taylor, R.

    2003-01-01

    This session presented highlights of the comments of 8 panelists who discussed the issue of contract design. The new electricity market in Ontario has introduced the energy trader, who enters into a contract with the consumer, based on the spot price set by the Independent Electricity Market Operator. Every contract has a fixed price payer as well as floating-price payers. If the floating price for a given amount of energy is higher than the fixed price, then the consumer gets the difference. Confusion, however, arises with the purchase of retail physical power in the market, particularly in deciding a fixed rate that the consumer will be paying. Different billing options were also discussed with emphasis on mid to large retail customers that have portfolios in the tens of MW and up to 100 MW or more. figs

  12. Heavy precipitation and the responses within emergency management - a new approach for emergency planning and disaster prevention by utilizing fire brigade operation data

    Science.gov (United States)

    Kutschker, Thomas; Glade, Thomas

    2015-04-01

    An increase of intense rainfall events in the center regions of Europe is one of the assumed effects of climate change. Climate scenarios indicate also large seasonal and regional differences concerning the magnitude. Structural damages and financial loss resulting from heavy precipitation depend on natural parameters such as topography and vegetation cover of the specific area, but also on socio-economic parameters such as urbanized and industrialized areas, population density and the presence of critical infrastructure. In particular mudflows and floods cause damages such as flooded basements and streets, undercutting of roads or spilled sewage drains. The emergency management has to consider these effects appropriately. Commonly, this is the responsibilities is taken by the fire brigades and civil protection units. Within their daily routines, numerous data is collected, but commonly not utilized for scientific purposes. In particular fire brigade operation data can be used accordingly to describe the intensity of the aftermath when heavy precipitation strikes a certain area. One application is described in this study based on a example in Offenbach, Germany. The civil protection in Germany is based on a federal system with a bottom-up command-structure and responsibility to the local community. Therefore it is not easy to collect the overall incident data for a widespread affected area. To examine particular local effects of heavy precipitation events it is necessary to match the meteorological data provided by the German Meteorological Service (DWD) with the incident data of all effected fire brigades, which sometimes is impeded by the usual resolution of meteorological data. In this study, a method of comprehensive evaluation of meteorological data and the operation data from local fire brigades has been developed for the Rhine-Main-Area. This area is one of the largest metropolitan regions in Germany with a very high density in population as well as

  13. Discussion with CERN Directorate

    CERN Document Server

    CERN. Geneva

    2017-01-01

    Please note that the Discussion with CERN Directorate will be transmitted also in the following rooms: Council Chamber - 503-1-001 IT Amphitheatre - 31-3-004 Prevessin 774-R-013 Simultaneous interpreting into French and English will be available in the Main Auditorium. Une interprétation simultanée en français et en anglais sera disponible dans l'amphithéâtre principal.

  14. Evaluating Emergency Response Solutions for Sustainable Community Development by Using Fuzzy Multi-Criteria Group Decision Making Approaches: IVDHF-TOPSIS and IVDHF-VIKOR

    Directory of Open Access Journals (Sweden)

    Junling Zhang

    2016-03-01

    Full Text Available Emergency management is vital in implementing sustainable community development, for which community planning must include emergency response solutions to potential natural and manmade hazards. To help maintain such solution repository, we investigate effective fuzzy multi-criteria group decision making (FMCGDM approaches for the complex problems of evaluating alternative emergency response solutions, where weights for decision makers and criteria are unknown due to problem complexity. We employ interval-valued dual hesitant fuzzy (IVDHF set to address decision hesitancy more effectively. Based on IVDHF assessments, we develop a deviation maximizing model to compute criteria weights and another compatibility maximizing model to calculate weights for decision makers. Then, two ideal-solution-based FMCGDM approaches are proposed: (i by introducing a synthesized IVDHF group decision matrix into TOPSIS, we develop an IVDHF-TOPSIS approach for fuzzy group settings; (ii when emphasizing both maximum group utility and minimum individual regret, we extend VIKOR to develop an IVDHF-VIKOR approach, where the derived decision makers’ weights are utilized to obtain group decision matrix and the determined criteria weights are integrated to reflect the relative importance of distances from the compromised ideal solution. Compared with aggregation-operators-based approach, IVDHF-TOPSIS and IVDHF-VIKOR can alleviate information loss and computational complexity. Numerical examples have validated the effectiveness of the proposed approaches.

  15. Discussion Club "Profitable Heritage"

    Directory of Open Access Journals (Sweden)

    Marina Tkacheva

    2017-09-01

    Full Text Available The authors and participants of the project and the expert community analyze the problems related to the realization of a big-scale concept of renovation of the historical center “Irkutsk Quarters”. They discuss preservation of wooden architecture of the city, changes in social functions of the territory, inclusion of the new facilities in the fabric of the area, as well as the problems of the territory’s tourist function and preservation of the identity of Irkutsk downtown.

  16. Development of measures to assess the safety of existing NPPs and the effectiveness of regulations and regulatory actions (including 'prescriptive' and 'performance based' approaches). Peer discussions on regulatory practices

    International Nuclear Information System (INIS)

    1996-09-01

    This report arises from the fourth series of peer discussions on regulatory practices entitled D evelopment of measures to assess the safety of existing nuclear power plants and the effectiveness of regulations and regulatory actions (including 'prescriptive' and 'performance based' approaches) . Senior regulators from 23 Member States participated in four peer group discussions during 1995-1996. This report presents the outcome of these meetings and recommendations of good practices identified by these senior regulators. The purpose of this report is to disseminate the views which the senior regulators presented at the meetings relating to measures used for assessing the safety of existing nuclear power plants and evaluating the effectiveness of regulators and regulatory actions. The intention in doing this is to assist Member States in the enhancement of their regulatory practices by identifying commonly accepted good practices. This report is structured so that it covers the subject matter under the following main headings: 'Prescriptive and Performance Based' Approaches to Regulation; Common Features of Regulatory Approaches; Effectiveness of the Regulator and Regulatory Actions; Recommendations of Good Practice. It is important to note that recommendations of good practice are included if they have been identified by at least one of the groups. It does not follow that all of the groups or individual Member States would necessarily endorse all of the recommendations. However, it is considered that if a single group of senior regulators judge that a particular practice is worthy of recommendation then it should be included for serious consideration. In some cases the same recommendations arise from all of the Groups

  17. Abordaje subcraneal discusión y revisión histórica de la técnica quirúrgica Anterior subcranial approach: Discussion and historical review of the surgical technique

    Directory of Open Access Journals (Sweden)

    I. Zubillaga Rodríguez

    2009-02-01

    multidisciplinary teamwork. Material and methods. The subcranial approach is described as an alternative to traditional approaches to the skull base. The history of different key steps in the subcranial approach is described and discussed. Discussion. The selection of the most suitable approach to the skull base in each case is essential for obtaining satisfactory surgical results overall. Initially, the selection of an approach depends on the exact anatomic location of the lesion in the skull base, its threedimensional extension, as well as the nature of the lesion. The subcranial approach is an important step in the development of surgical techniques for the skull base. Conclusions. The anterior subcranial approach provides ample and optimal exposure of all the planes of the anterior cranial fossa, from the anterior ethmoidal roof to the clivus-sphenoid plate, including the orbital roofs. This objective is achieved without having to retract the frontal lobes, thus avoiding the associated morbidity and mortality that this maneuver entails. The anterior subcranial approach makes precise earlier management of oncologic pathology with intradural and extradural involvement possible, as well as the treatment of fractures produced by high-energy impact with involvement of the anterior cranial fossa.

  18. Research on Group Decision-Making Mechanism of Internet Emergency Management

    Science.gov (United States)

    Xie, Kefan; Chen, Gang; Qian, Wu; Shi, Zhao

    With the development of information technology, internet has become a popular term and internet emergency has an intensive influence on people's life. This article offers a short history of internet emergency management. It discusses the definition, characteristics, and factor of internet emergency management. A group decision-making mechanism of internet emergency is presented based on the discussion. The authors establish a so-called Rough Set Scenario Flow Graphs (RSSFG) of group decision-making mechanism of internet emergency management and make an empirical analysis based on the RSSFG approach. The experimental results confirm that this approach is effective in internet emergency decision-making.

  19. capital. A discussion paper

    Directory of Open Access Journals (Sweden)

    Ewa Chojnacka

    2015-04-01

    Full Text Available The purpose of this study is to confront certain propositions presented in Lesław Niemczyk’s publication Rachunkowość finansowa aktywów kompetencyjnych i kapitału intelektualnego. Nowy dział rachunkowości(Accounting for Competence Assets and Intellectual Capital. A New Area in Accounting with ideas published in other studies. The authors discuss issues concerning firm value, selected definitions of intellectual capital, as well as certain methods of intellectual capital measurement and valuation. Other problems analysed include accounting for and reporting of intellectual capital and similarities and differences between the way those issues are presented in Polish and in international studies as well as in existing legal regulations and standards.

  20. Results and discussion

    International Nuclear Information System (INIS)

    1998-01-01

    The author deals with the experimental study of sorption, desorption and vertical migration of radionuclides in Sr-85 and Cs-137 in selected soil samples from around of NPP Bohunice and NPP Mochovce and other localities of the Slovakia. The influence of different materials [concurrent ions (K + , Ca 2+ , NH 4 + , pH), organic matter (peat) and zeolite, humidity] on kinetic of sorption and desorption of strontium and cesium as well as distribution coefficient (K D ) and transfer coefficients in followed samples of soils were followed. Obtained adsorption isotherm are presented and discussed. Using the Tessiere's sequential extraction analysis a gross variability in binding of radionuclides on soils was found. The obtained results were processed with the correlation analysis and the compartment model

  1. Developing Off-site Emergency Preparedness and Response Model (OEPRM) for Severe Accident of NPP in a Densely Populated Country Using System Dynamics Approach

    Energy Technology Data Exchange (ETDEWEB)

    Hossena, Muhammed Mufazzal; Kang, Kyoung Ho; Song, Jin Ho [KAERI, Deajeon (Korea, Republic of)

    2016-05-15

    The main objectives of this study are to find the influencing factors of systems and sub-systems of OEPRM, to find the interdependency among the influencing factors, and to develop a conceptual qualitative OEPRM for densely populated NPP country in case of SA using system dynamics (SD). NPP accidents are classified as nuclear accidents and incidents depending on the severity. Severe accident (SA) is certain low probability accident that are beyond design basis accident which may arise due to multiple failures of safety systems leading to significant core degradation and jeopardize the integrity of many or all of the barriers to the release of radioactive material. The weakness to the off-site emergency response in the time of Fukushima accident was observed. So, it is crucial to develop an off-site emergency preparedness and responses model (OEPRM) for radiological emergency in densely populated country from the Fukushima emergency response lesson. In this study, an OEPRM is developed for densely populated NPP country to mitigate radiological effects in case of SA using SD approach. Besides, this study focuses the weakness of emergency response in Fukushima accident and proposed solution approach. The development of OEPRM in case of SA of NPP is very complex because of the involvement of various organization and it requires highly specialized agencies and technical experts. Moreover, if the country is agriculture based, it will make completely sophisticated.

  2. Developing Off-site Emergency Preparedness and Response Model (OEPRM) for Severe Accident of NPP in a Densely Populated Country Using System Dynamics Approach

    International Nuclear Information System (INIS)

    Hossena, Muhammed Mufazzal; Kang, Kyoung Ho; Song, Jin Ho

    2016-01-01

    The main objectives of this study are to find the influencing factors of systems and sub-systems of OEPRM, to find the interdependency among the influencing factors, and to develop a conceptual qualitative OEPRM for densely populated NPP country in case of SA using system dynamics (SD). NPP accidents are classified as nuclear accidents and incidents depending on the severity. Severe accident (SA) is certain low probability accident that are beyond design basis accident which may arise due to multiple failures of safety systems leading to significant core degradation and jeopardize the integrity of many or all of the barriers to the release of radioactive material. The weakness to the off-site emergency response in the time of Fukushima accident was observed. So, it is crucial to develop an off-site emergency preparedness and responses model (OEPRM) for radiological emergency in densely populated country from the Fukushima emergency response lesson. In this study, an OEPRM is developed for densely populated NPP country to mitigate radiological effects in case of SA using SD approach. Besides, this study focuses the weakness of emergency response in Fukushima accident and proposed solution approach. The development of OEPRM in case of SA of NPP is very complex because of the involvement of various organization and it requires highly specialized agencies and technical experts. Moreover, if the country is agriculture based, it will make completely sophisticated

  3. Development of the public exercise system for an emergency using response action applied with the event tree approach

    Energy Technology Data Exchange (ETDEWEB)

    Lee, De Whey; Lee, Byung Il; Park, Youn Won [BEES Inc., Rm No. L507, KAIST Munji Campus, Daejeon (Korea, Republic of)

    2016-12-15

    According to APPRE (Act on Physical Protection and Radiological Emergency), Korea Nuclear Safety and Security Committee (NSSC) jointly with other central government ministries shall conduct a unified radiological exercise once every year while a local government conduct an integrated exercise once every two-year period. What we experience up to date there are several limitations in the emergency exercises such as low public acceptance, poor enthusiasm in the exercise participation, not very attracting exercise scenarios, low efficiency in conducting an exercise, and so on. In order to overcome the limitations of the current exercise system, we have endeavored to develop an emergency exercise system using the VR (virtual reality) method based on a radioactive material release accident from the nuclear power plant. In this paper, we aim to introduce some basic development methods and emergency response action event tree for the public based on the exercise scenario as a beginning stage. We introduce a VR based emergency exercise system, which is expected to overcome some difficulties in the current exercise system. After developing this system properly and by testing it, we shall expect to deduce the weak points identified in the current emergency arrangements and emergency response strategy we now have.

  4. Final plenary discussion

    International Nuclear Information System (INIS)

    Federline, M.

    2004-01-01

    Rapporteur, chose to highlight other themes and issues from the seminar that appeared to be: - important for successful D and D; - worth further work in an international context; - controversial and worthy of further debate. The five main themes selected were as follows: - stakeholder involvement and communication; - strategy selection; - waste management and clearance; - funding and costs; - satisfying social demands. Various issues were identified under each one of these five themes and, in order to make best use of the time available for discussion, participants were invited to vote on the issues of most importance to them. Subsequent discussion was then focussed on the issues so identified. (author)

  5. Fuel ethanol discussion paper

    International Nuclear Information System (INIS)

    1992-01-01

    In recognition of the potential benefits of ethanol and the merits of encouraging value-added agricultural development, a committee was formed to develop options for the role of the Ontario Ministry of Agriculture and Food in the further development of the ethanol industry in Ontario. A consultation with interested parties produced a discussion paper which begins with an outline of the role of ethanol as an alternative fuel. Ethanol issues which require industry consideration are presented, including the function of ethanol as a gasoline oxygenate or octane enhancer, environmental impacts, energy impacts, agricultural impacts, trade and fiscal implications, and regulation. The ethanol industry and distribution systems in Ontario are then described. The current industry consists of one ethanol plant and over 30 retail stations. The key issue for expanding the industry is the economics of producing ethanol. At present, production of ethanol in the short term depends on tax incentives amounting to 23.2 cents/l. In the longer term, a significant reduction in feedstock costs and a significant improvement in processing technology, or equally significant gasoline price increases, will be needed to create a sustainable ethanol industry that does not need incentives. Possible roles for the Ministry are identified, such as support for ethanol research and development, financial support for construction of ethanol plants, and active encouragement of market demand for ethanol-blended gasolines

  6. Emergence delirium

    DEFF Research Database (Denmark)

    Munk, Louise; Andersen, Lars Peter Holst; Gögenur, Ismail

    2013-01-01

    Emergence delirium (ED) is a well-known phenomenon in the postoperative period. However, the literature concerning this clinical problem is limited. This review evaluates the literature with respect to epidemiology and risk factors. Treatment strategies are discussed. The review concludes...

  7. Exploring practical approaches to maximising data quality in electronic healthcare records in the primary care setting and associated benefits. Report of panel-led discussion held at SAPC in July 2014.

    Science.gov (United States)

    Dungey, Sheena; Glew, Simon; Heyes, Barbara; Macleod, John; Tate, A Rosemary

    2016-09-01

    Electronic healthcare records provide information about patient care over time which not only affords the opportunity to improve patient care directly through effective monitoring and identification of care requirements but also offers a unique platform for both clinical and service-model research essential to the longer-term development of the health service. The quality of the recorded data can, however, be variable and can compromise the validity of data use both for primary and secondary purposes. In order to explore the challenges and benefits of and approaches to recording high quality primary care electronic records, a Clinical Practice Research Datalink (CPRD) sponsored workshop was held at the Society of Academic Primary Care (SAPC) conference in 2014 with the aim of engaging GPs and other data users. The workshop was held as a structured discussion, led by an expert panel and focused around three questions: (1) What are the data quality priorities for clinicians and researchers? How do these priorities differ or overlap? (2) What challenges might GPs face in provision of good data quality both for treating their patients and for research? Do these aims conflict? (3) What tools (such as data metrics and visualisations or software components) could assist the GP in improving data quality and patient management and could this tie in with analytical processes occurring at the research stage? The discussion highlighted both overlap and differences in the perceived data quality priorities and challenges for different user groups. Five key areas of focus were agreed upon and recommendations determined for moving forward in improving quality. The importance of good high quality electronic healthcare records has been set forth along with the need for a practical user-considered and collaborative approach to its improvement.

  8. Fluoroalkyl Amino Reagents (FARs: A General Approach towards the Synthesis of Heterocyclic Compounds Bearing Emergent Fluorinated Substituents

    Directory of Open Access Journals (Sweden)

    Bruno Commare

    2017-06-01

    Full Text Available Fluorinated heterocycles are important building blocks in pharmaceutical, agrochemical and material sciences. Therefore, organofluorine chemistry has witnessed high interest in the development of efficient methods for the introduction of emergent fluorinated substituents (EFS onto heterocycles. In this context, fluoroalkyl amino reagents (FARs—a class of chemicals that was slightly forgotten over the last decades—has emerged again recently and proved to be a powerful tool for the introduction of various fluorinated groups onto (heteroaromatic derivatives.

  9. Fluoroalkyl Amino Reagents (FARs): A General Approach towards the Synthesis of Heterocyclic Compounds Bearing Emergent Fluorinated Substituents.

    Science.gov (United States)

    Commare, Bruno; Schmitt, Etienne; Aribi, Fallia; Panossian, Armen; Vors, Jean-Pierre; Pazenok, Sergiy; Leroux, Frédéric R

    2017-06-12

    Fluorinated heterocycles are important building blocks in pharmaceutical, agrochemical and material sciences. Therefore, organofluorine chemistry has witnessed high interest in the development of efficient methods for the introduction of emergent fluorinated substituents (EFS) onto heterocycles. In this context, fluoroalkyl amino reagents (FARs)-a class of chemicals that was slightly forgotten over the last decades-has emerged again recently and proved to be a powerful tool for the introduction of various fluorinated groups onto (hetero)aromatic derivatives.

  10. A Survey over the Dentists' and Endodntists' Approaches towards the Management of Endodontic Emergencies in Mashhad, Iran.

    Science.gov (United States)

    Bidar, Maryam; Gharechahi, Maryam; Soleimani, Tayebeh; Eslami, Neda

    2015-01-01

    Pain or swelling caused by various stages of inflammation/infection of the pulp/periradicular area is among endodontic emergencies. Determining the most effective method of emergency treatment is a challenging issue in endodontics. The goal of this study was to determine and compare the level of knowledge in general dentists and endodontists about endodontic emergency treatment plan in Mashhad, Iran in 2012-2013. In this cross-sectional descriptive study, 152 questionnaires were distributed among 120 general dentists and 32 endodontists of Mashhad. The questionnaire contained two separate parts. The first part included demographic information and in the second part different treatment protocols were suggested for 12 various conditions of pulp/periapical emergencies, and the participants were asked to choose the correct option(s). To determine the relationship between qualitative variables, the chi-square analysis was used. The level of significance was set at 0.05. There were significant differences between treatment plans presented by general dentists and endodontists about endodontic emergencies, especially in cases of necrotic pulp and subsequent swelling. Level of knowledge of dentists about the indications of incision and drainage, intra-canal medicament, root filing beyond the apical foramen and antibiotic prescription was not enough. These findings highlight the importance of refreshing courses for general dentists to improve their competency in the management of endodontic emergencies.

  11. A Survey over the Dentists’ and Endodntists’ Approaches towards the Management of Endodontic Emergencies in Mashhad, Iran

    Science.gov (United States)

    Bidar, Maryam; Gharechahi, Maryam; Soleimani, Tayebeh; Eslami, Neda

    2015-01-01

    Introduction: Pain or swelling caused by various stages of inflammation/infection of the pulp/periradicular area is among endodontic emergencies. Determining the most effective method of emergency treatment is a challenging issue in endodontics. The goal of this study was to determine and compare the level of knowledge in general dentists and endodontists about endodontic emergency treatment plan in Mashhad, Iran in 2012-2013. Methods and Materials: In this cross-sectional descriptive study, 152 questionnaires were distributed among 120 general dentists and 32 endodontists of Mashhad. The questionnaire contained two separate parts. The first part included demographic information and in the second part different treatment protocols were suggested for 12 various conditions of pulp/periapical emergencies, and the participants were asked to choose the correct option(s). To determine the relationship between qualitative variables, the chi-square analysis was used. The level of significance was set at 0.05. Results: There were significant differences between treatment plans presented by general dentists and endodontists about endodontic emergencies, especially in cases of necrotic pulp and subsequent swelling. Conclusion: Level of knowledge of dentists about the indications of incision and drainage, intra-canal medicament, root filing beyond the apical foramen and antibiotic prescription was not enough. These findings highlight the importance of refreshing courses for general dentists to improve their competency in the management of endodontic emergencies. PMID:26523142

  12. Synthetic biology analysed tools for discussion and evaluation

    CERN Document Server

    2016-01-01

    Synthetic biology is a dynamic, young, ambitious, attractive, and heterogeneous scientific discipline. It is constantly developing and changing, which makes societal evaluation of this emerging new science a challenging task, prone to misunderstandings. Synthetic biology is difficult to capture, and confusion arises not only regarding which part of synthetic biology the discussion is about, but also with respect to the underlying concepts in use. This book offers a useful toolbox to approach this complex and fragmented field. It provides a biological access to the discussion using a 'layer' model that describes the connectivity of synthetic or semisynthetic organisms and cells to the realm of natural organisms derived by evolution. Instead of directly reviewing the field as a whole, firstly our book addresses the characteristic features of synthetic biology that are relevant to the societal discussion. Some of these features apply only to parts of synthetic biology, whereas others are relevant to synthetic bi...

  13. Utilization of Health Care Coalitions and Resiliency Forums in the United States and United Kingdom: Different Approaches to Strengthen Emergency Preparedness.

    Science.gov (United States)

    Walsh, John; Swan, Allan Graeme

    2016-02-01

    The process for developing national emergency management strategies for both the United States and the United Kingdom has led to the formulation of differing approaches to meet similar desired outcomes. Historically, the pathways for each are the result of the enactment of legislation in response to a significant event or a series of events. The resulting laws attempt to revise practices and policies leading to more effective and efficient management in preparing, responding, and mitigating all types of natural, manmade, and technological hazards. Following the turn of the 21st century, each country has experienced significant advancements in emergency management including the formation and utilization of 2 distinct models: health care coalitions in the United States and resiliency forums in the United Kingdom. Both models have evolved from circumstances and governance unique to each country. Further in-depth study of both approaches will identify strengths, weaknesses, and existing gaps to meet continued and future challenges of our respective disaster health care systems.

  14. Nuclear and radiological emergency management and rehabilitation strategies: towards a EU approach for decision support tools (EURANOS)

    International Nuclear Information System (INIS)

    Raskob, W.; Gering, F.; Lochard, J.; Nisbet, A.; Starostova, V.; Tomic, B.

    2010-01-01

    The 5-year multi-national project EURANOS, funded by the European Commission and 23 European Member States, started in April 2004. Integrating 17 national emergency management organisations with 33 research institutes, it brings together best practices, knowledge and technology to enhance the preparedness for Europe's response to any radiation emergency and long term contamination. Key objectives of the project are to collate information on the likely effectiveness and consequences of a wide range of countermeasures, to provide guidance to emergency management organisations and decision makers on the establishment of an appropriate response strategy and to further enhance advanced decision support systems (DSS), in particular, RODOS, through feedback from their operational use. Further, the project aims to create regional initiatives leading to information exchange based on state-of-the-art information technologies, to develop guidance which assists Member States in developing a framework for the sustainable rehabilitation of living conditions in contaminated areas

  15. Syncope in pediatric patients: a practical approach to differential diagnosis and management in the emergency department [digest].

    Science.gov (United States)

    Fant, Colleen; Cohen, Ari; Vazquez, Michelle N

    2017-04-22

    Syncope is a condition that is often seen in the emergency department. Most syncope is benign, but it can be a symptom of a life-threatening condition. While syncope often requires an extensive workup in adults, in the pediatric population, critical questioning and simple, noninvasive testing is usually sufficient to exclude significant or life-threatening causes. For low-risk patients, resource-intensive workups are rarely diagnostic, and add significant cost to medical care. This issue will highlight critical diseases that cause syncope, identify high-risk "red flags," and enable the emergency clinician to develop a cost-effective, minimally invasive algorithm for the diagnosis and treatment of pediatric syncope. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  16. Emergency control; Kawalan kecemasan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1988-12-31

    The chapter briefly discussed the following subjects: plans and actions taken in emergency condition. It covers four main elements in planning, command, control center, emergency plans, continuous training and practices.

  17. A developmental approach of imitation to study the emergence of mirror neurons in a sensory-motor controller

    Directory of Open Access Journals (Sweden)

    Gaussier Philippe

    2011-12-01

    Full Text Available Mirror neurons have often been considered as the explanation of how primates can imitate. In this paper, we show that a simple neural network architecture that learns visuo-motor associations can be enough to let low level imitation emerge without a priori mirror neurons. Adding sequence learning mechanisms and action inhibition allows to perform deferred imitation of gestures demonstrated visually or by body manipulation. With the building of a cognitive map giving the capability of learning plans, we can study in our model the emergence of both low level and high level resonances highlighted by Rizzolatti et al.

  18. Anorectal emergencies

    Science.gov (United States)

    Lohsiriwat, Varut

    2016-01-01

    Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up. PMID:27468181

  19. Novel effects-based monitoring approaches to evaluate chemicals of emerging concern in the St. Louis River estuary

    Science.gov (United States)

    As part of an on-going program of research in support of the Great Lakes Restoration Initiative, the US EPA MED laboratory has been developing effects-based biomonitoring tools to evaluate the occurrence and potential hazards associated with Chemicals of Emerging Concern (CECs). ...

  20. Novel effects-based monitoring approaches to evaluate chemicals of emerging concern in Great Lakes areas of concern

    Science.gov (United States)

    As part of an on-going program of research in support of the Great Lakes Restoration Initiative, we have been developing effects-based biomonitoring tools to evaluate the occurrence and potential hazards associated with Chemicals of Emerging Concern (CECs). Over three field seaso...

  1. A comparative study between nonlinear regression and artificial neural network approaches for modelling wild oat (Avena fatua) field emergence

    Science.gov (United States)

    Non-linear regression techniques are used widely to fit weed field emergence patterns to soil microclimatic indices using S-type functions. Artificial neural networks present interesting and alternative features for such modeling purposes. In this work, a univariate hydrothermal-time based Weibull m...

  2. Discussion

    International Nuclear Information System (INIS)

    Mittleman, M.H.

    1985-01-01

    The positive energy projection operators, just described by Prof. Sucher, convert the sick Hamiltonian, H/sub DC/, into a more robust one which can support bound states. They are however still a subject of some controversy. Prof. Grant pointed out that existing computer codes produce remarkable accuracy in numerical calculations which start from H/sub DC/ (with no projection operators) and so he questioned whether these operators were indeed necessary. In response, it was pointed out by several people in the audience that the codes implicitly limit the Dirac-Hartee-Fock wave functions to a normalizable sub-space and that this operation can be described as a projection operator which has the effect of eliminating the negative energy states which are not normalizable. This operation is however, not any of the three projection operators described by Sucher and so the question arises as to the sensitivity of the results (for the energy and wave functions) to the particular projection operators which are used. This appears to be an open question

  3. [Enterostomy post emergency enterectomy].

    Science.gov (United States)

    Gavrilescu, S; Velicu, D; Gheorghiu, L; Duţescu, S

    2002-01-01

    This is a clinical approach regarding 43 resection of intestine, performed in emergency condition, terminated as enterostomy, with represent 20% of enterectomyes performed in emergency condition and 1.6% of urgent operations. The decision of enterostomy has been taken in the conditions of peritoneal sepsis, occlusion or the association of the two circumstances. The results are comparatively analyzed between the cases with enterostomy that has been made from the beginning (66% success, 33% gone wrong), and those with enterostomy made at the second intervention (14% success, 86% gone wrong). One discusses problems of leading, technique and post-operating nursing. The intestinal reintegration has been made possible at 16 patients after a timing of three of four weeks.

  4. Emergency planning and the Control of Major Accident Hazards (COMAH/Seveso II) Directive: An approach to determine the public safety zone for toxic cloud releases

    International Nuclear Information System (INIS)

    O'Mahony, Mary T.; Doolan, Donal; O'Sullivan, Alice; Hession, Michael

    2008-01-01

    The EU Control of Major Accidents Hazards Directive (Seveso II) requires an external emergency plan for each top tier site. This paper sets out a method to build the protection of public health into emergency planning for Seveso sites in the EU. The method involves the review of Seveso site details prescribed under the directive. The site safety report sets out the potential accident scenarios. The safety report's worst-case scenario, and chemical involved, is used as the basis for the external emergency plan. A decision was needed on the appropriate threshold value to use as the level of concern to protect public health. The definitions of the regulatory standards (air quality standards and occupational standards) in use were studied, how they are derived and for what purpose. The 10 min acute exposure guideline level (AEGL) for a chemical is recommended as the threshold value to inform decisions taken to protect public health from toxic cloud releases. The area delimited by AEGL 1 defines the population who may be concerned about being exposed. They need information based on comprehensive risk assessment. The area delimited by AEGL 2 defines the population for long-term surveillance when indicated and may include first responders. The area delimited by AEGL 3 defines the population who may present acutely to the medical services. It ensures that the emergency responders site themselves safely. A standard methodology facilitates discussions with plant operators and concerned public. Examples show how the methodology can be adapted to suit explosive risk and response to fire

  5. Poststroke Fatigue: Emerging Evidence and Approaches to Management: A Scientific Statement for Healthcare Professionals From the American Heart Association.

    Science.gov (United States)

    Hinkle, Janice L; Becker, Kyra J; Kim, Jong S; Choi-Kwon, Smi; Saban, Karen L; McNair, Norma; Mead, Gillian E

    2017-07-01

    At least half of all stroke survivors experience fatigue; thus, it is a common cause of concern for patients, caregivers, and clinicians after stroke. This scientific statement provides an international perspective on the emerging evidence surrounding the incidence, prevalence, quality of life, and complex pathogenesis of poststroke fatigue. Evidence for pharmacological and nonpharmacological interventions for management are reviewed, as well as the effects of poststroke fatigue on both stroke survivors and caregivers. © 2017 American Heart Association, Inc.

  6. [Application of a continual improvement approach to selecting diagnostic markers for acute pancreatitis in an emergency department].

    Science.gov (United States)

    Salinas, María; Flores, Emilio; López-Garrigós, Maite; Díaz, Elena; Esteban, Patricia; Leiva-Salinas, Carlos

    2017-01-01

    To apply a continual improvement model to develop an algorithm for ordering laboratory tests to diagnose acute pancreatitis in a hospital emergency department. Quasi-experimental study using the continual improvement model (plan, do, check, adjust cycles) in 2 consecutive phases in emergency patients: amylase and lipase results were used to diagnose acute pancreatitis in the first phase; in the second, only lipase level was first determined; amylase testing was then ordered only if the lipase level fell within a certain range. We collected demographic data, number amylase and lipase tests ordered and the findings, final diagnosis, and the results of a questionnaire to evaluate satisfaction with emergency care. The first phase included 517 patients, of whom 20 had acute pancreatitis. For amylase testing sensitivity was 0.70; specificity, 0.85; positive predictive value (PPV), 17; and negative predictive value (NPV), 0.31. For lipase testing these values were sensitivity, 0.85; specificity, 0.96; PPV, 21, and NPV, 0.16. When both tests were done, sensitivity was 0.85; specificity 0.99; PPV, 85; and NPV, 0.15. The second phase included data for 4815 patients, 118 of whom had acute pancreatitis. The measures of diagnostic yield for the new algorithm were sensitivity, 0.92; specificity, 0.98; PPV, 46; and NPV, 0.08]. This study demonstrates a process for developing a protocol to guide laboratory testing in acute pancreatitis in the hospital emergency department. The proposed sequence of testing for pancreatic enzyme levels can be effective for diagnosing acute pancreatitis in patients with abdominal pain.

  7. Employees’ Performance Contribution to the Growth of the Company on the Emerging Markets – a Managerial Approach

    Directory of Open Access Journals (Sweden)

    Raluca Ioana Vosloban

    2013-02-01

    Full Text Available An appropriate human resources strategycan be the necessary competitive advantage that acompany must have on the emerging markets in particular.This paper aims to underline themanagers’ implication on the employees’ performance, what strategies are used to retain them, whatinfluences theirperformance, how this contributes to company’s growth and development. These areimportant aspects, being part of the continuous improvement plans on the emerging markets. Morestudies have treated this topic and its relevance to the economic literature, trying to provide moreexplanations for the variance of employees’ performance and its results within different types oforganizations. This study used the semi-conducted in-depth interview method, among 13 managersfrom Bucharest, having three tested and confirmed hypotheses. It was confirmed that there arevarious factors that influence employees’ performance and factors that prevent employees from beingperformant. The employees’ performance significantly contributes to the growth of the company.This study has mainly managerial implications, as it emphasizes the role of the human capital to thesuccess of the company. The study is valuable through the emerging character of our country and theneed of efficient strategies that could provide competitive advantage.

  8. Emergency preparedness in obstetrics.

    Science.gov (United States)

    Haeri, Sina; Marcozzi, David

    2015-04-01

    During and after disasters, focus is directed toward meeting the immediate needs of the general population. As a result, the routine health care and the special needs of some vulnerable populations such as pregnant and postpartum women may be overlooked within a resource-limited setting. In the event of hazards such as natural disasters, manmade disasters, and terrorism, knowledge of emergency preparedness strategies is imperative for the pregnant woman and her family, obstetric providers, and hospitals. Individualized plans for the pregnant woman and her family should include knowledge of shelter in place, birth at home, and evacuation. Obstetric providers need to have a personal disaster plan in place that accounts for work responsibilities in case of an emergency and business continuity strategies to continue to provide care to their communities. Hospitals should have a comprehensive emergency preparedness program utilizing an "all hazards" approach to meet the needs of pregnant and postpartum women and other vulnerable populations during disasters. With lessons learned in recent tragedies such as Hurricane Katrina in mind, we hope this review will stimulate emergency preparedness discussions and actions among obstetric providers and attenuate adverse outcomes related to catastrophes in the future.

  9. 46 Testing of the 'always events' approach to improve the patient experience in the emergency department.

    Science.gov (United States)

    Lowe, David; Kay, Cameron; Taylor, Dagshagini; Hepburn, Scott; Littlewood, Nicola; Bowie, Paul

    2017-12-01

    This project aimed to identify issues patients would like to see improved when interacting with the Minor Injuries Unit (MIU) and as a result generate measurable and feasible Always Events (AEs) based on patient feedback that can be implemented via a Quality Improvement (QI) process. We then looked to assess and improve on the delivery of the agreed AEs to enhance MIU patient experience. AEs were identified by using a short semi-structured survey questionnaire with a free text response section from 45 patients. Patients were asked what should always happen in the ED. Iterative thematic analysis identified information provision and explaining how the department worked as key themes. Two interventions, an educational poster and a video campaign, were designed and implemented to address this issue. Improvement was assessed via convenience sampling of patient questionnaires using a five-point bipolar Likert scale and free text responses which were compared to a set of baseline results via run charts to examine impact of each intervention. A total of 300 patients completed questionnaires throughout the baseline and intervention periods. Baseline results stood at 80% for patient satisfaction regarding information provision, rising to 88% by the end of the poster intervention and 92% by the end of the video intervention. Understanding of how the ED functions stood at 83% in the baseline sample before rising to 86% throughout the poster and video intervention. Composite survey results rose from a baseline level of 82.2% to 86.3% for the poster intervention and 88.8% by the end of the video intervention stage. Patient questionnaires indicated that information provision directly from staff was variable throughout the study period.emermed;34/12/A890-b/F1F1F1Figure 1emermed;34/12/A890-b/F2F2F2Figure 2 DISCUSSION: Implementing the AE approach in the MIU has had a positive effect on patient experience. The poster intervention had the greatest impact on enhancing patient

  10. A multi-method approach to curriculum development for in-service training in China's newly established health emergency response offices.

    Directory of Open Access Journals (Sweden)

    Yadong Wang

    Full Text Available To describe an innovative approach for developing and implementing an in-service curriculum in China for staff of the newly established health emergency response offices (HEROs, and that is generalisable to other settings.The multi-method training needs assessment included reviews of the competency domains needed to implement the International Health Regulations (2005 as well as China's policies and emergency regulations. The review, iterative interviews and workshops with experts in government, academia, the military, and with HERO staff were reviewed critically by an expert technical advisory panel.Over 1600 participants contributed to curriculum development. Of the 18 competency domains identified as essential for HERO staff, nine were developed into priority in-service training modules to be conducted over 2.5 weeks. Experts from academia and experienced practitioners prepared and delivered each module through lectures followed by interactive problem-solving exercises and desktop simulations to help trainees apply, experiment with, and consolidate newly acquired knowledge and skills.This study adds to the emerging literature on China's enduring efforts to strengthen its emergency response capabilities since the outbreak of SARS in 2003. The multi-method approach to curriculum development in partnership with senior policy-makers, researchers, and experienced practitioners can be applied in other settings to ensure training is responsive and customized to local needs, resources and priorities. Ongoing curriculum development should reflect international standards and be coupled with the development of appropriate performance support systems at the workplace for motivating staff to apply their newly acquired knowledge and skills effectively and creatively.

  11. A multi-method approach to curriculum development for in-service training in China's newly established health emergency response offices.

    Science.gov (United States)

    Wang, Yadong; Li, Xiangrui; Yuan, Yiwen; Patel, Mahomed S

    2014-01-01

    To describe an innovative approach for developing and implementing an in-service curriculum in China for staff of the newly established health emergency response offices (HEROs), and that is generalisable to other settings. The multi-method training needs assessment included reviews of the competency domains needed to implement the International Health Regulations (2005) as well as China's policies and emergency regulations. The review, iterative interviews and workshops with experts in government, academia, the military, and with HERO staff were reviewed critically by an expert technical advisory panel. Over 1600 participants contributed to curriculum development. Of the 18 competency domains identified as essential for HERO staff, nine were developed into priority in-service training modules to be conducted over 2.5 weeks. Experts from academia and experienced practitioners prepared and delivered each module through lectures followed by interactive problem-solving exercises and desktop simulations to help trainees apply, experiment with, and consolidate newly acquired knowledge and skills. This study adds to the emerging literature on China's enduring efforts to strengthen its emergency response capabilities since the outbreak of SARS in 2003. The multi-method approach to curriculum development in partnership with senior policy-makers, researchers, and experienced practitioners can be applied in other settings to ensure training is responsive and customized to local needs, resources and priorities. Ongoing curriculum development should reflect international standards and be coupled with the development of appropriate performance support systems at the workplace for motivating staff to apply their newly acquired knowledge and skills effectively and creatively.

  12. Using systems thinking to identify workforce enablers for a whole systems approach to urgent and emergency care delivery: a multiple case study.

    Science.gov (United States)

    Manley, Kim; Martin, Anne; Jackson, Carolyn; Wright, Toni

    2016-08-09

    Overcrowding in emergency departments is a global issue, which places pressure on the shrinking workforce and threatens the future of high quality, safe and effective care. Healthcare reforms aimed at tackling this crisis have focused primarily on structural changes, which alone do not deliver anticipated improvements in quality and performance. The purpose of this study was to identify workforce enablers for achieving whole systems urgent and emergency care delivery. A multiple case study design framed around systems thinking was conducted in South East England across one Trust consisting of five hospitals, one community healthcare trust and one ambulance trust. Data sources included 14 clinical settings where upstream or downstream pinch points are likely to occur including discharge planning and rapid response teams; ten regional stakeholder events (n = 102); a qualitative survey (n = 48); and a review of literature and analysis of policy documents including care pathways and protocols. The key workforce enablers for whole systems urgent and emergency care delivery identified were: clinical systems leadership, a single integrated career and competence framework and skilled facilitation of work based learning. In this study, participants agreed that whole systems urgent and emergency care allows for the design and implementation of care delivery models that meet complexity of population healthcare needs, reduce duplication and waste and improve healthcare outcomes and patients' experiences. For this to be achieved emphasis needs to be placed on holistic changes in structures, processes and patterns of the urgent and emergency care system. Often overlooked, patterns that drive the thinking and behavior in the workplace directly impact on staff recruitment and retention and the overall effectiveness of the organization. These also need to be attended to for transformational change to be achieved and sustained. Research to refine and validate a single

  13. Human Cloning: Let's Discuss It.

    Science.gov (United States)

    Taras, Loretta; Stavroulakis, Anthea M.; Ortiz, Mary T.

    1999-01-01

    Describes experiences with holding discussions on cloning at a variety of levels in undergraduate biology courses. Discusses teaching methods used and student reactions to the discussions. Contains 12 references. (WRM)

  14. Radiation emergency response in Illinois, Alabama, and Texas

    International Nuclear Information System (INIS)

    Larsen, D.K.; Chester, R.O.

    1978-03-01

    The objective of this study was to examine state radiation emergency response and to locate any areas of emergency planning in need of improvement. This report briefly presents a summary of laws and defining documents governing radiation emergency response, describes the existing and projected need for such response, and presents the authors' analyses of the evolution of state response plans and their application to radiation incidents. Three states' programs are discussed in detail: Illinois, Alabama, and Texas. These states were selected because they have quite different emergency-response programs. Therefore, these state programs provide a wide variety of approaches to state radiation emergency response

  15. Diabetic Emergencies

    Science.gov (United States)

    ... Campaigns Share this! EmergencyCareForYou » Emergency 101 » Diabetic Emergencies Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  16. A reliability-based approach of fastest routes planning in dynamic traffic network under emergency management situation

    Directory of Open Access Journals (Sweden)

    Ye Sun

    2011-12-01

    Full Text Available In order to establish an available emergency management system, it is important to conduct effective evacuation with reliable and real time optimal route plans. This paper aims at creating a route finding strategy by considering the time dependent factors as well as uncertainties that may be encountered during the emergency management system. To combine dynamic features with the level of reliability in the process of fastest route planning, the speed distribution of typical intercity roads is studied in depth, and the strategy of modifying real time speed to a more reliable value based on speed distribution is proposed. Two algorithms of route planning have been developed to find three optimal routes with the shortest travel time and the reliability of 0.9. In order to validate the new strategy, experimental implementation of the route planning method is conducted based on road speed information acquired by field study. The results show that the proposed strategy might provide more reliable routes in dynamic traffic networks by conservatively treating roads with large speed discretion or with relative extreme real speed value.

  17. Autism spectrum disorder traits in typically developing emerging adults and associated parenting: A person-centered approach.

    Science.gov (United States)

    McKinney, Cliff; Gadke, Daniel L; Malkin, Mallory L

    2018-02-15

    Research on parenting children with autism spectrum disorder (ASD) indicates these children receive parenting tailored to their condition. However, little is known about ASD in adulthood, especially in emerging adults at college, and how they are parented. The current study examined how emerging adults in a non-clinical typically-developing sample differed in their current perceptions of parenting as a function of ASD traits. Participants completed questionnaires about their current perceptions of parenting and self-reported ASD traits. Parenting characteristics assessed included parenting style, discipline, parent-child relationship quality, and parental distress. Results indicated that higher levels of self-reported ASD traits were associated with increasingly ineffective parenting characteristics including lower authoritative style, harsher discipline, poorer parent-child relationship quality (e.g., lower involvement), and higher parental distress. Researchers are encouraged to extend ASD research into adulthood by validating diagnostic methods with adults and investigating processes in adulthood that have been well-established in the childhood ASD literature.

  18. Emerging treatments in alopecia.

    Science.gov (United States)

    Falto-Aizpurua, Leyre; Choudhary, Sonal; Tosti, Antonella

    2014-12-01

    Alopecia is a common concern encountered in the medical practice. Treatment approach varies according to the type and severity of alopecia. However, available treatment options have limited efficacy and several adverse effects. Presently, there are different treatment options being studied to overcome these limitations. Additionally, cellular pathways involved in the pathophysiology of alopecia are further being clarified to potentially target pathogenic molecules. We searched the literature for recently published articles discussing new treatment options as well as mechanisms involved in alopecia. We discuss the use of stem cells, growth factors, cellular pathways and robotic hair transplant, among other emerging therapies used for alopecia. Future looks very promising and new effective treatments such as janus kinase inhibitors could possibly be available for alopecia areata. The stem-cell technology is advancing and companies involved in hair follicle neogenesis are starting clinical trials on patients with androgenetic alopecia.

  19. Conceptualization of Approaches and Thought Processes Emerging in Validating of Model in Mathematical Modeling in Technology Aided Environment

    Science.gov (United States)

    Hidiroglu, Çaglar Naci; Bukova Güzel, Esra

    2013-01-01

    The aim of the present study is to conceptualize the approaches displayed for validation of model and thought processes provided in mathematical modeling process performed in technology-aided learning environment. The participants of this grounded theory study were nineteen secondary school mathematics student teachers. The data gathered from the…

  20. Learning Experiences and Practices of Elementary Teacher Candidates on the Use of Emerging Technology: A Grounded Theory Approach

    Science.gov (United States)

    Bahng, EunJin; Lee, Mimi

    2017-01-01

    The purpose of this study is to understand the phenomenon of the "professional journey" of elementary teacher candidates (ETC) both as learners and as teachers by exploring their learning experiences and practices regarding the virtual reality (VR) platform called Second Life (SL). Using the grounded theory approach, we designed an…

  1. A Bayesian Approach for the Analysis of Macroeconomic Dynamic in Case of Emerging Countries-Monetary and Fiscal Policy Model

    Directory of Open Access Journals (Sweden)

    Georgiana-Alina Ionita

    2016-10-01

    Full Text Available The paper proposes the analysis of the main drivers of the economic growth in Central and Eastern Europe, in three emerging countries: Czech Republic, Hungary and Poland, with a development stage similar with that of Romania. Given the vulnerabilities of the Central and Eastern Europe region at the beginning and during the recent global economic and financial crisis, there is an increased interest to identify the models that can describe the principalcharacteristics of the Central and Eastern Europe macroeconomic variables: gross domestic product, investment, wages and salaries, inflation, hours worked, consumption and themonetary variable- interest rate. Moreover, another scope is to analyze the frictions that describe the evolution of the seven data series, as the stochastic dynamic of the macroeconomic model is driven by orthogonal structural shocks.

  2. Fiscal Deficit, National Saving and Sustainability of Economic Growth in Emerging Economies: A Dynamic GMM Panel Data Approach

    Directory of Open Access Journals (Sweden)

    Buscemi Antonino

    2012-01-01

    Full Text Available The neoclassical growth models argued that the movement to steady states; technology, exogenous rate of savings, population growth and technical progress stimulate higher growth levels (Solow 1956. Contrary to the neoclassical argument, endogenous growth model argues that, in the theory of endogenous growth, government play a significant role in promoting accumulation of knowledge, research and development, public investment, human capital development, law and order can generate growth both in the short and long run. Moreover, they assumed technical progress as endogenous variable for growth (Barro 1995. This study analyze the effects of fiscal deficit on sustainability of economic growth and provided new empirical evidence on the effects of fiscal deficit on saving and sustainability of economic growth based on the assumption of endogenous growth model. We estimated using the reduced form of GMM method for dynamic panels covers 1990-2009 for three emerging countries that includes China, India and South Africa.

  3. Accession of the Slovak Republic to EU - new legislation, new conditions and new approaches in the area of emergency preparedness

    International Nuclear Information System (INIS)

    Sladek, V.; Metke, E.

    2003-01-01

    At present after five years of Urad jadroveho dozoru (UJD) experience of using new Slovak regulations and before entering to European Union (EU), which is foreseen since May 2004 a comprehensive review of Atomic Act and all relevant decrees is being made with the objective to fit them to EU directives. On line with that also necessary organizational and technical arrangements in the area of regulatory activities including emergency preparedness are prepared. UJD participate actively in EU and IAEA projects to achieve the harmonization of its practices with EU and other countries with developed nuclear power and makes efforts to keep on a high level of nuclear safety to be a valuable member of EU

  4. Human Brucellosis Trends: Re-emergence and Prospects for Control Using a One Health Approach in Azerbaijan (1983-2009).

    Science.gov (United States)

    Kracalik, I T; Abdullayev, R; Asadov, K; Ismayilova, R; Baghirova, M; Ustun, N; Shikhiyev, M; Talibzade, A; Blackburn, J K

    2016-06-01

    Brucellosis is one of the most common and widely spread zoonotic diseases in the world. Control of the disease in humans is dependent upon limiting the infection in animals through surveillance and vaccination. Given the dramatic economic and political changes that have taken place in the former Soviet Union, which have limited control, evaluating the status of human brucellosis in former Soviet states is crucial. We assessed annual spatial and temporal trends in the epidemiology of human brucellosis in Azerbaijan, 1983-2009, in conjunction with data from a livestock surveillance and control programme (2002-2009). To analyse trends, we used a combination of segmented regression and spatial analysis. From 1983 to 2009, a total of 11 233 cases of human brucellosis were reported. Up to the mid-1990s, the incidence of human brucellosis showed a pattern of re-emergence, increasing by 25% annually, on average. Following Soviet governance, the incidence rates peaked, increasing by 1.8% annually, on average, and subsequently decreasing by 5% annually, on average, during the period 2002-2009. Despite recent national declines in human incidence, we identified geographic changes in the case distribution characterized by a geographic expansion and an increasing incidence among districts clustered in the south-east, compared to a decrease of elsewhere in the country. Males were consistently, disproportionately afflicted (71%) and incidence was highest in the 15 to 19 age group (18.1 cases/100 000). During the period 2002-2009, >10 million small ruminants were vaccinated with Rev1. Our findings highlight the improving prospects for human brucellosis control following livestock vaccination; however, the disease appears to be re-emerging in south-eastern Azerbaijan. Sustained one health measures are needed to address changing patterns of brucellosis in Azerbaijan and elsewhere in the former Soviet Union. © 2015 The Authors. Zoonoses and Public Health Published by Blackwell

  5. Emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, J. [Key Safety and Blowout Control Corp., Sylvan Lake, AB (Canada)

    2001-07-01

    This presentation included several slides depicting well control and emergency preparedness. It provided information to help in pre-emergency planning for potential well control situations. Key Safety and Blowout Control Corp has gained experience in the Canadian and International well control industry as well as from the fires of Kuwait. The president of the company lectures on the complications and concerns of managers, wellsite supervisors, service companies, the public sector, land owners, government agencies and the media. The slides presented scenarios based on actual blowout recovery assignments and described what types of resources are needed by a well control team. The presentation addressed issues such as the responsibility of a well control team and what they can be expected to do. The issue of how government agencies become involved was also discussed. The presentation combines important information and descriptive images of personal experiences in fire fighting and well control. The emergency situations presented here demonstrate the need for a thorough understanding of preplanning for emergencies and what to expect when a typical day in the oil patch turns into a high stress, volatile situation. tabs., figs.

  6. How is Civic Engagement Related to Personal Identity and Social Identity in Late Adolescents and Emerging Adults? A Person-Oriented Approach.

    Science.gov (United States)

    Lannegrand-Willems, Lyda; Chevrier, Basilie; Perchec, Cyrille; Carrizales, Alexia

    2018-04-01

    Adolescence and emerging adulthood are periods in life when individuals both question and define their place in society and form their identity. Meanwhile, active youth civic engagement represents a challenge for each democracy. The purpose of this study was to analyze the different forms of civic engagement among late adolescents and emerging adults and how they are related to personal identity and social identity, while adopting an integrative perspective through the lens of a person-oriented approach. The participants were 1217 (62.3% female) 16-24 year-old French students (M age  = 19.17; SD age  = 1.83). First, derived from cluster analyses, the findings emphasized diversity in civic engagement, from strong civic participation (in different formal and informal ways) to various forms of passivity. Diversity was also highlighted for personal identity and social identity profiles. Second, a Configural Frequency Analysis revealed a typical pattern associating passivity in civic engagement, personal carefree diffusion and rejection of social identity. Overall, these findings highlight an absence of general youth disaffection and provide a meaningful specific pattern for the understanding of passivity in political and civic matters in late adolescence and emerging adulthood.

  7. [Emerging noninfectious diseases].

    Science.gov (United States)

    Consiglio, Ezequiel

    2008-11-01

    In recent years, emerging diseases were defined as being infectious, acquiring high incidence, often suddenly, or being a threat or an unexpected phenomenon. This study discusses the hallmarks of emerging diseases, describing the existence of noninfectious emerging diseases, and elaborating on the advantages of defining noninfectious diseases as emerging ones. From the discussion of various mental health disorders, nutritional deficiencies, external injuries and violence outcomes, work injuries and occupational health, and diseases due to environmental factors, the conclusion is drawn that a wide variety of noninfectious diseases can be defined as emergent. Noninfectious emerging diseases need to be identified in order to improve their control and management. A new definition of "emergent disease" is proposed, one that emphasizes the pathways of emergence and conceptual traits, rather than descriptive features.

  8. Emerging wind energy technologies

    DEFF Research Database (Denmark)

    Rasmussen, Flemming; Grivel, Jean-Claude; Faber, Michael Havbro

    2014-01-01

    This chapter will discuss emerging technologies that are expected to continue the development of the wind sector to embrace new markets and to become even more competitive.......This chapter will discuss emerging technologies that are expected to continue the development of the wind sector to embrace new markets and to become even more competitive....

  9. Emission trading: A discussion paper

    International Nuclear Information System (INIS)

    1992-05-01

    Emission trading is a market-based incentive program designed to control air emissions in which a cap is placed on the total quantity of pollutants allowed to be emitted in an airshed. Appropriate shares of this amount are allocated among participating emission sources, and participants can buy or sell their shares. Advantages of emission trading include its potential to achieve air emission targets at a lower cost than the traditional command and control approach, and its ability to accommodate economic growth without compromising environmental quality. A study was conducted to evaluate the potential use of emission trading programs to achieve emission reduction goals set for nitrogen oxides, volatile organic compounds (VOC), and sulfur oxides. Emission trading programs in the USA are reviewed and a set of factors important for the success of emission trading are identified. Key policy and design issues related to an emission trading program are identified, explained, and discussed. Administrative issues are then analyzed, such as legislative authority, monitoring and enforcement requirements, and trading between jurisdictions. A preliminary assessment of emission trading for control of NOx and VOC in the Lower Fraser Valley indicates that emission trading would be feasible, but legislative authority to implement such a program would have to be introduced

  10. Soviet-designed pressurized water reactor symptomatic emergency operating instruction analytical procedure: approach, methodology, development and application

    International Nuclear Information System (INIS)

    Beelman, R.J.

    1999-01-01

    A symptom approach to the analytical validation of symptom-based EOPs includes: (1) Identification of critical safety functions to the maintenance of fission product barrier integrity; (2) Identification of the symptoms which manifest an impending challenge to critical safety function maintenance; (3) Development of a symptomatic methodology to delineate bounding plant transient response modes; (4) Specification of bounding scenarios; (5) Development of a systematic calculational approach consistent with the objectives of the methodology; (6) Performance of thermal-hydraulic computer code calculations implementing the analytical methodology; (7) Interpretation of the analytical results on the basis of information available to the operator; (8) Application of the results to the validation of the proposed operator actions; (9) Production of a technical basis document justifying the proposed operator actions. (author)

  11. Evaluating the sustainability impacts of emerging regulations in the electronics industry - a comparison of US and European approaches

    Energy Technology Data Exchange (ETDEWEB)

    Darby, L.; Hines, F.; Williams, A. [ESRC Centre for Business Relationships, Accountability, Sustainability and Society (BRASS), Cardiff (United Kingdom)

    2004-07-01

    In response to a growing awareness of the problems associated with the manufacture, use and disposal of e-waste, a number of different regulatory approaches have been developed. These new approaches are not, however, sufficiently comprehensive in their appreciation of the broader sustainability implications inherent in regulatory design and implementation. They tend to focus on issues seen as most pressing, instead of taking a more holistic, long term strategic view. Regulatory approaches often have far reaching consequences that extend beyond the initial intentions of policy makers, and this paper considers some of the key sustainability related issues such as the need to ensure long term financing, and the importance of raising consumer awareness and encouraging an ethic of individual responsibility. Using EU and US examples, this paper investigates the ways in which key sustainability issues are being addressed under different regulatory models. It critically analyses the implications for sustainability, and offers recommendations for policy-makers in considering a broader range of sustainability issues both when designing and implementing new regulations. (orig.)

  12. Emergency Communication

    Science.gov (United States)

    : Environmental Documents, Reports LANL Home Calendar Search Contacts Resources » Emergency Communication Emergency Communication Stay informed of emergencies, weather delays, closures, other alerts. Find links to

  13. Development of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach.

    Science.gov (United States)

    Wakai, Abel; O'Sullivan, Ronan; Staunton, Paul; Walsh, Cathal; Hickey, Fergal; Plunkett, Patrick K

    2013-04-01

    The objective of this study was to develop a consensus among emergency medicine (EM) specialists working in Ireland for emergency department (ED) key performance indicators (KPIs). The method employed was a three-round electronic modified-Delphi process. An online questionnaire with 54 potential KPIs was set up for round 1 of the Delphi process. The Delphi panel consisted of all registered EM specialists in Ireland. Each indicator on the questionnaire was rated using a five-point Likert-type rating scale. Agreement was defined as at least 70% of the responders rating an indicator as 'agree' or 'strongly agree' on the rating scale. Data were analysed using standard descriptive statistics. Data were also analysed as the mean of the Likert rating with 95% confidence intervals (95% CIs). Sensitivity of the ratings was examined for robustness by bootstrapping the original sample. Statistical analyses were carried out using SPSS version 16.0. The response rates in rounds 1, 2 and 3 were 86, 88 and 88%, respectively. Ninety-seven potential indicators reached agreement after the three rounds. In the context of the Donabedian structure-process-outcome framework of performance indicators, 41 (42%) of the agreed indicators were structure indicators, 52 (54%) were process indicators and four (4%) were outcome indicators. Overall, the top-three highest rated indicators were: presence of a dedicated ED clinical information system (4.7; 95% CI 4.6-4.9), ED compliance with minimum design standards (4.7; 95% CI 4.5-4.8) and time from ED arrival to first ECG in suspected cardiac chest pain (4.7; 95% CI 4.5-4.9). The top-three highest rated indicators specific to clinical care of children in EDs were: time to administration of antibiotics in children with suspected bacterial meningitis (4.6; 95% CI 4.5-4.8), separate area available within EDs (seeing both adults and children) to assess children (4.4; 95% CI 4.2-4.6) and time to administration of analgesia in children with forearm

  14. Development of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach.

    LENUS (Irish Health Repository)

    Wakai, Abel

    2012-02-29

    OBJECTIVE: The objective of this study was to develop a consensus among emergency medicine (EM) specialists working in Ireland for emergency department (ED) key performance indicators (KPIs). METHODS: The method employed was a three-round electronic modified-Delphi process. An online questionnaire with 54 potential KPIs was set up for round 1 of the Delphi process. The Delphi panel consisted of all registered EM specialists in Ireland. Each indicator on the questionnaire was rated using a five-point Likert-type rating scale. Agreement was defined as at least 70% of the responders rating an indicator as \\'agree\\' or \\'strongly agree\\' on the rating scale. Data were analysed using standard descriptive statistics. Data were also analysed as the mean of the Likert rating with 95% confidence intervals (95% CIs). Sensitivity of the ratings was examined for robustness by bootstrapping the original sample. Statistical analyses were carried out using SPSS version 16.0. RESULTS: The response rates in rounds 1, 2 and 3 were 86, 88 and 88%, respectively. Ninety-seven potential indicators reached agreement after the three rounds. In the context of the Donabedian structure-process-outcome framework of performance indicators, 41 (42%) of the agreed indicators were structure indicators, 52 (54%) were process indicators and four (4%) were outcome indicators. Overall, the top-three highest rated indicators were: presence of a dedicated ED clinical information system (4.7; 95% CI 4.6-4.9), ED compliance with minimum design standards (4.7; 95% CI 4.5-4.8) and time from ED arrival to first ECG in suspected cardiac chest pain (4.7; 95% CI 4.5-4.9). The top-three highest rated indicators specific to clinical care of children in EDs were: time to administration of antibiotics in children with suspected bacterial meningitis (4.6; 95% CI 4.5-4.8), separate area available within EDs (seeing both adults and children) to assess children (4.4; 95% CI 4.2-4.6) and time to administration of

  15. Contemporary imaging in abdominal emergencies

    International Nuclear Information System (INIS)

    Sivit, Carlos J.

    2008-01-01

    Imaging is often a fundamental part in the evaluation of an injured or ill child. A variety of imaging modalities (radiography, angiography/fluoroscopy, sonography, CT, magnetic resonance imaging and scintigraphy) are among the options. CT is worth focused attention because of its usefulness in a variety of emergency department settings, its increasing use, and its potential radiation risks. CT plays an important role in the evaluation of traumatic and nontraumatic abdominal emergencies in children. Therefore, the goal of this paper is to review current imaging approaches and controversies in the evaluation of common acute abdominal emergencies. Through discussion of various modalities, especially CT in evaluation of abdominal pain and trauma, the relative advantages and disadvantages including radiation risk will be reviewed. (orig.)

  16. Recent developments in neonatal and paediatric emergencies.

    Science.gov (United States)

    Turner, Nigel M

    2011-07-01

    The present article is intended as an update for anaesthesiologists on recent developments in life-threatening paediatric emergencies and paediatric resuscitation. It is assumed that the reader has at least a basic knowledge of the general principles of emergency medicine, such as the ABCDE-approach and the principle of 'treat first what kills first'; and also that the reader is familiar with the anatomical, physiological and psychological differences between adults and children. The article begins with a description of the background to paediatric emergencies followed by a description of a widely used systematic approach to the assessment of the seriously ill child. In the second half of the article, the principles of the initial treatment for acute, life-threatening problems in children and paediatric resuscitation are discussed with reference to the recent literature. The article ends with a discussion of the changes in latest guidelines for resuscitation of babies at birth.

  17. The emergence of the State. A holistic approach to understand the origin, the role and challenges of public power

    Directory of Open Access Journals (Sweden)

    Luis I. Gordillo Pérez

    2017-01-01

    Full Text Available The term "State" is often used to identify a political phenomenon that emerged in Europe since the collapse of feudalism with the fundamental characteristics of territoriality, centralization, sovereignty, differentiation and institutionalization. This concept leads to limitations that result from the application of a methodology that is incomplete for a comprehensive understanding of the State, as it does not differentiate within the so-called States, the various existing types and political and social consequences derived from each of these types. This paper advocates the use of the methodology used by Pierre Birnbaum to analyze the State as a historical fact and social which is a creation from own social practices of a time and a specific space, in relation to a particular culture and with a particular historical trajectory. To this end, this article deals, first, with the sociological-historical theory on the origin of the State along with the presentation of their methodology and analysis of the relationship of capitalism, social structure and culture with the State (paragraphs 2 and 3 ; secondly, this work focuses on the advantages of the methodology proposed by Birnbaum to analyze the State while original creation, highlighting the division Strong State / Weak State proposed by the author (4 and 5; and, finally, it raises the challenges facing the State today (paragraphs 6 and 7.

  18. A comparison of multivariate and univariate time series approaches to modelling and forecasting emergency department demand in Western Australia.

    Science.gov (United States)

    Aboagye-Sarfo, Patrick; Mai, Qun; Sanfilippo, Frank M; Preen, David B; Stewart, Louise M; Fatovich, Daniel M

    2015-10-01

    To develop multivariate vector-ARMA (VARMA) forecast models for predicting emergency department (ED) demand in Western Australia (WA) and compare them to the benchmark univariate autoregressive moving average (ARMA) and Winters' models. Seven-year monthly WA state-wide public hospital ED presentation data from 2006/07 to 2012/13 were modelled. Graphical and VARMA modelling methods were used for descriptive analysis and model fitting. The VARMA models were compared to the benchmark univariate ARMA and Winters' models to determine their accuracy to predict ED demand. The best models were evaluated by using error correction methods for accuracy. Descriptive analysis of all the dependent variables showed an increasing pattern of ED use with seasonal trends over time. The VARMA models provided a more precise and accurate forecast with smaller confidence intervals and better measures of accuracy in predicting ED demand in WA than the ARMA and Winters' method. VARMA models are a reliable forecasting method to predict ED demand for strategic planning and resource allocation. While the ARMA models are a closely competing alternative, they under-estimated future ED demand. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Lactococcus garvieae: where is it from? A first approach to explore the evolutionary history of this emerging pathogen.

    Directory of Open Access Journals (Sweden)

    Chiara Ferrario

    Full Text Available The population structure and diversity of Lactococcus garvieae, an emerging pathogen of increasing clinical significance, was determined at both gene and genome level. Selected lactococcal isolates of various origins were analyzed by a multi locus sequence typing (MLST. This gene-based analysis was compared to genomic characteristics, estimated through the complete genome sequences available in database. The MLST identified two branches containing the majority of the strains and two branches bearing one strain each. One strain was particularly differentiated from the other L. garvieae strains, showing a significant genetic distance. The genomic characteristics, correlated to the MLST-based phylogeny, indicated that this "separated strain" appeared first and could be considered the evolutionary intermediate between Lactococcus lactis and L. garvieae main clusters. A preliminary genome analysis of L. garvieae indicated a pan-genome constituted of about 4100 genes, which included 1341 core genes and 2760 genes belonging to the dispensable genome. A total of 1491 Clusters of Orthologous Genes (COGs were found to be specific to the 11 L. garvieae genomes, with the genome of the "separated strain" showing the highest presence of unique genes.

  20. Syncope: Assessment of risk and an approach to evaluation in the emergency department and urgent care clinic

    Directory of Open Access Journals (Sweden)

    Baris Akdemir

    2015-03-01

    Full Text Available Syncope is among the most frequent forms of transient loss of consciousness (TLOC, and is characterized by a relatively brief and self-limited loss of consciousness that by definition is triggered by transient cerebral hypoperfusion. Most often, syncope is caused by a temporary drop of systemic arterial pressure below that required to maintain cerebral function, but brief enough not to cause permanent structural brain injury. Currently, approximately one-third of syncope/collapse patients seen in the emergency department (ED or urgent care clinic are admitted to hospital for evaluation. The primary objective of developing syncope/TLOC risk stratification schemes is to provide guidance regarding the immediate prognostic risk of syncope patients presenting to the ED or clinic; thereafter, based on that risk assessment physicians may be better equipped to determine which patients can be safely evaluated as outpatients, and which require hospital care. In general, the need for hospitalization is determined by several key issues: i the patient's immediate (usually considered 1 week to 1 month mortality risk and risk for physical injury (e.g., falls risk, ii the patient's ability to care for him/herself, and iii whether certain treatments inherently require in-hospital initiation (e.g., pacemaker implantation. However, at present no single risk assessment protocol appears to be satisfactory for universal application, and development of a consensus recommendation is an essential next step.

  1. Tackling Complex Emergency Response Solutions Evaluation Problems in Sustainable Development by Fuzzy Group Decision Making Approaches with Considering Decision Hesitancy and Prioritization among Assessing Criteria.

    Science.gov (United States)

    Qi, Xiao-Wen; Zhang, Jun-Ling; Zhao, Shu-Ping; Liang, Chang-Yong

    2017-10-02

    In order to be prepared against potential balance-breaking risks affecting economic development, more and more countries have recognized emergency response solutions evaluation (ERSE) as an indispensable activity in their governance of sustainable development. Traditional multiple criteria group decision making (MCGDM) approaches to ERSE have been facing simultaneous challenging characteristics of decision hesitancy and prioritization relations among assessing criteria, due to the complexity in practical ERSE problems. Therefore, aiming at the special type of ERSE problems that hold the two characteristics, we investigate effective MCGDM approaches by hiring interval-valued dual hesitant fuzzy set (IVDHFS) to comprehensively depict decision hesitancy. To exploit decision information embedded in prioritization relations among criteria, we firstly define an fuzzy entropy measure for IVDHFS so that its derivative decision models can avoid potential information distortion in models based on classic IVDHFS distance measures with subjective supplementing mechanism; further, based on defined entropy measure, we develop two fundamental prioritized operators for IVDHFS by extending Yager's prioritized operators. Furthermore, on the strength of above methods, we construct two hesitant fuzzy MCGDM approaches to tackle complex scenarios with or without known weights for decision makers, respectively. Finally, case studies have been conducted to show effectiveness and practicality of our proposed approaches.

  2. Tackling Complex Emergency Response Solutions Evaluation Problems in Sustainable Development by Fuzzy Group Decision Making Approaches with Considering Decision Hesitancy and Prioritization among Assessing Criteria

    Directory of Open Access Journals (Sweden)

    Xiao-Wen Qi

    2017-10-01

    Full Text Available In order to be prepared against potential balance-breaking risks affecting economic development, more and more countries have recognized emergency response solutions evaluation (ERSE as an indispensable activity in their governance of sustainable development. Traditional multiple criteria group decision making (MCGDM approaches to ERSE have been facing simultaneous challenging characteristics of decision hesitancy and prioritization relations among assessing criteria, due to the complexity in practical ERSE problems. Therefore, aiming at the special type of ERSE problems that hold the two characteristics, we investigate effective MCGDM approaches by hiring interval-valued dual hesitant fuzzy set (IVDHFS to comprehensively depict decision hesitancy. To exploit decision information embedded in prioritization relations among criteria, we firstly define an fuzzy entropy measure for IVDHFS so that its derivative decision models can avoid potential information distortion in models based on classic IVDHFS distance measures with subjective supplementing mechanism; further, based on defined entropy measure, we develop two fundamental prioritized operators for IVDHFS by extending Yager’s prioritized operators. Furthermore, on the strength of above methods, we construct two hesitant fuzzy MCGDM approaches to tackle complex scenarios with or without known weights for decision makers, respectively. Finally, case studies have been conducted to show effectiveness and practicality of our proposed approaches.

  3. Round Table Discussion on EASTWEST

    Directory of Open Access Journals (Sweden)

    Marina Tkacheva

    2017-12-01

    Full Text Available The discussion is focused on various aspects of interrelations between East and West. Its participants discuss the problems of the increasing tourist flows from China and the specific characteristics of Chinese tourists. The future development of tourism in the Baikal region is formulated, and the peculiarities of ethno tourism and its prospects are discussed.

  4. Childhood Emergencies

    Science.gov (United States)

    ... SUBSCRIBE Emergency 101 Share this! Home » Emergency 101 Childhood Emergencies Keeping children healthy and safe is every ... and tools to prevent, recognize and address a childhood emergency is the first step in keeping your ...

  5. Eye Emergencies

    Science.gov (United States)

    ... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Eye Emergencies Lung Emergencies Surgeries Eye Emergencies Marfan syndrome significantly increases your risk of retinal detachment, a ...

  6. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... IUD placed inside the uterus CHOICES FOR EMERGENCY CONTRACEPTION Two emergency contraceptive pills may be bought without a prescription. ...

  7. Particle acceleration in regions of magnetic flux emergence: a statistical approach using test-particle- and MHD-simulations

    Science.gov (United States)

    Vlahos, Loukas; Archontis, Vasilis; Isliker, Heinz

    We consider 3D nonlinear MHD simulations of an emerging flux tube, from the convection zone into the corona, focusing on the coronal part of the simulations. We first analyze the statistical nature and spatial structure of the electric field, calculating histograms and making use of iso-contour visualizations. Then test-particle simulations are performed for electrons, in order to study heating and acceleration phenomena, as well as to determine HXR emission. This study is done by comparatively exploring quiet, turbulent explosive, and mildly explosive phases of the MHD simulations. Also, the importance of collisional and relativistic effects is assessed, and the role of the integration time is investigated. Particular aim of this project is to verify the quasi- linear assumptions made in standard transport models, and to identify possible transport effects that cannot be captured with the latter. In order to determine the relation of our results to Fermi acceleration and Fokker-Planck modeling, we determine the standard transport coefficients. After all, we find that the electric field of the MHD simulations must be downscaled in order to prevent an un-physically high degree of acceleration, and the value chosen for the scale factor strongly affects the results. In different MHD time-instances we find heating to take place, and acceleration that depends on the level of MHD turbulence. Also, acceleration appears to be a transient phenomenon, there is a kind of saturation effect, and the parallel dynamics clearly dominate the energetics. The HXR spectra are not yet really compatible with observations, we have though to further explore the scaling of the electric field and the integration times used.

  8. Ghost probiotics with a combined regimen: a novel therapeutic approach against the Zika virus, an emerging world threat.

    Science.gov (United States)

    Bajpai, Vivek K; Chandra, Vishal; Kim, Na-Hyung; Rai, Rajni; Kumar, Pradeep; Kim, Kangmin; Aeron, Abhinav; Kang, Sun Chul; Maheshwari, D K; Na, MinKyun; Rather, Irfan A; Park, Yong-Ha

    2018-05-01

    The Zika virus (ZIKV) used to be an obscure flavivirus closely related to dengue virus (DENV). Transmission of this epidemic pathogen occurs mainly via mosquitoes, but it is also capable of placental and sexual transmission. Although the characteristics of these viruses are well defined, infections are unpredictable in terms of disease severity, unusual clinical manifestations, unexpected methods of transmission, long-term persistence, and the development of new strains. Recently, ZIKV has gained huge medical attention following the large-scale epidemics around the world, and reported cases of congenital abnormalities associated with Zika virus infections which have created a public health emergency of international concern. Despite continuous research on ZIKV, no specific treatment or vaccine has been developed, excepting a preventive strategy for congenital ZIKV infection. Probiotics, known as GRAS, are bacteria that confer various health beneficial effects, and have been shown to be effective at curing a number of viral diseases by modulating the immune system. Furthermore, probiotic preparations consisting of dead cells and cellular metabolites, so-called "Ghost probiotics", can also act as biological response modifiers. Here, we review available information on the epidemiology, transmission, and clinical features of ZIKV, and on treatment and prevention strategies. In addition, we emphasize the use of probiotics and plant-based natural remedies and describe their action mechanisms, and the green technologies for microbial conversion, which could contribute to the development of novel therapies that may reduce the pathogenicity of ZIKV. Accordingly, we draw attention to new findings, unanswered questions, unresolved issues, and controversies regarding ZIKV.

  9. Enhancing the emergency department approach to pediatric sexual assault care: implementation of a pediatric sexual assault response team program.

    Science.gov (United States)

    Goyal, Monika K; Mollen, Cynthia J; Hayes, Katie L; Molnar, Jennifer; Christian, Cindy W; Scribano, Philip V; Lavelle, Jane

    2013-09-01

    The objectives of this study were to describe the experience of a novel pediatric sexual assault response team (SART) program in the first 3 years of implementation and compare patient characteristics, evaluation, and treatment among subpopulations of patients. This was a retrospective chart review of a consecutive sample of patients evaluated at a pediatric emergency department (ED) who met institutional criteria for a SART evaluation. Associations of evaluation and treatment with sex, menarchal status, and presence of injuries were measured using logistic regression. One hundred eighty-four patients met criteria for SART evaluation, of whom 87.5% were female; mean age was 10.1 (SD, 4.6) years. The majority of patients underwent forensic evidence collection (89.1%), which varied by menarchal status among girls (P < 0.01), but not by sex. Evidence of acute anogenital injury on physical examination was found in 20.6% of patients. As per the Centers for Disease Control and Prevention guidelines for acute sexual assault evaluations in pediatric patients, menarchal girls were more likely to undergo testing for sexually transmitted infections and pregnancy (P < 0.01) and to be offered pregnancy, sexually transmitted infection, and HIV prophylaxis (P < 0.01). In an effort to improve quality and consistency of acute sexual assault examinations in a pediatric ED, development of a SART program supported the majority of eligible patients undergoing forensic evidence collection. Furthermore, a substantial number of patients had evidence of injury on examination. These findings underscore the importance of having properly trained personnel to support ED care for pediatric victims of acute sexual assault.

  10. A Binomial Modeling Approach for Upscaling Colloid Transport Under Unfavorable Attachment Conditions: Emergent Prediction of Nonmonotonic Retention Profiles

    Science.gov (United States)

    Hilpert, Markus; Johnson, William P.

    2018-01-01

    We used a recently developed simple mathematical network model to upscale pore-scale colloid transport information determined under unfavorable attachment conditions. Classical log-linear and nonmonotonic retention profiles, both well-reported under favorable and unfavorable attachment conditions, respectively, emerged from our upscaling. The primary attribute of the network is colloid transfer between bulk pore fluid, the near-surface fluid domain (NSFD), and attachment (treated as irreversible). The network model accounts for colloid transfer to the NSFD of downgradient grains and for reentrainment to bulk pore fluid via diffusion or via expulsion at rear flow stagnation zones (RFSZs). The model describes colloid transport by a sequence of random trials in a one-dimensional (1-D) network of Happel cells, which contain a grain and a pore. Using combinatorial analysis that capitalizes on the binomial coefficient, we derived from the pore-scale information the theoretical residence time distribution of colloids in the network. The transition from log-linear to nonmonotonic retention profiles occurs when the conditions underlying classical filtration theory are not fulfilled, i.e., when an NSFD colloid population is maintained. Then, nonmonotonic retention profiles result potentially both for attached and NSFD colloids. The concentration maxima shift downgradient depending on specific parameter choice. The concentration maxima were also shown to shift downgradient temporally (with continued elution) under conditions where attachment is negligible, explaining experimentally observed downgradient transport of retained concentration maxima of adhesion-deficient bacteria. For the case of zero reentrainment, we develop closed-form, analytical expressions for the shape, and the maximum of the colloid retention profile.

  11. Environmental Sensitivity in Nuclear Emergencies in Rural and Semi-natural Environments. Report of Working Group 8, Environmental Sensitivity of EMRAS II Topical Heading Approaches for Assessing Emergency Situations. Environmental Modelling for RAdiation Safety (EMRAS II) Programme

    International Nuclear Information System (INIS)

    2013-11-01

    Effects Modelling Approaches for Assessing Emergency Situations; - Working Group 7: Tritium Accidents; - Working Group 8: Environmental Sensitivity; - Working Group 9: Urban Areas. This report describes the work of the Environmental Sensitivities Working Group. The work was partially supported by the FMO/EEA FM Grants through the EL0086 - NTUA Scholarship and Mobility Program 2004-2011

  12. Effectiveness of E-learning Compared to Classroom Learning in the Diagnostic Approach to Bioterrorism and Chemical Terrorism for Emergency Physicians

    Directory of Open Access Journals (Sweden)

    Mustafa Alavi-Moghaddam

    2015-07-01

    Full Text Available Background and purpose: Emergency physicians play an important role in the immediate diagnosis of bioterrorism activities. The present study was conducted with the purpose of comparing the effectiveness of e-learning and classroom learning in approach to bioterrorism and chemical terrorism for emergency physicians.Methods: This was a semi-empirical study, which was conducted via testing knowledge before and after the educational intervention in the field of bioterrorism and chemical terrorism on the emergency physicians in Tehran. The external validity of the questionnaire was confirmed by two academic experts in order to determine the ability to detect bioterrorist and chemical terrorist diseases. In this study, education was done in both virtual and classroom forms. The education regarded 6 bioterrorist diseases in group A (anthrax, plague, viral hemorrhagic fever, tularemia, smallpox, and 5 chemical terrorist diseases (nerve gas, mustard, lewisite, phosgene, chlorine.Results: 160 doctors participated in this study. 96 people (60% were men and 64 people (40% were women. The average age of the participants was 36.2±5.5 years. In e-learning method, the pre-test scores average was (30.6%, while the post-test scores average was (81.6% (p=0.001. In classroom learning method, the pre-test scores average was (41.9%, while the post-test scores average was (72.9%, which the pre-test and post-test scores average differences in both cases are significant (p<0.001. In e-learning method, the difference was (51%, and in the classroom method it was (31%, which these two represent a 20% difference between methods. From statistical point of view, this difference indicates that the e-learning method being more effective (p=0.02.Conclusions: Based on the study results, it seems that in comparison to the classroom learning, e-learning method is more effective in helping emergency physicians to diagnose bioterrorism or chemical terrorism factors.Keywords: E

  13. The Usage of an Online Discussion Forum for the Facilitation of Case-Based Learning in an Intermediate Accounting Course: A New Zealand Case

    Science.gov (United States)

    Weil, Sidney; McGuigan, Nicholas; Kern, Thomas

    2011-01-01

    This paper describes the implementation of an online discussion forum as a means of facilitating case-based learning in an intermediate financial accounting course. The paper commences with a review of case-based learning literature and the use of online discussions as a delivery platform, linking these pedagogical approaches to the emerging needs…

  14. Emerging jets

    Energy Technology Data Exchange (ETDEWEB)

    Schwaller, Pedro; Stolarski, Daniel [European Organization for Nuclear Research (CERN), Geneva (Switzerland). TH-PH Div.; Weiler, Andreas [European Organization for Nuclear Research (CERN), Geneva (Switzerland). TH-PH Div.; Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2015-02-15

    In this work, we propose a novel search strategy for new physics at the LHC that utilizes calorimeter jets that (i) are composed dominantly of displaced tracks and (ii) have many different vertices within the jet cone. Such emerging jet signatures are smoking guns for models with a composite dark sector where a parton shower in the dark sector is followed by displaced decays of dark pions back to SM jets. No current LHC searches are sensitive to this type of phenomenology. We perform a detailed simulation for a benchmark signal with two regular and two emerging jets, and present and implement strategies to suppress QCD backgrounds by up to six orders of magnitude. At the 14 TeV LHC, this signature can be probed with mediator masses as large as 1.5 TeV for a range of dark pion lifetimes, and the reach is increased further at the high-luminosity LHC. The emerging jet search is also sensitive to a broad class of long-lived phenomena, and we show this for a supersymmetric model with R-parity violation. Possibilities for discovery at LHCb are also discussed.

  15. Emerging jets

    International Nuclear Information System (INIS)

    Schwaller, Pedro; Stolarski, Daniel

    2015-02-01

    In this work, we propose a novel search strategy for new physics at the LHC that utilizes calorimeter jets that (i) are composed dominantly of displaced tracks and (ii) have many different vertices within the jet cone. Such emerging jet signatures are smoking guns for models with a composite dark sector where a parton shower in the dark sector is followed by displaced decays of dark pions back to SM jets. No current LHC searches are sensitive to this type of phenomenology. We perform a detailed simulation for a benchmark signal with two regular and two emerging jets, and present and implement strategies to suppress QCD backgrounds by up to six orders of magnitude. At the 14 TeV LHC, this signature can be probed with mediator masses as large as 1.5 TeV for a range of dark pion lifetimes, and the reach is increased further at the high-luminosity LHC. The emerging jet search is also sensitive to a broad class of long-lived phenomena, and we show this for a supersymmetric model with R-parity violation. Possibilities for discovery at LHCb are also discussed.

  16. Analytical approaches for the detection of emerging therapeutics and non-approved drugs in human doping controls.

    Science.gov (United States)

    Thevis, Mario; Schänzer, Wilhelm

    2014-12-01

    The number and diversity of potentially performance-enhancing substances is continuously growing, fueled by new pharmaceutical developments but also by the inventiveness and, at the same time, unscrupulousness of black-market (designer) drug producers and providers. In terms of sports drug testing, this situation necessitates reactive as well as proactive research and expansion of the analytical armamentarium to ensure timely, adequate, and comprehensive doping controls. This review summarizes literature published over the past 5 years on new drug entities, discontinued therapeutics, and 'tailored' compounds classified as doping agents according to the regulations of the World Anti-Doping Agency, with particular attention to analytical strategies enabling their detection in human blood or urine. Among these compounds, low- and high-molecular mass substances of peptidic (e.g. modified insulin-like growth factor-1, TB-500, hematide/peginesatide, growth hormone releasing peptides, AOD-9604, etc.) and non-peptidic (selective androgen receptor modulators, hypoxia-inducible factor stabilizers, siRNA, S-107 and ARM036/aladorian, etc.) as well as inorganic (cobalt) nature are considered and discussed in terms of specific requirements originating from physicochemical properties, concentration levels, metabolism, and their amenability for chromatographic-mass spectrometric or alternative detection methods. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Neurologic emergencies in sports.

    Science.gov (United States)

    Williams, Vernon B

    2014-12-01

    Sports neurology is an emerging area of subspecialty. Neurologists and non-neurologists evaluating and managing individuals participating in sports will encounter emergencies that directly or indirectly involve the nervous system. Since the primary specialty of sports medicine physicians and other practitioners involved in the delivery of medical care to athletes in emergency situations varies significantly, experience in recognition and management of neurologic emergencies in sports will vary as well. This article provides a review of information and elements essential to neurologic emergencies in sports for the practicing neurologist, although content may be of benefit to readers of varying background and expertise. Both common neurologic emergencies and less common but noteworthy neurologic emergencies are reviewed in this article. Issues that are fairly unique to sports participation are highlighted in this review. General concepts and principles related to treatment of neurologic emergencies that are often encountered unrelated to sports (eg, recognition and treatment of status epilepticus, increased intracranial pressure) are discussed but are not the focus of this article. Neurologic emergencies can involve any region of the nervous system (eg, brain, spine/spinal cord, peripheral nerves, muscles). In addition to neurologic emergencies that represent direct sports-related neurologic complications, indirect (systemic and generalized) sports-related emergencies with significant neurologic consequences can occur and are also discussed in this article. Neurologists and others involved in the care of athletes should consider neurologic emergencies in sports when planning and providing medical care.

  18. Discussion on Papers 11 - 13

    International Nuclear Information System (INIS)

    Haws, E.; Matthews, M.E.; Wilson, E.M.; Charles-Jones, S.; Allen, R.F.; Young, R.M.; O'Connor, B.

    1992-01-01

    The discussion covered the following topics: the nature of boulder clay for foundations; navigation through the barrage; the construction of sluice caissons; government subsidies for construction costs; the effect of wave action on river banks; allowances for reflected energy in hydrodynamic models; water quality in impounded pools; sediment deposition. Separate abstracts have been prepared for the three papers under discussion. (UK)

  19. Sectarian discussions limit vision on rational approaches. With ups and downs towards a coherent environmental policy?; Verkokerde discussies belemmeren het zicht op rationele benaderingen. Met vallen en opstaan op weg naar een samenhangend milieubeleid?

    Energy Technology Data Exchange (ETDEWEB)

    Sluijter, F.W.

    2008-07-01

    Current discussions on environmental policy in the Netherlands are systematically narrowed down to discussions on CO2 emissions. The mutual interaction between various measures remains undiscussed. Emotional arguments (e.g. the deployment of nuclear energy) play a larger role than rational arguments. In this article, the author sketches undiscussed and even unmentionable relations in the real world and thus hopes to contribute to a rational exchange of ideas on energy and environmental policy. [mk]. [Dutch] De lopende discussies over het milieubeleid in Nederland worden stelselmatig verengd tot discussies over de emissie van CO2. De onderlinge wisselwerking tussen verschillende maatregelen blijft daarbij onbesproken. Emotionele argumenten (bijvoorbeeld m.b.t. de inzet van kernenergie) spelen een grotere rol dan rationele argumenten. De auteur schets in dit artikel onbesproken en zelfs onbespreekbare samenhangen in de reele wereld en hoopt daarmee bij te dragen aan een rationele uitwisseling van ideeen over energie- en milieubeleid.

  20. Emotional discussions reduce memory recall.

    Science.gov (United States)

    Soleti, Emanuela; Wright, Daniel B; Curci, Antonietta

    2017-05-01

    People often discuss events they have seen and these discussions can influence later recollections. We investigated the effects of factual, emotional, and free retelling discussion on memory recollections of individuals who have witnessed an event. Participants were shown a video, made an initial individual recall, participated in one of the three retelling conditions (emotional versus factual versus free) or a control condition, and then recalled the event individually again. Participants in the factual and free retelling conditions reported more items not previously recalled than participants in the control condition did, while the emotional condition did not show the same advantage. Participants in all three retelling conditions failed to report more previously recalled items as compared with the control condition. Finally, a memory conformity effect was observed for all three retelling conditions. These findings suggest that eyewitnesses' discussions may influence the accuracy of subsequent memory reports, especially when these discussions are focused on emotional details and thoughts.

  1. The technical basis for emergency planning and preparedness in EC countries. An examination of criteria, practices and recent developments and proposals for a harmonized approach

    International Nuclear Information System (INIS)

    Eckered, T.

    1985-01-01

    Many existing or planned EPP measures are based on assumptions concerning accident sequences, release of radioactivity and accident consequences which in many cases are far too pessimistic. A higher level of ambition for EPP measures based on these assumptions does therefore not seem to be justified. This study is based mainly on the experience gained from operation of Light Water Reactors. Consequently, many of the conclusions and recommendations drawn from the discussions refers to LWRs. Horwever, EPP consist of many elements which are independent of the kind of reactor chosen. So much of the content of this report is therefore valid for other reactor systems. In this report different elements of risk scenarios (accident sequences, source-term assumption and release behaviour, dose assessment, contamination, etc.) and different protective actions (taking shelter, evacuation, use of potassium iodine, etc.) are discussed with reference to present knowledge and ongoing studies. Proposals are given for what emergency preparedness measures to choose and what priority to give them in order to create an efficient and sufficient protection of health and safety of the public

  2. Ensuring fair levels of executive directors’ remuneration: Regulation and use of principles against the use of detailed legal rules in determining the most effective approach for setting executive pay levels. A discussion

    Directory of Open Access Journals (Sweden)

    Ewgeni Hersonski

    2012-10-01

    Full Text Available The purpose of this paper is to present arguments concerning the fair levels of executive directors’ remuneration. It is argued that principles are a better way to achieve this goal. However, we also find arguments in support of detailed legal rules when dealing with this matter. Since both methods have their pros and cons the paper delivers a balanced discussion and also outlines how the executive pay is currently regulated in the UK, the United States as well as on the global scale.

  3. The Topology of a Discussion: The #Occupy Case.

    Directory of Open Access Journals (Sweden)

    Floriana Gargiulo

    Full Text Available We analyse a large sample of the Twitter activity that developed around the social movement 'Occupy Wall Street', to study the complex interactions between the human communication activity and the semantic content of a debate.We use a network approach based on the analysis of the bipartite graph @Users-#Hashtags and of its projections: the 'semantic network', whose nodes are hashtags, and the 'users interest network', whose nodes are users. In the first instance, we find out that discussion topics (#hashtags present a high structural heterogeneity, with a relevant role played by the semantic hubs that are responsible to guarantee the continuity of the debate. In the users' case, the self-organisation process of users' activity, leads to the emergence of two classes of communicators: the 'professionals' and the 'amateurs'.Both the networks present a strong community structure, based on the differentiation of the semantic topics, and a high level of structural robustness when certain sets of topics are censored and/or accounts are removed.By analysing the characteristics of the dynamical networks we can distinguish three phases of the discussion about the movement. Each phase corresponds to a specific moment of the movement: from declaration of intent, organisation and development and the final phase of political reactions. Each phase is characterised by the presence of prototypical #hashtags in the discussion.

  4. Animating Geometry Discussions with Flexigons.

    Science.gov (United States)

    McClintock, Ruth

    1994-01-01

    Presents activities with 10- and 4-straw flexigons, an object created by stringing together lengths of plastic drinking straws with nylon fishing line. Discusses several geometric theorems that can be demonstrated with flexigons. (MKR)

  5. Lunch to discuss IDRC's programming

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

    chantal Taylor

    Page 1. Description: Lunch to discuss IDRC's programming. Date: 2017-02-10. Attendees: 2 (IDRC 1). Location: Ottawa. Total: $79.92. Comments: 2016-2017 Hospitality Expense. Reports for Jean Lebel, President.

  6. LGBT Roundtable Discussion: Meet-up and Mentoring Discussion

    Science.gov (United States)

    2014-03-01

    The LGBT+ Physicists group welcomes those who identify as gender sexual minorities, as LGBTQQIAAP+, or as allies to participate in a round-table discussion on mentoring physicists. The session will provide an opportunity to learn and discuss successful mentoring strategies at different career stages for physicists in all environments, including academia, industry, etc. Attendees are encouraged to attend a social event to follow the panel to continue to network. Allies are especially welcome at this event to learn how to support and mentor LGBT+ physicists.

  7. Discussion on Papers 5 - 7

    International Nuclear Information System (INIS)

    Strongman, C.P.; Jones, R.; Moorhead, H.

    1992-01-01

    The topics raised in discussion included: the performance of the generator sets; the movement of sediments and the effect on beach levels; monitoring near-bed sediments; the erosion of barrage materials by suspended solids; sediment transport models; the accuracy of hydrographic and other surveys; the relative ornithological importance of the estuary with respect to others in the United Kingdom. Separate abstracts were prepared for each of the three papers under discussion. (UK)

  8. Open Education Week Panel Discussion

    OpenAIRE

    Doolittle, Peter; Hart, Heath; Hartman, Greg; Seyam, Mohammed; Walz, Anita R.

    2015-01-01

    Introduction by Julie Speer, Associate Dean for Research & Informatics. Open remarks by Anita Walz, Assessment, Open Education & Online Learning Environments Librarian. Mohammed Seyam discusses the value of openly licensed material as a student, research, and graduate assistant. Heath Hart reflects on his adoption of an open educational resource and a (subscribed) online textbook in, “A Rousing Success and an Unmitigated Disaster.” Greg Hartman discusses his experiences authoring open-source ...

  9. Lung Emergencies

    Science.gov (United States)

    ... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Lung Emergencies Surgeries Lung Emergencies People with Marfan syndrome can be at increased risk of sudden lung ...

  10. Prediction of In-hospital Mortality in Emergency Department Patients With Sepsis: A Local Big Data-Driven, Machine Learning Approach.

    Science.gov (United States)

    Taylor, R Andrew; Pare, Joseph R; Venkatesh, Arjun K; Mowafi, Hani; Melnick, Edward R; Fleischman, William; Hall, M Kennedy

    2016-03-01

    Predictive analytics in emergency care has mostly been limited to the use of clinical decision rules (CDRs) in the form of simple heuristics and scoring systems. In the development of CDRs, limitations in analytic methods and concerns with usability have generally constrained models to a preselected small set of variables judged to be clinically relevant and to rules that are easily calculated. Furthermore, CDRs frequently suffer from questions of generalizability, take years to develop, and lack the ability to be updated as new information becomes available. Newer analytic and machine learning techniques capable of harnessing the large number of variables that are already available through electronic health records (EHRs) may better predict patient outcomes and facilitate automation and deployment within clinical decision support systems. In this proof-of-concept study, a local, big data-driven, machine learning approach is compared to existing CDRs and traditional analytic methods using the prediction of sepsis in-hospital mortality as the use case. This was a retrospective study of adult ED visits admitted to the hospital meeting criteria for sepsis from October 2013 to October 2014. Sepsis was defined as meeting criteria for systemic inflammatory response syndrome with an infectious admitting diagnosis in the ED. ED visits were randomly partitioned into an 80%/20% split for training and validation. A random forest model (machine learning approach) was constructed using over 500 clinical variables from data available within the EHRs of four hospitals to predict in-hospital mortality. The machine learning prediction model was then compared to a classification and regression tree (CART) model, logistic regression model, and previously developed prediction tools on the validation data set using area under the receiver operating characteristic curve (AUC) and chi-square statistics. There were 5,278 visits among 4,676 unique patients who met criteria for sepsis. Of

  11. Energy emergency handbook

    Energy Technology Data Exchange (ETDEWEB)

    1979-01-01

    This Handbook identifies selected state and federal measures available to mitigate the impact of an energy emergency, and provides a comprehensive energy emergency communications directory. In the case of state remedial actions, particular emphasis has been placed on typical implementation procedures and likely impacts. The discussions of federal actions focus on initation and implementation procedures. The directory is designed to facilitate communications of all types (telephone, Telex, TWX, or facsimile) among key energy emergency officials in the federal and state governments.

  12. Entrepreneurship, Emerging Technologies, Emerging Markets

    NARCIS (Netherlands)

    Thukral, Inderpreet S.; Von Ehr, James; Walsh, Steven Thomas; Groen, Arend J.; van der Sijde, Peter; Adham, Khairul Akmaliah

    2008-01-01

    Academics and practitioners alike have long understood the benefits, if not the risks, of both emerging markets and emerging technologies.Yet it is only recently that foresighted firms have embraced emerging technologies and emerging markets through entrepreneurial activity. Emerging technologies

  13. Factual Summary of Papers, Presentations and Discussions

    International Nuclear Information System (INIS)

    2010-01-01

    Session 1 provided the opportunity to be informed of the Japanese institutional scene on geologic disposal as well as to acquaint the Japanese dignitaries and workshop participants with the RWMC Regulators' Forum, the challenges we face and the aims of the workshop. A lecture on accomplishments and issues in long-term safety regulation prepared discussions during the workshop. Session 2 - Fundamental Concepts and Evolution of International Guidance: One important point is that the use of language in this subject is not conducive to easy understanding by the public, certainly, and perhaps even by others. We need to consider how it might be made more accessible for the purpose of public involvement and regulatory dialogue. This might open the way to creating a readily comprehensible long-term objective for geological disposal that is consistent with the objectives for protecting society from the potential consequences of other activities with long-lived implications. The goal of the following presentations was to give an overall picture on these questions. Session 3 - Establishing Regulatory Criteria that Account for the Inherent Difficulties Associated with the Long-time Frames for Protection: Even though there have been significant developments in recent years and experience feedback from a number of ongoing geological disposal projects, international guidance remains rather difficult to understand and apply. The recent work from the RWMC-RF on long-term safety criteria for geological for geological disposal also shows that there are important differences between national criteria as well as differences in regulatory approach. It has emerged that we have no common basis for setting criteria as between different NEA countries and that the process of setting criteria is not readily explicable to the general public. Furthermore we are required, for the purposes of the international Joint Convention on the Safe Management of Spent Fuel and Radioactive Waste, to protect

  14. D 3.6 Africa: Discussion report

    DEFF Research Database (Denmark)

    Mandrup, Thomas

    2017-01-01

    in general, sub-matter experts, experts on peace and conflict studies, and practitioners in crisis management. A total of eighteen speakers explored the effectiveness of international assistance to the four African examples from different perspectives, drawing a rather pessimistic picture of the current......One round-table event was organised within the framework of Work Package III, part of the IECEU project. The events focused on the WP3’s four case studies: Libya, CAR, South Sudan and DRC. This report provides information on the round-table event and presents the main points of discussion...... that emerged during it. The round-table discussion and the subsequent seminar on the Effectiveness of International Assistance and Local Ownership in the four case studies was organised by the Royal Danish Defence College on 31 October-1. November 2016. The round-table participants included experts on Africa...

  15. Theme: Emerging Technologies.

    Science.gov (United States)

    Malpiedi, Barbara J.; And Others

    1989-01-01

    Consists of six articles discussing the effect of emerging technologies on agriculture. Specific topics include (1) agriscience programs, (2) the National Conference on Agriscience and Emerging Occupations and Technologies, (3) biotechnology, (4) program improvement through technology, (5) the Agriscience Teacher of the Year program, and (6)…

  16. Radiology in emergency medicine

    International Nuclear Information System (INIS)

    Levy, R.; Barsan, W.G.

    1986-01-01

    This book gives a discussion of radiologic modalities currently being used in emergency situations. Radiographs, echocardiographs, radionuclide scans and CT scans are systematically analyzed and evaluated to provide a step-by-step diagnostic process for emergency physicians to follow when a radiologist is not present

  17. Emerging trends in ICT security

    CERN Document Server

    Akhgar, Babak

    2013-01-01

    Emerging Trends in ICT Security, an edited volume, discusses the foundations and theoretical aspects of ICT security; covers trends, analytics, assessments and frameworks necessary for performance analysis and evaluation; and gives you the state-of-the-art knowledge needed for successful deployment of security solutions in many environments. Application scenarios provide you with an insider's look at security solutions deployed in real-life scenarios, including but limited to smart devices, biometrics, social media, big data security, and crowd sourcing. Provides a multidisciplinary approach

  18. Discussion on Papers 8 - 10

    International Nuclear Information System (INIS)

    Walker, R.; Wilson, E.A.; Gibson, P.

    1992-01-01

    Questions raised in the discussion are reported. These concerned: the Treasury discount rate for the construction of such a project; the CO 2 benefits of tidal schemes in developing countries; the criteria for deciding the total installed capacity of the scheme; the Government review of the cost-benefit analysis; the benefit arising from the elimination of nitrogen and sulphur oxides; security of supply; carbon tax projections. The only response reported is on the question of criteria for deciding the total installed capacity. Separate abstracts have been prepared on the three papers under discussion. (UK)

  19. Regional insertion: an emergent approach

    International Nuclear Information System (INIS)

    Serra, M.T.F.; Nascimento Teixeira, P. do

    1989-01-01

    The Brazilian Electrical Sector incorporates new variables that expressing the extensive spectrum of environmental impacts in the take of decisions, referring to the viability of realizing a electrical undertaking, attends the several restrictions that are important by the sector and by the society in the environment area and promotes the adequate generation of liquid benefits, consequential of the electrical undertaking. Due to these factors, the Electrical Sector is improving the concept of regional insertion, with the sectorial expansion in long-dated and the created demand in the environmental and social area, focalizing the solution for these questions. (C.G.C.). 1 fig, 2 tabs

  20. A community-engaged approach to quantifying caregiver preferences for the benefits and risks of emerging therapies for Duchenne muscular dystrophy.

    Science.gov (United States)

    Peay, Holly L; Hollin, Ilene; Fischer, Ryan; Bridges, John F P

    2014-05-01

    There is growing agreement that regulators performing benefit-risk evaluations should take patients' and caregivers' preferences into consideration. The Patient-Focused Drug Development Initiative at the US Food and Drug Administration offers patients and caregivers an enhanced opportunity to contribute to regulatory processes by offering direct testimonials. This process may be advanced by providing scientific evidence regarding treatment preferences through engagement of a broad community of patients and caregivers. In this article, we demonstrate a community-engaged approach to measure caregiver preferences for potential benefits and risks of emerging therapies for Duchenne muscular dystrophy (DMD). An advocacy oversight team led the community-engaged study. Caregivers' treatment preferences were measured by using best-worst scaling (BWS). Six relevant and understandable attributes describing potential benefits and risks of emerging DMD therapies were identified through engagement with advocates (n = 5), clinicians (n = 9), drug developers from pharmaceutical companies and academic centers (n = 11), and other stakeholders (n = 5). The attributes, each defined across 3 levels, included muscle function, life span, knowledge about the drug, nausea, risk of bleeds, and risk of arrhythmia. Cognitive interviewing with caregivers (n = 7) was used to refine terminology and assess acceptability of the BWS instrument. The study was implemented through an online survey of DMD caregivers, who were recruited in the United States through an advocacy group and snowball sampling. Caregivers were presented with 18 treatment profiles, identified via a main-effect orthogonal experimental design, in which the dependent variable was the respondents' judgment as to the best and worst feature in each profile. Preference weights were estimated by calculating the relative number of times a feature was chosen as best and as worst, which were then used to estimate relative attribute

  1. DISCUSSION METHODS: MODIFICATION AND TRANSFORMATION

    Directory of Open Access Journals (Sweden)

    A A Abbasova

    2015-12-01

    Full Text Available The article is devoted to the importance of selecting the optimal methods of stimulation and motivation for learning. In modern conditions it is very important that the teacher did not give the students ready knowledge, but pointed out the way for the acquisition of knowledge, taught them to gain knowledge. This demands from the philologist the choice of effective forms of working with texts of different types and styles of speech, listening, speaking. In this connection a special attention should be paid to the lessons of speech development. There is a special group of methods to stimulate the development of communicative competence. Among them, the method of discussion, which is increasingly being used during the Russian language lessons. The specificity of using this method in class for teaching Russian as a foreign language, its basic functions (teaching, developing, educating are considered. The key rules for conducting a discussion at the Russian language classes, the main and additional functions-roles of the teacher, the participants, the minute-taker are analyzed. The advantages of the discussion in Russian in comparison to the discussion in the students’ native language are summarized.

  2. General discussion of feasibility study

    International Nuclear Information System (INIS)

    Calori, F.

    1976-01-01

    Fundamentals, objectives and parameters of feasibility studies in the field of nuclear power project planning are discussed in a general way. Technical and economic problems to be considered are pointed out. In special cases, IAEA offers its aid and support. (UA) [de

  3. Helping Students Discuss Race Openly

    Science.gov (United States)

    Landsman, Julie

    2016-01-01

    One way teachers can disrupt inequities is by doing the work to foster discussions in which students talk about race--and racism--honestly together. Teachers also need to be ready to talk with students sensitively when the subject of race comes up spontaneously--in a student's work, connected to events outside school, or in response to a…

  4. Another Discussion about Academic Corruption

    Science.gov (United States)

    Changgeng, Li

    2007-01-01

    Academic corruption is a commonplace matter about which all people are clearly aware. However, people often overlook many hidden or latent manifestations of academic corruption. This article discusses eight of these manifestations: indiscriminate use of the academic team spirit, the proliferation of "word games," deliberate attacks on…

  5. Learning through synchronous electronic discussion

    NARCIS (Netherlands)

    Kanselaar, G.; Veerman, A.L.; Andriessen, J.E.B.

    2000-01-01

    This article reports a study examining university student pairs carrying out an electronic discussion task in a synchronous computer mediated communication (CMC) system (NetMeeting). The purpose of the assignment was to raise students' awareness concerning conceptions that characterise effective

  6. Choice Orientations, Discussions, and Prospects.

    Science.gov (United States)

    Raywid, Mary Anne

    1992-01-01

    Examining the contemporary school choice debate yields arguments that are education, economics, governance, and policy driven. To "break the exclusive franchise," school districts are increasingly sponsoring school operation and education services supplied by multiple sources, and states are discussing sponsorship of schools by entities…

  7. Abdominal emergencies

    International Nuclear Information System (INIS)

    Raissaki, M.

    2012-01-01

    Full text: There are numerous conditions that affect mainly or exclusively the pediatric population. These constitute true emergencies, related to patient's health. Delay in diagnosis and treatment of abdominal non-traumatic emergencies may result in rapid deterioration, peritonitis, sepsis, even death or in severe complications with subsequent morbidity. Abdominal emergencies in children mostly present with pain, tenderness, occasionally coupled by vomiting, fever, abdominal distension, and failure to pass meconium or stools. Diarrhea, blood per rectum, abnormal laboratory tests and lethargy may also be manifestations of acute abdominal conditions. Abdominal emergencies have a different aetiology, depending on age and whether the pain is acute or chronic. Symptoms have to be matched with age and gender. Newborns up to 1 months of age may have congenital diseases: atresia, low obstruction including Hirschsprung's disease, meconium ileus. Meconium plug is one of the commonest cause of low obstruction in newborns that may also develop necrotizing enterocolitis, incarcerated inguinal hernia and mid-gut volvulus. Past the immediate postnatal period, any duodenal obstruction should be considered midgut volvulus until proven otherwise and patients should undergo ultrasonography and/or properly performed upper GI contrast study that records the exact position of the deduno-jejunal junction. Infants 6 months-2 years carry the risk of intussusception, mid-gut volvulus, perforation, acute pyelonephritis. Preschool and school-aged children 2-12 years carry the risk of appendicitis, genito-urinary abnormalities including torsion, urachal abnormalities, haemolytic uremic syndrome and Henoch-Schonlein purpura. Children above 12 years suffer from the same conditions as in adults. Most conditions may affect any age despite age predilection. Abdominal solid organ ultrasonography (US) coupled with gastrointestinal ultrasonography is the principle imaging modality in radiosensitive

  8. Bats, emerging infectious diseases, and the rabies paradigm revisited

    Science.gov (United States)

    Kuzmin, Ivan V.; Bozick, Brooke; Guagliardo, Sarah A.; Kunkel, Rebekah; Shak, Joshua R.; Tong, Suxiang; Rupprecht, Charles E

    2011-01-01

    The significance of bats as sources of emerging infectious diseases has been increasingly appreciated, and new data have been accumulated rapidly during recent years. For some emerging pathogens the bat origin has been confirmed (such as lyssaviruses, henipaviruses, coronaviruses), for other it has been suggested (filoviruses). Several recently identified viruses remain to be ‘orphan’ but have a potential for further emergence (such as Tioman, Menangle, and Pulau viruses). In the present review we summarize information on major bat-associated emerging infections and discuss specific characteristics of bats as carriers of pathogens (from evolutionary, ecological, and immunological positions). We also discuss drivers and forces of an infectious disease emergence and describe various existing and potential approaches for control and prevention of such infections at individual, populational, and societal levels. PMID:24149032

  9. Bats, emerging infectious diseases, and the rabies paradigm revisited.

    Science.gov (United States)

    Kuzmin, Ivan V; Bozick, Brooke; Guagliardo, Sarah A; Kunkel, Rebekah; Shak, Joshua R; Tong, Suxiang; Rupprecht, Charles E

    2011-06-20

    The significance of bats as sources of emerging infectious diseases has been increasingly appreciated, and new data have been accumulated rapidly during recent years. For some emerging pathogens the bat origin has been confirmed (such as lyssaviruses, henipaviruses, coronaviruses), for other it has been suggested (filoviruses). Several recently identified viruses remain to be 'orphan' but have a potential for further emergence (such as Tioman, Menangle, and Pulau viruses). In the present review we summarize information on major bat-associated emerging infections and discuss specific characteristics of bats as carriers of pathogens (from evolutionary, ecological, and immunological positions). We also discuss drivers and forces of an infectious disease emergence and describe various existing and potential approaches for control and prevention of such infections at individual, populational, and societal levels.

  10. Teachers' Emotions: An Illustrated Discussion.

    Science.gov (United States)

    Golby, Michael

    1996-01-01

    Considers the situations of two women teachers who have profound commitments to their pupils and who gain considerable emotional security from this. Argues that they tend to define school matters outside of teaching as distractions. Suggests that professional development requires a whole-school approach with greater emotional commitment to…

  11. Emergency Medical Service (EMS): Rotorcraft Technology Workshop

    Science.gov (United States)

    Bauchspies, J. S.; Adams, R. J.

    1981-01-01

    A lead organization on the national level should be designated to establish concepts, locations, and the number of shock trauma air medical services. Medical specialists desire a vehicle which incorporates advances in medical technology trends in health care. Key technology needs for the emergency medical services helicopter of the future include the riding quality of fixed wing aircraft (reduced noise and vibration), no tail rotor, small rotor, small rotor diameter, improved visibility, crashworthy vehicle, IFR capability, more affordability high reliability, fuel efficient, and specialized cabins to hold medical/diagnostic and communications equipment. Approaches to a national emergency medical service are discussed.

  12. Real-time information support for managing plant emergency responses

    International Nuclear Information System (INIS)

    Cain, D.G.; Lord, R.J.; Wilkinson, C.D.

    1983-01-01

    The Three Mile Island Unit 2 accident highlighted the need to develop a systematic approach to managing plant emergency responses, to identify a better decision-making process, and to implement real-time information support for decision-making. The overall process management function is described and general information requirements for management of plant emergencies are identified. Basic information systems are being incorporated and future extensions and problem areas are discussed. (U.K.)

  13. A licensing discussion: SMRs in Canada

    International Nuclear Information System (INIS)

    De Vos, M.

    2013-01-01

    The CNSC (Canadian AECB) is ready to regulate Small Modular Reactors (SMR) facilities in Canada. The CNSC is well situated to engage with proponents of SMR reactors in design reviews or licensing discussions. A risk-informed (graded) approach is possible in many instances for reactors but it is not a relaxation of requirements. The vendor design review process helps reduce regulatory risks by encouraging early engagement.

  14. Discussion on Papers 14 - 16

    International Nuclear Information System (INIS)

    Charles-Jones, S.; Muirhead, S.; Wilson, E.A.; Jefferson, M.; Binnie, C.J.A.; O'Connor, B.A.; Rothwell, P.; Cowie, D.

    1992-01-01

    Further observations were made on the great potential for tidal power developments in NW Australia. Discussion on the Severn Barrage paper and environmental effects of tidal power plants centred mainly around the impact on bird populations. The topics covered were: the adaptability of birds to changes in their environment with particular reference to the importance of inter-tidal areas for wildfowl and wading birds in the United Kingdom; the creation of mudflats as replacement feeding areas for wading birds; whether there is a danger that pressure from the construction industry might result in a barrage being built before the uncertainties in the environmental impact assessment are removed. Separate abstracts have been prepared for the three papers under discussion. (UK)

  15. Discuss the approaches to improve the nursing teachers' teaching ability of multicultural education%提升护理专业教师多元文化教学能力的途径与方法

    Institute of Scientific and Technical Information of China (English)

    段功香; 万艳平; 王蓉; 赵玲; 苏银花

    2013-01-01

    目的 探索提升护理专业教师多元文化教学能力的途径与方法.方法 强化护理专业教师多元文化护理的教育理念;培养专业教师对文化差异的敏感性;提高专业教师对多元文化的认知水平;重建专业教师的多元文化的知识体系;促使专业教师成为多元文化的迁移者.结果 青年教师100%获硕士学位,50%以上获校级及以上教学讲课竞赛奖;申报校级及以上多元文化护理相关课题近10项,在省级以上刊物发表相关教改论文20余篇,编写和出版相关教材4部.结论 本研究采取的改革措施能有效提高专业教师的多元文化教学能力.%Objective To explore the approaches of improving nursing teachers' teaching ability of multicultural education.Methods Strengthened the nursing teacher's education philosophy of multicultural nursing,took the training for nursing teacher's sensitivity to cultural diversity,improved the nursing teachers' multicultural cognition level,reconstructed the multicultural knowledge system,promoted the nursing teacher to use multicultural knowledge.Results The proportion of young teachers got the master's degree and the awards of teaching match was 100% and over 50% respectively.Young teachers got the multicultural projects authorized by University of South China and Education Board of Hunan province with more than 10 items,and more than 20 pieces of thesis were established in or over the provincial journal and and published 4 multicultural books.Conclusions The measures of reforming can effectively improve the nursing teachers teaching ability of multicultural education.

  16. Summary of presentations and discussions

    International Nuclear Information System (INIS)

    Takeuchi, Mitsuo

    2008-01-01

    In December 2007, the Forum on Stakeholder Confidence discussed its theme entitled 'Link between research, development and demonstration (RD and D) and stakeholder confidence'. It was remarked that regulators need a technical demonstration to aid in evaluating the safety case. Local stakeholders appreciate the opportunity to visualise technological arrangements. In both cases, demonstration adds to confidence in the feasibility of solutions. Some believe there is an important role for analogues in communication with stakeholders, if handled with integrity. To explore and benchmark current practices, it was decided to hold a topical session at the 9. regular meeting of the FSC on 4 June 2008 regarding the use of analogues for confidence building. The session opened with an introductory presentation by the session rapporteur. This incorporated input provided for the purpose by FSC members in cooperation with their country's representative to the NEA RWMC 'Integration Group on the Safety Case'. Three speakers then presented the various uses of analogues by implementers, regulators and scientists to build their own confidence; a fourth speaker dealt with the experience of using natural analogues in public information. The presentations addressed the use of analogues in the field of geological disposal of high-level waste (HLW) and long-lived intermediate level (ILW-LL) radioactive waste. Then the FSC participants split into two working groups for discussion. The outcome of these discussions was reported in plenary on 6 June 2008 and it was agreed to publish proceedings of the session. The present summary, prepared by the session rapporteur with input from the NEA Secretariat, captures the main points heard in the course of the event. It combines data from the formal presentations and remarks made in discussion. The latter represent viewpoints expressed by a group whose primary focus is not natural analogues but rather stakeholder interests. The summary and viewpoints

  17. Color on emergency mapping

    Science.gov (United States)

    Jiang, Lili; Qi, Qingwen; Zhang, An

    2007-06-01

    There are so many emergency issues in our daily life. Such as typhoons, tsunamis, earthquake, fires, floods, epidemics, etc. These emergencies made people lose their lives and their belongings. Every day, every hour, even every minute people probably face the emergency, so how to handle it and how to decrease its hurt are the matters people care most. If we can map it exactly before or after the emergencies; it will be helpful to the emergency researchers and people who live in the emergency place. So , through the emergency map, before emergency is occurring we can predict the situation, such as when and where the emergency will be happen; where people can refuge, etc. After disaster, we can also easily assess the lost, discuss the cause and make the lost less. The primary effect of mapping is offering information to the people who care about the emergency and the researcher who want to study it. Mapping allows the viewers to get a spatial sense of hazard. It can also provide the clues to study the relationship of the phenomenon in emergency. Color, as the basic element of the map, it can simplify and clarify the phenomenon. Color can also affects the general perceptibility of the map, and elicits subjective reactions to the map. It is to say, structure, readability, and the reader's psychological reactions can be affected by the use of color.

  18. Cost-effectiveness of screening and referral to an alcohol health worker in alcohol misusing patients attending an accident and emergency department: a decision-making approach.

    Science.gov (United States)

    Barrett, Barbara; Byford, Sarah; Crawford, Mike J; Patton, Robert; Drummond, Colin; Henry, John A; Touquet, Robin

    2006-01-04

    We present the cost and cost-effectiveness of referral to an alcohol health worker (AHW) and information only control in alcohol misusing patients. The study was a pragmatic randomised controlled trial conducted from April 2001 to March 2003 in an accident and emergency department (AED) in a general hospital in London, England. A total of 599 adults identified as drinking hazardously according to the Paddington Alcohol Test were randomised to referral to an alcohol health worker who delivered a brief intervention (n = 287) or to an information only control (n = 312). Total societal costs, including health and social services costs, criminal justice costs and productivity losses, and clinical measures of alcohol consumption were measured. Levels of drinking were observably lower in those referred to an AHW at 12 months follow-up and statistically significantly lower at 6 months follow-up. Total costs were not significantly different at either follow-up. Referral to AHWs in an AED produces favourable clinical outcomes and does not generate a significant increase in cost. A decision-making approach revealed that there is at least a 65% probability that referral to an AHW is more cost-effective than the information only control in reducing alcohol consumption among AED attendees with a hazardous level of drinking.

  19. Canada's Assisted Human Reproductive Act: is it scientific censorship, or a reasoned approach to the regulation of rapidly emerging reproductive technologies?

    Science.gov (United States)

    Rasmussen, Colin

    2004-01-01

    After more than a decade of study, discussion and debate, the Canadian House of Commons and Senate have approved the Assisted Human Reproduction Act. Building on the earlier Bill C-47, which died on the order paper in 1997, the Act bans human cloning for reproductive or therapeutic purposes, payment for surrogacy arrangements, and trading in human reproductive materials or their use without informed consent. In addition, the Act significantly restricts research using human reproductive materials. This article compares the Act to legislative regimes in other nations with advanced human reproductive science. It concludes that while the Act has many laudable goals, it is flawed in that it tries to cover too much legislative ground. As a result it unreasonable impairs the ability of Canadian scientists to compete in areas such as stem cell research, and area that is expected to yield significant new approaches to treating human disease.

  20. Entropy, Topological Theories and Emergent Quantum Mechanics

    Directory of Open Access Journals (Sweden)

    D. Cabrera

    2017-02-01

    Full Text Available The classical thermostatics of equilibrium processes is shown to possess a quantum mechanical dual theory with a finite dimensional Hilbert space of quantum states. Specifically, the kernel of a certain Hamiltonian operator becomes the Hilbert space of quasistatic quantum mechanics. The relation of thermostatics to topological field theory is also discussed in the context of the approach of the emergence of quantum theory, where the concept of entropy plays a key role.

  1. Historicism and Industry Emergence

    DEFF Research Database (Denmark)

    Kirsch, David; Moeen, Mahka; Wadhwani, Dan

    2014-01-01

    Management and organization scholars have increasingly turned to historical sources to examine the emergence and evolution of industries over time. This scholarship has typically used historical evidence as observations for testing theoretically relevant processes of industry emergence....... In this chapter, an alternative approach is explored that focuses on reconstructing causes and processes that time and theory have erased. The emergence of three industries—plant biotechnology, savings banking, and the automobile—shows how time, along with prevailing functional models of industry evolution, leads...... excluded phenomena and explanations, reconstructing uncertainty and alternative paths of industry emergence, and studying the processes of information elision and exclusion in the formation of industry knowledge....

  2. Earth Summit Science, policy discussed

    Science.gov (United States)

    Leath, Audrey T.

    The United Nations Conference on Environment and Development, the “Earth Summit,” convenes in Rio de Janeiro on June 3. President Bush has pledged to attend part of the 2-week conference. The highlight of the summit will be the signing of an international framework convention to reduce emissions of greenhouse gases. The final elements of the agreement were negotiated in New York last week by representative of 143 countries. In anticipation of the Rio conference, the Senate Committee on Energy and Natural Resources held two standing-roomonly hearings, reviewing the scientific basis for global warming due to greenhouse gases and discussing the details of the proposed convention.

  3. Emerging issues on the sustainability of the community based rural water resources management approach in Zimbabwe: A case study of Gwanda District

    Directory of Open Access Journals (Sweden)

    Thulani Dube

    2012-12-01

    Full Text Available Although there is considerable on-going debate about the suitability and sustainability of community based water resources management (CBWRM in Africa as a water provision strategy, evidence shows that this approach has gone a long way in promoting access to clean water amongst rural African communities. CBWRM provides an alternative approach to water provision for rural communities. This paper examines how the strategy has been operationalised in Gwanda District in Zimbabwe. The paper examines the experiences of rural communities in using CBWRM. Data was collected using focus group discussions, key informant in-depth interviews and a survey of 685 households in Gwanda district across five wards. The findings of this study are that 67% of the surveyed rural communities in Gwanda depended on community managed water resources mostly in the form of boreholes and protected wells. High rates of nun-functional sources were reported at 60-70% in most wards. Several system weaknesses were noted in the current CBWRM set-up including a depletion of committee memberships, inadequate community resources, limited agency and government support. This paper makes several recommendations on strengthening the capacity of CBWRM in Zimbabwe and Africa.

  4. Round table discussion during session 2

    International Nuclear Information System (INIS)

    Mays, C.

    2004-01-01

    The round table discussions of the second session of the FSC Belgium Workshop addressed the following questions: - Do local stakeholders have, internally or externally, all the expertise they need in order to address the issues raised by radioactive waste management projects? - Do institutional stakeholders have all the expertise they need to take local impacts into account? - What kinds of expert input are sought and attained by the different stakeholders? - Were any formal methods used to aid local partnerships perform technology assessments? Or other types of assessment? - How to maintain the knowledge and expertise achieved by the stakeholders? Discussion took place after the plenary presentations, at tables grouping Belgian stakeholders and FSC delegates. As in Session I, most of the round table discussion focussed specifically on the experience of the local partnerships. Many insights were shared about the nature and role of expertise in complex decision making. They are summarised below, on the basis of the feedback provided to the plenary by each round table. Some of these insights can be generalised to other contexts. All in all, a profile emerged of the local partnerships as a unique and effective tool to deal with knowledge issues in managing risk. (author)

  5. Optimization of Installation, Operation and Maintenance at Offshore Wind Projects in the U.S.: Review and Modeling of Existing and Emerging Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Baldock, Nick [Garrad Hassan & Partners Ltd, Glasgow (United Kingdom); Sevilla, Fernando [Garrad Hassan & Partners Ltd, Glasgow (United Kingdom); Redfern, Robin [Garrad Hassan & Partners Ltd, Glasgow (United Kingdom); Storey, Alexis [Garrad Hassan & Partners Ltd, Glasgow (United Kingdom); Kempenaar, Anton [Garrad Hassan & Partners Ltd, Glasgow (United Kingdom); Elkinton, Chris [Garrad Hassan America, Inc., San Diego, CA (United States)

    2014-12-19

    The United States Department of Energy (DOE) awarded a grant to GL Garrad Hassan (GL GH) to investigate the logistics, opportunities, and costs associated with existing and emerging installation and operation and maintenance (O&M) activities at offshore wind projects as part of the DOE’s program to reduce barriers facing offshore wind project development in the United States (U.S.). This report (the Report) forms part of Subtopic 5.3 “Optimized Installation, Operation and Maintenance Strategies Study” which in turn is part of the “Removing Market Barriers in U.S. Offshore Wind” set of projects for the DOE. The purpose of Subtopic 5.3 is to aid and facilitate informed decision-making regarding installation and O&M during the development, installation, and operation of offshore wind projects in order to increase efficiency and reduce the levelized cost of energy (LCoE). Given the large area of U.S. territorial waters, the generally higher mean wind speeds offshore, and the proximity to the coast of many large U.S. cities, offshore wind power has the potential to become a significant contributor of energy to U.S. markets. However, for the U.S. to ensure that the development of offshore wind energy projects is carried out in an efficient and cost-effective manner, it is important to be cognizant of the current and emerging practices in both the domestic and international offshore wind energy industries. The U.S. can harness the experience gained globally and combine this with the skills and assets of an already sizeable onshore wind industry, as well as the resources of a mature offshore oil and gas industry, to develop a strong offshore wind sector. The work detailed in this report is aimed at assisting with that learning curve, particularly in terms of offshore specific installation and O&M activities. This Report and the Installation and O&M LCoE Analysis Tool, which were developed together by GL GH as part of this study, allow readers to identify, model

  6. The emergence of time's arrows and special science laws from physics

    OpenAIRE

    Loewer, Barry

    2011-01-01

    In this paper, I will argue that there is an important connection between two questions concerning how certain features of the macro world emerge from the laws and processes of fundamental microphysics and suggest an approach to answering these questions. The approach involves a kind of emergence but quite different from ‘top-down’ emergence discussed at the conference, for which an earlier version of this paper was written. The two questions are (i) How do ‘the arrows of time’ emerge from mi...

  7. Nuclear criticality safety aspects of emergency response at the Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Baker, J.S.

    2003-01-01

    Emergency response at Los Alamos National Laboratory (LANL) is handled through a graded approach depending on the specific emergency situation . LANL maintains a comprehensive capability to respond to events ranging from minor facility events (alerts) through major community events (general emergencies), including criticality accidents . Criticality safety and emergency response apply to all activities involving significant quantities of fissile material at LANL, primarily at Technical Area 18 (TA-18, the Los Alamos Critical Experiments Facility) and Technical Area 55 (TA-55, the Plutonium Facility). This discussion focuses on response to a criticality accident at TA-55; the approach at TA-18 is comparable .

  8. Emerging nuclear suppliers

    International Nuclear Information System (INIS)

    Sands, A.

    1990-01-01

    Efforts to prevent the spread of nuclear weapons have usually taken two tracks: The traditional approach has concentrated on a potential proliferant's perceived need for nuclear technology and possibly weapons; a second approach has targeted the supply side of the proliferation equation. The issue being examined in this book---emerging nuclear suppliers---falls between these two approaches. The potential proliferants have emerged as possible unrestrained suppliers of nuclear materials and technology. They threaten the entire nonproliferation regime by their exporting, not their weapons development. Analyzing and understanding the issue of emerging suppliers requires a refined definition of suppliers in general. The simple dichotomy of traditional versus emerging suppliers is no longer an adequate framework for analysis. Suppliers differ significantly in their technical capabilities, experience, and regime involvement, and these distinctions result in different nuclear export policies

  9. First-trimester emergencies: a radiologist's perspective.

    Science.gov (United States)

    Phillips, Catherine H; Wortman, Jeremy R; Ginsburg, Elizabeth S; Sodickson, Aaron D; Doubilet, Peter M; Khurana, Bharti

    2018-02-01

    The purpose of this article is to help the practitioner ensure early diagnosis and response to emergencies in the first trimester by reviewing anatomy of the developing embryo, highlighting the sonographic appearance of common first-trimester emergencies, and discussing key management pathways for treating emergent cases. First-trimester fetal development is a stepwise process that can be challenging to evaluate in the emergency department (ED) setting. This is due, in part, to the complex anatomy of early pregnancy, subtlety of the sonographic findings, and the fact that fewer than half of patients with ectopic pregnancy present with the classic clinical findings of a positive pregnancy test, vaginal bleeding, pelvic pain, and tender adnexa. Ultrasound (US) has been the primary approach to diagnostic imaging of first-trimester emergencies, with magnetic resonance imaging (MRI) and computed tomography (CT) playing a supportive role in a small minority of cases. Familiarity with the sonographic findings diagnostic of and suspicious for early pregnancy failure, ectopic pregnancy, retained products of conception, gestational trophoblastic disease, failed intrauterine devices, and complications associated with assisted reproductive technology (ART) is critical for any emergency radiologist. Evaluation of first-trimester emergencies is challenging, and knowledge of key imaging findings and familiarity with management pathways are needed to ensure early diagnosis and response.

  10. DISCUSSION METHODS: MODIFICATION AND TRANSFORMATION

    Directory of Open Access Journals (Sweden)

    Abbasova, A.A.

    2016-03-01

    Full Text Available This article is about how to the importance of selecting the optimal methods of stimulation and motivation to learn. In modern conditions it is very important that the teacher gave the students ready knowledge, and pointed the way for the acquisition of knowledge, taught to acquire knowledge. This requires the selection of effective forms of language and literature work with texts of different types and styles of speech, listening, speaking. In this regard, special attention should be given lessons of speech development. There is a special group of methods to stimulate the development of communicative competence. Among them, and the method of discussion, which is increasingly being used in the classroom in the Russian language

  11. Open discussions on nuclear energy

    International Nuclear Information System (INIS)

    1978-01-01

    In the first part, economic prospects in the world and in the European Community and their repercussions on energy demand are examined. Supply structure and growth scenari are outlined. Present and potential contribution of nuclear energy to energy supply is developed. The pros and cons are given. In the second part is examined how the production and use of various form of energy including nuclear energy, can affect health and the environment, with special reference to waste of all kinds. Safety problems and risk of accidents are examined in both non nuclear and nuclear sectors. Prospects for a low energy society and economic and social implications of the use of new forms of energy are also discussed

  12. Discussing epigenetics in Southern California

    Science.gov (United States)

    2012-01-01

    With the goal of discussing how epigenetic control and chromatin remodeling contribute to the various processes that lead to cellular plasticity and disease, this symposium marks the collaboration between the Institut National de la Santé et de la Recherche Médicale (INSERM) in France and the University of California, Irvine (UCI). Organized by Paolo Sassone-Corsi (UCI) and held at the Beckman Center of the National Academy of Sciences at the UCI campus December 15–16, 2011, this was the first of a series of international conferences on epigenetics dedicated to the scientific community in Southern California. The meeting also served as the official kick off for the newly formed Center for Epigenetics and Metabolism at the School of Medicine, UCI (http://cem.igb.uci.edu). PMID:22414797

  13. COINCO Strategy 2025 - Discussion Paper

    DEFF Research Database (Denmark)

    Jespersen, Per Homann; Jensen, Anne; Stroschein, Christoph

     The regions and cities in the COINCO-corridor Oslo-Göteborg-Malmö-Copenhagen-Berlin have worked out a strategy proposal which is presented in this discussion paper. Behind the strategy is a political will to utilize mutual strengths and together become a leading player in a globalized world, based...... on matters essential to development - ‘hard' issues such as transport infrastructure and ‘soft' issues on improving cooperation within business, administration and knowledge production. The synergy of COINCO will have to come from collaboration among businesses. Supporting cooperation between existing...... to be institutionally supported. Therefore a number of knowledge institutions have to be formed organized around the ‘triple helix'-principle - a tight collaboration between business, administration and knowledge producers, especially universities. Also new ways of collaboration have to be explored - ‘network...

  14. Emerging Hopes

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    China looks to strategically important emerging industries for innovation-driven economic growthc hina will soon announce a decision to rev up seven strategically impor- tant emerging industries,said the National

  15. Bruxism: Conceptual discussion and review

    Science.gov (United States)

    Murali, R. V.; Rangarajan, Priyadarshni; Mounissamy, Anjana

    2015-01-01

    Bruxism is commonly considered a detrimental motor activity, potentially causing overload of the stomatognathic structures. The etiology of bruxism is unclear, but the condition has been associated with stress, occlusal disorders, allergies and sleep positioning. Due to its nonspecific pathology, bruxism may be difficult to diagnose. Unfortunately, very little data exists on the subject of a cause-and-effect relationship of bruxism to the point that expert opinions and cautionary approaches are still considered the best available sources for suggesting good practice indicators. The present paper reviewed current concepts on bruxism, etiology, diagnosis and management, underlining its effects on dental structures in an attempt to provide clinically useful suggestions based on scientifically sound data. PMID:26015729

  16. Emerging Multilingual Awareness in Educational Contexts: From Theory to Practice

    Science.gov (United States)

    Jessner, Ulrike; Allgäuer-Hackl, Elisabeth; Hofer, Barbara

    2016-01-01

    The aim of this article is to stress the importance of a dynamic systems or complexity theory approach as a necessary prerequisite to understanding the development of multi-competence in multilingual learners. Selected results from a study on emergent multilingual awareness in children, carried out in South Tyrol, are outlined and discussed. The…

  17. The Emergent Nature of Strategic Mediation in ESL Teacher Education

    Science.gov (United States)

    Kaur, Kuldip

    2015-01-01

    This article concentrates on a practitioner-driven approach to teacher education aimed at advancing ESL teachers' instructional knowledge about writing. Based on activity-centred interaction between a group of Malaysian English teachers and their teacher educator, the discussion demonstrates (1) the emergent, unplanned nature of strategic…

  18. The debate about death: an imperishable discussion?

    Directory of Open Access Journals (Sweden)

    FÉLIX BACIGALUPO

    2007-01-01

    Full Text Available In this concise review we discuss some of the complex edges of the concept of death that arose after the notorious advances in science and medicine over the last 50 years, in which the classical cardio-pulmonary criteria have led to the neurological criteria of death. New complicated questions like the definition of death and the operational criteria for diagnosing it have arisen and we think that they are far from being adequately and satisfactorily solved. A number of important issues -like the reliability and differences between cardio-pulmonary versus brain based criteria of death, if death is an event or a process, the meaning of integration and irreversibility- have not yet received sufficient attention. Here we have approached the death problem from two (biological complex system perspectives: the organism level and the cellular-molecular level. We also discuss issues from a third systemic approach, that is, the entire society, thus involving legal, religious, bioethical and political aspects of death. Our aim is to integrate new perspectives in order to promote further discussion on these critical yet frequently neglected issues

  19. Emergent Expertise?

    Science.gov (United States)

    McGivern, Patrick

    2014-01-01

    The concept of emergence appears in various places within the literature on expertise and expert practice. Here, I examine some of these applications of emergence in the light of two prominent accounts of emergence from the philosophy of science and philosophy of mind. I evaluate these accounts with respect to several specific contexts in which…

  20. To discuss illicit nuclear trafficking

    Energy Technology Data Exchange (ETDEWEB)

    Balatsky, Galya I [Los Alamos National Laboratory; Severe, William R [Los Alamos National Laboratory; Wallace, Richard K [Los Alamos National Laboratory

    2010-01-01

    The Illicit nuclear trafficking panel was conducted at the 4th Annual INMM workshop on Reducing the Risk from Radioactive and Nuclear Materials on February 2-3, 2010 in Washington DC. While the workshop occurred prior to the Nuclear Security Summit, April 12-13 2010 in Washington DC, some of the summit issues were raised during the workshop. The Communique of the Washington Nuclear Security Summit stated that 'Nuclear terrorism is one of the most challenging threats to international security, and strong nuclear security measures are the most effective means to prevent terrorists, criminals, or other unauthorized actors from acquiring nuclear materials.' The Illicit Trafficking panel is one means to strengthen nuclear security and cooperation at bilateral, regional and multilateral levels. Such a panel promotes nuclear security culture through technology development, human resources development, education and training. It is a tool which stresses the importance of international cooperation and coordination of assistance to improve efforts to prevent and respond to incidents of illicit nuclear trafficking. Illicit trafficking panel included representatives from US government, an international organization (IAEA), private industry and a non-governmental organization to discuss illicit nuclear trafficking issues. The focus of discussions was on best practices and challenges for addressing illicit nuclear trafficking. Terrorism connection. Workshop discussions pointed out the identification of terrorist connections with several trafficking incidents. Several trafficking cases involved real buyers (as opposed to undercover law enforcement agents) and there have been reports identifying individuals associated with terrorist organizations as prospective plutonium buyers. Some specific groups have been identified that consistently search for materials to buy on the black market, but no criminal groups were identified that specialize in nuclear materials or isotope

  1. Emergent Principles for Digital Documentary

    Directory of Open Access Journals (Sweden)

    Richard Lachman

    2016-12-01

    Full Text Available Digital Documentaries are an area of rapid invention and experimentation at all levels, including creative content, production techniques, and business models.  As with many forms of digital storytelling, a focus on technologies can be distracting; platforms change rapidly, and are dependent on external commercial forces rather than creative potential.  This article presents several design strategies for driving experimentation in digital documentary above and beyond the specific of platform and technology. The core focus is on treating digital docs as experiences, with an expanded range of designable moments, as well as a strategic approach to designing interactions for their unique set of challenges.  The discussion is not intended to fully define digital documentary design factors, but rather, defines a useful subset of methods that can lead emerging practitioners to new innovations in their approach.

  2. Consultant radiographer leadership - A discussion

    International Nuclear Information System (INIS)

    Hogg, Peter; Hogg, Dianne; Henwood, Suzanne

    2008-01-01

    Effective leadership can be defined in many ways and is an essential element of successful organisations; poor leadership can result in problems such as low staff morale, high staff turnover and reduced productivity. Effective leadership behaviours are well documented in the literature and various leadership models have been proposed that illustrate these behaviours. This discussion paper does not focus on any particular model. Instead it considers the 'Leadership Qualities Framework' which was developed specifically for use within the UK National Health Service. This framework draws upon a range of leadership models and as such it gives a broad indication of leadership behaviours. The framework comprises three components - 'personal qualities', 'setting direction' and 'delivering the service'. This paper commences with an argument as to why effective leadership is important in organisations generally, and specifically within healthcare organisations. Various examples of leadership are illustrated from within and outside the NHS in order to demonstrate effective leadership behaviours. The Leadership Qualities Framework is then examined, along with scenarios to illustrate effective leadership behaviours in context (i.e. within a healthcare organisation). Subsequent reflections on the scenarios aim to identify leadership behaviours that are explained within the framework. The final element of this paper draws on [limited] published evidence of where consultant radiographers have demonstrated effective leadership behaviours. In this section the published evidence is examined and reflected upon. At the end of the article we indicate additional reading for those who wish to further develop their theoretical and practical leadership skills

  3. The metal failure cases discussed

    Energy Technology Data Exchange (ETDEWEB)

    Gupton, P

    1978-06-05

    The metal failure cases discussed by P. Gupton (Monsanto Chem. Co.) at a joint meeting of the American Society of Metals (ASM) and the National Association of Corrosion Engineers Calgary Section (Calgary 1978) include a high-temperature (1775/sup 0/-1800/sup 0/F) failure in an HK 40 outside heater tube in a synthesis gas steam-methane reformer, resulting in two major fissures caused by carbonization and oxide deposits with high carbon and lead contents due to the use of remelt scrap material with high lead content; separation of a support pad from a 30 in. pipeline due to corrosion caused by molybdenum-peroxide action; oxidation of a section of 180/sup 0/ U-bend in a thermal ethylene cracking furnace due to fluxing reaction of a high sodium and calcium feed which collected in the return bed; stress corrosion cracking of an austenitic stainless cracker tube from high temperature and electrolytic attack; and other cases of metal failure caused by weld quality problems, use of contaminated material and inadequate designs, processing, and fabrication.

  4. Consultant radiographer leadership - A discussion

    Energy Technology Data Exchange (ETDEWEB)

    Hogg, Peter [Directorate of Radiography, University of Salford, Allerton Building, Frederick Road, Salford, Greater Manchester M6 6PU (United Kingdom)], E-mail: p.hogg@salford.ac.uk; Hogg, Dianne [Henwood Associates (South East) Ltd, Company Number: 513796, Registered Office: 2 Lakeview Stables, Lower St Clere, Kemsing, Kent, TN15 6NL (United Kingdom); Henwood, Suzanne [East Lancashire Primary Care Trust, Linden Business Centre, Linden Road, Colne. BB8 9BA (United Kingdom)

    2008-12-15

    Effective leadership can be defined in many ways and is an essential element of successful organisations; poor leadership can result in problems such as low staff morale, high staff turnover and reduced productivity. Effective leadership behaviours are well documented in the literature and various leadership models have been proposed that illustrate these behaviours. This discussion paper does not focus on any particular model. Instead it considers the 'Leadership Qualities Framework' which was developed specifically for use within the UK National Health Service. This framework draws upon a range of leadership models and as such it gives a broad indication of leadership behaviours. The framework comprises three components - 'personal qualities', 'setting direction' and 'delivering the service'. This paper commences with an argument as to why effective leadership is important in organisations generally, and specifically within healthcare organisations. Various examples of leadership are illustrated from within and outside the NHS in order to demonstrate effective leadership behaviours. The Leadership Qualities Framework is then examined, along with scenarios to illustrate effective leadership behaviours in context (i.e. within a healthcare organisation). Subsequent reflections on the scenarios aim to identify leadership behaviours that are explained within the framework. The final element of this paper draws on [limited] published evidence of where consultant radiographers have demonstrated effective leadership behaviours. In this section the published evidence is examined and reflected upon. At the end of the article we indicate additional reading for those who wish to further develop their theoretical and practical leadership skills.

  5. Performance-based regulation. Panel Discussion

    International Nuclear Information System (INIS)

    Youngblood, Robert; Bier, Vicki M.; Bukowski, Richard W.; Prasad Kadambi, N.; Koonce, James F.

    2001-01-01

    Full text of publication follows: Performance-based regulation is a part of the NRC's Strategic Plan and is realizing steady progress in conceptual development for actual applications. For example, high-level, conceptual guidelines have been proposed that would apply to reactors, materials, and waste areas. Performance-based approaches are also being applied in other regulated industries such as FAA and OSHA. The discussion will include comments from speakers from different parts of the nuclear industry and other industries regarding benefits and weaknesses of performance-based regulation. (authors)

  6. Modeling Psychological Attributes in Psychology – An Epistemological Discussion: Network Analysis vs. Latent Variables

    Science.gov (United States)

    Guyon, Hervé; Falissard, Bruno; Kop, Jean-Luc

    2017-01-01

    Network Analysis is considered as a new method that challenges Latent Variable models in inferring psychological attributes. With Network Analysis, psychological attributes are derived from a complex system of components without the need to call on any latent variables. But the ontological status of psychological attributes is not adequately defined with Network Analysis, because a psychological attribute is both a complex system and a property emerging from this complex system. The aim of this article is to reappraise the legitimacy of latent variable models by engaging in an ontological and epistemological discussion on psychological attributes. Psychological attributes relate to the mental equilibrium of individuals embedded in their social interactions, as robust attractors within complex dynamic processes with emergent properties, distinct from physical entities located in precise areas of the brain. Latent variables thus possess legitimacy, because the emergent properties can be conceptualized and analyzed on the sole basis of their manifestations, without exploring the upstream complex system. However, in opposition with the usual Latent Variable models, this article is in favor of the integration of a dynamic system of manifestations. Latent Variables models and Network Analysis thus appear as complementary approaches. New approaches combining Latent Network Models and Network Residuals are certainly a promising new way to infer psychological attributes, placing psychological attributes in an inter-subjective dynamic approach. Pragmatism-realism appears as the epistemological framework required if we are to use latent variables as representations of psychological attributes. PMID:28572780

  7. Emergence of multilateral proto-institutions in global health and new approaches to governance: analysis using path dependency and institutional theory.

    Science.gov (United States)

    Gómez, Eduardo J; Atun, Rifat

    2013-05-10

    The role of multilateral donor agencies in global health is a new area of research, with limited research on how these agencies differ in terms of their governance arrangements, especially in relation to transparency, inclusiveness, accountability, and responsiveness to civil society. We argue that historical analysis of the origins of these agencies and their coalition formation processes can help to explain these differences. We propose an analytical approach that links the theoretical literature discussing institutional origins to path dependency and institutional theory relating to proto institutions in order to illustrate the differences in coalition formation processes that shape governance within four multilateral agencies involved in global health. We find that two new multilateral donor agencies that were created by a diverse coalition of state and non-state actors, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and GAVI, what we call proto-institutions, were more adaptive in strengthening their governance processes. This contrasts with two well-established multilateral donor agencies, such as the World Bank and the Asian Development Bank, what we call Bretton Woods (BW) institutions, which were created by nation states alone; and hence, have different origins and consequently different path dependent processes.

  8. Transfusion Related Emergencies

    OpenAIRE

    Osborn, Megan Boysen; Tran, Min-Ha

    2016-01-01

    Audience: This exercise is appropriate for all emergency medicine learners (residents and medical students) and learners from other specialties (internal medicine, family medicine, anesthesia). Introduction: About 85 million red blood cell units are transfused worldwide each year. Transfusion reactions can complicate up to 8% of blood transfusions and can range from benign to life threatening. An emergency physician must be able to discuss the risks and benefits of blood transfusion...

  9. Diabetic and endocrine emergencies

    OpenAIRE

    Kearney, T; Dang, C

    2007-01-01

    Endocrine emergencies constitute only a small percentage of the emergency workload of general doctors, comprising about 1.5% of all hospital admission in England in 2004–5. Most of these are diabetes related with the remaining conditions totalling a few hundred cases at most. Hence any individual doctor might not have sufficient exposure to be confident in their management. This review discusses the management of diabetic ketoacidosis, hyperosmolar hyperglycaemic state, hypoglycaemia, hyperca...

  10. Planning for nuclear emergencies

    International Nuclear Information System (INIS)

    Lakey, J.R.A.

    1989-01-01

    This paper aims to stimulate discussions between nuclear engineers and the radiological protection professions in order to facilitate planning for nuclear emergencies. A brief review is given of the response to nuclear accidents. Studying accidents can lead to prevention, but some effort must be put into emergency response. Such issues as decontamination and decommissioning, socio-economic consequences, education and training for nuclear personnel and exercises and drills, are raised. (UK)

  11. Alcohol screening and brief intervention among drug users in primary care: a discussion paper.

    LENUS (Irish Health Repository)

    Field, C A

    2011-08-24

    BACKGROUND: Problem alcohol use is common among problem drug users (PDU) and associated with adverse health outcomes. Primary care has an important role in the overall stepped approach to alcohol treatment, especially screening and brief intervention (SBI). AIM: To discuss three themes that emerged from an exploration of the literature on SBI for problem alcohol use in drug users attending primary care. METHODS: Material for this discussion paper was gathered from three biomedical databases (PubMed, PsycINFO and Cochrane library), conference proceedings and online resources of professional organisations or national health agencies. RESULTS: Themes discussed in this paper are: (a) the potential of primary care for delivery of alcohol SBIs to PDUs, (b) screening methods and (c) application of brief interventions to PDUs. CONCLUSIONS: Although SBI improves health outcomes associated with problem alcohol use in the general population, further research is needed among high-risk patient groups, especially PDUs.

  12. Highlights from panel discussion on key issues for future developments in microwave processing

    International Nuclear Information System (INIS)

    Gac, F.D.; Iskander, M.F.

    1992-01-01

    This paper reports on highlights from a panel discussion on Key Issues for Future Development in Microwave Processing. Although the panelists represented a mix of individuals from government, academia, and industry, only one aspect of industry was represented, namely microwave system manufacturers. For further panel discussions, it is recommended that the materials manufacturing (i.e., microwave user) sector also be represented. Three important points emerged from the panel discussion. The first deals with the credibility and usability of information, be it dielectric property measurements, experimental procedures, or microwave processing results. Second, a considerable communication and education gap continues to exist between the materials community and microwave engineers. Finally, a more realistic approach should be taken in identifying where microwave processing makes sense

  13. Episodes of care: is emergency medicine ready?

    Science.gov (United States)

    Wiler, Jennifer L; Beck, Dennis; Asplin, Brent R; Granovsky, Michael; Moorhead, John; Pilgrim, Randy; Schuur, Jeremiah D

    2012-05-01

    Optimizing resource use, eliminating waste, aligning provider incentives, reducing overall costs, and coordinating the delivery of quality care while improving outcomes have been major themes of health care reform initiatives. Recent legislation contains several provisions designed to move away from the current fee-for-service payment mechanism toward a model that reimburses providers for caring for a population of patients over time while shifting more financial risk to providers. In this article, we review current approaches to episode of care development and reimbursement. We describe the challenges of incorporating emergency medicine into the episode of care approach and the uncertain influence this delivery model will have on emergency medicine care, including quality outcomes. We discuss the limitations of the episode of care payment model for emergency services and advocate retention of the current fee-for-service payment model, as well as identify research gaps that, if addressed, could be used to inform future policy decisions of emergency medicine health policy leaders. We then describe a meaningful role for emergency medicine in an episode of care setting. Copyright © 2011. Published by Mosby, Inc.

  14. Systematic Molecular Phenotyping: A Path Towards Precision Emergency Medicine?

    Science.gov (United States)

    Limkakeng, Alexander T.; Monte, Andrew; Kabrhel, Christopher; Puskarich, Michael; Heitsch, Laura; Tsalik, Ephraim L.; Shapiro, Nathan I.

    2016-01-01

    Precision medicine is an emerging approach to disease treatment and prevention that considers variability in patient genes, environment, and lifestyle. However, little has been written about how such research impacts emergency care. Recent advances in analytical techniques have made it possible to characterize patients in a more comprehensive and sophisticated fashion at the molecular level, promising highly individualized diagnosis and treatment. Among these techniques are various systematic molecular phenotyping analyses (e.g., genomics, transcriptomics, proteomics, and metabolomics). Although a number of emergency physicians use such techniques in their research, widespread discussion of these approaches has been lacking in the emergency care literature and many emergency physicians may be unfamiliar with them. In this article, we briefly review the underpinnings of such studies, note how they already impact acute care, discuss areas in which they might soon be applied, and identify challenges in translation to the emergency department. While such techniques hold much promise, it is unclear whether the obstacles to translating their findings to the emergency department will be overcome in the near future. Such obstacles include validation, cost, turnaround time, user interface, decision support, standardization, and adoption by end users. PMID:27288269

  15. Systematic Molecular Phenotyping: A Path Toward Precision Emergency Medicine?

    Science.gov (United States)

    Limkakeng, Alexander T; Monte, Andrew A; Kabrhel, Christopher; Puskarich, Michael; Heitsch, Laura; Tsalik, Ephraim L; Shapiro, Nathan I

    2016-10-01

    Precision medicine is an emerging approach to disease treatment and prevention that considers variability in patient genes, environment, and lifestyle. However, little has been written about how such research impacts emergency care. Recent advances in analytical techniques have made it possible to characterize patients in a more comprehensive and sophisticated fashion at the molecular level, promising highly individualized diagnosis and treatment. Among these techniques are various systematic molecular phenotyping analyses (e.g., genomics, transcriptomics, proteomics, and metabolomics). Although a number of emergency physicians use such techniques in their research, widespread discussion of these approaches has been lacking in the emergency care literature and many emergency physicians may be unfamiliar with them. In this article, we briefly review the underpinnings of such studies, note how they already impact acute care, discuss areas in which they might soon be applied, and identify challenges in translation to the emergency department (ED). While such techniques hold much promise, it is unclear whether the obstacles to translating their findings to the ED will be overcome in the near future. Such obstacles include validation, cost, turnaround time, user interface, decision support, standardization, and adoption by end-users. © 2016 by the Society for Academic Emergency Medicine.

  16. The emergence of consensus: a primer

    Science.gov (United States)

    Baronchelli, Andrea

    2018-02-01

    The origin of population-scale coordination has puzzled philosophers and scientists for centuries. Recently, game theory, evolutionary approaches and complex systems science have provided quantitative insights on the mechanisms of social consensus. However, the literature is vast and widely scattered across fields, making it hard for the single researcher to navigate it. This short review aims to provide a compact overview of the main dimensions over which the debate has unfolded and to discuss some representative examples. It focuses on those situations in which consensus emerges `spontaneously' in the absence of centralized institutions and covers topics that include the macroscopic consequences of the different microscopic rules of behavioural contagion, the role of social networks and the mechanisms that prevent the formation of a consensus or alter it after it has emerged. Special attention is devoted to the recent wave of experiments on the emergence of consensus in social systems.

  17. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  18. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...

  19. Emergent Properties in Natural and Artificial Dynamical Systems

    CERN Document Server

    Aziz-Alaoui, M.A

    2006-01-01

    An important part of the science of complexity is the study of emergent properties arising through dynamical processes in various types of natural and artificial systems. This is the aim of this book, which is the outcome of a discussion meeting within the first European conference on complex systems. It presents multidisciplinary approaches for getting representations of complex systems and using different methods to extract emergent structures. This carefully edited book studies emergent features such as self organization, synchronization, opening on stability and robustness properties. Invariant techniques are presented which can express global emergent properties in dynamical and in temporal evolution systems. This book demonstrates how artificial systems such as a distributed platform can be used for simulation used to search emergent placement during simulation execution.

  20. Irish Culinary Manuscripts and Printed Books:a Discussion

    OpenAIRE

    Mac Con Iomaire, Máirtín; Cashman, Dorothy

    2011-01-01

    This paper provides a discussion of Irish Culinary Manuscripts and Printed Cookbooks. It covers Gaelic hospitality and aristocratic hospitality, setting the background for the Anglo-Irish households from which many manuscripts emerge. It charts the growing sources of information on Irish culinary history. It outlines Barbara Wheaton's framework for reading historic cookbooks and discusses the growing manuscript cookbook collection in the National Library of Ireland.