A problem-solving routine for improving hospital operations.

Science.gov (United States)

Ghosh, Manimay; Sobek Ii, Durward K

2015-01-01

The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. The study was conducted in one hospital setting. Hospital managers can improve patient care and increase operational efficiency by adopting and diffusing problem-solving routines that embody three key characteristics. This paper offers new insights on why caregivers adopt short-term approaches to problem solving. Three characteristics of an effective problem-solving routine in a healthcare setting are proposed.

Numerical Aspects of Atomic Physics: Helium Basis Sets and Matrix Diagonalization

Science.gov (United States)

Jentschura, Ulrich; Noble, Jonathan

2014-03-01

We present a matrix diagonalization algorithm for complex symmetric matrices, which can be used in order to determine the resonance energies of auto-ionizing states of comparatively simple quantum many-body systems such as helium. The algorithm is based in multi-precision arithmetic and proceeds via a tridiagonalization of the complex symmetric (not necessarily Hermitian) input matrix using generalized Householder transformations. Example calculations involving so-called PT-symmetric quantum systems lead to reference values which pertain to the imaginary cubic perturbation (the imaginary cubic anharmonic oscillator). We then proceed to novel basis sets for the helium atom and present results for Bethe logarithms in hydrogen and helium, obtained using the enhanced numerical techniques. Some intricacies of ``canned'' algorithms such as those used in LAPACK will be discussed. Our algorithm, for complex symmetric matrices such as those describing cubic resonances after complex scaling, is faster than LAPACK's built-in routines, for specific classes of input matrices. It also offer flexibility in terms of the calculation of the so-called implicit shift, which is used in order to ``pivot'' the system toward the convergence to diagonal form. We conclude with a wider overview.

Pulse processing routines for neutron time-of-flight data

CERN Document Server

Žugec, P; Guerrero, C; Gunsing, F; Vlachoudis, V; Sabate-Gilarte, M; Stamatopoulos, A; Wright, T; Lerendegui-Marco, J; Mingrone, F; Ryan, J A; Warren, S G; Tsinganis, A; Barbagallo, M

2016-01-01

A pulse shape analysis framework is described, which was developed for n_TOF-Phase3, the third phase in the operation of the n_TOF facility at CERN. The most notable feature of this new framework is the adoption of generic pulse shape analysis routines, characterized by a minimal number of explicit assumptions about the nature of pulses. The aim of these routines is to be applicable to a wide variety of detectors, thus facilitating the introduction of the new detectors or types of detectors into the analysis framework. The operational details of the routines are suited to the specific requirements of particular detectors by adjusting the set of external input parameters. Pulse recognition, baseline calculation and the pulse shape fitting procedure are described. Special emphasis is put on their computational efficiency, since the most basic implementations of these conceptually simple methods are often computationally inefficient.

High performance matrix inversion based on LU factorization for multicore architectures

KAUST Repository

Dongarra, Jack; Faverge, Mathieu; Ltaief, Hatem; Luszczek, Piotr R.

2011-01-01

on the available processing units. The reported results from our LU-based matrix inversion implementation significantly outperform the state-of-the-art numerical libraries such as LAPACK (5x), MKL (5x) and ScaLAPACK (2.5x) on a contemporary AMD platform with four

Using the Intel Math Kernel Library on Peregrine | High-Performance

Science.gov (United States)

Computing | NREL the Intel Math Kernel Library on Peregrine Using the Intel Math Kernel Library on Peregrine Learn how to use the Intel Math Kernel Library (MKL) with Peregrine system software. MKL architectures. Core math functions in MKL include BLAS, LAPACK, ScaLAPACK, sparse solvers, fast Fourier

Intelligent stochastic optimization routine for in-core fuel cycle design

International Nuclear Information System (INIS)

Parks, G.T.

1988-01-01

Any reactor fuel management strategy must specify the fuel design, batch sizes, loading configurations, and operational procedures for each cycle. To permit detailed design studies, the complex core characteristics must necessarily be computer modeled. Thus, the identification of an optimal fuel cycle design represents an optimization problem with a nonlinear objective function (OF), nonlinear safety constraints, many control variables, and no direct derivative information. Most available library routines cannot tackle such problems; this paper introduces an intelligent stochastic optimization routine that can. There has been considerable interest recently in the application of stochastic methods to difficult optimization problems, based on the statistical mechanics algorithms originally attributed to Metropolis. Previous work showed that, in optimizing the performance of a British advanced gas-cooled reactor fuel stringer, a rudimentary version of the Metropolis algorithm performed as efficiently as the only suitable routine in the Numerical Algorithms Group library. Since then the performance of the Metropolis algorithm has been considerably enhanced by the introduction of self-tuning capabilities by which the routine adjusts its control parameters and search pattern as it progresses. Both features can be viewed as examples of artificial intelligence, in which the routine uses the accumulation of data, or experience, to guide its future actions

System for remote routine monitoring of power equipment at TPP and NPP

International Nuclear Information System (INIS)

Kantsedalov, V.G.; Samojlenko, V.P.; Doroshenko, V.A.

1988-01-01

A system for remote routine monitoring of TPP and NPP pipeline metals is described. The principal functional unit of the system is the unit of remote routine methods and techniques for studying and monitoring the metal and properties. The system is equipped with 5 types of routine monitoring equipment: robots, remote aggregated complexes, periodical diagnostic monitors, other means of metal diagnostics (endoscopes, introscopes). All current information enters the unit for estimating and forecasting the service life of power unit, where it is compared with the standard indices of reliability, duravility and efficiency. The system considered permits to reduce significantly or minimize the scope of works on metal monitoring during overhauls, increase intermonitoring and interrepairing compaigns to 8 years

Increasing Efficiency of Routine Robot Space Operations through Adjustable Autonomy and Learning from Human Instructions

Data.gov (United States)

National Aeronautics and Space Administration — This research aims to address the execution of repetitive, routine and potentially hazardous tasks by robots operating in crewed low Earth orbit, lunar and...

External Agents' Effect on Routine Dynamics:Lack of Compliance Resulting in Routine Breakdown

OpenAIRE

Busse Hansen, Nicolai

2014-01-01

Prior investigations on organizational routines have called for re- search to enlighten our understanding of how social actors establish and main- tain of routines as well as the causes of their disruption. The present paper con- tributes to this call by conducting systematic microethnographic analyses of naturally occurring interactional routine data in the form of recordings of job interviews in an international oil contractor company. The term interactional routine is used to describe recu...

Implementing a New Dense Symmetric Eigensolver on Multicore Systems

KAUST Repository

Sukkari, Dalal E.

2013-07-01

We present original advanced architecture implementations of the QDWHeig algo- rithm for solving dense symmetric eigenproblems. The algorithm (Y. Nakatsukasa and N. J. Higham, 2012) performs a spectral divide-and-conquer, which recursively divides the matrix into smaller submatrices by finding an invariant subspace for a subset of the spectrum. The main contribution of this thesis is to enhance the per- formance of QDWHeig algorithm by relying on a high performance kernels from PLASMA [1] and LAPACK [2]. We demonstrate the quality of the eigenpairs that are computed with the QDWHeig algorithm for many matrix types with different eigenvalue clustering. We then implement QDWHeig using kernels from LAPACK and PLASMA, and compare its performance against other divide-and-conquer sym- metric eigensolvers. The main part of QDWHeig is finding a polar decomposition. We introduce mixed precision to enhance the performance in finding the polar decom- position. Our evaluation considers speed and accuracy of the computed eigenvalues. Some applications require finding only a subspectrum of the eigenvalues; therefore we modify the algorithm to find the eigenpairs in a given interval of interest. An ex- perimental study shows significant improvement on the performance of our algorithm using mixed precision and PLASMA routines.

Power profiling of Cholesky and QR factorizations on distributed memory systems

KAUST Repository

Bosilca, George

2012-08-30

This paper presents the power profile of two high performance dense linear algebra libraries on distributed memory systems, ScaLAPACK and DPLASMA. From the algorithmic perspective, their methodologies are opposite. The former is based on block algorithms and relies on multithreaded BLAS and a two-dimensional block cyclic data distribution to achieve high parallel performance. The latter is based on tile algorithms running on top of a tile data layout and uses fine-grained task parallelism combined with a dynamic distributed scheduler (DAGuE) to leverage distributed memory systems. We present performance results (Gflop/s) as well as the power profile (Watts) of two common dense factorizations needed to solve linear systems of equations, namely Cholesky and QR. The reported numbers show that DPLASMA surpasses ScaLAPACK not only in terms of performance (up to 2X speedup) but also in terms of energy efficiency (up to 62 %). © 2012 Springer-Verlag (outside the USA).

The embeddedness of selfish Routines

DEFF Research Database (Denmark)

Andersen, Poul Houman

2001-01-01

Routines have traditionally been seen as an organisational feature. However, like genes, routines may be carriers and initiators of organisations as well......Routines have traditionally been seen as an organisational feature. However, like genes, routines may be carriers and initiators of organisations as well...

Generating Novelty Through Interdependent Routines: A Process Model of Routine Work

NARCIS (Netherlands)

Deken, F.; Carlile, P.R.; Berends, H.; Lauche, K.

2016-01-01

We investigate how multiple actors accomplish interdependent routine performances directed at novel intended outcomes and how this affects routine dynamics over time. We report findings from a longitudinal ethnographic study in an automotive company where actors developed a new business model around

An interdisciplinary perspective on industrial energy efficiency

International Nuclear Information System (INIS)

Palm, Jenny; Thollander, Patrik

2010-01-01

This paper combines engineering and social science approaches to enhance our understanding of industrial energy efficiency and broaden our perspective on policy making in Europe. Sustainable development demands new strategies, solutions, and policy-making approaches. Numerous studies of energy efficiency potential state that cost-effective energy efficiency technologies in industry are not always implemented for various reasons, such as lack of information, procedural impediments, and routines not favoring energy efficiency. Another reason for the efficiency gap is the existence of particular values, unsupportive of energy efficiency, in the dominant networks of a branch of trade. Analysis indicates that different sectors of rather closed communities have established their own tacit knowledge, perceived truths, and routines concerning energy efficiency measures. Actors in different industrial sectors highlight different barriers to energy efficiency and why cost-effective energy efficiency measures are not being implemented. The identified barriers can be problematized in relation to the social context to understand their existence and how to resolve them.

Bedtime routines child wellbeing & development.

Science.gov (United States)

Kitsaras, George; Goodwin, Michaela; Allan, Julia; Kelly, Michael P; Pretty, Iain A

2018-03-21

Bedtime routines has shown important associations with areas associated with child wellbeing and development. Research into bedtime routines is limited with studies mainly focusing on quality of sleep. The objectives of the present study were to examine the relationship between bedtime routines and a variety of factors associated with child wellbeing and to examine possible determinants of bedtime routines. A total of 50 families with children between 3 and 5 years old took part in the study. Data on bedtime routines, parenting styles, school readiness, children's dental health, and executive function were collected. Children in families with optimal bedtime routines showed better performance in terms of executive function, specifically working memory (t (44)= - 8.51, p ≤ .001), inhibition and attention (t (48)= - 9.70, p ≤ .001) and cognitive flexibility (t (48)= - 13.1, p ≤ .001). Also, children in households with optimal bedtime routines scored higher in their readiness for school (t (48)= 6.92, p ≤ .001) and had better dental health (U = 85.5, p = .011). Parents in households with suboptimal bedtime routines showed worse performance on all measures of executive function including working memory (t (48)= - 10.47, p ≤ .001), inhibition-attention (t (48)= - 10.50, p ≤ .001) and cognitive flexibility (t (48)= - 13.6, p ≤ .001). Finally, parents with optimal bedtime routines for their children deployed a more positive parenting style in general (i.e. authoritative parenting) compared to those with suboptimal bedtime routines (t (48)= - 6.45, p ≤ .001). The results of the present study highlight the potentially important role of bedtime routines in a variety of areas associated with child wellbeing and the need for further research.

Routine recovery: an ethical plan for greatly increasing the supply of transplantable organs.

Science.gov (United States)

Spital, Aaron; Taylor, James S

2008-04-01

All current organ procurement policies require some form of consent. Many families refuse to permit organ recovery from a recently deceased relative; therefore, the major cost of requiring consent is the loss of some lives that could have been saved through transplantation. Here, we argue for a much more efficient approach to organ procurement from brain dead individuals - routine recovery of all transplantable organs without consent. Careful analysis of the relevant literature shows that, compared with its competitors, routine recovery has the greatest potential to increase cadaveric organ procurement and save lives while causing very little harm. Furthermore, a recent survey suggests that 30% of the US public would already accept routine recovery even though the respondents were not educated regarding the value of this approach. Patients on the transplant waiting list are dying while organs that could have saved them are being buried or burned because of family refusal to allow posthumous organ procurement. Routine recovery would eliminate this tragic loss of life-saving organs without violating ethical principles. Indeed, we argue that of all the proposals designed to increase the supply of transplantable cadaveric organs, routine recovery is the best.

The significance of routines in nursing practice.

Science.gov (United States)

Rytterström, Patrik; Unosson, Mitra; Arman, Maria

2011-12-01

The aim of this study was to illuminate the significance of routines in nursing practice. Clinical nursing is performed under the guidance of routines to varying degrees. In the nursing literature, routine is described as having both negative and positive aspects, but use of the term is inconsistent, and empirical evidence is sparse. In the research on organisational routines, a distinction is made between routine as a rule and routine as action. A qualitative design using a phenomenological-hermeneutic approach. Data collection from three focus groups focused on nurses' experience of routines. Seventeen individual interviews from a previous study focusing on caring culture were also analysed in a secondary qualitative analysis. All participants were employed as 'qualified nursing pool' nurses. Routines are experienced as pragmatic, obstructive and meaningful. The aim of the pragmatic routine was to ensure that daily working life works; this routine is practised more on the basis of rational arguments and obvious intentions. The obstructive routine had negative consequences for nursing practice and was described as nursing losing its humanity and violating the patient's integrity. The meaningful routine involved becoming one with the routine and for the nurses, it felt right and meaningful to adapt to it. Routines become meaningful when the individual action is in harmony with the cultural pattern on which the nursing work is based. Instead of letting contemporary practice passively become routine, routines can be assessed and developed using research and theoretical underpinnings as a starting point for nursing practice. Leaders have a special responsibility to develop and support meaningful routines. One approach could be to let wards examine their routines from a patient perspective on the basis of the themes of pragmatic, meaningful and obstructive routine. © 2010 Blackwell Publishing Ltd.

Data format translation routines

International Nuclear Information System (INIS)

Burris, R.D.

1981-02-01

To enable the effective connection of several dissimilar computers into a network, modification of the data being passed from one computer to another may become necessary. This document describes a package of routines which permit the translation of data in PDP-8 formats to PDP-11 or DECsystem-10 formats or from PDP-11 format to DECsystem-10 format. Additional routines are described which permit the effective use of the translation routines in the environment of the Fusion Energy Division (FED) network and the Elmo Bumpy Torus (EBT) data base

Routines and Organizational Change

DEFF Research Database (Denmark)

Yi, Sangyoon; Becker, Markus; Knudsen, Thorbjørn

2014-01-01

Routines have been perceived as a source of inertia in the process of organizational change. In this study, we suggest an overlooked, but prevalent, mechanism by which the inertial nature of routines helps, rather than hinders, organizational adaptation. Routine-level inertia plays a hidden role...... to cope with its task environment. In our nuanced perspective, inertia is not only a consequence of adaptation but also a source of adaptation. This logic is helpful to understand why reliable but apparently inertial organizations keep surviving and often exhibit outstanding performance. We conclude...

Efficiency Optimization in Class-D Audio Amplifiers

DEFF Research Database (Denmark)

Yamauchi, Akira; Knott, Arnold; Jørgensen, Ivan Harald Holger

2015-01-01

This paper presents a new power efficiency optimization routine for designing Class-D audio amplifiers. The proposed optimization procedure finds design parameters for the power stage and the output filter, and the optimum switching frequency such that the weighted power losses are minimized under...... the given constraints. The optimization routine is applied to minimize the power losses in a 130 W class-D audio amplifier based on consumer behavior investigations, where the amplifier operates at idle and low power levels most of the time. Experimental results demonstrate that the optimization method can...... lead to around 30 % of efficiency improvement at 1.3 W output power without significant effects on both audio performance and the efficiency at high power levels....

Increased Exposure to Rigid Routines Can Lead to Increased Challenging Behavior Following Changes to Those Routines

Science.gov (United States)

Bull, Leah E.; Oliver, Chris; Callaghan, Eleanor; Woodcock, Kate A.

2015-01-01

Several neurodevelopmental disorders are associated with preference for routine and challenging behavior following changes to routines. We examine individuals with Prader-Willi syndrome, who show elevated levels of this behavior, to better understand how previous experience of a routine can affect challenging behavior elicited by disruption to…

The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery.

Science.gov (United States)

Jones, Jason J; Chu, Jeffrey; Graham, Jacob; Zaluski, Serge; Rocha, Guillermo

2016-01-01

The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL) delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%-12.0% (Psystem also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity.

An Open-Source Auto-Calibration Routine Supporting the Stormwater Management Model

Science.gov (United States)

Tiernan, E. D.; Hodges, B. R.

2017-12-01

The stormwater management model (SWMM) is a clustered model that relies on subcatchment-averaged parameter assignments to correctly capture catchment stormwater runoff behavior. Model calibration is considered a critical step for SWMM performance, an arduous task that most stormwater management designers undertake manually. This research presents an open-source, automated calibration routine that increases the efficiency and accuracy of the model calibration process. The routine makes use of a preliminary sensitivity analysis to reduce the dimensions of the parameter space, at which point a multi-objective function, genetic algorithm (modified Non-dominated Sorting Genetic Algorithm II) determines the Pareto front for the objective functions within the parameter space. The solutions on this Pareto front represent the optimized parameter value sets for the catchment behavior that could not have been reasonably obtained through manual calibration.

Multi-Threaded Dense Linear Algebra Libraries for Low-Power Asymmetric Multicore Processors

OpenAIRE

Catalán, Sandra; Herrero, José R.; Igual, Francisco D.; Rodríguez-Sánchez, Rafael; Quintana-Ortí, Enrique S.

2015-01-01

Dense linear algebra libraries, such as BLAS and LAPACK, provide a relevant collection of numerical tools for many scientific and engineering applications. While there exist high performance implementations of the BLAS (and LAPACK) functionality for many current multi-threaded architectures,the adaption of these libraries for asymmetric multicore processors (AMPs)is still pending. In this paper we address this challenge by developing an asymmetry-aware implementation of the BLAS, based on the...

TU-AB-BRC-11: Moving a GPU-OpenCL-Based Monte Carlo (MC) Dose Engine Towards Routine Clinical Use: Automatic Beam Commissioning and Efficient Source Sampling

Energy Technology Data Exchange (ETDEWEB)

Tian, Z; Folkerts, M; Jiang, S; Jia, X [UT Southwestern Medical Ctr, Dallas, TX (United States); Li, Y [Beihang University, Beijing (China)

2016-06-15

Purpose: We have previously developed a GPU-OpenCL-based MC dose engine named goMC with built-in analytical linac beam model. To move goMC towards routine clinical use, we have developed an automatic beam-commissioning method, and an efficient source sampling strategy to facilitate dose calculations for real treatment plans. Methods: Our commissioning method is to automatically adjust the relative weights among the sub-sources, through an optimization process minimizing the discrepancies between calculated dose and measurements. Six models built for Varian Truebeam linac photon beams (6MV, 10MV, 15MV, 18MV, 6MVFFF, 10MVFFF) were commissioned using measurement data acquired at our institution. To facilitate dose calculations for real treatment plans, we employed inverse sampling method to efficiently incorporate MLC leaf-sequencing into source sampling. Specifically, instead of sampling source particles control-point by control-point and rejecting the particles blocked by MLC, we assigned a control-point index to each sampled source particle, according to MLC leaf-open duration of each control-point at the pixel where the particle intersects the iso-center plane. Results: Our auto-commissioning method decreased distance-to-agreement (DTA) of depth dose at build-up regions by 36.2% averagely, making it within 1mm. Lateral profiles were better matched for all beams, with biggest improvement found at 15MV for which root-mean-square difference was reduced from 1.44% to 0.50%. Maximum differences of output factors were reduced to less than 0.7% for all beams, with largest decrease being from1.70% to 0.37% found at 10FFF. Our new sampling strategy was tested on a Head&Neck VMAT patient case. Achieving clinically acceptable accuracy, the new strategy could reduce the required history number by a factor of ∼2.8 given a statistical uncertainty level and hence achieve a similar speed-up factor. Conclusion: Our studies have demonstrated the feasibility and effectiveness of

42 CFR 493.931 - Routine chemistry.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Routine chemistry. 493.931 Section 493.931 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.931 Routine chemistry. (a) Program content and frequency of challenge. To be approved for proficiency testing for routine chemistry, a program...

Microfoundations of Routines and Capabilities

DEFF Research Database (Denmark)

Felin, Teppo; Foss, Nicolai Juul; Heimriks, Koen H.

We discuss the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories of micro-level components underlying routines...

OpenMP Issues Arising in the Development of Parallel BLAS and LAPACK Libraries

Directory of Open Access Journals (Sweden)

C. Addison

2003-01-01

Full Text Available Dense linear algebra libraries need to cope efficiently with a range of input problem sizes and shapes. Inherently this means that parallel implementations have to exploit parallelism wherever it is present. While OpenMP allows relatively fine grain parallelism to be exploited in a shared memory environment it currently lacks features to make it easy to partition computation over multiple array indices or to overlap sequential and parallel computations. The inherent flexible nature of shared memory paradigms such as OpenMP poses other difficulties when it becomes necessary to optimise performance across successive parallel library calls. Notions borrowed from distributed memory paradigms, such as explicit data distributions help address some of these problems, but the focus on data rather than work distribution appears misplaced in an SMP context.

Consuming technologies - developing routines

DEFF Research Database (Denmark)

Gram-Hanssen, Kirsten

2008-01-01

technologies and in this article these processes will be investigated from three different perspectives: an historical perspective of how new technologies have entered homes, a consumer perspective of how both houses and new technologies are purchased and finally, as the primary part of the article, a user...... perspective of how routines develop while these technologies are being used. In the conclusion these insights are discussed in relation to possible ways of influencing routines....

Technique for comparing automatic quadrature routines

Energy Technology Data Exchange (ETDEWEB)

Lyness, J N; Kaganove, J J

1976-02-01

The present unconstrained proliferation of automatic quadrature routines is a phenomenon which is wasteful in human time and computing resources. At the root of the problem is an absence of generally acceptable standards or benchmarks for comparing or evaluating such routines. In this paper a general technique, based on the nature of the performance profile, is described which can be used for evaluation of routines.

Routinely collected data as a strategic resource for research: priorities for methods and workforce.

Science.gov (United States)

Jorm, Louisa

2015-09-30

In the era of 'big data', research using routinely collected data offers greater potential than ever before to drive health system effectiveness and efficiency, and population health improvement. In Australia, the policy environment, and emerging frameworks and processes for data governance and access, increasingly support the use of routinely collected data for research. Capitalising on this strategic resource requires investment in both research methods and research workforce. Priorities for methods development include validation studies, techniques for analysing complex longitudinal data, exploration of bias introduced through linkage error, and a robust toolkit to evaluate policies and programs using 'natural experiments'. Priorities for workforce development include broadening the skills base of the existing research workforce, and the formation of new, larger, interdisciplinary research teams to incorporate capabilities in computer science, partnership research, research translation and the 'business' aspects of research. Large-scale, long-term partnership approaches involving government, industry and researchers offer the most promising way to maximise returns on investment in research using routinely collected data.

Active Movement Warm-Up Routines

Science.gov (United States)

Walter, Teri; Quint, Ashleigh; Fischer, Kim; Kiger, Joy

2011-01-01

This article presents warm-ups that are designed to physiologically and psychologically prepare students for vigorous physical activity. An active movement warm-up routine is made up of three parts: (1) active warm-up movement exercises, (2) general preparation, and (3) the energy system. These warm-up routines can be used with all grade levels…

Fit Between Organization Design and Organizational Routines

Directory of Open Access Journals (Sweden)

Constance E. Helfat

2014-07-01

Full Text Available Despite decades of research on both organization design and organizational routines, little research has analyzed the relationship between them. Here we propose a normative theory in which the effectiveness of organization design and redesign depends on the characteristics of routines. The analysis shows which types of organization designs may be useful as well as which design changes may or may not succeed depending on (a the specificity of routines and (b the dynamic versus static purposes of organizational routines.

Improving care coordination using organisational routines.

Science.gov (United States)

Prætorius, Thim

2016-01-01

The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change and can be replicated, the way they are influenced by the organisation and the way they influence health care professionals. Theory of routines is systematically applied to care pathways in order to develop theoretically derived propositions. Care pathways mirror routines by being recurrent, collective and embedded and specific to an organisation. In particular, care pathways resemble standard operating procedures that can give rise to recurrent collective action patterns. In all, 11 propositions related to five categories are proposed by building on these insights: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications - The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research. The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality/value - Theory on organisational routines offers fundamental, yet unexplored, insights into hospital processes, including in particular care coordination.

42 CFR 493.1210 - Condition: Routine chemistry.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Routine chemistry. 493.1210 Section 493....1210 Condition: Routine chemistry. If the laboratory provides services in the subspecialty of Routine chemistry, the laboratory must meet the requirements specified in §§ 493.1230 through 493.1256, § 493.1267...

Solution of the Skyrme-Hartree-Fock-Bogolyubov equations in the Cartesian deformed harmonic-oscillator basis.. (VII) HFODD (v2.49t): A new version of the program

Science.gov (United States)

Schunck, N.; Dobaczewski, J.; McDonnell, J.; Satuła, W.; Sheikh, J. A.; Staszczak, A.; Stoitsov, M.; Toivanen, P.

2012-01-01

We describe the new version (v2.49t) of the code HFODD which solves the nuclear Skyrme-Hartree-Fock (HF) or Skyrme-Hartree-Fock-Bogolyubov (HFB) problem by using the Cartesian deformed harmonic-oscillator basis. In the new version, we have implemented the following physics features: (i) the isospin mixing and projection, (ii) the finite-temperature formalism for the HFB and HF + BCS methods, (iii) the Lipkin translational energy correction method, (iv) the calculation of the shell correction. A number of specific numerical methods have also been implemented in order to deal with large-scale multi-constraint calculations and hardware limitations: (i) the two-basis method for the HFB method, (ii) the Augmented Lagrangian Method (ALM) for multi-constraint calculations, (iii) the linear constraint method based on the approximation of the RPA matrix for multi-constraint calculations, (iv) an interface with the axial and parity-conserving Skyrme-HFB code HFBTHO, (v) the mixing of the HF or HFB matrix elements instead of the HF fields. Special care has been paid to using the code on massively parallel leadership class computers. For this purpose, the following features are now available with this version: (i) the Message Passing Interface (MPI) framework, (ii) scalable input data routines, (iii) multi-threading via OpenMP pragmas, (iv) parallel diagonalization of the HFB matrix in the simplex-breaking case using the ScaLAPACK library. Finally, several little significant errors of the previous published version were corrected. New version program summaryProgram title:HFODD (v2.49t) Catalogue identifier: ADFL_v3_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADFL_v3_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: GNU General Public Licence v3 No. of lines in distributed program, including test data, etc.: 190 614 No. of bytes in distributed program, including test data, etc.: 985 898 Distribution

The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery

Directory of Open Access Journals (Sweden)

Jones JJ

2016-06-01

Full Text Available Jason J Jones,1 Jeffrey Chu,2 Jacob Graham,2 Serge Zaluski,3 Guillermo Rocha4 1Jones Eye Clinic, Sioux City, IA, 2Quorum Consulting Inc., San Francisco, CA, USA; 3VISIS, Perpignan, France; 4Ocular Microsurgery & Laser Centre, Brandon, MB, Canada Purpose: The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Methods: Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. Results: The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%–12.0% (P<0.001 for data from Canada and the US and P<0.05 for data from France. Use of the preloaded delivery system also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Conclusion: Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity. Keywords: time and motion, provider impact, surgical throughput, IOL

LAPACKrc: Fast linear algebra kernels/solvers for FPGA accelerators

International Nuclear Information System (INIS)

Gonzalez, Juan; Nunez, Rafael C

2009-01-01

We present LAPACKrc, a family of FPGA-based linear algebra solvers able to achieve more than 100x speedup per commodity processor on certain problems. LAPACKrc subsumes some of the LAPACK and ScaLAPACK functionalities, and it also incorporates sparse direct and iterative matrix solvers. Current LAPACKrc prototypes demonstrate between 40x-150x speedup compared against top-of-the-line hardware/software systems. A technology roadmap is in place to validate current performance of LAPACKrc in HPC applications, and to increase the computational throughput by factors of hundreds within the next few years.

Routines Are the Foundation of Classroom Management

Science.gov (United States)

Lester, Robin Rawlings; Allanson, Patricia Bolton; Notar, Charles E.

2017-01-01

Classroom management is the key to learning. Routines are the foundation of classroom management. Students require structure in their lives. Routines provide that in all of their life from the time they awake until the time they go to bed. Routines in a school and in the classroom provide the environment for learning to take place. The paper is…

Improvements in routine internal monitoring - An overview of the IDEA project

International Nuclear Information System (INIS)

Schmitzer, C.; Fischer, H.; Andrasi, A.; Bouvier, C.; Carlan, L.; Franck, D.; Hollriegl, V.; Li, W. B.; Oeh, U.; Ritt, J.; Roth, P.; Wahl, W.; Zombori, P.

2007-01-01

The IDEA project aimed to improve the assessment of incorporated radionuclides through developments of advanced in vivo and bioassay monitoring techniques and making use of such enhancements for improvements in routine monitoring. Many of these findings are not new in the sense that they are being already employed in advanced laboratories or for specialised applications. The primary goal was to categorise those new developments regarding their potential and eligibility for the routine monitoring community. Attention has been given to in vivo monitoring techniques with respect to detector characteristics and measurement geometry to improve measurement efficiency with special attention to low energy gamma emitters. Calibration - specifically supported by or through methods of numerical simulation - have been carefully analysed to reduce overall measurement uncertainties and explore ways to accommodate the individual variability based on characteristic features of a given person. For bioassay measurements at low detection limits, inductively coupled plasma mass spectroscopy offers significant advantages both in accuracy, speed, and sample preparation. Specifically, the determination of U and Th in urine and the associated models have been investigated. Finally, the scientific achievements have been analysed regarding their potential to offer benefits for routine monitoring. These findings will be presented in greater detail in other papers at this conference, whereas this paper intends to give an overview and put both the scientific achievements as well as the derived benefits into perspective. (authors)

Improvements in routine internal monitoring - an overview of the IDEA project

International Nuclear Information System (INIS)

Schmitzer, C.; Fischer, H.; Schlagbauer, M.; Bouvier, C.; Carlan, L.; Franck, D.; Ritt, J.; Hoellriegl, V.; Li, W.B.; Oeh, U.; Roth, P.; Wahl, W.; Andrasi, A.; Zombori, P.

2005-01-01

Full text: The IDEA project aimed to improve the assessment of incorporated radionuclides through developments of advanced in-vivo and bioassay monitoring techniques and making use of such enhancements for improvements in routine monitoring. Many of those findings are not new in the sense that they are being already employed in advanced laboratories or for specialized applications. The primary goal was to categorize those new developments regarding their potential and eligibility for the routine monitoring community. Attention has been given to in-vivo monitoring techniques with respect to detector characteristics and measurement geometry to improve measurement efficiency with special attention to low energy gamma emitters. Calibration - specifically supported by or through methods of numerical simulation - have been carefully analyzed to reduce overall measurement uncertainties and explore ways to accommodate the individual variability based on characteristic features of a given person. For bioassay measurements at low detection limits, inductively coupled plasma mass spectroscopy offers significant advantages both in accuracy, speed, and sample preparation. Specifically, the determination of U and Th in urine and the associated models have been investigated. Finally, the scientific achievements have been analyzed regarding their potential to offer benefits for routine monitoring. These findings will be presented in greater detail in other papers at this conference, whereas this paper intends to give an overview and put both the scientific achievements as well as the derived benefits into perspective. (author)

Stitching interferometry of high numerical aperture cylindrical optics without using a fringe-nulling routine.

Science.gov (United States)

Peng, Junzheng; Wang, Qingquan; Peng, Xiang; Yu, Yingjie

2015-11-01

Stitching interferometry is a common method for measuring the figure error of high numerical aperture optics. However, subaperture measurement usually requires a fringe-nulling routine, thus making the stitching procedure complex and time-consuming. The challenge when measuring a surface without a fringe-nulling routine is that the rays no longer perpendicularly hit the surface. This violation of the null-test condition can lead to high fringe density and introduce high-order misalignment aberrations into the measurement result. This paper demonstrates that the high-order misalignment aberrations can be characterized by low-order misalignment aberrations; then, an efficient method is proposed to separate the high-order misalignment aberrations from subaperture data. With the proposed method, the fringe-nulling routine is not required. Instead, the subaperture data is measured under a nonzero fringe pattern. Then, all possible misalignment aberrations are removed with the proposed method. Finally, the full aperture map is acquired by connecting all subaperture data together. Experimental results showing the feasibility of the proposed procedure are presented.

Don't believe everything you hear: Routine validation of audiovisual information in children and adults.

Science.gov (United States)

Piest, Benjamin A; Isberner, Maj-Britt; Richter, Tobias

2018-04-05

Previous research has shown that the validation of incoming information during language comprehension is a fast, efficient, and routine process (epistemic monitoring). Previous research on this topic has focused on epistemic monitoring during reading. The present study extended this research by investigating epistemic monitoring of audiovisual information. In a Stroop-like paradigm, participants (Experiment 1: adults; Experiment 2: 10-year-old children) responded to the probe words correct and false by keypress after the presentation of auditory assertions that could be either true or false with respect to concurrently presented pictures. Results provide evidence for routine validation of audiovisual information. Moreover, the results show a stronger and more stable interference effect for children compared with adults.

On the numerical verification of industrial codes

International Nuclear Information System (INIS)

Montan, Sethy Akpemado

2013-01-01

Numerical verification of industrial codes, such as those developed at EDF R and D, is required to estimate the precision and the quality of computed results, even more for code running in HPC environments where millions of instructions are performed each second. These programs usually use external libraries (MPI, BLACS, BLAS, LAPACK). In this context, it is required to have a tool as non intrusive as possible to avoid rewriting the original code. In this regard, the CADNA library, which implements the Discrete Stochastic Arithmetic, appears to be one of a promising approach for industrial applications. In the first part of this work, we are interested in an efficient implementation of the BLAS routine DGEMM (General Matrix Multiply) implementing Discrete Stochastic Arithmetic. The implementation of a basic algorithm for matrix product using stochastic types leads to an overhead greater than 1000 for a matrix of 1024 * 1024 compared to the standard version and commercial versions of xGEMM. Here, we detail different solutions to reduce this overhead and the results we have obtained. A new routine Dgemm- CADNA have been designed. This routine has allowed to reduce the overhead from 1100 to 35 compare to optimized BLAS implementations (GotoBLAS). Then, we focus on the numerical verification of Telemac-2D computed results. Performing a numerical validation with the CADNA library shows that more than 30% of the numerical instabilities occurring during an execution come from the dot product function. A more accurate implementation of the dot product with compensated algorithms is presented in this work. We show that implementing these kinds of algorithms, in order to improve the accuracy of computed results does not alter the code performance. (author)

Routine sputum culture

Science.gov (United States)

Sputum culture ... There, it is placed in a special dish (culture). It is then watched to see if bacteria ... Elsevier; 2018:chap 36. Chernecky CC, Berger BJ. Culture, routine. In: Chernecky CC, Berger BJ, eds. Laboratory ...

Pitfalls in lung cancer molecular pathology: how to limit them in routine practice?

Science.gov (United States)

Ilie, M; Hofman, P

2012-01-01

New treatment options in advanced non-small cell lung carcinoma (NSCLC) targeting activating epidermal growth factor receptor (EGFR) gene mutations and other genetic alterations demonstrated the clinical significance of the molecular features of specific subsets of tumors. Therefore, the development of personalized medicine has stimulated the routine integration into pathology departments of somatic mutation testing. However, clinical mutation testing must be optimized and standardized with regard to histological profile, type of samples, pre-analytical steps, methodology and result reporting. Routine molecular testing in NSCLC is currently moving beyond EGFR mutational analysis. Recent progress of targeted therapies will require molecular testing for a wide panel of mutations for a personalized molecular diagnosis. As a consequence, efficient testing of multiple molecular abnormalities is an urgent requirement in thoracic oncology. Moreover, increasingly limited tumor sample becomes a major challenge for molecular pathology. Continuous efforts should be made for safe, effective and specific molecular analyses. This must be based on close collaboration between the departments involved in the management of lung cancer. In this review we explored the practical issues and pitfalls surrounding the routine implementation of molecular testing in NSCLC in a pathology laboratory.

FASTPLOT, Interface Routines to MS FORTRAN Graphics Library

International Nuclear Information System (INIS)

1999-01-01

1 - Description of program or function: FASTPLOT is a library of routines that can be used to interface with the Microsoft FORTRAN Graphics library (GRAPHICS.LIB). The FASTPLOT routines simplify the development of graphics applications and add capabilities such as histograms, Splines, symbols, and error bars. FASTPLOT also includes routines that can be used to create menus. 2 - Methods: FASTPLOT is a library of routines which must be linked with a user's FORTRAN programs that call any FASTPLOT routines. In addition, the user must link with the Microsoft FORTRAN Graphics library (GRAPHICS.LIB). 3 - Restrictions on the complexity of the problem: None noted

External Agents' Effect on Routine Dynamics

DEFF Research Database (Denmark)

Busse Hansen, Nicolai

Prior investigations on organizational routines have called for re- search to enlighten our understanding of how social actors establish and main- tain of routines as well as the causes of their disruption. The present paper con- tributes to this call by conducting systematic microethnographic...... and affiliation are central to how routines are maintained but also susceptible to disruption in case of mis- management. Also the paper contributes with a more fine-tuned understanding of action in terms of them being organized in accordance with preference, which basically means that some actions are preferred...... over others. In producing an action, the relevant next action is projected. However the relevant next action is projected in a specific way and if this is not taken in to account then the routine becomes disrupted. Another core aspect is the notion of deontics that lends itself towards describing who...

Preventive child health care at elementary school age: The costs of routine assessments with a triage approach

NARCIS (Netherlands)

Bezem, J.; Ploeg, C. van der; Numans, M.; Buitendijk, S.; Kocken, P.; Akker, E. van der

2017-01-01

Background. Triage in Preventive Child Health Care (PCH) assessments could further the efficient use of human resources and budgets and therefore make extra care possible for children with specific needs. We assessed the costs of routine PCH assessments with and without triage for children aged 5/6

Routine Radiological Environmental Monitoring Plan

International Nuclear Information System (INIS)

Bechtel Nevada

1998-01-01

The U.S. Department of Energy manages the Nevada Test Site in a manner that meets evolving DOE Missions and responds to the concerns of affected and interested individuals and agencies. This Routine Radiological Monitoring Plan addressess complicance with DOE Orders 5400.1 and 5400.5 and other drivers requiring routine effluent monitoring and environmental surveillance on the Nevada Test Site. This monitoring plan, prepared in 1998, addresses the activities conducted onsite NTS under the Final Environmental Impact Statement and Record of Decision. This radiological monitoring plan, prepared on behalf of the Nevada Test Site Landlord, brings together sitewide environmental surveillance; site-specific effluent monitoring; and operational monitoring conducted by various missions, programs, and projects on the NTS. The plan provides an approach to identifying and conducting routine radiological monitoring at the NTS, based on integrated technical, scientific, and regulatory complicance data needs

Interpreted consultations as 'business as usual'? An analysis of organisational routines in general practices.

Science.gov (United States)

Greenhalgh, Trisha; Voisey, Christopher; Robb, Nadia

2007-09-01

UK general practices operate in an environment of high linguistic diversity, because of recent large-scale immigration and of the NHS's commitment to provide a professional interpreter to any patient if needed. Much activity in general practice is co-ordinated and patterned into organisational routines (defined as repeated patterns of interdependent actions, involving multiple actors, bound by rules and customs) that tend to be stable and to persist. If we want to understand how general practices are responding to pressures to develop new routines, such as interpreted consultations, we need to understand how existing organisational routines change. This will then help us to address a second question, which is how the interpreted consultation itself is being enacted and changing as it becomes routinised (or not) in everyday general practice. In seeking answers to these two questions, we undertook a qualitative study of narratives of interpreted primary care consultations in three London boroughs with large minority ethnic populations. In 69 individual interviews and two focus groups, we sought accounts of interpreted consultations from service users, professional interpreters, family member interpreters, general practitioners, practice nurses, receptionists, and practice managers. We asked participants to tell us both positive and negative stories of their experiences. We analysed these data by searching for instances of concepts relating to the organisational routine, the meaning of the interpreted consultation to the practice, and the sociology of medical work. Our findings identified a number of general properties of the interpreted consultation as an organisational routine, including the wide variation in the form of adoption, the stability of the routine, the adaptability of the routine, and the strength of the routine. Our second key finding was that this variation could be partly explained by characteristics of the practice as an organisation, especially

In search for effective methods of routine formation

Directory of Open Access Journals (Sweden)

Kandora Marcin

2017-05-01

Full Text Available Organizational routines are a frequently researched phenomenon in contemporary management science. Although the available theoretical foundations of Routine Theory seem to have reached a significant degree of maturity over the last thirty years, the same could not be said about the availability of material advice for the management practice. This paper addresses this gap and proposes a framework for an effective routine shaping process. It builds on a brief analysis of available literature on routine formation, supported by case study findings. The approach proposed stresses the importance of the controlled learning process and underlines the importance of deliberate implementation, in contrast to the evolutionary and engineering views on routine emergence.

40 CFR 141.621 - Routine monitoring.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Routine monitoring. 141.621 Section....621 Routine monitoring. (a) Monitoring. (1) If you submitted an IDSE report, you must begin monitoring..., you must monitor at the location(s) and dates identified in your monitoring plan in § 141.132(f...

Automation of analytical processes. A tool for higher efficiency and safety

International Nuclear Information System (INIS)

Groll, P.

1976-01-01

The analytical laboratory of a radiochemical facility is usually faced with the fact that numerous analyses of a similar type must be routinely carried out. Automation of such routine analytical procedures helps in increasing the efficiency and safety of the work. A review of the requirements for automation and its advantages is given and demonstrated on three examples. (author)

Improved Discrete Ordinate Solutions in the Presence of an Anisotropically Reflecting Lower Boundary: Upgrades of the DISORT Computational Tool

Science.gov (United States)

Lin, Z.; Stamnes, S.; Jin, Z.; Laszlo, I.; Tsay, S. C.; Wiscombe, W. J.; Stamnes, K.

2015-01-01

A successor version 3 of DISORT (DISORT3) is presented with important upgrades that improve the accuracy, efficiency, and stability of the algorithm. Compared with version 2 (DISORT2 released in 2000) these upgrades include (a) a redesigned BRDF computation that improves both speed and accuracy, (b) a revised treatment of the single scattering correction, and (c) additional efficiency and stability upgrades for beam sources. In DISORT3 the BRDF computation is improved in the following three ways: (i) the Fourier decomposition is prepared "off-line", thus avoiding the repeated internal computations done in DISORT2; (ii) a large enough number of terms in the Fourier expansion of the BRDF is employed to guarantee accurate values of the expansion coefficients (default is 200 instead of 50 in DISORT2); (iii) in the post processing step the reflection of the direct attenuated beam from the lower boundary is included resulting in a more accurate single scattering correction. These improvements in the treatment of the BRDF have led to improved accuracy and a several-fold increase in speed. In addition, the stability of beam sources has been improved by removing a singularity occurring when the cosine of the incident beam angle is too close to the reciprocal of any of the eigenvalues. The efficiency for beam sources has been further improved from reducing by a factor of 2 (compared to DISORT2) the dimension of the linear system of equations that must be solved to obtain the particular solutions, and by replacing the LINPAK routines used in DISORT2 by LAPACK 3.5 in DISORT3. These beam source stability and efficiency upgrades bring enhanced stability and an additional 5-7% improvement in speed. Numerical results are provided to demonstrate and quantify the improvements in accuracy and efficiency of DISORT3 compared to DISORT2.

Modeling Routinization in Games: An Information Theory Approach

DEFF Research Database (Denmark)

Wallner, Simon; Pichlmair, Martin; Hecher, Michael

2015-01-01

Routinization is the result of practicing until an action stops being a goal-directed process. This paper formulates a definition of routinization in games based on prior research in the fields of activity theory and practice theory. Routinization is analyzed using the formal model of discrete......-time, discrete-space Markov chains and information theory to measure the actual error between the dynamically trained models and the player interaction. Preliminary research supports the hypothesis that Markov chains can be effectively used to model routinization in games. A full study design is presented...

Routine environmental monitoring schedule, calendar year 1997

Energy Technology Data Exchange (ETDEWEB)

Markes, B.M., Westinghouse Hanford

1996-12-10

This document provides the Environmental Restorations Contractor (ERC) and the Project Hanford Management Contractor.(PHMC) a schedule in accordance with the WHC-CM-7-5, Environmental Compliance` and BHI- EE-02, Environmental Requirements, of monitoring and sampling routines for the Near-Field Monitoring (NFM) program during calendar year (CY) 1997. Every attempt will be made to consistently follow this schedule; any deviation from this schedule will be documented by an internal memorandum (DSI) explaining the reason for the deviation. The DSI will be issued by the scheduled performing organization and directed to Near-Field Monitoring. The survey frequencies for particular sites are determined by the technical judgment of Near- Field Monitoring and may depend on the site history, radiological status, use, and general conditions. Additional surveys may be requested at irregular frequencies if conditions warrant. All radioactive wastes sites are scheduled to be surveyed at least annually. Any newly discovered wastes sites not documented by this schedule will be included in the revised schedule for CY 1998. The outside perimeter road surveys of 200 East and West Area and the rail survey from the 300 Area to Columbia Center will be performed in the year 2000 per agreement with Department of Energy. Richland Field Office. This schedule does not discuss staffing needs, nor does it list the monitoring equipment to be used in completing specific routines. Personnel performing routines to meet this schedule shall communicate any need for assistance in completing these routines to Radiological Control management and Near-Field Monitoring. After each routine survey is completed, a copy of the survey record, maps, and data sheets will be forwarded to Near-Field Monitoring. These routine surveys will not be considered complete until this documentation is received. At the end of each month, the ERC and PHMC radiological control organizations shall forward a copy of the Routine

Improving care coordination using organisational routines

DEFF Research Database (Denmark)

Prætorius, Thim

2016-01-01

Purpose – The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change......: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications – The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research....... Practical implications – The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality...

Behavioral Logistics - Analysis of behavioral routines and governance structures in the interorganizational maritime transport chain

Directory of Open Access Journals (Sweden)

2010-09-01

Full Text Available The strong improvements in information and communication systems as well as better transshipment technologies provide the platform for more efficient transport within interorganizational transport chains. Nevertheless these technologies do not automatically optimize systems based on routines and behavioral patterns, established over the last decades. Logisticians - in theory and practice - have to consider the field of behavioral science to describe and analyse transport problems regarding to involved actors' strategic behavior and social embeddedness, too. The objective of this paper is to illustrate behavioral aspects of supposed technical problems in interorganizational transport chains. Therefore, this paper analyses behavioral routines and governance structures in the interorganizational maritime transport chain using a case study, dealing with the generation and circulation of transport information at the earliest point available, so called "estimated time of arrival" (ETA.

[The controversy of routine articulator mounting in orthodontics].

Science.gov (United States)

Wang, Li; Han, Xianglong; Bai, Ding

2013-06-01

Articulators have been widely used by clinicians of dentistry. But routine articulator mounting is still controversial in orthodontics. Orthodontists oriented by gnathology approve routine articulator mounting while nongnathologic orthodontists disapprove it. This article reviews the thoughts of orthodontist that they agree or disagree with routine articulator mounting based on the considerations of biting, temporomandibular disorder (TMD), periodontitis, and so on.

Protein alignment algorithms with an efficient backtracking routine on multiple GPUs

Directory of Open Access Journals (Sweden)

Kierzynka Michal

2011-05-01

Full Text Available Abstract Background Pairwise sequence alignment methods are widely used in biological research. The increasing number of sequences is perceived as one of the upcoming challenges for sequence alignment methods in the nearest future. To overcome this challenge several GPU (Graphics Processing Unit computing approaches have been proposed lately. These solutions show a great potential of a GPU platform but in most cases address the problem of sequence database scanning and computing only the alignment score whereas the alignment itself is omitted. Thus, the need arose to implement the global and semiglobal Needleman-Wunsch, and Smith-Waterman algorithms with a backtracking procedure which is needed to construct the alignment. Results In this paper we present the solution that performs the alignment of every given sequence pair, which is a required step for progressive multiple sequence alignment methods, as well as for DNA recognition at the DNA assembly stage. Performed tests show that the implementation, with performance up to 6.3 GCUPS on a single GPU for affine gap penalties, is very efficient in comparison to other CPU and GPU-based solutions. Moreover, multiple GPUs support with load balancing makes the application very scalable. Conclusions The article shows that the backtracking procedure of the sequence alignment algorithms may be designed to fit in with the GPU architecture. Therefore, our algorithm, apart from scores, is able to compute pairwise alignments. This opens a wide range of new possibilities, allowing other methods from the area of molecular biology to take advantage of the new computational architecture. Performed tests show that the efficiency of the implementation is excellent. Moreover, the speed of our GPU-based algorithms can be almost linearly increased when using more than one graphics card.

Functional connectivity experiments reflect routine movement behavior of a tropical hummingbird species.

Science.gov (United States)

Volpe, Noelia L; Hadley, Adam S; Robinson, W Douglas; Betts, Matthew G

Translocation experiments, in which researchers displace animals and then monitor their movements to return home, are commonly used as tools to assess functional connectivity of fragmented landscapes. Such experiments are purported to have important advantages of being time efficient and of standardizing “motivation” to move across individuals. Yet, we lack tests of whether movement behavior of translocated birds reflects natural behavior of unmanipulated birds. We compared the routine movement behavior of a tropical hummingbird, the Green Hermit (Phaethornis guy), to that of experimentally translocated individuals. We tested for differences in site selection patterns during movement at two spatial scales (point and path levels). We also compared movement rates between treatments. Behaviors documented during translocation experiments reflected those observed during routine movements. At the point level, both translocated and non-translocated birds showed similar levels of preference for mature tropical forest. At the path level, step selection functions showed both translocated and non-translocated hummingbirds avoiding movement across non-forested matrix and selecting streams as movement corridors. Movement rates were generally higher during translocation experiments. However, the negative influence of forest cover on movement rates was proportionately similar in translocation and routine movement treatments. We report the first evidence showing that movement behavior of birds during translocation experiments is similar to their natural movement behavior. Therefore, translocation experiments may be reliable tools to address effects of landscape structure on animal movement. We observed consistent selection of landscape elements between translocated and non-translocated birds, indicating that both routine and translocation movement studies lead to similar conclusions regarding the effect of landscape structure and forest composition on functional connectivity

The Endogenous Origins of Experience, Routines and Organizational Capabilities

DEFF Research Database (Denmark)

Foss, Nicolai Juul; Felin, Teppo

2011-01-01

In this paper we discuss the origins and emergence of organizational routines and capabilities. We first argue that there are theoretical and endogeneity-related concerns associated with the key antecedents and mechanisms specified by the extant routines and capabilities literature. Specifically,...... or rationalist, choice-based approach can provide a more fruitful (though preliminary) foundation for understanding organizational behavior and capabilities.......In this paper we discuss the origins and emergence of organizational routines and capabilities. We first argue that there are theoretical and endogeneity-related concerns associated with the key antecedents and mechanisms specified by the extant routines and capabilities literature. Specifically......, we explicate the behaviorist and empiricist foundations of the organizational routines and capabilities literature and the extant emphasis placed on experience, repetition, and observation as the key antecedents and mechanisms of routines and capabilities. Based on this discussion we highlight...

The impact of electronic health records on collaborative work routines: A narrative network analysis.

Science.gov (United States)

Chao, Chia-An

2016-10-01

This study examined collaborative work routines and changes after the implementation of a perinatal EHR. The change process and underlying drivers were analyzed to offer insight into why changes - intended or unintended - did or did not occur and their implications for EHR design and implementation. This mixed-method case study included both qualitative and quantitative information. Pre- and post-implementation observations took place over an 18-month period totaling 90h. Formal and informal interviews with administrative and clinical staff, pre- and post-implementation surveys, project meeting observations, and artifact review supplemented data gathered from the observations. Workflow and narrative network analyses of work routines were used to identify changes pre- and post-EHR and to represent different perspectives of work routines. EHR improved documentation efficiency and in- and out-patient information exchange, but increased variability in documentation. Some variabilities were institutionally sanctioned or tolerated, but other variabilities - while ingenious and emblematic of the generative nature of routines enabled by the EHR - were problematic. EHR's support for clinician communication and coordination was limited and its cognitive support insufficient. In some cases, EHR increased cognitive load as the unlocalized EHR scattered information, and the lengthy printouts contributed to information fragmentation and made information retrieval more difficult. The process of the EHR implementation and the changes observed was the confluence of three factors: resource constraint - in particular EHR expertise and experience - not uncommon in many community hospitals; the functional properties of the EHR focusing on information aggregation, storage, and retrieval; and the extant culture and practice of healthcare emphasizing autonomy and flexibility. While collaborative and communication changes were prompted by EHR implementation, the system played a minimal

The institutionalization of a routine

DEFF Research Database (Denmark)

Nickelsen, Niels Christian

2008-01-01

-which has before largely been treated in overview by institutionalism-plays an important role in the making of a routine. In my empirical study, I demonstrate that the concept and practice of the valve changes, and that it is identified in a number of ways, as it passes through the testing phase...... of production. I argue that the negotiation of these changes during test production is the fulcrum in the routinization of the production procedure. It is through these identity shifts that the valve is both reified, and rendered producible and applicable in the customer world....

ORGANIZATIONAL ROUTINES IN RUSSIAN COMPANIES: REVIEW OF PRACTICES

Directory of Open Access Journals (Sweden)

Olga Valieva

2014-10-01

Full Text Available Results of the first stage of the researches conducted in 2012-2013 are presented in article. Researches are connected with studying of transformational processes intra corporate of managemetn practices in the Russian companies and their subsequent institutionalization. Preliminary results showed that in the companies there is a standard set of organizational routines which part are information, and administrative routines, routines of the power of the founder, genetic, institutional and development routines. During research statistically significant connection between types of organizational structures, the sizes of the organization, information processing and administrative practices is established. It is revealed as change of approaches to management of the organization can affect a corruption component.

Transforming Parent-Child Interaction in Family Routines: Longitudinal Analysis with Families of Children with Developmental Disabilities.

Science.gov (United States)

Lucyshyn, Joseph M; Fossett, Brenda; Bakeman, Roger; Cheremshynski, Christy; Miller, Lynn; Lohrmann, Sharon; Binnendyk, Lauren; Khan, Sophia; Chinn, Stephen; Kwon, Samantha; Irvin, Larry K

2015-12-01

The efficacy and consequential validity of an ecological approach to behavioral intervention with families of children with developmental disabilities was examined. The approach aimed to transform coercive into constructive parent-child interaction in family routines. Ten families participated, including 10 mothers and fathers and 10 children 3-8 years old with developmental disabilities. Thirty-six family routines were selected (2 to 4 per family). Dependent measures included child problem behavior, routine steps completed, and coercive and constructive parent-child interaction. For each family, a single case, multiple baseline design was employed with three phases: baseline, intervention, and follow-up. Visual analysis evaluated the functional relation between intervention and improvements in child behavior and routine participation. Nonparametric tests across families evaluated the statistical significance of these improvements. Sequential analyses within families and univariate analyses across families examined changes from baseline to intervention in the percentage and odds ratio of coercive and constructive parent-child interaction. Multiple baseline results documented functional or basic effects for 8 of 10 families. Nonparametric tests showed these changes to be significant. Follow-up showed durability at 11 to 24 months postintervention. Sequential analyses documented the transformation of coercive into constructive processes for 9 of 10 families. Univariate analyses across families showed significant improvements in 2- and 4-step coercive and constructive processes but not in odds ratio. Results offer evidence of the efficacy of the approach and consequential validity of the ecological unit of analysis, parent-child interaction in family routines. Future studies should improve efficiency, and outcomes for families experiencing family systems challenges.

An improved scattering routine for collimation tracking studies at LHC

CERN Document Server

Tambasco, Claudia; Salvachua Ferrando, Maria Belen; Cavoto, Gianluca

The present Master thesis work has been carried out at CERN in the framework of the LHC (Large Hadron Collider) Collimation project. The LHC accelerates proton beams up to 7 TeV colliding in the experiment detectors installed in four points of the accelerator ring. The LHC is built to store a energy of 360MJ for each beam. The energy deposition induced by local beam losses could quench the superconducting magnets located around the accelerator beam pipes. To prevent and keep under control dangerous beam losses, an efficient collimation system is required. In addition, the achievable LHC beam intensity is related to the beam loss rate and, consequently, to the cleaning efficiency of the collimation system. Collimation studies at LHC are carried out also by means of simulations by using SixTrack, a dedicated simulation tool that tracks a large numbers of particles for many turns around the ring. The SixTrack code includes a scattering routine to model proton interactions with the material of the collimators j...

42 CFR 493.1267 - Standard: Routine chemistry.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Routine chemistry. 493.1267 Section 493.1267 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Systems § 493.1267 Standard: Routine chemistry. For blood gas analyses, the laboratory must perform the...

Breaking the Waves: Routines and Rituals in Entrepreneurship Education

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Neergaard, Helle; Christensen, Dorthe Refslund

2017-01-01

Learning is related to the environment created for the learning experience. This environment is often highly routinized and involves a certain social structure, but in entrepreneurship education, such routinization and structure may actually counteract the learning goals. This article investigates how classroom routines and rituals impact on…

42 CFR 493.841 - Standard; Routine chemistry.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Routine chemistry. 493.841 Section 493.841 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.841 Standard; Routine chemistry. (a) Failure to attain a score of at least 80 percent...

Efficiency curves of NIRR-1 gamma-ray spectrometry system at near ...

African Journals Online (AJOL)

The full-energy peak efficiency curves of the gamma-ray spectrometry for use with the Nigeria Research Reactor-1 (NIRR-1) have been determined by both theoretical and experimental at two source-detector positions for routine neutron activation analysis. Standard gamma ray sources were used to determine the efficiency ...

Scheduling Two-Sided Transformations Using Tile Algorithms on Multicore Architectures

Directory of Open Access Journals (Sweden)

Hatem Ltaief

2010-01-01

Full Text Available The objective of this paper is to describe, in the context of multicore architectures, three different scheduler implementations for the two-sided linear algebra transformations, in particular the Hessenberg and Bidiagonal reductions which are the first steps for the standard eigenvalue problems and the singular value decompositions respectively. State-of-the-art dense linear algebra softwares, such as the LAPACK and ScaLAPACK libraries, suffer performance losses on multicore processors due to their inability to fully exploit thread-level parallelism. At the same time the fine-grain dataflow model gains popularity as a paradigm for programming multicore architectures. Buttari et al. (Parellel Comput. Syst. Appl. 35 (2009, 38–53 introduced the concept of tile algorithms in which parallelism is no longer hidden inside Basic Linear Algebra Subprograms but is brought to the fore to yield much better performance. Along with efficient scheduling mechanisms for data-driven execution, these tile two-sided reductions achieve high performance computing by reaching up to 75% of the DGEMM peak on a 12000×12000 matrix with 16 Intel Tigerton 2.4 GHz processors. The main drawback of the tile algorithms approach for two-sided transformations is that the full reduction cannot be obtained in one stage. Other methods have to be considered to further reduce the band matrices to the required forms.

Adoption of routine telemedicine in Norway: the current picture

Science.gov (United States)

Zanaboni, Paolo; Knarvik, Undine; Wootton, Richard

2014-01-01

Background Telemedicine appears to be ready for wider adoption. Although existing research evidence is useful, the adoption of routine telemedicine in healthcare systems has been slow. Objective We conducted a study to explore the current use of routine telemedicine in Norway, at national, regional, and local levels, to provide objective and up-to-date information and to estimate the potential for wider adoption of telemedicine. Design A top-down approach was used to collect official data on the national use of telemedicine from the Norwegian Patient Register. A bottom-up approach was used to collect complementary information on the routine use of telemedicine through a survey conducted at the five largest publicly funded hospitals. Results Results show that routine telemedicine has been adopted in all health regions in Norway and in 68% of hospitals. Despite being widely adopted, the current level of use of telemedicine is low compared to the number of face-to-face visits. Examples of routine telemedicine can be found in several clinical specialties. Most services connect different hospitals in secondary care, and they are mostly delivered as teleconsultations via videoconference. Conclusions Routine telemedicine in Norway has been widely adopted, probably for geographical reasons, as in other settings. However, the level of use of telemedicine in Norway is rather low, and it has significant potential for further development as an alternative to face-to-face outpatient visits. This study is a first attempt to map routine telemedicine at regional, institutional, and clinical levels, and it provides useful information to understand the adoption of telemedicine in routine healthcare and to measure change in future updates. PMID:24433942

Understanding teachers’ routines to inform classroom technology design

NARCIS (Netherlands)

An, P.; Bakker, S.; Eggen, J.H.

2017-01-01

Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers’ daily routines. Peripheral interaction is a human-computer

Informational Aspects of Telepathology in Routine Surgical Pathology

Directory of Open Access Journals (Sweden)

Peter Gombas

2000-01-01

Full Text Available Application of computer and telecommunication technology calls serious challenges in routine diagnostic pathology. Complete data integration, fast access patients' data to usage of diagnosis thesaurus labeled with standardized codes and free text supplements, complex inquiry of the data contents, data exchange via teleconsultation and multilevel data protection are required functions of an integrated information system. Increasing requirement for teleconsultation transferring a large amount of multimedia data among different pathology information systems raises new questions in telepathology. Creation of complex telematic systems in pathology requires efficient methods of software engineering and implementation. Information technology of object‐oriented modeling, usage of client server architecture and relational database management systems enables more compatible systems in field of telepathology. The aim of this paper is to present a practical example how to unify text based database, image archive and teleconsultation in a frame of an integrated telematic system and to discuss the main conceptual questions of information technology of telepathology.

DEVELOPING AND INSTRUCTING PRE-PERFORMANCE ROUTINES FOR TENPIN BOWLING COMPETITIONS (1).

Science.gov (United States)

Lee, Seungmin; Lee, Keunchul; Kwon, Sungho

2015-06-01

This preliminary study developed pre-performance routines for tenpin bowlers and instructed them. To develop the routine, the situations before throwing the ball were divided into four phases; participants were examined through interviews and observations. This study used an A-B design; the A stage included the development of the routines for 3 wk., while the B stage included the instruction and two evaluations of the routine consistency. Practice was implemented for 4 hr. per day for 9 wk. The participants noted they understood the developed routine easily and experienced an atmosphere similar to that of a competition during training through the routines. They found it difficult to practice the relaxation phase, but emphasized that the relaxation phase was helpful. Consistent routines were associated with an improved mental state and performance in a competition. This study suggests that pre-performance routines stabilize the mental state of the athletes, apparently giving them a competitive advantage.

The emergence and change of management accounting routines

NARCIS (Netherlands)

van der Steen, M.P.

2011-01-01

Purpose - The purpose of this paper is to explore the dynamics involved in the emergence and change of management accounting routines. It seeks to provide an understanding of the ways in which these complex routines foster stability and change in management accounting practices.

High performance matrix inversion based on LU factorization for multicore architectures

KAUST Repository

Dongarra, Jack

2011-01-01

The goal of this paper is to present an efficient implementation of an explicit matrix inversion of general square matrices on multicore computer architecture. The inversion procedure is split into four steps: 1) computing the LU factorization, 2) inverting the upper triangular U factor, 3) solving a linear system, whose solution yields inverse of the original matrix and 4) applying backward column pivoting on the inverted matrix. Using a tile data layout, which represents the matrix in the system memory with an optimized cache-aware format, the computation of the four steps is decomposed into computational tasks. A directed acyclic graph is generated on the fly which represents the program data flow. Its nodes represent tasks and edges the data dependencies between them. Previous implementations of matrix inversions, available in the state-of-the-art numerical libraries, are suffer from unnecessary synchronization points, which are non-existent in our implementation in order to fully exploit the parallelism of the underlying hardware. Our algorithmic approach allows to remove these bottlenecks and to execute the tasks with loose synchronization. A runtime environment system called QUARK is necessary to dynamically schedule our numerical kernels on the available processing units. The reported results from our LU-based matrix inversion implementation significantly outperform the state-of-the-art numerical libraries such as LAPACK (5x), MKL (5x) and ScaLAPACK (2.5x) on a contemporary AMD platform with four sockets and the total of 48 cores for a matrix of size 24000. A power consumption analysis shows that our high performance implementation is also energy efficient and substantially consumes less power than its competitors. © 2011 ACM.

Understanding Teachers' Routines to Inform Classroom Technology Design

Science.gov (United States)

An, Pengcheng; Bakker, Saskia; Eggen, Berry

2017-01-01

Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers' daily routines. Peripheral interaction is a human-computer interaction style that aims to enable interaction…

A Nonlinear Modal Aeroelastic Solver for FUN3D

Science.gov (United States)

Goldman, Benjamin D.; Bartels, Robert E.; Biedron, Robert T.; Scott, Robert C.

2016-01-01

A nonlinear structural solver has been implemented internally within the NASA FUN3D computational fluid dynamics code, allowing for some new aeroelastic capabilities. Using a modal representation of the structure, a set of differential or differential-algebraic equations are derived for general thin structures with geometric nonlinearities. ODEPACK and LAPACK routines are linked with FUN3D, and the nonlinear equations are solved at each CFD time step. The existing predictor-corrector method is retained, whereby the structural solution is updated after mesh deformation. The nonlinear solver is validated using a test case for a flexible aeroshell at transonic, supersonic, and hypersonic flow conditions. Agreement with linear theory is seen for the static aeroelastic solutions at relatively low dynamic pressures, but structural nonlinearities limit deformation amplitudes at high dynamic pressures. No flutter was found at any of the tested trajectory points, though LCO may be possible in the transonic regime.

Computer-aided diagnosis in routine mammography

International Nuclear Information System (INIS)

Sittek, H.; Perlet, C.; Helmberger, R.; Linsmeier, E.; Kessler, M.; Reiser, M.

1998-01-01

Purpose: Computer-aided diagnosis in mammography is a topic many study groups have been concerned with since the first presentation of a system for computer-aided interpretation in 1967. Currently, there is only one system avilable for clinical use in mammography, the CAD-System Image Checker (R2 Technology). The purpose of our prospective study was to evaluate whether the integration of the CAD-system into the routine of a radiological breast diagnosis unit is feasible. Results: After the installation of the CAD-system, 300 patients with 1110 mammograms were included for evaluation in the present study. In 54 of these cases histological examination was indicated due to suspect criteria on conventional mammography. In 39 of 54 cases (72,2%) malignancy could be proven histologically. The CAD-system marked 82,1% of the histologically verified carcinomas correctly 94,3% of all 1797 marks made by the CAD-system indicated normal or benign structures. Routinely performed CAD analysis prolonged patients waiting time by about 15 min because the marks of the CAD system had to be interpreted in addition to the routine diagnostic investigations. Conclusion: Our experience with the use of the CAD-system in daily routine showed that CAD analysis can easily be integrated into a preexisting mammography unit. However, the diagnostic benefit is not yet clearly established. Since the rate of false negative marks by the CAD-system Image Checker is still high, the results of CAD analysis must be checked and corrected by an observer well experienced in mammography reading. (orig.) [de

User manual for two simple postscript output FORTRAN plotting routines

Science.gov (United States)

Nguyen, T. X.

1991-01-01

Graphics is one of the important tools in engineering analysis and design. However, plotting routines that generate output on high quality laser printers normally come in graphics packages, which tend to be expensive and system dependent. These factors become important for small computer systems or desktop computers, especially when only some form of a simple plotting routine is sufficient. With the Postscript language becoming popular, there are more and more Postscript laser printers now available. Simple, versatile, low cost plotting routines that can generate output on high quality laser printers are needed and standard FORTRAN language plotting routines using output in Postscript language seems logical. The purpose here is to explain two simple FORTRAN plotting routines that generate output in Postscript language.

Thinking Routines: Replicating Classroom Practices within Museum Settings

Science.gov (United States)

Wolberg, Rochelle Ibanez; Goff, Allison

2012-01-01

This article describes thinking routines as tools to guide and support young children's thinking. These learning strategies, developed by Harvard University's Project Zero Classroom, actively engage students in constructing meaning while also understanding their own thinking process. The authors discuss how thinking routines can be used in both…

Routine Radiological Environmental Monitoring Plan. Volume 1

Energy Technology Data Exchange (ETDEWEB)

Bechtel Nevada

1999-12-31

The U.S. Department of Energy manages the Nevada Test Site in a manner that meets evolving DOE Missions and responds to the concerns of affected and interested individuals and agencies. This Routine Radiological Monitoring Plan addressess complicance with DOE Orders 5400.1 and 5400.5 and other drivers requiring routine effluent monitoring and environmental surveillance on the Nevada Test Site. This monitoring plan, prepared in 1998, addresses the activities conducted onsite NTS under the Final Environmental Impact Statement and Record of Decision. This radiological monitoring plan, prepared on behalf of the Nevada Test Site Landlord, brings together sitewide environmental surveillance; site-specific effluent monitoring; and operational monitoring conducted by various missions, programs, and projects on the NTS. The plan provides an approach to identifying and conducting routine radiological monitoring at the NTS, based on integrated technical, scientific, and regulatory complicance data needs.

Stochastic hyperfine interactions modeling library

Science.gov (United States)

Zacate, Matthew O.; Evenson, William E.

2011-04-01

The stochastic hyperfine interactions modeling library (SHIML) provides a set of routines to assist in the development and application of stochastic models of hyperfine interactions. The library provides routines written in the C programming language that (1) read a text description of a model for fluctuating hyperfine fields, (2) set up the Blume matrix, upon which the evolution operator of the system depends, and (3) find the eigenvalues and eigenvectors of the Blume matrix so that theoretical spectra of experimental techniques that measure hyperfine interactions can be calculated. The optimized vector and matrix operations of the BLAS and LAPACK libraries are utilized; however, there was a need to develop supplementary code to find an orthonormal set of (left and right) eigenvectors of complex, non-Hermitian matrices. In addition, example code is provided to illustrate the use of SHIML to generate perturbed angular correlation spectra for the special case of polycrystalline samples when anisotropy terms of higher order than A can be neglected. Program summaryProgram title: SHIML Catalogue identifier: AEIF_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEIF_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: GNU GPL 3 No. of lines in distributed program, including test data, etc.: 8224 No. of bytes in distributed program, including test data, etc.: 312 348 Distribution format: tar.gz Programming language: C Computer: Any Operating system: LINUX, OS X RAM: Varies Classification: 7.4 External routines: TAPP [1], BLAS [2], a C-interface to BLAS [3], and LAPACK [4] Nature of problem: In condensed matter systems, hyperfine methods such as nuclear magnetic resonance (NMR), Mössbauer effect (ME), muon spin rotation (μSR), and perturbed angular correlation spectroscopy (PAC) measure electronic and magnetic structure within Angstroms of nuclear probes through the hyperfine interaction. When

Modeling the irradiance dependency of the quantum efficiency of potosynthesis

NARCIS (Netherlands)

Silsbe, G.M.; Kromkamp, J.C.

2012-01-01

Measures of the quantum efficiency of photosynthesis (phi(PSII)) across an irradiance (E) gradient are an increasingly common physiological assay and alternative to traditional photosynthetic-irradiance (PE) assays. Routinely, the analysis and interpretation of these data are analogous to PE

Implementing cognitive therapies into routine psychosis care: organisational foundations.

Science.gov (United States)

Dark, Frances; Whiteford, Harvey; Ashkanasy, Neal M; Harvey, Carol; Crompton, David; Newman, Ellie

2015-08-05

receiving the lowest rating indicative of organisational weakness. Profiling the factors associated with successful implementation of service reform informed the implementation planning and the efficient deployment of resources in a mental health service introducing cognitive therapies for psychosis into routine clinical care. The majority of staff had positive attitudes to the evidence based cognitive therapies allowing a focus on training and supervision and the development of supporting organisational elements.

Intelligent Routines

CERN Document Server

Anastassiou, George A

“Intelligent Routines II: Solving Linear Algebra and Differential Geometry with Sage” contains numerous of examples and problems as well as many unsolved problems. This book extensively applies the successful software Sage, which can be found free online http://www.sagemath.org/. Sage is a recent and popular software for mathematical computation, available freely and simple to use. This book is useful to all applied scientists in mathematics, statistics and engineering, as well for late undergraduate and graduate students of above subjects. It is the first such book in solving symbolically with Sage problems in Linear Algebra and Differential Geometry. Plenty of SAGE applications are given at each step of the exposition.

An intelligent stochastic optimization routine for nuclear fuel cycle design

International Nuclear Information System (INIS)

Parks, G.T.

1990-01-01

A simulated annealing (Metropolis algorithm) optimization routine named AMETROP, which has been developed for use on realistic nuclear fuel cycle problems, is introduced. Each stage of the algorithm is described and the means by which it overcomes or avoids the difficulties posed to conventional optimization routines by such problems are explained. Special attention is given to innovations that enhance AMETROP's performance both through artificial intelligence features, in which the routine uses the accumulation of data to influence its future actions, and through a family of simple performance aids, which allow the designer to use his heuristic knowledge to guide the routine's essentially random search. Using examples from a typical fuel cycle optimization problem, the performance of the stochastic Metropolis algorithm is compared to that of the only suitable deterministic routine in a standard software library, showing AMETROP to have many advantages

Individual values, learning routines and academic procrastination.

Science.gov (United States)

Dietz, Franziska; Hofer, Manfred; Fries, Stefan

2007-12-01

Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. The model tested in this study posits that postmodern value orientations are positively related to procrastination and to a lack of daily routines concerning the performance of academic activities. In contrast, modern values are negatively related to procrastination and positively to learning routines. Academic procrastination, in-turn, should be associated with the tendency to prefer leisure activities to schoolwork in case of conflicts between these two life domains. Seven hundred and four students from 6th and 8th grade with a mean age of 13.5 years participated in the study. The sample included students from all tracks of the German educational system. Students completed a questionnaire containing two value prototypes as well as scales on learning routines and procrastination. Decisions in motivational conflicts were measured using two vignettes. Results from structural equation modelling supported the proposed model for the whole sample as well as for each school track. A planned course of the day can prevent procrastination and foster decisions for academic tasks in case of conflicts. Students' learning takes place within a societal context and reflects the values held in the respective culture.

Daily life activity routine discovery in hemiparetic rehabilitation patients using topic models.

Science.gov (United States)

Seiter, J; Derungs, A; Schuster-Amft, C; Amft, O; Tröster, G

2015-01-01

Monitoring natural behavior and activity routines of hemiparetic rehabilitation patients across the day can provide valuable progress information for therapists and patients and contribute to an optimized rehabilitation process. In particular, continuous patient monitoring could add type, frequency and duration of daily life activity routines and hence complement standard clinical scores that are assessed for particular tasks only. Machine learning methods have been applied to infer activity routines from sensor data. However, supervised methods require activity annotations to build recognition models and thus require extensive patient supervision. Discovery methods, including topic models could provide patient routine information and deal with variability in activity and movement performance across patients. Topic models have been used to discover characteristic activity routine patterns of healthy individuals using activity primitives recognized from supervised sensor data. Yet, the applicability of topic models for hemiparetic rehabilitation patients and techniques to derive activity primitives without supervision needs to be addressed. We investigate, 1) whether a topic model-based activity routine discovery framework can infer activity routines of rehabilitation patients from wearable motion sensor data. 2) We compare the performance of our topic model-based activity routine discovery using rule-based and clustering-based activity vocabulary. We analyze the activity routine discovery in a dataset recorded with 11 hemiparetic rehabilitation patients during up to ten full recording days per individual in an ambulatory daycare rehabilitation center using wearable motion sensors attached to both wrists and the non-affected thigh. We introduce and compare rule-based and clustering-based activity vocabulary to process statistical and frequency acceleration features to activity words. Activity words were used for activity routine pattern discovery using topic models

Microfoundations of Routines and Capabilities

DEFF Research Database (Denmark)

Felin, Tippo; Foss, Nicolai Juul; Heimericks, Koen H.

2012-01-01

This article introduces the Special Issue and discusses the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories ...

Unsupervised daily routine and activity discovery in smart homes.

Science.gov (United States)

Jie Yin; Qing Zhang; Karunanithi, Mohan

2015-08-01

The ability to accurately recognize daily activities of residents is a core premise of smart homes to assist with remote health monitoring. Most of the existing methods rely on a supervised model trained from a preselected and manually labeled set of activities, which are often time-consuming and costly to obtain in practice. In contrast, this paper presents an unsupervised method for discovering daily routines and activities for smart home residents. Our proposed method first uses a Markov chain to model a resident's locomotion patterns at different times of day and discover clusters of daily routines at the macro level. For each routine cluster, it then drills down to further discover room-level activities at the micro level. The automatic identification of daily routines and activities is useful for understanding indicators of functional decline of elderly people and suggesting timely interventions.

ORCODE.77: a computer routine to control a nuclear physics experiment by a PDP-15 + CAMAC system, written in assembler language and including many new routines of general interest

International Nuclear Information System (INIS)

Dickens, J.K.; McConnell, J.W.

1977-01-01

ORCODE.77 is a versatile data-handling computer routine written in MACRO (assembler) language for a PDP-15 computer with EAE (extended arithmetic capability) connected to a CAMAC interface. The Interrupt feature of the computer is utilized. Although the code is oriented for a specific experimental problem, there are many routines of general interest, including a CAMAC Scaler handler, an executive routine to interpret and act upon three-character teletype commands, concise routines to type out double-precision integers (both octal and decimal) and floating-point numbers and to read in integers and floating-point numbers, a routine to convert to and from PDP-15 FORTRAN-IV floating-point format, a routine to handle clock interrupts, and our own DECTAPE handling routine. Routines having specific applications which are applicable to other very similar applications include a display routine using CAMAC instructions, control of external mechanical equipment using CAMAC instructions, storage of data from an Analog-to-digital Converter, analysis of stored data into time-dependent pulse-height spectra, and a routine to read the contents of a Nuclear Data 5050 Analyzer and to prepare DECTAPE output of these data for subsequent analysis by a code written in PDP-15-compiled FORTRAN-IV

Revenue, relationships and routines: the social organization of acute myocardial infarction patient transfers in the United States.

Science.gov (United States)

Veinot, Tiffany C; Bosk, Emily A; Unnikrishnan, K P; Iwashyna, Theodore J

2012-11-01

Heart attack, or acute myocardial infarction (AMI), is a leading cause of death in the United States (U.S.). The most effective therapy for AMI is rapid revascularization: the mechanical opening of the clogged artery in the heart. Forty-four percent of patients with AMI who are admitted to a non-revascularization hospital in the U.S. are transferred to a hospital with that capacity. Yet, we know little about the process by which community hospitals complete these transfers, and why publicly available hospital quality data plays a small role in community hospitals' choice of transfer destinations. Therefore, we investigated how community hospital staff implement patient transfers and select destinations. We conducted a mixed methods study involving: interviews with staff at three community hospitals (n = 25) in a Midwestern state and analysis of U.S. national Medicare records for 1996-2006. Community hospitals in the U.S., including our field sites, typically had longstanding relationships with one key receiving hospital. Community hospitals addressed the need for rapid AMI patient transfers by routinizing the collective, interhospital work process. Routinization reduced staff uncertainty, coordinated their efforts and conserved their cognitive resources for patient care. While destination selection was nominally a physician role, the decision was routinized, such that staff immediately contacted a "usual" transfer destination upon AMI diagnosis. Transfer destination selection was primarily driven at an institutional level by organizational concerns and bed supply, rather than physician choice or patient preference. Transfer routinization emerged as a form of social order that invoked tradeoffs between process speed and efficiency and patient-centered, quality-driven decision making. We consider the implications of routinization and institutional imperatives for health policy, quality improvement and health informatics interventions. Copyright © 2012 Elsevier Ltd

Toshiba General Hospital PACS for routine in- and outpatient clinics

Science.gov (United States)

Toshimitsu, Akihiro; Okazaki, Nobuo; Kura, Hiroyuki; Nishihara, Eitaro; Tsubura, Shinichi

1996-05-01

The Toshiba General Hospital introduced a departmental RIS/PACS (Radiology Information System/Picture Archiving and Communication System) in the radiology department in May, 1993. It has been used routinely since that time. In order to provide efficient means for clinicians to find and read many images, the system has been expanded to the neurosurgery and urology clinics and wards since May, 1995, and five image referring workstations now provide digital images to clinicians. In this paper we discuss an algorithm for image migration, one of the key issues to accomplish the expansion to outpatient clinics successfully, and propose the WYWIWYG (what you want is what you get) image transfer logic. This is the logic used to transfer images that physicians require refer without increasing the traffic between the image server and referring workstations. We accomplish the WYWIWYG logic by prioritizing exams the physicians have not yet viewed and by finding historical exams according to the modality, anatomy, and marking. Clinicians gave us comments from their first use of the system and suggested that the PACS enables clinicians to review images more efficiently compared to a film-based system. Our experience suggests that it is a key to the effective application of PACS in outpatient clinics to incorporate consideration patterns of clinicians on the migration algorithm.

Conversational routines in English convention and creativity

CERN Document Server

Aijmer, Karin

2014-01-01

It is surprising how much of everyday conversation consists of repetitive expressions such as 'thank you', 'sorry', would you mind?' and their many variants. However commonplace they may be, they do have important functions in communication.This thorough study draws upon original data from the London-Lund Corpus of Spoken English to provide a discoursal and pragmatic account of the more common expressions found in conversational routines, such as apologising, thanking, requesting and offering.The routines studied in this book range from conventionalized or idiomatized phrases t

Changing of the Guard: How Different School Leaders Change Organizational Routines

Science.gov (United States)

Enomoto, Ernestine K.; Conley, Sharon

2008-01-01

While providing stability and uniformity, organizational routines can foster continuous change. Using Feldman's (2000) performative model of routinized action theory, coupled with leadership succession research, we examined how three successive administrations in a California high school revised a student attendance (tardy-monitoring) routine over…

Endocarditis : Effects of routine echocardiography during Gram-positive bacteraemia

NARCIS (Netherlands)

Vos, F J; Bleeker-Rovers, C P; Sturm, P D; Krabbe, P F M; van Dijk, A P J; Oyen, W J G; Kullberg, B J

2011-01-01

BACKGROUND: Despite firm recommendations to perform echocardiography in high-risk patients with Gram-positive bacteraemia, routine echocardiography is not embedded in daily practice in many settings. The aim of this study was to evaluate whether a regime including routine echocardiography results in

3D CSEM inversion based on goal-oriented adaptive finite element method

Science.gov (United States)

Zhang, Y.; Key, K.

2016-12-01

We present a parallel 3D frequency domain controlled-source electromagnetic inversion code name MARE3DEM. Non-linear inversion of observed data is performed with the Occam variant of regularized Gauss-Newton optimization. The forward operator is based on the goal-oriented finite element method that efficiently calculates the responses and sensitivity kernels in parallel using a data decomposition scheme where independent modeling tasks contain different frequencies and subsets of the transmitters and receivers. To accommodate complex 3D conductivity variation with high flexibility and precision, we adopt the dual-grid approach where the forward mesh conforms to the inversion parameter grid and is adaptively refined until the forward solution converges to the desired accuracy. This dual-grid approach is memory efficient, since the inverse parameter grid remains independent from fine meshing generated around the transmitter and receivers by the adaptive finite element method. Besides, the unstructured inverse mesh efficiently handles multiple scale structures and allows for fine-scale model parameters within the region of interest. Our mesh generation engine keeps track of the refinement hierarchy so that the map of conductivity and sensitivity kernel between the forward and inverse mesh is retained. We employ the adjoint-reciprocity method to calculate the sensitivity kernels which establish a linear relationship between changes in the conductivity model and changes in the modeled responses. Our code uses a direcy solver for the linear systems, so the adjoint problem is efficiently computed by re-using the factorization from the primary problem. Further computational efficiency and scalability is obtained in the regularized Gauss-Newton portion of the inversion using parallel dense matrix-matrix multiplication and matrix factorization routines implemented with the ScaLAPACK library. We show the scalability, reliability and the potential of the algorithm to deal with

Literature Review Lifestyles and routine activities of South African ...

African Journals Online (AJOL)

Journal of Child and Adolescent Mental Health ... Lifestyles and routine activities of South African teenagers at risk of being trafficked for involuntary prostitution. Thozama ... Actual lifestyle and routine activities of South African teenagers and risky behaviours (substance abuse, intergenerational sex and child prostitution) are ...

Routine maintenance prolongs ESP time between failures

International Nuclear Information System (INIS)

Hurst, T.; Lannom, R.W.; Divine, D.L.

1992-01-01

This paper reports that routine maintenance of electric submersible motors (ESPs) significantly lengthened the mean time between motor failures (MTBF), decreased operating costs, and extended motor run life in the Sacroc Unit of the Kelly-Snyder field in West Texas. After the oil price boom of the early 1980s. rapidly eroding profit margins from producing properties caused a much stronger focus on reducing operating costs. In Sacroc, ESP operating life and repair costs became a major target of cost reduction efforts. The routine ESP maintenance program has been in place for over 3 years

Strengthening Routine Data Systems to Track the HIV Epidemic and Guide the Response in Sub-Saharan Africa.

Science.gov (United States)

Rice, Brian; Boulle, Andrew; Baral, Stefan; Egger, Matthias; Mee, Paul; Fearon, Elizabeth; Reniers, Georges; Todd, Jim; Schwarcz, Sandra; Weir, Sharon; Rutherford, George; Hargreaves, James

2018-04-03

The global HIV response has entered a new phase with the recommendation of treating all persons living with HIV with antiretroviral therapy, and with the goals of reducing new infections and AIDS-related deaths to fewer than 500,000 by 2020. This new phase has intensive data requirements that will need to utilize routine data collected through service delivery platforms to monitor progress toward these goals. With a focus on sub-Saharan African, we present the following priorities to improve the demand, supply, and use of routine HIV data: (1) strengthening patient-level HIV data systems that support continuity of clinical care and document sentinel events; (2) leveraging data from HIV testing programs; (3) using targeting data collection in communities and among clients; and (4) building capacity and promoting a culture of HIV data quality assessment and use. When fully leveraged, routine data can efficiently provide timely information at a local level to inform action, as well as provide information at scale with wide geographic coverage to strengthen estimation efforts. ©Brian Rice, Andrew Boulle, Stefan Baral, Matthias Egger, Paul Mee, Elizabeth Fearon, Georges Reniers, Jim Todd, Sandra Schwarcz, Sharon Weir, George Rutherford, James Hargreaves. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 03.04.2018.

User's Manual: Routines for Radiative Heat Transfer and Thermometry

Science.gov (United States)

Risch, Timothy K.

2016-01-01

Determining the intensity and spectral distribution of radiation emanating from a heated surface has applications in many areas of science and engineering. Areas of research in which the quantification of spectral radiation is used routinely include thermal radiation heat transfer, infrared signature analysis, and radiation thermometry. In the analysis of radiation, it is helpful to be able to predict the radiative intensity and the spectral distribution of the emitted energy. Presented in this report is a set of routines written in Microsoft Visual Basic for Applications (VBA) (Microsoft Corporation, Redmond, Washington) and incorporating functions specific to Microsoft Excel (Microsoft Corporation, Redmond, Washington) that are useful for predicting the radiative behavior of heated surfaces. These routines include functions for calculating quantities of primary importance to engineers and scientists. In addition, the routines also provide the capability to use such information to determine surface temperatures from spectral intensities and for calculating the sensitivity of the surface temperature measurements to unknowns in the input parameters.

The role of informal dimensions of safety in high-volume organisational routines: an ethnographic study of test results handling in UK general practice.

Science.gov (United States)

Grant, Suzanne; Checkland, Katherine; Bowie, Paul; Guthrie, Bruce

2017-04-27

The handling of laboratory, imaging and other test results in UK general practice is a high-volume organisational routine that is both complex and high risk. Previous research in this area has focused on errors and harm, but a complementary approach is to better understand how safety is achieved in everyday practice. This paper ethnographically examines the role of informal dimensions of test results handling routines in the achievement of safety in UK general practice and how these findings can best be developed for wider application by policymakers and practitioners. Non-participant observation was conducted of high-volume organisational routines across eight UK general practices with diverse organisational characteristics. Sixty-two semi-structured interviews were also conducted with the key practice staff alongside the analysis of relevant documents. While formal results handling routines were described similarly across the eight study practices, the everyday structure of how the routine should be enacted in practice was informally understood. Results handling safety took a range of local forms depending on how different aspects of safety were prioritised, with practices varying in terms of how they balanced thoroughness (i.e. ensuring the high-quality management of results by the most appropriate clinician) and efficiency (i.e. timely management of results) depending on a range of factors (e.g. practice history, team composition). Each approach adopted created its own potential risks, with demands for thoroughness reducing productivity and demands for efficiency reducing handling quality. Irrespective of the practice-level approach adopted, staff also regularly varied what they did for individual patients depending on the specific context (e.g. type of result, patient circumstances). General practices variably prioritised a legitimate range of results handling safety processes and outcomes, each with differing strengths and trade-offs. Future safety

Understanding teachers’ routines to inform classroom technology design

OpenAIRE

An, P.; Bakker, S.; Eggen, J.H.

2017-01-01

Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers’ daily routines. Peripheral interaction is a human-computer interaction style that aims to enable interaction to take place both in the center and periphery of users’ attention and naturally shift between the two. We believe that classroom technologies emplo...

How to Analyze Routines in Teachers' Thinking Processes during Lesson Planning.

Science.gov (United States)

Bromme, Rainer

A justification for the study of teachers' routines, as they affect the preparation of lesson plans, prefaces this paper on teachers' thought processes during lesson planning. In focusing on the importance of research into teachers' routines, it is pointed out that lesson preparation and classroom routines permit teachers to direct attention to…

Improving Automation Routines for Automatic Heating Load Detection in Buildings

Directory of Open Access Journals (Sweden)

Stephen Timlin

2012-11-01

Full Text Available Energy managers use weather compensation data and heating system cut off routines to reduce heating energy consumption in buildings and improve user comfort. These routines are traditionally based on the calculation of an estimated building load that is inferred from the external dry bulb temperature at any point in time. While this method does reduce heating energy consumption and accidental overheating, it can be inaccurate under some weather conditions and therefore has limited effectiveness. There remains considerable scope to improve on the accuracy and relevance of the traditional method by expanding the calculations used to include a larger range of environmental metrics. It is proposed that weather compensation and automatic shut off routines that are commonly used could be improved notably with little additional cost by the inclusion of additional weather metrics. This paper examines the theoretical relationship between various external metrics and building heating loads. Results of the application of an advanced routine to a recently constructed building are examined, and estimates are made of the potential savings that can be achieved through the use of the routines proposed.

Family routines and rituals following separation: continuity and change

NARCIS (Netherlands)

Bakker, W.; Karsten, L.; Mulder, C.H.

2015-01-01

Separation always changes family life. The aim of this study is to gain insight into the everyday practices of ‘doing family’ after separation. We focus on two central elements of family life: routines and rituals. While in most families both parents are involved in family routines and rituals, this

Toward a High Performance Tile Divide and Conquer Algorithm for the Dense Symmetric Eigenvalue Problem

KAUST Repository

Haidar, Azzam; Ltaief, Hatem; Dongarra, Jack

2012-01-01

dynamic runtime system to multicore architectures. A detailed analysis of performance and accuracy is included. Performance improvements of 14-fold and 4-fold speedups are reported relative to LAPACK and Intel's Math Kernel Library.

Cyclophosphamide administration routine in autoimmune rheumatic diseases: a review

Directory of Open Access Journals (Sweden)

Kaian Amorim Teles

Full Text Available Abstract Cyclophosphamide is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy, administration of cyclophosphamide, and post-chemotherapy, taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare - but serious - side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system.

An Element of Practical Knowledge in Education: Professional Routines

Science.gov (United States)

Lacourse, France

2011-01-01

The question of practical knowledge and its teaching has arisen more perceptibly since the appearance of the aim to professionalize teachers. How can imperceptible knowledge such as professional routines be taught? To establish a social fabric and effective class management, it is essential to call on creative and adaptive professional routines.…

32 CFR 701.121 - Processing “routine use” disclosures.

Science.gov (United States)

2010-07-01

... DEPARTMENT OF THE NAVY DOCUMENTS AFFECTING THE PUBLIC DON Privacy Program § 701.121 Processing “routine use... be in writing and state that it is being made under a “routine use” established by a specific PA... and maintain a disclosure accounting of the information released. (See § 701.111.) (b) Failure to cite...

Predictors of routine episiotomy in primigravida women in Oman.

Science.gov (United States)

Al-Ghammari, Khadija; Al-Riyami, Zainab; Al-Moqbali, Moza; Al-Marjabi, Fatma; Al-Mahrouqi, Basma; Al-Khatri, Amal; Al-Khasawneh, Esra M

2016-02-01

Episiotomy is still the most common surgical procedure performed on women, despite the evidence against its routine use. This cross-sectional study was conducted to determine the practice and predictors of routine episiotomy on primigravidae in Oman. Demographic data, reasons for and rate of performing routine episiotomies, and perceptions of 269 obstetricians, midwives and nurses from 11 hospitals in Oman regarding the procedure were recorded and analyzed. The rate of episiotomies was 66%. In terms of performing routine episiotomies (p<0.05): non-Omanis were 4.49 times more likely than Omanis; bachelor's degree-holders were 2.26 more likely than diploma-holders; and regional hospitals were 2.36 times more likely than tertiary hospitals. The majority perceived episiotomies "reduce spontaneous perineal tearing risk", "reduce shoulder dystocia complications", and allow for "easier suturing". The rate of episiotomies was higher than other similar contexts. An urgent intervention is necessary to curb this excessive practice, and create a culture of evidence-based practice to deal with misleading perceptions. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Non-routine activities in RP Group in 1995

International Nuclear Information System (INIS)

Hoefert, M.; Stevenson, G.R.

1996-01-01

The activities not directly concerned with the daily routine, but nevertheless essential to ensure a steady progress in radiation protection at CERN, concern mostly tests and intercomparisons of existing methods (quality control), development of new ideas, methods, and instruments. New projects, another non-routine activity, require in most cases profound studies to prove their feasibility with respect to radiation protection requirements. All these activities are documented in Divisional Reports, Internal Reports and Technical Memoranda, and are listed

Phthalates in surface water - a method for routine trace level analysis

International Nuclear Information System (INIS)

Furtmann, K.

1994-01-01

A routine method for the determination of phthalates in water is presented. It is suitable for all kinds of water like surface water, waste water, landfill leachate, rain water and ground water. Unfiltered water samples including all suspended particulate matter are extracted by solid-phase extraction in an all-glass apparatus using RPC-18. The extracts are measured by GC/MSD in the SIM mode. Due to an easy but efficient decontamination technique, method blanks could be decreased below 0.02 μg/l for all phthalates. The detection limits are 0.01 to 0.02 μg/l, the determination limits are 0.02 to 0.05 μg/l. Recovery for all phthalates is about 98% (± 5%). Phthalates were measured in about 400 samples of water of the river Rhine and its main affluents in Northrhine-Westfalia. (orig.)

[Routine fluoroscopic investigations after primary bariatric surgery].

Science.gov (United States)

Gärtner, D; Ernst, A; Fedtke, K; Jenkner, J; Schöttler, A; Reimer, P; Blüher, M; Schön, M R

2016-03-01

Staple line and anastomotic leakages are life-threatening complications after bariatric surgery. Upper gastrointestinal (GI) tract X-ray examination with oral administration of a water-soluble contrast agent can be used to detect leaks. The aim of this study was to evaluate the impact of routine upper GI tract fluoroscopy after primary bariatric surgery. Between January 2009 and December 2014 a total of 658 bariatric interventions were carried out of which 442 were primary bariatric operations. Included in this single center study were 307 sleeve gastrectomies and 135 Roux-en-Y gastric bypasses. Up to December 2012 upper GI tract fluoroscopy was performed routinely between the first and third postoperative days and the detection of leakages was evaluated. In the investigation period 8 leakages (2.6 %) after sleeve gastrectomy, 1 anastomotic leakage in gastrojejunostomy and 1 in jejunojejunostomy after Roux-en-Y gastric bypass occurred. All patients developed clinical symptoms, such as abdominal pain, tachycardia or fever. In one case the leakage was detected by upper GI fluoroscopy and in nine cases radiological findings were unremarkable. No leakages were detected in asymptomatic patients. Routine upper GI fluoroscopy is not recommended for uneventful postoperative courses after primary bariatric surgery.

Building Micro-Foundations for the Routines, Capabilities, and Performance Links

DEFF Research Database (Denmark)

Abell, Peter; Felin, Teppo; Foss, Nicolai Juul

2007-01-01

a neglect of micro-foundations - is incomplete. There are no mechanisms that work solely on the macro-level, directly connecting routines and capabilities to firm-level outcomes. While routines and capabilities are useful shorthand for complicated patterns of individual action and interaction, ultimately...... they are best understood at the micro-level. Second, we provide a formal model that shows precisely why macro explanation is incomplete and which exemplifies how explicit micro-foundations may be built for notions of routines and capabilities and for how these impact firm performance....

Costs and financing of routine immunization: Approach and selected findings of a multi-country study (EPIC).

Science.gov (United States)

Brenzel, Logan; Young, Darwin; Walker, Damian G

2015-05-07

Few detailed facility-based costing studies of routine immunization (RI) programs have been conducted in recent years, with planners, managers and donors relying on older information or data from planning tools. To fill gaps and improve quality of information, a multi-country study on costing and financing of routine immunization and new vaccines (EPIC) was conducted in Benin, Ghana, Honduras, Moldova, Uganda and Zambia. This paper provides the rationale for the launch of the EPIC study, as well as outlines methods used in a Common Approach on facility sampling, data collection, cost and financial flow estimation for both the routine program and new vaccine introduction. Costing relied on an ingredients-based approach from a government perspective. Estimating incremental economic costs of new vaccine introduction in contexts with excess capacity are highlighted. The use of more disaggregated System of Health Accounts (SHA) coding to evaluate financial flows is presented. The EPIC studies resulted in a sample of 319 primary health care facilities, with 65% of facilities in rural areas. The EPIC studies found wide variation in total and unit costs within each country, as well as between countries. Costs increased with level of scale and socio-economic status of the country. Governments are financing an increasing share of total RI financing. This study provides a wealth of high quality information on total and unit costs and financing for RI, and demonstrates the value of in-depth facility approaches. The paper discusses the lessons learned from using a standardized approach, as well as proposes further areas of methodology development. The paper discusses how results can be used for resource mobilization and allocation, improved efficiency of services at the country level, and to inform policies at the global level. Efforts at routinizing cost analysis to support sustainability efforts would be beneficial. Copyright © 2015 Elsevier Ltd. All rights reserved.

Community-driven demand creation for the use of routine viral load testing: a model to scale up routine viral load testing.

Science.gov (United States)

Killingo, Bactrin M; Taro, Trisa B; Mosime, Wame N

2017-11-01

HIV treatment outcomes are dependent on the use of viral load measurement. Despite global and national guidelines recommending the use of routine viral load testing, these policies alone have not translated into widespread implementation or sufficiently increased access for people living with HIV (PLHIV). Civil society and communities of PLHIV recognize the need to close this gap and to enable the scale up of routine viral load testing. The International Treatment Preparedness Coalition (ITPC) developed an approach to community-led demand creation for the use of routine viral load testing. Using this Community Demand Creation Model, implementers follow a step-wise process to capacitate and empower communities to address their most pressing needs. This includes utlizing a specific toolkit that includes conducting a baseline assessment, developing a treatment education toolkit, organizing mobilization workshops for knowledge building, provision of small grants to support advocacy work and conducting benchmark evaluations. The Community Demand Creation Model to increase demand for routine viral load testing services by PLHIV has been delivered in diverse contexts including in the sub-Saharan African, Asian, Latin American and the Caribbean regions. Between December 2015 and December 2016, ITPC trained more than 240 PLHIV activists, and disbursed US$90,000 to network partners in support of their national advocacy work. The latter efforts informed a regional, community-driven campaign calling for domestic investment in the expeditious implementation of national viral load testing guidelines. HIV treatment education and community mobilization are critical components of demand creation for access to optimal HIV treatment, especially for the use of routine viral load testing. ITPC's Community Demand Creation Model offers a novel approach to achieving this goal. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of

A QDWH-Based SVD Software Framework on Distributed-Memory Manycore Systems

KAUST Repository

Sukkari, Dalal; Ltaief, Hatem; Esposito, Aniello; Keyes, David E.

2017-01-01

, the inherent high level of concurrency associated with Level 3 BLAS compute-bound kernels ultimately compensates for the arithmetic complexity overhead. Using the ScaLAPACK two-dimensional block cyclic data distribution with a rectangular processor topology

Enhancing parallelism of tile bidiagonal transformation on multicore architectures using tree reduction

KAUST Repository

Ltaief, Hatem; Luszczek, Piotr R.; Dongarra, Jack

2012-01-01

The objective of this paper is to enhance the parallelism of the tile bidiagonal transformation using tree reduction on multicore architectures. First introduced by Ltaief et. al [LAPACK Working Note #247, 2011], the bidiagonal transformation using

Master schedule for CY-1978. Hanford Environmental Surveillance Routine Program

International Nuclear Information System (INIS)

Blumer, P.J.; Myers, D.A.; Fix, J.J.

1977-12-01

This report provides the current schedule of data collection for the routine environmental surveillance program at the Hanford Site. No results are presented in this report. The data collected are available in routine reports issued by the Environmental Evaluations staff

Learning Together and Working Apart: Routines for Organizational Learning in Virtual Teams

Science.gov (United States)

Dixon, Nancy

2017-01-01

Purpose: Research suggests that teaming routines facilitate learning in teams. This paper identifies and details how specific teaming routines, implemented in a virtual team, support its continual learning. The study's focus was to generate authentic and descriptive accounts of the interviewees' experiences with virtual teaming routines.…

Older adults' personal routine at time of hospitalization.

Science.gov (United States)

Zisberg, Anna; Gur-Yaish, Nurit

This study is the first to explore whether hospitalization disrupts the daily routines of dependent and independent older adults. Data were collected as part of a prospectively designed study from 330 hospitalized older adults age 70+. Patients reported prehospitalization frequency, duration, and timing of basic activities of daily living and leisure activities at hospital admission. Hospital routine was assessed on day of discharge. Results indicated that frequency and duration of most basic activities decreased during hospitalization; the sharpest decrease was in frequency of getting dressed. Showering occurred 2 h earlier in the hospital setting, and getting dressed occurred an hour and a half later. For dependent respondents, the greatest change was in duration; for independent respondents, the greatest change was in frequency. Given the importance of routine maintenance to health and well-being, understanding the dynamics of its disruption in the hospital setting is imperative. Copyright © 2016 Elsevier Inc. All rights reserved.

Efficiency of hydrogen peroxide in improving disinfection of ICU rooms.

Science.gov (United States)

Blazejewski, Caroline; Wallet, Frédéric; Rouzé, Anahita; Le Guern, Rémi; Ponthieux, Sylvie; Salleron, Julia; Nseir, Saad

2015-02-02

The primary objective of this study was to determine the efficiency of hydrogen peroxide (H₂O₂) techniques in disinfection of ICU rooms contaminated with multidrug-resistant organisms (MDRO) after patient discharge. Secondary objectives included comparison of the efficiency of a vaporizator (HPV, Bioquell) and an aerosolizer using H₂O₂, and peracetic acid (aHPP, Anios) in MDRO environmental disinfection, and assessment of toxicity of these techniques. This prospective cross-over study was conducted in five medical and surgical ICUs located in one University hospital, during a 12-week period. Routine terminal cleaning was followed by H₂O₂ disinfection. A total of 24 environmental bacteriological samplings were collected per room, from eight frequently touched surfaces, at three time-points: after patient discharge (T0), after terminal cleaning (T1) and after H₂O₂ disinfection (T2). In total 182 rooms were studied, including 89 (49%) disinfected with aHPP and 93 (51%) with HPV. At T0, 15/182 (8%) rooms were contaminated with at least 1 MDRO (extended spectrum β-lactamase-producing Gram-negative bacilli 50%, imipenem resistant Acinetobacter baumannii 29%, methicillin-resistant Staphylococcus aureus 17%, and Pseudomonas aeruginosa resistant to ceftazidime or imipenem 4%). Routine terminal cleaning reduced environmental bacterial load (P disinfection efficiency.

Theoretical optimization of GaInP/GaAs dual-junction solar cell: Toward a 36% efficiency at 1000 suns

Energy Technology Data Exchange (ETDEWEB)

Baudrit, Mathieu; Algora, Carlos [Instituto de Energia Solar, Universidad Politecnica de Madrid (Spain)

2010-02-15

A theoretical conversion efficiency of 36.4% at 1000 suns concentration has been determined by means of realistic models and an improved optimization routine. The starting point device was the recent world-record monolithic GaInP/GaAs dual-junction solar cell that was grown lattice matched on a GaAs substrate by MOVPE, which has an efficiency of 32.6% at 1000 suns. Using previously calibrated models developed at our institution, IES-UPM, together with Silvaco ATLAS TCAD software, we reproduced the characteristics of the world-record solar cell, and then determined a cell configuration that would yield greater efficiency by using an optimization routine to hone the doping concentration and the thickness of each layer. (Abstract Copyright [2010], Wiley Periodicals, Inc.)

Rules and routines in organizations and the management of safety rules

Energy Technology Data Exchange (ETDEWEB)

Weichbrodt, J. Ch.

2013-07-01

This thesis is concerned with the relationship between rules and routines in organizations and how the former can be used to steer the latter. Rules are understood as formal organizational artifacts, whereas organizational routines are collective patterns of action. While research on routines has been thriving, a clear understanding of how rules can be used to influence or control organizational routines (and vice-versa) is still lacking. This question is of particular relevance to safety rules in high-risk organizations, where the way in which organizational routines unfold can ultimately be a matter of life and death. In these organizations, an important and related issue is the balancing of standardization and flexibility – which, in the case of rules, takes the form of finding the right degree of formalization. In high-risk organizations, the question is how to adequately regulate actors’ routines in order to facilitate safe behavior, while at the same time leaving enough leeway for actors to make good decisions in abnormal situations. The railroads are regarded as high-risk industries and also rely heavily on formal rules. In this thesis, the Swiss Federal Railways (SBB) were therefore selected for a field study on rules and routines. The issues outlined so far are being tackled theoretically (paper 1), empirically (paper 2), and from a practitioner’s (i.e., rule maker’s) point of view (paper 3). In paper 1, the relationship between rules and routines is theoretically conceptualized, based on a literature review. Literature on organizational control and coordination, on rules in human factors and safety, and on organizational routines is combined. Three distinct roles (rule maker, rule supervisor, and rule follower) are outlined. Six propositions are developed regarding the necessary characteristics of both routines and rules, the respective influence of the three roles on the rule-routine relationship, and regarding organizational aspects such as

Rules and routines in organizations and the management of safety rules

International Nuclear Information System (INIS)

Weichbrodt, J. Ch.

2013-01-01

This thesis is concerned with the relationship between rules and routines in organizations and how the former can be used to steer the latter. Rules are understood as formal organizational artifacts, whereas organizational routines are collective patterns of action. While research on routines has been thriving, a clear understanding of how rules can be used to influence or control organizational routines (and vice-versa) is still lacking. This question is of particular relevance to safety rules in high-risk organizations, where the way in which organizational routines unfold can ultimately be a matter of life and death. In these organizations, an important and related issue is the balancing of standardization and flexibility – which, in the case of rules, takes the form of finding the right degree of formalization. In high-risk organizations, the question is how to adequately regulate actors’ routines in order to facilitate safe behavior, while at the same time leaving enough leeway for actors to make good decisions in abnormal situations. The railroads are regarded as high-risk industries and also rely heavily on formal rules. In this thesis, the Swiss Federal Railways (SBB) were therefore selected for a field study on rules and routines. The issues outlined so far are being tackled theoretically (paper 1), empirically (paper 2), and from a practitioner’s (i.e., rule maker’s) point of view (paper 3). In paper 1, the relationship between rules and routines is theoretically conceptualized, based on a literature review. Literature on organizational control and coordination, on rules in human factors and safety, and on organizational routines is combined. Three distinct roles (rule maker, rule supervisor, and rule follower) are outlined. Six propositions are developed regarding the necessary characteristics of both routines and rules, the respective influence of the three roles on the rule-routine relationship, and regarding organizational aspects such as

IONEOS: a fast, analytic, ion equation-of-state routine

International Nuclear Information System (INIS)

Cranfill, C.W.; More, R.

1978-10-01

A routine IONEOS has been developed to compute ion pressure and specific energy along with their derivatives. The theoretical model used is due to R.D. Cowan and includes non-ideal-gas behavior. The routine is designed for use in large hydrodynamics codes as an improved procedure for splitting the total pressure and specific energy (which are usually tabulated) into ion and electron components

42 CFR 493.941 - Hematology (including routine hematology and coagulation).

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Hematology (including routine hematology and....941 Hematology (including routine hematology and coagulation). (a) Program content and frequency of challenge. To be approved for proficiency testing for hematology, a program must provide a minimum of five...

Marshalling embedded routines in support of firm creation

DEFF Research Database (Denmark)

Houman Andersen, Poul; Norus, Jesper

2003-01-01

The paper has a dual purpose. First, we suggest that entrepreneurs in their establishment of new businesses draw on a range of pre-existing socially embedded routines for creating acceptance by their environment. Also they draw upon external resources that are used in patterning specific practices....... This ability is treated as entrepreneurial assets. Secondly, we argue that the existence and patterning of these socially embedded routines used in new business development are contingent on the institutional context. We see the institutional context as complex and fragmented, composed and shaped by different...

Assessing the technical efficiency of health posts in rural Guatemala: a data envelopment analysis.

Science.gov (United States)

Hernández, Alison R; San Sebastián, Miguel

2014-01-01

Strengthening health service delivery to the rural poor is an important means of redressing inequities. Meso-level managers can help enhance efficiency in the utilization of existing resources through the application of practical tools to analyze routinely collected data reflecting inputs and outputs. This study aimed to assess the efficiency and change in productivity of health posts over two years in a rural department of Guatemala. Data envelopment analysis was used to measure health posts' technical efficiency and productivity change for 2008 and 2009. Input/output data were collected from the regional health office of Alta Verapaz for 34 health posts from the 19 districts comprising the health region. Technical efficiency varied widely across health posts, with mean scores of 0.78 (SD=0.24) and 0.75 (SD=0.21) in 2008 and 2009, respectively. Overall, productivity increased by 4%, though 47% of health posts experienced a decline in productivity. Results were combined on a bivariate plot to identify health posts at the high and low extremes of efficiency, which should be followed up to determine how and why their production processes are operating differently. Assessing efficiency using the data that are available at the meso-level can serve as a first step in strengthening performance. Further work is required to support managers in the routine application of efficiency analysis and putting the results to use in guiding efforts to improve service delivery and increase utilization.

Developing Routines in Large Inter-organisational Projects: A Case Study of an Infrastructure Megaproject

Directory of Open Access Journals (Sweden)

Therese Eriksson

2015-08-01

Full Text Available General management research has increasingly recognised the significance of routines in organisational performance. Among organisational tasks, megaprojects depend more on routines selected and created within the project than standard, small-scale projects do, owing largely to their size, duration, and uniqueness. Within this context, the present paper investigates how project routines were established and developed during the early design phase of an inter-organisational megaproject. A case study of a large public infrastructure project was conducted, in which data were collected during observations, semi-structured interviews, and project document studies over the course of three years. Results of analysis revealed that the client exerted the greatest impact on choice of routines and that the temporary nature of tasks limited efforts to fine-tune routines. Changes in routines were primarily reactive to new knowledge concerning project needs. The findings suggest that meta-routines to consciously review routines should be used to a greater extent and designed to capture supplier experiences as well.

Efficiency performance of China's health care delivery system.

Science.gov (United States)

Zhang, Luyu; Cheng, Gang; Song, Suhang; Yuan, Beibei; Zhu, Weiming; He, Li; Ma, Xiaochen; Meng, Qingyue

2017-07-01

Improving efficiency performance of the health care delivery system has been on the agenda for the health system reform that China initiated in 2009. This study examines the changes in efficiency performance and determinants of efficiency after the reform to provide evidence to assess the progress of the reform from the perspective of efficiency. Descriptive analysis, Data Envelopment Analysis, the Malmquist Index, and multilevel regressions are used with data from multiple sources, including the World Bank, the China Health Statistical Yearbook, and routine reports. The results indicate that over the last decade, health outcomes compared with health investment were relatively higher in China than in most other countries worldwide, and the trend was stable. The overall efficiency and total factor productivity increased after the reform, indicating that the reform was likely to have had a positive impact on the efficiency performance of the health care delivery system. However, the health care delivery structure showed low system efficiency, mainly attributed to the weakened primary health care system. Strengthening the primary health care system is central to enhancing the future performance of China's health care delivery system. Copyright © 2017 John Wiley & Sons, Ltd.

Preventive child health care at elementary school age: The costs of routine assessments with a triage approach.

Directory of Open Access Journals (Sweden)

Janine Bezem

Full Text Available Triage in Preventive Child Health Care (PCH assessments could further the efficient use of human resources and budgets and therefore make extra care possible for children with specific needs. We assessed the costs of routine PCH assessments with and without triage for children aged 5/6 years and 10/11 years. In a triage approach, PCH assistants conduct pre-assessments to identify children requiring follow-up assessments by a physician or nurse. In the usual approach, all children are assessed by a physician and an assistant (children aged 5/6 years or a nurse (children aged 10/11 years.All the direct costs of conducting routine PCH assessments with the triage and usual approach were assessed using a bottom-up micro-costing approach. In four PCH services in the Netherlands, two using triage and two the usual approach, professionals completed questionnaires about time spent on assessments, including time related to non-attendance at assessments, the referral of children and administration.The projected costs for PCH professionals working on PCH assessments amounted to €5.2 million per cohort of 100,000 children aged 5/6 years in the triage approach, and €7.6 million in the usual approach. The projected costs in both approaches for children aged 10/11 years were about €4 million per 100,000 children.The triage approach to PCH resulted in a projected cost reduction of about one-third, compared with usual practice, for routine assessments by physicians of children aged 5/6 years. There are minimal cost savings in the group of children aged 10/11 years when nurses are involved and so other considerations such as workforce shortages would be required to justify a change to a triage approach. Further research is needed to investigate the differences in costs of care after the completion of the routine assessments.

Applicability and Efficiency of NGS in Routine Diagnosis: In-Depth Performance Analysis of a Complete Workflow for CFTR Mutation Analysis.

Directory of Open Access Journals (Sweden)

Adrien Pagin

Full Text Available Actually, about 2000 sequence variations have been documented in the CFTR gene requiring extensive and multi-step genetic testing in the diagnosis of cystic fibrosis and CFTR-related disorders. We present a two phases study, with validation and performance monitoring, of a single experiment methodology based on multiplex PCR and high throughput sequencing that allows detection of all variants, including large rearrangements, affecting the coding regions plus three deep intronic loci.A total of 340 samples, including 257 patients and 83 previously characterized control samples, were sequenced in 17 MiSeq runs and analyzed with two bioinformatic pipelines in routine diagnostic conditions. We obtained 100% coverage for all the target regions in every tested sample.We correctly identified all the 87 known variants in the control samples and successfully confirmed the 62 variants identified among the patients without observing false positive results. Large rearrangements were identified in 18/18 control samples. Only 17 patient samples showed false positive signals (6.6%, 12 of which showed a borderline result for a single amplicon. We also demonstrated the ability of the assay to detect allele specific dropout of amplicons when a sequence variation occurs at a primer binding site thus limiting the risk for false negative results.We described here the first NGS workflow for CFTR routine analysis that demonstrated equivalent diagnostic performances compared to Sanger sequencing and multiplex ligation-dependent probe amplification. This study illustrates the advantages of NGS in term of scalability, workload reduction and cost-effectiveness in combination with an improvement of the overall data quality due to the simultaneous detection of SNVs and large rearrangements.

A sensitive and efficient method for routine pesticide multiresidue analysis in bee pollen samples using gas and liquid chromatography coupled to tandem mass spectrometry.

Science.gov (United States)

Vázquez, P Parrilla; Lozano, A; Uclés, S; Ramos, M M Gómez; Fernández-Alba, A R

2015-12-24

Several clean-up methods were evaluated for 253 pesticides in pollen samples concentrating on efficient clean-up and the highest number of pesticides satisfying the recovery and precision criteria. These were: (a) modified QuEChERS using dSPE with PSA+C18; (b) freeze-out prior to QuEChERS using dSPE with PSA+C18; (c) freeze-out prior to QuEChERS using dSPE with PSA+C18+Z-Sep; and (d) freeze-out followed by QuEChERS using dSPE with PSA+C18 and SPE with Z-Sep. Determinations were made using LC-MS/MS and GC-MS/MS. The modified QuEChERS protocol applying a freeze-out followed by dSPE with PSA+C18 and SPE clean-up with Z-Sep was selected because it provided the highest number of pesticides with mean recoveries in the 70-120% range, as well as relative standard deviations (RSDs) typically below 20% (12.2% on average) and ensured much better removal of co-extracted matrix compounds of paramount importance in routine analysis. Limits of quantification at levels as low as 5μgkg(-1) were obtained for the majority of the pesticides. The proposed methodology was applied to the analysis of 41 pollen bee samples from different areas in Spain. Pesticides considered potentially toxic to bees (DL50bee) were detected in some samples with concentrations up to 72.7μgkg(-1), which could negatively affect honeybee health. Copyright © 2015 Elsevier B.V. All rights reserved.

Factors for Radical Creativity, Incremental Creativity, and Routine, Noncreative Performance

Science.gov (United States)

Madjar, Nora; Greenberg, Ellen; Chen, Zheng

2011-01-01

This study extends theory and research by differentiating between routine, noncreative performance and 2 distinct types of creativity: radical and incremental. We also use a sensemaking perspective to examine the interplay of social and personal factors that may influence a person's engagement in a certain level of creative action versus routine,…

See, Say, Write: A Writing Routine for the Preschool Classroom

Science.gov (United States)

Copp, Stefanie B.; Cabell, Sonia Q.; Tortorelli, Laura S.

2016-01-01

See, Say, Write is an adaptable classroom writing routine that teachers can use across a range of activities in the preschool classroom. This preschool writing routine offers an opportunity for teachers to build on a shared experience through engagement in rich conversation and writing. After a shared experience, teachers will provide a visual…

Probability and statistics with integrated software routines

CERN Document Server

Deep, Ronald

2005-01-01

Probability & Statistics with Integrated Software Routines is a calculus-based treatment of probability concurrent with and integrated with statistics through interactive, tailored software applications designed to enhance the phenomena of probability and statistics. The software programs make the book unique.The book comes with a CD containing the interactive software leading to the Statistical Genie. The student can issue commands repeatedly while making parameter changes to observe the effects. Computer programming is an excellent skill for problem solvers, involving design, prototyping, data gathering, testing, redesign, validating, etc, all wrapped up in the scientific method.See also: CD to accompany Probability and Stats with Integrated Software Routines (0123694698)* Incorporates more than 1,000 engaging problems with answers* Includes more than 300 solved examples* Uses varied problem solving methods

Highly Efficient Agrobacterium-Mediated Transformation of Wheat Via In Planta Inoculation

Science.gov (United States)

Risacher, Thierry; Craze, Melanie; Bowden, Sarah; Paul, Wyatt; Barsby, Tina

This chapter details a reproducible method for the transformation of spring wheat using Agrobacterium tumefaciens via the direct inoculation of bacteria into immature seeds in planta as described in patent WO 00/63398(1. Transformation efficiencies from 1 to 30% have been obtained and average efficiencies of at least 5% are routinely achieved. Regenerated plants are phenotypically normal with 30-50% of transformation events carrying introduced genes at single insertion sites, a higher rate than is typically reported for transgenic plants produced using biolistic transformation methods.

Is Routine Preoperative Chest X-ray Indicated in Elderly Patients ...

African Journals Online (AJOL)

Background: In our hospital pre-operative chest x-ray (CXR) are routinely requested without prior establishment of any medical indication for patients of 70 or more years of age who are undergoing elective surgery. The aim of this study was to determine if routine preoperative chest x-rays are justifiably indicated for elderly ...

Alanine/ESR dosimetry system for routine use in radiation processing

International Nuclear Information System (INIS)

Kojima, T.; Haruyama, Y.; Tachibana, H.; Tanaka, R.; Okamoto, J.; Hara, H.; Kashiwazaki, S.

1993-01-01

A new alanine-polystyrene(PS) dosimeter prepared with simplified molding procedure and an automatic desk-top dose-reader of alanine dosimeter were developed for the purpose of routine use. Combination of these two allows us to apply a reliable alanine/ESR dosimetry system to routine dosimetric process control in industrial gamma radiation processing. (Author)

Linking child travel routes and routine health data

Directory of Open Access Journals (Sweden)

Amy Mizen

2017-04-01

Depending on modelled accuracy, a GIS and data linkage approach may allow the investigation of natural experiments and intervention evaluation at the scale of the total population. This is the first step towards anonymously modelling part of the daily exposure environment using routine data. A limitation is the lack of routinely collected BMI data for older children and teenagers an age when they are more likely to have the option to choose to buy food on the school route. This work will have many potential applications, including the delivery and evaluation of multiple school and workplace commuting interventions.

The impact of introducing intensity modulated radiotherapy into routine clinical practice.

Science.gov (United States)

Miles, Elizabeth A; Clark, Catharine H; Urbano, M Teresa Guerrero; Bidmead, Margaret; Dearnaley, David P; Harrington, Kevin J; A'Hern, Roger; Nutting, Christopher M

2005-12-01

Intensity modulated radiotherapy (IMRT) at the Royal Marsden Hospital London was introduced in July 2001. Treatment delivery was dynamic using a single-phase technique. Concerns were raised regarding increased clinical workload due to introduction of new technology. The potential increased use of resources was assessed. IMRT patient selection was within guidelines of clinical trials and included patients undergoing prostate plus pelvic lymph node (PPN) irradiation and head and neck cancer (HNC) treatment. Patient planning, quality assurance and treatment times were collected for an initial IMRT patient group. A comparative group of patients with advanced HNC undergoing two- or three-phase conventional radiotherapy, requiring matched photon and electron fields, were also timed. The median overall total planning time for IMRT was greater for HNC patients compared to the PPN cohort. For HNC the overall IMRT planning time was significantly longer than for conventional. The median treatment time for conventional two- or three-phase HNC treatments, encompassing similar volumes to those treated with IMRT, was greater than that for the IMRT HNC patient cohort. A reduction in radiographer man hours per patient of 4.8h was recorded whereas physics time was increased by 4.9h per patient. IMRT currently increases overall planning time. Additional clinician input is required for target volume localisation. Physics time is increased, a significant component of this being patient specific QA. Radiographer time is decreased. For HNC a single phase IMRT treatment has proven to be more efficient than a multiple phase conventional treatment. IMRT has been integrated smoothly and efficiently into the existing treatment working day. This preliminary study suggests that IMRT could be a routine treatment with efficient use of current radiotherapy resources.

GRALIB, DISSPLA Plot Routines Emulator

International Nuclear Information System (INIS)

Dunford, L.

1999-01-01

1 - Description of program or function: GRALIB is a library of graphics subroutines used by PLOTEF. 2 - Method of solution: The PLOTEF library contains routines to generate and manipulate data which are independent of the output graphics device. In order to produce output for a given graphics device - which interact with GRALIB using the DISSPLA conventions - a device driver must be written by the user for this device

Routine health information system utilization and factors associated thereof among health workers at government health institutions in East Gojjam Zone, Northwest Ethiopia.

Science.gov (United States)

Shiferaw, Atsede Mazengia; Zegeye, Dessalegn Tegabu; Assefa, Solomon; Yenit, Melaku Kindie

2017-08-07

Using reliable information from routine health information systems over time is an important aid to improving health outcomes, tackling disparities, enhancing efficiency, and encouraging innovation. In Ethiopia, routine health information utilization for enhancing performance is poor among health workers, especially at the peripheral levels of health facilities. Therefore, this study aimed to assess routine health information system utilization and associated factors among health workers at government health institutions in East Gojjam Zone, Northwest Ethiopia. An institution based cross-sectional study was conducted at government health institutions of East Gojjam Zone, Northwest Ethiopia from April to May, 2013. A total of 668 health workers were selected from government health institutions, using the cluster sampling technique. Data collected using a standard structured and self-administered questionnaire and an observational checklist were cleaned, coded, and entered into Epi-info version 3.5.3, and transferred into SPSS version 20 for further statistical analysis. Variables with a p-value of less than 0.05 at multiple logistic regression analysis were considered statistically significant factors for the utilization of routine health information systems. The study revealed that 45.8% of the health workers had a good level of routine health information utilization. HMIS training [AOR = 2.72, 95% CI: 1.60, 4.62], good data analysis skills [AOR = 6.40, 95%CI: 3.93, 10.37], supervision [AOR = 2.60, 95% CI: 1.42, 4.75], regular feedback [AOR = 2.20, 95% CI: 1.38, 3.51], and favorable attitude towards health information utilization [AOR = 2.85, 95% CI: 1.78, 4.54] were found significantly associated with a good level of routine health information utilization. More than half of the health workers working at government health institutions of East Gojjam were poor health information users compared with the findings of others studies. HMIS training, data

Methods to improve routine bioassay monitoring for freshly separated, poorly transported plutonium

International Nuclear Information System (INIS)

Bihl, D.E.; Lynch, T.P.; Carbaugh, E.H.; Sula, M.J.

1988-09-01

Several human cases involving inhalation of plutonium oxide at Hanford have shown clearance half-times from the lung that are much longer than the 500-day half-time recommended for class Y plutonium in Publication 30 of the International Commission on Radiological Protection(ICRP). The more tenaciously retained material is referred to as super class Y plutonium. The ability to detect super class Y plutonium by current routine bioassay measurements is shown to be poor. Pacific Northwest Laboratory staff involved in the Hanford Internal Dosimetry Program investigated four methods to se if improvements in routine monitoring of workers for fresh super class Y plutonium are feasible. The methods were lung counting, urine sampling, fecal sampling, and use of diethylenetriaminepentaacetate (DTPA) to enhance urinary excretion. Use of DTPA was determined to be not feasible. Routine fecal sampling was found to be feasible but not recommended. Recommendations were made to improve the detection level for routine annual urinalysis and routine annual lung counting. 12 refs., 9 figs., 7 tabs

A methodology to extract outcomes from routine healthcare data for patients with locally advanced non-small cell lung cancer.

Science.gov (United States)

Wong, Swee-Ling; Ricketts, Kate; Royle, Gary; Williams, Matt; Mendes, Ruheena

2018-04-11

to use routine datasets to determine outcome indicators in patients with LA NSCLC that will be a surrogate to analysing manual data. The ability to enable efficient and large scale analysis of current lung cancer strategies has a huge potential impact on the healthcare system.

Taking medicine at home - create a routine

Science.gov (United States)

... page: //medlineplus.gov/ency/patientinstructions/000613.htm Taking medicine at home - create a routine To use the ... teeth. Find Ways to Help You Remember Your Medicines You can: Set the alarm on your clock, ...

Linearized self-consistent quasiparticle GW method: Application to semiconductors and simple metals

Science.gov (United States)

Kutepov, A. L.; Oudovenko, V. S.; Kotliar, G.

2017-10-01

We present a code implementing the linearized quasiparticle self-consistent GW method (LQSGW) in the LAPW basis. Our approach is based on the linearization of the self-energy around zero frequency which differs it from the existing implementations of the QSGW method. The linearization allows us to use Matsubara frequencies instead of working on the real axis. This results in efficiency gains by switching to the imaginary time representation in the same way as in the space time method. The all electron LAPW basis set eliminates the need for pseudopotentials. We discuss the advantages of our approach, such as its N3 scaling with the system size N, as well as its shortcomings. We apply our approach to study the electronic properties of selected semiconductors, insulators, and simple metals and show that our code produces the results very close to the previously published QSGW data. Our implementation is a good platform for further many body diagrammatic resummations such as the vertex-corrected GW approach and the GW+DMFT method. Program Files doi:http://dx.doi.org/10.17632/cpchkfty4w.1 Licensing provisions: GNU General Public License Programming language: Fortran 90 External routines/libraries: BLAS, LAPACK, MPI (optional) Nature of problem: Direct implementation of the GW method scales as N4 with the system size, which quickly becomes prohibitively time consuming even in the modern computers. Solution method: We implemented the GW approach using a method that switches between real space and momentum space representations. Some operations are faster in real space, whereas others are more computationally efficient in the reciprocal space. This makes our approach scale as N3. Restrictions: The limiting factor is usually the memory available in a computer. Using 10 GB/core of memory allows us to study the systems up to 15 atoms per unit cell.

Reduced order modeling and parameter identification of a building energy system model through an optimization routine

International Nuclear Information System (INIS)

Harish, V.S.K.V.; Kumar, Arun

2016-01-01

Highlights: • A BES model based on 1st principles is developed and solved numerically. • Parameters of lumped capacitance model are fitted using the proposed optimization routine. • Validations are showed for different types of building construction elements. • Step response excitations for outdoor air temperature and relative humidity are analyzed. - Abstract: Different control techniques together with intelligent building technology (Building Automation Systems) are used to improve energy efficiency of buildings. In almost all control projects, it is crucial to have building energy models with high computational efficiency in order to design and tune the controllers and simulate their performance. In this paper, a set of partial differential equations are formulated accounting for energy flow within the building space. These equations are then solved as conventional finite difference equations using Crank–Nicholson scheme. Such a model of a higher order is regarded as a benchmark model. An optimization algorithm has been developed, depicted through a flowchart, which minimizes the sum squared error between the step responses of the numerical and the optimal model. Optimal model of the construction element is nothing but a RC-network model with the values of Rs and Cs estimated using the non-linear time invariant constrained optimization routine. The model is validated with comparing the step responses with other two RC-network models whose parameter values are selected based on a certain criteria. Validations are showed for different types of building construction elements viz., low, medium and heavy thermal capacity elements. Simulation results show that the optimal model closely follow the step responses of the numerical model as compared to the responses of other two models.

The Emergence of Routines: Entrepreneurship, Organization, and Business History

DEFF Research Database (Denmark)

Lubinski, Christina

2018-01-01

Book review of: The Emergence of Routines: Entrepreneurship, Organization, and Business History. Edited by Daniel M. G. Raff and Philip Scranton. Oxford: Oxford University Press, 2017. xii + 358 pp. Figures, notes, index. Cloth, $90.00. ISBN: 978-0-19-878776-1.......Book review of: The Emergence of Routines: Entrepreneurship, Organization, and Business History. Edited by Daniel M. G. Raff and Philip Scranton. Oxford: Oxford University Press, 2017. xii + 358 pp. Figures, notes, index. Cloth, $90.00. ISBN: 978-0-19-878776-1....

Sequencing-based breast cancer diagnostics as an alternative to routine biomarkers.

Science.gov (United States)

Rantalainen, Mattias; Klevebring, Daniel; Lindberg, Johan; Ivansson, Emma; Rosin, Gustaf; Kis, Lorand; Celebioglu, Fuat; Fredriksson, Irma; Czene, Kamila; Frisell, Jan; Hartman, Johan; Bergh, Jonas; Grönberg, Henrik

2016-11-30

Sequencing-based breast cancer diagnostics have the potential to replace routine biomarkers and provide molecular characterization that enable personalized precision medicine. Here we investigate the concordance between sequencing-based and routine diagnostic biomarkers and to what extent tumor sequencing contributes clinically actionable information. We applied DNA- and RNA-sequencing to characterize tumors from 307 breast cancer patients with replication in up to 739 patients. We developed models to predict status of routine biomarkers (ER, HER2,Ki-67, histological grade) from sequencing data. Non-routine biomarkers, including mutations in BRCA1, BRCA2 and ERBB2(HER2), and additional clinically actionable somatic alterations were also investigated. Concordance with routine diagnostic biomarkers was high for ER status (AUC = 0.95;AUC(replication) = 0.97) and HER2 status (AUC = 0.97;AUC(replication) = 0.92). The transcriptomic grade model enabled classification of histological grade 1 and histological grade 3 tumors with high accuracy (AUC = 0.98;AUC(replication) = 0.94). Clinically actionable mutations in BRCA1, BRCA2 and ERBB2(HER2) were detected in 5.5% of patients, while 53% had genomic alterations matching ongoing or concluded breast cancer studies. Sequencing-based molecular profiling can be applied as an alternative to histopathology to determine ER and HER2 status, in addition to providing improved tumor grading and clinically actionable mutations and molecular subtypes. Our results suggest that sequencing-based breast cancer diagnostics in a near future can replace routine biomarkers.

Contextualising renal patient routines: Everyday space-time contexts, health service access, and wellbeing.

Science.gov (United States)

McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish

2017-06-01

Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals' everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients' space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants' everyday lives. We found that participants' everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants' everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off 'ripple effects' within participants' space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise and de

[Routine oral examinations and specific after-care for removable partial dentures

NARCIS (Netherlands)

Baat, C. de; Witter, D.J.; Keltjens, H.M.A.M.; Creugers, N.H.J.

2011-01-01

Following treatment with a removable partial denture, routine oral examinations are required to stabilize the existing condition in a sustainable way and to make possible the timely treatment of anomalies which have appeared. In cases of problems assessed during a routine oral examination in

Evidence for Acute Electrophysiological and Cognitive Changes Following Routine Soccer Heading

Directory of Open Access Journals (Sweden)

Thomas G. Di Virgilio

2016-11-01

Discussion: Sub-concussive head impacts routine in soccer heading are associated with immediate, measurable electrophysiological and cognitive impairments. Although these changes in brain function were transient, these effects may signal direct consequences of routine soccer heading on (long-term brain health which requires further study.

Clinician’s Attitudes to the Introduction of Routine Weighing in Pregnancy

Directory of Open Access Journals (Sweden)

Tim Hasted

2016-01-01

Full Text Available Background. Excessive gestational weight gain poses significant short- and long-term health risks to both mother and baby. Professional bodies and health services increasingly recommend greater attention be paid to weight gain in pregnancy. A large Australian tertiary maternity hospital plans to facilitate the (reintroduction of routine weighing of all women at every antenatal visit. Objective. To identify clinicians’ perspectives of barriers and enablers to routinely weighing pregnant women and variations in current practice, knowledge, and attitudes between different staff groups. Method. Forty-four maternity staff from three professional groups were interviewed in four focus groups. Staff included midwives; medical staff; and dietitians. Transcripts underwent qualitative content analysis to identify and examine barriers and enablers to the routine weighing of women throughout pregnancy. Results. While most staff supported routine weighing, various concerns were raised. Issues included access to resources and staff; the ability to provide appropriate counselling and evidence-based interventions; and the impact of weighing on patients and the therapeutic relationship. Conclusion. Many clinicians supported the practice of routine weighing in pregnancy, but barriers were also identified. Implementation strategies will be tailored to the discrete professional groups and will address identified gaps in knowledge, resources, and clinician skills and confidence.

An Evaluation of Java for Numerical Computing

Directory of Open Access Journals (Sweden)

Brian Blount

1999-01-01

Full Text Available This paper describes the design and implementation of high performance numerical software in Java. Our primary goals are to characterize the performance of object‐oriented numerical software written in Java and to investigate whether Java is a suitable language for such endeavors. We have implemented JLAPACK, a subset of the LAPACK library in Java. LAPACK is a high‐performance Fortran 77 library used to solve common linear algebra problems. JLAPACK is an object‐oriented library, using encapsulation, inheritance, and exception handling. It performs within a factor of four of the optimized Fortran version for certain platforms and test cases. When used with the native BLAS library, JLAPACK performs comparably with the Fortran version using the native BLAS library. We conclude that high‐performance numerical software could be written in Java if a handful of concerns about language features and compilation strategies are adequately addressed.

Benchmarking routine psychological services: a discussion of challenges and methods.

Science.gov (United States)

Delgadillo, Jaime; McMillan, Dean; Leach, Chris; Lucock, Mike; Gilbody, Simon; Wood, Nick

2014-01-01

Policy developments in recent years have led to important changes in the level of access to evidence-based psychological treatments. Several methods have been used to investigate the effectiveness of these treatments in routine care, with different approaches to outcome definition and data analysis. To present a review of challenges and methods for the evaluation of evidence-based treatments delivered in routine mental healthcare. This is followed by a case example of a benchmarking method applied in primary care. High, average and poor performance benchmarks were calculated through a meta-analysis of published data from services working under the Improving Access to Psychological Therapies (IAPT) Programme in England. Pre-post treatment effect sizes (ES) and confidence intervals were estimated to illustrate a benchmarking method enabling services to evaluate routine clinical outcomes. High, average and poor performance ES for routine IAPT services were estimated to be 0.91, 0.73 and 0.46 for depression (using PHQ-9) and 1.02, 0.78 and 0.52 for anxiety (using GAD-7). Data from one specific IAPT service exemplify how to evaluate and contextualize routine clinical performance against these benchmarks. The main contribution of this report is to summarize key recommendations for the selection of an adequate set of psychometric measures, the operational definition of outcomes, and the statistical evaluation of clinical performance. A benchmarking method is also presented, which may enable a robust evaluation of clinical performance against national benchmarks. Some limitations concerned significant heterogeneity among data sources, and wide variations in ES and data completeness.

Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Lee, Kang Wook; Lee, Heon Young [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

1995-06-15

Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

International Nuclear Information System (INIS)

Lee, Kang Wook; Lee, Heon Young

1995-01-01

Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

Signal Peptide and Denaturing Temperature are Critical Factors for Efficient Mammalian Expression and Immunoblotting of Cannabinoid Receptors*

Science.gov (United States)

WANG, Chenyun; WANG, Yingying; WANG, Miao; CHEN, Jiankui; YU, Nong; SONG, Shiping; KAMINSKI, Norbert E.; ZHANG, Wei

2013-01-01

Summary Many researchers employed mammalian expression system to artificially express cannabinoid receptors, but immunoblot data that directly prove efficient protein expression can hardly be seen in related research reports. In present study, we demonstrated cannabinoid receptor protein was not able to be properly expressed with routine mammalian expression system. This inefficient expression was rescued by endowing an exogenous signal peptide ahead of cannabinoid receptor peptide. In addition, the artificially synthesized cannabinoid receptor was found to aggregate under routine sample denaturing temperatures (i.e., ≥95°C), forming a large molecular weight band when analyzed by immunoblotting. Only denaturing temperatures ≤75°C yielded a clear band at the predicted molecular weight. Collectively, we showed that efficient mammalian expression of cannabinoid receptors need a signal peptide sequence, and described the requirement for a low sample denaturing temperature in immunoblot analysis. These findings provide very useful information for efficient mammalian expression and immunoblotting of membrane receptors. PMID:22528237

Development and Validation of the Pediatric Diabetes Routines Questionnaire for Adolescents.

Science.gov (United States)

Pierce, Jessica S; Jordan, Sara S; Arnau, Randolph C

2018-04-06

This study describes the development and psychometric evaluation of an adolescent self-report version of the Pediatric Diabetes Routines Questionnaire (PDRQ:A), a measure of diabetes-specific routines for youth with type 1 diabetes, and further validation of the parent-version (PDRQ:P) in an adolescent sample. Participants included 120 parent-adolescent dyads (ages 12-17) and an additional 24 parents who completed measures of diabetes-specific adolescent routines, general adolescent routines, diabetes self-care, and family support of youth diabetes care. The PDRQ:P/A demonstrated good internal consistency, test-retest reliability, and parent-child agreement, and adequate validity coefficients. Confirmatory factor analysis supported a one-factor model. Promising results were obtained. The PDRQ:P/A is a clinically feasible parent- and self-report measure that can provide valuable information regarding how frequently adolescents engage in their diabetes management tasks in a consistent manner. Addition of an adolescent report format will enhance the utility of the measure for clinical and research use.

Equipment recommendations for uniform work places for routine stomatological radiodiagnosis

Energy Technology Data Exchange (ETDEWEB)

Rother, U [Rostock Univ. (German Democratic Republic). Radiologische Klinik; Taschner, P [Staatliches Amt fuer Atomsicherheit und Strahlenschutz, Berlin (German Democratic Republic); Wiltschke, F; Tonne, E; Kuehling, U; Nenning, K

1977-03-01

Corresponding to the different objectives, the Working Group on Radiology of the Stomatological Society has designed 6 standardized work places for routine radiodiagnosis in stomatology. Apart from the objectives, the problems related to the division of rooms, equipment, radioprotection and film processing are dealt with separately and specifically. The work places for routine stomatological radiodiagnosis are intended for achieving an improvement in a sector of stomatological care.

Doubling immunochemistry laboratory testing efficiency with the cobas e 801 module while maintaining consistency in analytical performance.

Science.gov (United States)

Findeisen, P; Zahn, I; Fiedler, G M; Leichtle, A B; Wang, S; Soria, G; Johnson, P; Henzell, J; Hegel, J K; Bendavid, C; Collet, N; McGovern, M; Klopprogge, K

2018-06-04

The new immunochemistry cobas e 801 module (Roche Diagnostics) was developed to meet increasing demands on routine laboratories to further improve testing efficiency, while maintaining high quality and reliable data. During a non-interventional multicenter evaluation study, the overall performance, functionality and reliability of the new module was investigated under routine-like conditions. It was tested as a dedicated immunochemistry system at four sites and as a consolidator combined with clinical chemistry at three sites. We report on testing efficiency and analytical performance of the new module. Evaluation of sample workloads with site-specific routine request patterns demonstrated increased speed and almost doubled throughput (maximal 300 tests per h), thus revealing that one cobas e 801 module can replace two cobas e 602 modules while saving up to 44% floor space. Result stability was demonstrated by QC analysis per assay throughout the study. Precision testing over 21 days yielded excellent results within and between labs, and, method comparison performed versus the cobas e 602 module routine results showed high consistency of results for all assays under study. In a practicability assessment related to performance and handling, 99% of graded features met (44%) or even exceeded (55%) laboratory expectations, with enhanced reagent management and loading during operation being highlighted. By nearly doubling immunochemistry testing efficiency on the same footprint as a cobas e 602 module, the new module has a great potential to further consolidate and enhance laboratory testing while maintaining high quality analytical performance with Roche platforms. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Effective education for energy efficiency

International Nuclear Information System (INIS)

Zografakis, Nikolaos; Menegaki, Angeliki N.; Tsagarakis, Konstantinos P.

2008-01-01

A lot of today's world vices can be eliminated if certain targeted modules and adapted curricula are introduced in the schooling system. One of these vices is energy squandering with all its negative consequences for the planet (e.g. depletion of finite energy sources and the subsequent climate change). This paper describes the results of an energy-thrift information and education project taking place in different levels of education in Crete-Greece, which records 321 students' and their parents' routine energy-related behavior and proves that this behavior changes to a more energy efficient one, after the dissemination of relevant information and the participation into the energy education projects. Namely, response percentages indicating the energy-efficient behavior increased after project participation while the ones indicating an energy-squandering behavior decreased. The Wilcoxon signed rank test was statistically significant in all energy behavior questions related to students and to most questions related to parents

Routine Design for Mechanical Engineering

OpenAIRE

Brinkop, Axel; Laudwein, Norbert; Maasen, Rudiger

1995-01-01

COMIX (configuration of mixing machines) is a system that assists members of the EKATO Sales Department in designing a mixing machine that fulfills the requirements of a customer. It is used to help the engineer design the requested machine and prepare an offer that's to be submitted to the customer. comix integrates more traditional software techniques with explicit knowledge representation and constraint propagation. During the process of routine design, some design decisions have to be mad...

An improved routine for the fast estimate of ion cyclotron heating efficiency in tokamak plasmas

International Nuclear Information System (INIS)

Brambilla, M.

1992-02-01

The subroutine ICEVAL for the rapid simulation of Ion Cyclotron Heating in tokamak plasmas is based on analytic estimates of the wave behaviour near resonances, and on drastic but reasonable simplifications of the real geometry. The subroutine has been rewritten to improve the model and to facilitate its use as input in transport codes. In the new version the influence of quasilinear minority heating on the damping efficiency is taken into account using the well-known Stix analytic approximation. Among other improvements are: a) the possibility of considering plasmas with more than two ion species; b) inclusion of Landau, Transit Time and collisional damping on the electrons non localised at resonances; c) better models for the antenna spectrum and for the construction of the power deposition profiles. The results of ICEVAL are compared in detail with those of the full-wave code FELICE for the case of Hydrogen minority heating in a Deuterium plasma; except for details which depend on the excitation of global eigenmodes, agreement is excellent. ICEVAL is also used to investigate the enhancement of the absorption efficiency due to quasilinear heating of the minority ions. The effect is a strongly non-linear function of the available power, and decreases rapidly with increasing concentration. For parameters typical of Asdex Upgrade plasmas, about 4 MW are required to produce a significant increase of the single-pass absorption at concentrations between 10 and 20%. (orig.)

Plato: A localised orbital based density functional theory code

Science.gov (United States)

Kenny, S. D.; Horsfield, A. P.

2009-12-01

The Plato package allows both orthogonal and non-orthogonal tight-binding as well as density functional theory (DFT) calculations to be performed within a single framework. The package also provides extensive tools for analysing the results of simulations as well as a number of tools for creating input files. The code is based upon the ideas first discussed in Sankey and Niklewski (1989) [1] with extensions to allow high-quality DFT calculations to be performed. DFT calculations can utilise either the local density approximation or the generalised gradient approximation. Basis sets from minimal basis through to ones containing multiple radial functions per angular momenta and polarisation functions can be used. Illustrations of how the package has been employed are given along with instructions for its utilisation. Program summaryProgram title: Plato Catalogue identifier: AEFC_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEFC_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 219 974 No. of bytes in distributed program, including test data, etc.: 1 821 493 Distribution format: tar.gz Programming language: C/MPI and PERL Computer: Apple Macintosh, PC, Unix machines Operating system: Unix, Linux and Mac OS X Has the code been vectorised or parallelised?: Yes, up to 256 processors tested RAM: Up to 2 Gbytes per processor Classification: 7.3 External routines: LAPACK, BLAS and optionally ScaLAPACK, BLACS, PBLAS, FFTW Nature of problem: Density functional theory study of electronic structure and total energies of molecules, crystals and surfaces. Solution method: Localised orbital based density functional theory. Restrictions: Tight-binding and density functional theory only, no exact exchange. Unusual features: Both atom centred and uniform meshes available

Instrumental neutron activation analysis - a routine method

International Nuclear Information System (INIS)

Bruin, M. de.

1983-01-01

This thesis describes the way in which at IRI instrumental neutron activation analysis (INAA) has been developed into an automated system for routine analysis. The basis of this work are 20 publications describing the development of INAA since 1968. (Auth.)

Cultural Responsiveness and Routines: When Center and Home Don't Match

Science.gov (United States)

Gonzalez-Mena, Janet

2010-01-01

This article discusses cultural responsiveness and routines of child care centers that do not match what families are accustomed to at home. It can be difficult to discuss cultural differences in some routine caregiving activities because of the standards, rules, regulations, best practices, and health concerns that those trained in early…

The impact of introducing intensity modulated radiotherapy into routine clinical practice

International Nuclear Information System (INIS)

Miles, Elizabeth A.; Clark, Catharine H.; Urbano, M. Teresa Guerrero; Bidmead, Margaret; Dearnaley, David P.; Harrington, Kevin J.; A'Hern, Roger; Nutting, Christopher M.

2005-01-01

Background and purpose: Intensity modulated radiotherapy (IMRT) at Royal Marsden Hospital London was introduced in July 2001. Treatment delivery was dynamic using a single-phase technique. Concerns were raised regarding increased clinical workload due to introduction of new technology. The potential increased use of resources was assessed. Patients and methods: IMRT patient selection was within guidelines of clinical trials and included patients undergoing prostate plus pelvic lymph node (PPN) irradiation and head and neck cancer (HNC) treatment. Patient planning, quality assurance and treatment times were collected for an initial IMRT patient group. A comparative group of patients with advanced HNC undergoing two- or three-phase conventional radiotherapy, requiring matched photon and electron fields, were also timed. Results: The median overall total planning time for IMRT was greater for HNC patients compared to the PPN cohort. For HNC the overall IMRT planning time was significantly longer than for conventional. The median treatment time for conventional two- or three-phase HNC treatments, encompassing similar volumes to those treated with IMRT, was greater than that for the IMRT HNC patient cohort. A reduction in radiographer man hours per patient of 4.8 h was recorded whereas physics time was increased by 4.9 h per patient. Conclusions: IMRT currently increases overall planning time. Additional clinician input is required for target volume localisation. Physics time is increased, a significant component of this being patient specific QA. Radiographer time is decreased. For HNC a single phase IMRT treatment has proven to be more efficient than a multiple phase conventional treatment. IMRT has been integrated smoothly and efficiently into the existing treatment working day. This preliminary study suggests that IMRT could be a routine treatment with efficient use of current radiotherapy resources

A recursive Formulation of the Inversion of symmetric positive defite matrices in packed storage data format

DEFF Research Database (Denmark)

Andersen, Bjarne Stig; Gunnels, John A.; Gustavson, Fred

2002-01-01

A new Recursive Packed Inverse Calculation Algorithm for symmetric positive definite matrices has been developed. The new Recursive Inverse Calculation algorithm uses minimal storage, \\$n(n+1)/2\\$, and has nearly the same performance as the LAPACK full storage algorithm using \\$n\\^2\\$ memory words...

Implementing a New Dense Symmetric Eigensolver on Multicore Systems

KAUST Repository

Sukkari, Dalal E.

2013-01-01

the matrix into smaller submatrices by finding an invariant subspace for a subset of the spectrum. The main contribution of this thesis is to enhance the per- formance of QDWHeig algorithm by relying on a high performance kernels from PLASMA [1] and LAPACK [2

Examining the cost of delivering routine immunization in Honduras.

Science.gov (United States)

Janusz, Cara Bess; Castañeda-Orjuela, Carlos; Molina Aguilera, Ida Berenice; Felix Garcia, Ana Gabriela; Mendoza, Lourdes; Díaz, Iris Yolanda; Resch, Stephen C

2015-05-07

Many countries have introduced new vaccines and expanded their immunization programs to protect additional risk groups, thus raising the cost of routine immunization delivery. Honduras recently adopted two new vaccines, and the country continues to broaden the reach of its program to adolescents and adults. In this article, we estimate and examine the economic cost of the Honduran routine immunization program for the year 2011. The data were gathered from a probability sample of 71 health facilities delivering routine immunization, as well as 8 regional and 1 central office of the national immunization program. Data were collected on vaccinations delivered, staff time dedicated to the program, cold chain equipment and upkeep, vehicle use, infrastructure, and other recurrent and capital costs at each health facility and administrative office. Annualized economic costs were estimated from a modified societal perspective and reported in 2011 US dollars. With the addition of rotavirus and pneumococcal conjugate vaccines, the total cost for routine immunization delivery in Honduras for 2011 was US$ 32.5 million. Vaccines and related supplies accounted for 23% of the costs. Labor, cold chain, and vehicles represented 54%, 4%, and 1%, respectively. At the facility level, the non-vaccine system costs per dose ranged widely, from US$ 25.55 in facilities delivering fewer than 500 doses per year to US$ 2.84 in facilities with volume exceeding 10,000 doses per year. Cost per dose was higher in rural facilities despite somewhat lower wage rates for health workers in these settings; this appears to be driven by lower demand for services per health worker in sparsely populated areas, rather than increased cost of outreach. These more-precise estimates of the operational costs to deliver routine immunizations provide program managers with important information for mobilizing resources to help sustain the program and for improving annual planning and budgeting as well as longer

Should the lateral chest radiograph be routinely performed?

International Nuclear Information System (INIS)

Osman, Fatuma; Williams, Imelda

2014-01-01

Background: The chest x-ray is one of the most common plain film radiographic examinations performed. Inclusion of the lateral chest radiograph varies internationally and nationally across radiology departments and states in Australia. Search strategy: A search strategy of the databases Cochrane Library, Ovid Medline/Medline, PubMed, Scopus and Science Direct was conducted. The results were restricted to those published between 1985 and 2013 and those published in English. The following search terms were used: ‘lateral chest’, ‘radiograph’, ‘digital radiography’, ‘chest x-ray’, ‘plain film radiography’, ‘ionising radiation’. The results were restricted to publications with these terms in the title, abstract and/or keywords. Main findings: There are few national or international guidelines pertaining to the inclusion of the lateral chest x-ray as routine. Primary concerns are the increased radiation dose associated with the additional chest view and reduction of medical imaging services cost. Modern digital imaging systems result in a lower radiation dose. The diagnostic yield of the lateral chest x-ray is highly dependent on the clinical indications of the patient. Further research into the routine inclusion of the lateral chest x-ray is recommended. Conclusion: Review of the literature suggests that the lateral chest radiograph should not be performed routinely unless clinically indicated

Selective versus routine use of episiotomy for vaginal birth

Science.gov (United States)

Jiang, Hong; Qian, Xu; Carroli, Guillermo; Garner, Paul

2017-01-01

Background Some clinicians believe that routine episiotomy, a surgical cut of the vagina and perineum, will prevent serious tears during childbirth. On the other hand, an episiotomy guarantees perineal trauma and sutures. Objectives To assess the effects on mother and baby of a policy of selective episiotomy ('only if needed') compared with a policy of routine episiotomy ('part of routine management') for vaginal births. Search methods We searched Cochrane Pregnancy and Childbirth's Trials Register (14 September 2016) and reference lists of retrieved studies. Selection criteria Randomised controlled trials (RCTs) comparing selective versus routine use of episiotomy, irrespective of parity, setting or surgical type of episiotomy. We included trials where either unassisted or assisted vaginal births were intended. Quasi-RCTs, trials using a cross-over design or those published in abstract form only were not eligible for inclusion in this review. Data collection and analysis Two authors independently screened studies, extracted data, and assessed risk of bias. A third author mediated where there was no clear consensus. We observed good practice for data analysis and interpretation where trialists were review authors. We used fixed-effect models unless heterogeneity precluded this, expressed results as risk ratios (RR) and 95% confidence intervals (CI), and assessed the certainty of the evidence using GRADE. Main results This updated review includes 12 studies (6177 women), 11 in women in labour for whom a vaginal birth was intended, and one in women where an assisted birth was anticipated. Two were trials each with more than 1000 women (Argentina and the UK), and the rest were smaller (from Canada, Germany, Spain, Ireland, Malaysia, Pakistan, Columbia and Saudi Arabia). Eight trials included primiparous women only, and four trials were in both primiparous and multiparous women. For risk of bias, allocation was adequately concealed and reported in nine trials; sequence

Family routine moderates the relation between child impulsivity and oppositional defiant disorder symptoms.

Science.gov (United States)

Lanza, H Isabella; Drabick, Deborah A G

2011-01-01

Although child impulsivity is associated with oppositional defiant disorder (ODD) symptoms, few studies have examined whether family processes moderate this association. To address this gap, we tested whether child-reported family routine moderated the relation between child hyperactivity/impulsivity (HI) and ODD symptoms among a sample of low-income, urban, ethnic-minority children (N = 87, 51% male). Child HI and ODD symptoms were assessed using parent and teacher reports. HI also was indexed by a laboratory task. Family routine was assessed using child self-report. Hierarchical regression analyses indicated that family routine moderated child HI. Among children with higher levels of teacher-reported HI symptoms, lower levels of family routine were associated with higher levels of teacher-reported ODD symptoms compared to children with lower levels of teacher-reported HI symptoms. Children who self-reported higher levels of family routine were rated as low on teacher-reported ODD symptoms, regardless of teacher-reported HI levels. Parent report and laboratory measures of child HI did not produce significant interactions. Lower levels of family routine may confer risk for ODD symptoms among low-income, urban, ethnic-minority children experiencing higher levels of HI.

Parallel reduction to condensed forms for symmetric eigenvalue problems using aggregated fine-grained and memory-aware kernels

KAUST Repository

Haidar, Azzam

2011-01-01

This paper introduces a novel implementation in reducing a symmetric dense matrix to tridiagonal form, which is the preprocessing step toward solving symmetric eigenvalue problems. Based on tile algorithms, the reduction follows a two-stage approach, where the tile matrix is first reduced to symmetric band form prior to the final condensed structure. The challenging trade-off between algorithmic performance and task granularity has been tackled through a grouping technique, which consists of aggregating fine-grained and memory-aware computational tasks during both stages, while sustaining the application\\'s overall high performance. A dynamic runtime environment system then schedules the different tasks in an out-of-order fashion. The performance for the tridiagonal reduction reported in this paper is unprecedented. Our implementation results in up to 50-fold and 12-fold improvement (130 Gflop/s) compared to the equivalent routines from LAPACK V3.2 and Intel MKL V10.3, respectively, on an eight socket hexa-core AMD Opteron multicore shared-memory system with a matrix size of 24000×24000. Copyright 2011 ACM.

Master schedule for CY-1982 Hanford environmental surveillance routine program

International Nuclear Information System (INIS)

Blumer, P.J.; Sula, M.J.; Eddy, P.A.

1981-12-01

This report provides the current schedule of data collection for the routine environmental surveillance program at the Hanford Site. The environmental surveillance program objectives are to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5484.1. The routine sampling schedule provided does not include samples which are planned to be collected during FY-1982 in support of special studies or for quality control purposes. In addition, the routine program outlined in this schedule is subject to modification during the year in response to changes in Site operations, program requirements, or unusual sample results. Sampling schedules are presented for the following: air; Columbia River; sanitary water; surface water; ground water; foodstuffs; wildlife; soil and vegetation; external radiation measurements; portable instrument surveys; and surveillance of waste disposal sites

Factors Associated with Routine Dental Attendance among Aboriginal Australians.

Science.gov (United States)

Amarasena, Najith; Kapellas, Kostas; Skilton, Michael R; Maple-Brown, Louise J; Brown, Alex; Bartold, Mark; O'Dea, Kerin; Celermajer, David; Jamieson, Lisa M

2016-01-01

To determine factors associated with routine dental attendance in Aboriginal Australians. Data of 271 Aboriginal adults residing in Australia's Northern Territory were used. Routine dental attendance was defined as last visiting a dentist less than one year ago or visiting a dentist for a check-up. Both bivariate and multivariable analytical techniques were used. While 27% visited a dentist in the past year, 29% of these visited for a check-up. In bivariate analysis, being female, low psychological distress, and low clinical attachment loss (CAL) were associated with visiting a dentist within last year. Being aged younger than 39 years, male, no oral health impairment, being caries-free, low CAL, and low apolipoprotein B were associated with visiting for a check-up. Clinical attachment loss remained associated with visiting a dentist less than one year ago while being younger than 39 years and having no oral health impairment remained associated with usually visiting for a check-up in multivariable analysis. Younger age, no oral health impairment, and low CAL were associated with routine dental attendance among Indigenous Australians.

Epidural analgesia during labour, routinely or on request: a cost-effectiveness analysis.

Science.gov (United States)

Bonouvrié, Kimberley; van den Bosch, Anouk; Roumen, Frans J M E; van Kuijk, Sander M; Nijhuis, Jan G; Evers, Silvia M A A; Wassen, Martine M L H

2016-12-01

To assess the cost-effectiveness of routine labour epidural analgesia (EA), from a societal perspective, as compared with labour analgesia on request. Women delivering of a singleton in cephalic presentation beyond 36+0 weeks' gestation were randomly allocated to routine labour EA or analgesia on request in one university and one non-university teaching hospital in the Netherlands. Costs included all medical, non-medical and indirect costs from randomisation to 6 weeks postpartum. Effectiveness was defined as a non-operative, spontaneous vaginal delivery without EA-related maternal adverse effects. Incremental cost-effectiveness ratio (ICER) was defined as the ratio of the difference in costs and the difference in effectiveness between both groups. Data were analysed according to intention to treat and divided into a base case analysis and a sensitivity analysis. Total delivery costs in the routine EA group (n=233) were higher than in the labour on request group (n=255) (difference -€ 322, 95% CI -€ 60 to € 355) due to more medication costs (including EA), a longer stay in the labour ward, and more operations including caesarean sections. Total postpartum hospital costs in the routine EA group were lower (difference -€ 344, 95% CI -€ 1338 to € 621) mainly due to less neonatal admissions (difference -€ 472, 95% CI -€ 1297 to € 331), whereas total postpartum home and others costs were comparable (difference -€ 20, 95% CI -€ 267 to € 248, and -€ 1, 95% CI -€ 67 to € 284, respectively). As a result, the overall mean costs per woman were comparable between the routine EA group and the analgesia on request group (€ 8.708 and € 8.710, respectively, mean difference -€ 2, 95% CI -€ 1.012 to € 916). Routine labour EA resulted in more deliveries with maternal adverse effects, nevertheless the ICER remained low (€ 8; bootstrap 95% CI -€ 6.120 to € 8.659). The cost-effectiveness acceptability curve indicated a low probability that

Novel structuring routines of titania films for application in photovoltaics

OpenAIRE

Niedermeier, Martin A.

2014-01-01

Novel routines to structure titania thin films on various length scales are investigated regarding photovoltaic applications. The main focus of the investigations lies on the custom-tailoring of the morphologies of the titania films using sol-gel chemistry in combination with block copolymer templating. Additionally, a low-temperature routine for functional hybrid films as well as the growth of gold as electrode material on top of an organic hole-conductor are investigated. Im Hinblick auf...

Radioprotective shield - an adequate radioprotective device for routine stomatological radiodiagnosis

Energy Technology Data Exchange (ETDEWEB)

Wiltschke, F [Ernst-Moritz-Arndt-Univ., Greifswald (German Democratic Republic); Taschner, P; Koenig, W; Menzel, B [Staatliches Amt fuer Atomsicherheit und Strahlenschutz, Berlin (German Democratic Republic)

1975-01-01

Starting from the shortcomings of the radioprotective devices at present used in routine stomatological radiodiagnosis, the authors describe the advantages of a radioprotective shield which has been produced in the Greifswald University Stomatological Clinic. On the basis of dosimetric studies, the National Board for Nuclear Safety and Radiological Protection of the GDR (Staatliches Amt fuer Atomsicherheit und Strahlenschutz der DDR) could demonstrate the suitability of this shield as a radioprotective device for routine stomatological radiodiagnosis.

Acceptability of routine offer of HIV testing (opt-out approach) among ...

African Journals Online (AJOL)

Background: With the introduction of the opt out HIV testing policy in Ghana, the HIV test is offered routinely to all pregnant women unless they decline testing. Objective: To assess acceptability of the routine offer of HIV testing antenatal clinic (ANC) clients in the Wa municipality, Ghana. Design: Cross-sectional study of 270 ...

The Surgical Teams' Perception of the Effects of a Routine Intraoperative Pause.

Science.gov (United States)

Erestam, Sofia; Angenete, Eva; Derwinger, Kristoffer

2016-12-01

A pause routine may reduce stress and errors during surgery. The aim of this study was to explore how the team, divided into the different professional groups, perceived the implementation of a pause routine and its possible impact on safety. A pause routine was introduced at a University hospital operating theatre in Sweden in 2013. Questionnaires were distributed about 1 year later to all members of the operating theatre team. The questions included different perspectives of possible effects of the pause routine. A majority were positive to scheduled pauses. The surgeons often felt refreshed and at times changed their view on both anatomy and their surgical strategy. They were also perceived by other team members as improved regarding communication. All groups felt that patient safety was promoted. There were differences by profession in perception of team communication. The pause routine was well perceived by the surgical team. A majority believed that scheduled and regular pauses contribute to improved patient safety and better team communication. There were also findings of differences in communication and experience of team coherence between personnel categories that could benefit from further acknowledgement and exploration.

You don't have to believe everything you read: background knowledge permits fast and efficient validation of information.

Science.gov (United States)

Richter, Tobias; Schroeder, Sascha; Wöhrmann, Britta

2009-03-01

In social cognition, knowledge-based validation of information is usually regarded as relying on strategic and resource-demanding processes. Research on language comprehension, in contrast, suggests that validation processes are involved in the construction of a referential representation of the communicated information. This view implies that individuals can use their knowledge to validate incoming information in a routine and efficient manner. Consistent with this idea, Experiments 1 and 2 demonstrated that individuals are able to reject false assertions efficiently when they have validity-relevant beliefs. Validation processes were carried out routinely even when individuals were put under additional cognitive load during comprehension. Experiment 3 demonstrated that the rejection of false information occurs automatically and interferes with affirmative responses in a nonsemantic task (epistemic Stroop effect). Experiment 4 also revealed complementary interference effects of true information with negative responses in a nonsemantic task. These results suggest the existence of fast and efficient validation processes that protect mental representations from being contaminated by false and inaccurate information.

performance routines followed by free throw shooting accuracy in secondary basketball players

Directory of Open Access Journals (Sweden)

Phelps Ashley

2015-12-01

Full Text Available Study aim: The purpose of the current study was to determine whether existing pre-performance routines had an effect on free throw shooting accuracy in high school pupils as compared to shooting without a pre-performance routine.

Bayesian estimation of test characteristics of real-time PCR, bacteriological culture and California mastitis test for diagnosis of intramammary infections with Staphylococcus aureus in dairy cattle at routine milk recordings

DEFF Research Database (Denmark)

Mahmmod, Yasser; Toft, Nils; Katholm, Jørgen

2013-01-01

Danish farmers can order a real-time PCR mastitis diagnostic test on routinely takencow-level samples from milk recordings. Validation of its performance in comparison toconventional mastitis diagnostics under field conditions is essential for efficient control ofintramammary infections (IMI......) with Staphylococcus aureus (S. aureus). Therefore, the objec-tive of this study was to estimate the sensitivity (Se) and specificity (Sp) of real-time PCR,bacterial culture (BC) and California mastitis test (CMT) for the diagnosis of the naturallyoccurring IMI with S. aureus in routinely collected milk samples using...... latent class anal-ysis (LCA) to avoid the assumption of a perfect reference test. Using systematic randomsampling, a total of 609 lactating dairy cows were selected from 6 dairy herds with bulktank milk PCR cycle threshold (Ct) value ≤39 for S. aureus. At routine milk recordings, auto-matically obtained...

Cyclotrons, radionuclides, precursors, and demands for routine versus research compounds

International Nuclear Information System (INIS)

Wolf, A.P.

1984-01-01

Accelerators for producing commonly used short-lived positron emitters for positron emission tomography are addressed in the context of their use for the preparation of labeled compounds for research and routine biomedical applications. Progress and direction in the preparation and use of radiotracers for studies of the brain are discussed. Advancement to complete automation is stressed as an important factor for the eventual use of positron emission tomography as a routine clinical tool in universities and major medical centers

Age at BCG administration during routine immunization.

African Journals Online (AJOL)

Age at BCG administration during routine immunization. R.D. Wammanda , M.J. Gambo and I. Abdulkadir. Department of Paediatrics,. Ahmadu Bello University Teaching Hospital,. Zaria. Correspondence to: Dr.R.D. Wammanda. Email: wammanda@yahoo.com. Summary. In Nigeria, as part of the National Programme on ...

Community Pharmacies As Possible Centres For Routine ...

African Journals Online (AJOL)

Method: Sixty (60) pre-tested questionnaires were randomly administered to community pharmacists. Forty-three (43) questionnaires were retrieved for analysis. Results: The study revealed that the use of community pharmacies as places where routine immunization services can be provided is feasible as shown by 95.3% ...

Individual Values, Learning Routines and Academic Procrastination

Science.gov (United States)

Dietz, Franziska; Hofer, Manfred; Fries, Stefan

2007-01-01

Background: Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. Aims: The…

Interval of Routine Maintenance and Maintenance Performance: A Literature Review

Directory of Open Access Journals (Sweden)

Au-Yong Cheong Peng

2016-01-01

Full Text Available In high-rise residential buildings, the quality of facilities management services is significant to the normal operation of the facilities. Unfortunately, lack of concern towards building maintenance, especially preventive maintenance, happens in domestic housing industry in Malaysia. Majority of the maintenance operations of condominiums suffer from lack of planning, lack of proactive maintenance plan, and lack of proper implementation. Thus, this paper reviews the implementation of preventive maintenance strategy, routine maintenance in specific. An extensive review of literature published in 1987 to 2014 is performed for the purpose of this research. The publications are sourced from journal articles, conference proceedings and books. The literature analysis confirms that the routine maintenance of facilities and building services is vital and it can be influential towards the maintenance performance. Subsequently, a theoretical framework is developed, which shows the relationship between routine maintenance of building facilities & services and maintenance performance. The building facilities & services are divided into two categories. They are essential facilities & services that ensure the safety, health, habitability, and operability of buildings; while value-added facilities & services deal with property value, return on investment, and quality living of buildings. Based on the findings, a future research is proposed, which aims to identify the appropriate routine of maintenance for the facilities and services in high-rise residential buildings to improve the maintenance performance.

Improved Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway

Science.gov (United States)

2010-01-15

information. 2.0 DESCRIPTION Naval Submarine Medical Research Laboratory (NSMRL) is seeking information from the eyewear industry that will provide...Improved Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway by Alison America, MA Wayne G. Horn, MD...Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway 50818 Alison America, MA Wayne G. Horn, MD Naval Submarine Medical Research

Unified Access Architecture for Large-Scale Scientific Datasets

Science.gov (United States)

Karna, Risav

2014-05-01

Data-intensive sciences have to deploy diverse large scale database technologies for data analytics as scientists have now been dealing with much larger volume than ever before. While array databases have bridged many gaps between the needs of data-intensive research fields and DBMS technologies (Zhang 2011), invocation of other big data tools accompanying these databases is still manual and separate the database management's interface. We identify this as an architectural challenge that will increasingly complicate the user's work flow owing to the growing number of useful but isolated and niche database tools. Such use of data analysis tools in effect leaves the burden on the user's end to synchronize the results from other data manipulation analysis tools with the database management system. To this end, we propose a unified access interface for using big data tools within large scale scientific array database using the database queries themselves to embed foreign routines belonging to the big data tools. Such an invocation of foreign data manipulation routines inside a query into a database can be made possible through a user-defined function (UDF). UDFs that allow such levels of freedom as to call modules from another language and interface back and forth between the query body and the side-loaded functions would be needed for this purpose. For the purpose of this research we attempt coupling of four widely used tools Hadoop (hadoop1), Matlab (matlab1), R (r1) and ScaLAPACK (scalapack1) with UDF feature of rasdaman (Baumann 98), an array-based data manager, for investigating this concept. The native array data model used by an array-based data manager provides compact data storage and high performance operations on ordered data such as spatial data, temporal data, and matrix-based data for linear algebra operations (scidbusr1). Performances issues arising due to coupling of tools with different paradigms, niche functionalities, separate processes and output

Artificial intelligence aid to efficient plant operations

International Nuclear Information System (INIS)

Wildberger, A.M.; Pack, R.W.

1987-01-01

As the nuclear power industry matures, it is becoming more and more important that plants be operated in an efficient, cost-effective manner, without, of course, any decrease in the essential margins of safety. Indeed, most opportunities for improved efficiency have little or no relation to nuclear safety, but are based on trade-offs among operator controllable parameters both within and external to the reactor itself. While these trade-offs are describable in terms of basic physical theory, thermodynamics, and the mathematics of control systems, their actual application is highly plant specific and influenced even by the day-to-day condition of the various plant components. This paper proposes the use of artificial intelligence techniques to construct a computer-based expert assistant to the plant operator for the purpose of aiding him in improving the efficiency of plant operation on a routine basis. The proposed system, which only advises the human operator, seems more amenable to the current regulatory approach than a truly automated control system even if the latter provides for manual override

Routine chest X-ray in the allergy clinic

International Nuclear Information System (INIS)

Garcia-Barredo, M.R.; Usamentiaga, E.; Fidalgo, I.

1997-01-01

To determine whether routine chest X-ray is indicated in allergy patients when there is no evidence of cardiopulmonary involvement. A retrospective study to analyze the indications and radiologic findings in 515 consecutive patients who underwent chest X-ray: Positive findings were considered to be any radiological sing that led to the performance of additional diagnostic measures or a change in the therapeutic management of the patient. Positive radiologic findings were observed in 39 cases (7.59%). Only two patients (0.38%) were diagnosed as having diseases that were susceptible to proper treatment. In one of them (0.19%), the failure to perform chest X-ray would have impeded the introduction of proper treatment. We do not recommend carrying out routine chest X-ray in this patient population. (Author) 7 refs

SVM detection of epileptiform activity in routine EEG.

LENUS (Irish Health Repository)

Kelleher, Daniel

2010-01-01

Routine electroencephalogram (EEG) is an important test in aiding the diagnosis of patients with suspected epilepsy. These recordings typically last 20-40 minutes, during which signs of abnormal activity (spikes, sharp waves) are looked for in the EEG trace. It is essential that events of short duration are detected during the routine EEG test. The work presented in this paper examines the effect of changing a range of input values to the detection system on its ability to distinguish between normal and abnormal EEG activity. It is shown that the length of analysis window in the range of 0.5s to 1s are well suited to the task. Additionally, it is reported that patient specific systems should be used where possible due to their better performance.

Implementation of a physically based water percolation routine in the Crocus/SURFEX (V7.3 snowpack model

Directory of Open Access Journals (Sweden)

C. J. L. D'Amboise

2017-09-01

Full Text Available We present a new water percolation routine added to the one-dimensional snowpack model Crocus as an alternative to the empirical bucket routine. This routine solves the Richards equation, which describes flow of water through unsaturated porous snow governed by capillary suction, gravity and hydraulic conductivity of the snow layers. We tested the Richards routine on two data sets, one recorded from an automatic weather station over the winter of 2013–2014 at Filefjell, Norway, and the other an idealized synthetic data set. Model results using the Richards routine generally lead to higher water contents in the snow layers. Snow layers often reached a point at which the ice crystals' surface area is completely covered by a thin film of water (the transition between pendular and funicular regimes, at which feedback from the snow metamorphism and compaction routines are expected to be nonlinear. With the synthetic simulation 18 % of snow layers obtained a saturation of  >  10 % and 0.57 % of layers reached saturation of  >  15 %. The Richards routine had a maximum liquid water content of 173.6 kg m−3 whereas the bucket routine had a maximum of 42.1 kg m−3. We found that wet-snow processes, such as wet-snow metamorphism and wet-snow compaction rates, are not accurately represented at higher water contents. These routines feed back on the Richards routines, which rely heavily on grain size and snow density. The parameter sets for the water retention curve and hydraulic conductivity of snow layers, which are used in the Richards routine, do not represent all the snow types that can be found in a natural snowpack. We show that the new routine has been implemented in the Crocus model, but due to feedback amplification and parameter uncertainties, meaningful applicability is limited. Updating or adapting other routines in Crocus, specifically the snow compaction routine and the grain metamorphism routine, is needed

Routine hemoglobin electrophoresis for pediatric surgery day case ...

African Journals Online (AJOL)

2015-09-25

Sep 25, 2015 ... 2016 Nigerian Journal of Clinical Practice | Published by Wolters Kluwer - Medknow ... surgery day case in at-risk populations: Suggested algorithm for screening .... HBE is a routine preoperative investigation before a surgical ...

Widely applicable MATLAB routines for automated analysis of saccadic reaction times.

Science.gov (United States)

Leppänen, Jukka M; Forssman, Linda; Kaatiala, Jussi; Yrttiaho, Santeri; Wass, Sam

2015-06-01

Saccadic reaction time (SRT) is a widely used dependent variable in eye-tracking studies of human cognition and its disorders. SRTs are also frequently measured in studies with special populations, such as infants and young children, who are limited in their ability to follow verbal instructions and remain in a stable position over time. In this article, we describe a library of MATLAB routines (Mathworks, Natick, MA) that are designed to (1) enable completely automated implementation of SRT analysis for multiple data sets and (2) cope with the unique challenges of analyzing SRTs from eye-tracking data collected from poorly cooperating participants. The library includes preprocessing and SRT analysis routines. The preprocessing routines (i.e., moving median filter and interpolation) are designed to remove technical artifacts and missing samples from raw eye-tracking data. The SRTs are detected by a simple algorithm that identifies the last point of gaze in the area of interest, but, critically, the extracted SRTs are further subjected to a number of postanalysis verification checks to exclude values contaminated by artifacts. Example analyses of data from 5- to 11-month-old infants demonstrated that SRTs extracted with the proposed routines were in high agreement with SRTs obtained manually from video records, robust against potential sources of artifact, and exhibited moderate to high test-retest stability. We propose that the present library has wide utility in standardizing and automating SRT-based cognitive testing in various populations. The MATLAB routines are open source and can be downloaded from http://www.uta.fi/med/icl/methods.html .

Peri-colonic haematoma following routine colonoscopy

OpenAIRE

Felicity Page; Olfunso Adedeji

2016-01-01

Introduction: We present a case of an extra-luminal haematoma following routine colonoscopy. This case highlights an uncommon but potentially life threatening complication in which there is little published literature to date. Presentation of case: A 73 year old male presented with abdominal pain and a reduction in haemoglobin following an uneventful colonoscopy. The imaging had been required as part of colorectal cancer follow up. Initial differential diagnosis included colonic perforatio...

Tools for Predicting Cleaning Efficiency in the LHC

CERN Document Server

Assmann, R W; Brugger, M; Hayes, M; Jeanneret, J B; Kain, V; Kaltchev, D I; Schmidt, F

2003-01-01

The computer codes SIXTRACK and DIMAD have been upgraded to include realistic models of proton scattering in collimator jaws, mechanical aperture restrictions, and time-dependent fields. These new tools complement long-existing simplified linear tracking programs used up to now for tracking with collimators. Scattering routines from STRUCT and K2 have been compared with one another and the results have been cross-checked to the FLUKA Monte Carlo package. A systematic error is assigned to the predictions of cleaning efficiency. Now, predictions of the cleaning efficiency are possible with a full LHC model, including chromatic effects, linear and nonlinear errors, beam-beam kicks and associated diffusion, and time-dependent fields. The beam loss can be predicted around the ring, both for regular and irregular beam losses. Examples are presented.

The Yield from Routine Chest X-Rays in Stage 3 Breast Cancer ...

African Journals Online (AJOL)

Context: Cancer of the breast is a common malignancy in Nigerian women and various imaging examinations, including the chest radiograph are routinely requested in all patients with this disease. Objective: The objective of this study was to determine the positive yield from routine chest radiographs in Nigerian patients ...

Use of WGS in Mycobacterium tuberculosis routine diagnosis

Directory of Open Access Journals (Sweden)

Daniela M Cirillo

2016-01-01

Conclusion: WGS is a rapid, cost-effective technique that promises to integrate and replace the other tests in routine laboratories for an accurate diagnosis of DR-TB, although it is suitable nowadays for cultured samples only.

Improving the Efficiency of Organic Solar Cells upon Addition of Polyvinylpyridine

Directory of Open Access Journals (Sweden)

Rita Rodrigues

2014-12-01

Full Text Available We report on the efficiency improvement of organic solar cells (OPVs based on the low energy gap polyfluorene derivative, APFO-3, and the soluble C60 fullerene PCBM, upon addition of a residual amount of poly (4-vinylpyridine (PVP. We find that the addition of 1% by weight of PVP with respect to the APFO-3 content leads to an increase of efficiency from 2.4% to 2.9%. Modifications in the phase separation details of the active layer were investigated as a possible origin of the efficiency increase. At high concentrations of PVP, the blend morphology is radically altered as observed by Atomic Force Microscopy. Although the use of low molecular weight additives is a routine method to improve OPVs efficiency, this report shows that inert polymers, in terms of optical and charge transport properties, may also improve the performance of polymer-based solar cells.

32 CFR 318.14 - Blanket routine uses.

Science.gov (United States)

2010-07-01

... interest of simplicity, economy and to avoid redundancy. (b) Routine Use—Law Enforcement. If a system of... to the OMB in connection with the review of private relief legislation as set forth in OMB Circular A-19 at any stage of the legislative coordination and clearance process as set forth in that Circular...

Cost of intensive routine control and incremental cost of insecticide-treated curtain deployment in a setting with low Aedes aegypti infestation

Directory of Open Access Journals (Sweden)

Alberto Baly

Full Text Available Abstract: INTRODUCTION Information regarding the cost of implementing insecticide-treated curtains (ITCs is scarce. Therefore, we evaluated the ITC implementation cost, in addition to the costs of intensive conventional routine activities of the Aedes control program in the city of Guantanamo, Cuba. METHODS A cost-analysis study was conducted from the perspective of the Aedes control program, nested in an ITC effectiveness trial, during 2009-2010. Data for this study were obtained from bookkeeping records and activity registers of the Provincial Aedes Control Programme Unit and the account records of the ITC trial. RESULTS The annual cost of the routine Aedes control program activities was US$16.80 per household (p.h. Among 3,015 households, 6,714 ITCs were distributed. The total average cost per ITC distributed was US$3.42, and 74.3% of this cost was attributed to the cost of purchasing the ITCs. The annualized costs p.h. of ITC implementation was US$3.80. The additional annualized cost for deploying ITCs represented 19% and 48.4% of the total cost of the routine Aedes control and adult-stage Aedes control programs, respectively. The trial did not lead to further reductions in the already relatively low Aedes infestation levels. CONCLUSIONS At current curtain prices, ITC deployment can hardly be considered an efficient option in Guantanamo and other comparable environments.

Cost of intensive routine control and incremental cost of insecticide-treated curtain deployment in a setting with low Aedes aegypti infestation.

Science.gov (United States)

Baly, Alberto; Toledo, Maria Eugenia; Lambert, Isora; Benítez, Elizabeth; Rodriguez, Karina; Rodriguez, Esther; Vanlerberghe, Veerle; Stuyft, Patrick Van der

2016-01-01

Information regarding the cost of implementing insecticide-treated curtains (ITCs) is scarce. Therefore, we evaluated the ITC implementation cost, in addition to the costs of intensive conventional routine activities of the Aedes control program in the city of Guantanamo, Cuba. A cost-analysis study was conducted from the perspective of the Aedes control program, nested in an ITC effectiveness trial, during 2009-2010. Data for this study were obtained from bookkeeping records and activity registers of the Provincial Aedes Control Programme Unit and the account records of the ITC trial. The annual cost of the routine Aedes control program activities was US$16.80 per household (p.h). Among 3,015 households, 6,714 ITCs were distributed. The total average cost per ITC distributed was US$3.42, and 74.3% of this cost was attributed to the cost of purchasing the ITCs. The annualized costs p.h. of ITC implementation was US$3.80. The additional annualized cost for deploying ITCs represented 19% and 48.4% of the total cost of the routine Aedes control and adult-stage Aedes control programs, respectively. The trial did not lead to further reductions in the already relatively low Aedes infestation levels. At current curtain prices, ITC deployment can hardly be considered an efficient option in Guantanamo and other comparable environments.

Identification of fall predictors in the active elderly population from the routine medical records of general practitioners.

Science.gov (United States)

Lastrucci, Vieri; Lorini, Chiara; Rinaldi, Giada; Bonaccorsi, Guglielmo

2018-03-01

Aim To evaluate the possibility of determining predictors of falls in the active community-dwelling elderly from the routine medical records of the general practitioners (GPs). Time constraints and competing demands in the clinical encounters frequently undermine fall-risk evaluation. In the context of proactive primary healthcare, quick, and efficient tools for a preliminary fall-risk assessment are needed in order to overcome these barriers. The study included 1220 subjects of 65 years of age or older. Data were extracted from the GPs' patient records. For each subject, the following variables were considered: age, gender, diseases, and pharmacotherapy. Univariate and multivariable analyses have been conducted to identify the independent predictors of falls. Findings The mean age of the study population was 77.8±8.7 years for women and 74.9±7.3 years for men. Of the sample, 11.6% had experienced one or more falls in the previous year. The risk of falling was found to increase significantly (P<0.05) with age (OR=1.03; 95% CI=1.01-1.05), generalized osteoarthritis (OR=2.01; 95% CI=1.23-3.30), tinnitus (OR=4.14; 95% CI=1.25-13.74), cognitive impairment (OR=4.12; 95% CI=2.18-7.80), and two or more co-existing diseases (OR=5.4; 95% CI=1.68-17.39). Results suggest that it is possible to identify patients at higher risk of falling by going through the current medical records, without adding extra workload on the health personnel. In the context of proactive primary healthcare, the analysis of fall predictors from routine medical records may allow the identification of which of the several known and hypothesized risk factors may be more relevant for developing quick and efficient tools for a preliminary fall-risk assessment.

Taking a new biomarker into routine use – A perspective from the routine clinical biochemistry laboratory

Science.gov (United States)

Sturgeon, Catharine; Hill, Robert; Hortin, Glen L; Thompson, Douglas

2010-01-01

There is increasing pressure to provide cost-effective healthcare based on “best practice.” Consequently, new biomarkers are only likely to be introduced into routine clinical biochemistry departments if they are supported by a strong evidence base and if the results will improve patient management and outcome. This requires convincing evidence of the benefits of introducing the new test, ideally reflected in fewer hospital admissions, fewer additional investigations and/or fewer clinic visits. Carefully designed audit and cost-benefit studies in relevant patient groups must demonstrate that introducing the biomarker delivers an improved and more effective clinical pathway. From the laboratory perspective, pre-analytical requirements must be thoroughly investigated at an early stage. Good stability of the biomarker in relevant physiological matrices is essential to avoid the need for special processing. Absence of specific timing requirements for sampling and knowledge of the effect of medications that might be used to treat the patients in whom the biomarker will be measured is also highly desirable. Analytically, automation is essential in modern high-throughput clinical laboratories. Assays must therefore be robust, fulfilling standard requirements for linearity on dilution, precision and reproducibility, both within- and between-run. Provision of measurements by a limited number of specialized reference laboratories may be most appropriate, especially when a new biomarker is first introduced into routine practice. PMID:21137030

The Efficiency of Freedom

DEFF Research Database (Denmark)

Østergaard Madsen, Christian; Kræmmergaard, Pernille

2015-01-01

-government and traditional channels are often used simultaneously, and citizens’ perceptions and previous histories with public authorities influence channel choice. Further, citizens’ existing routines related to third-party non-official channels also influence their interaction with public authorities. Moreover, we find......The Danish e-government strategy aims to increase the efficiency of public sector administration by making e-government channels mandatory for citizens by 2015. Although Danish citizens have adopted e-government channels to interact with public authorities, many also keep using traditional channels....... Previous studies have analyzed citizens’ channel choice in non-mandatory settings, and mostly surrounding a single isolated channel. To cover these gaps we present a mixed method study of citizens’ actual use of e-government channels using domestication theory as our framework. Our findings indicate that e...

Verification and quality control of routine hematology analyzers

NARCIS (Netherlands)

Vis, J Y; Huisman, A

2016-01-01

Verification of hematology analyzers (automated blood cell counters) is mandatory before new hematology analyzers may be used in routine clinical care. The verification process consists of several items which comprise among others: precision, accuracy, comparability, carryover, background and

Factors related to pain during routine photodynamic therapy

DEFF Research Database (Denmark)

Miller, I M; Nielsen, J S; Lophaven, S

2011-01-01

between pain-reducing intervention and diagnosis, pre-treatment, gender or age was found. CONCLUSIONS: Pain-reducing intervention was required in 44% of the PDT treatments. Intervention was particularly required when treating lesions in areas suited for PDT therapy for cosmetic reasons such as the scalp......BACKGROUND: Pain may be a limiting factor in the use of photodynamic therapy (PDT). The consequences of the pain i.e. the resources spent on pain-intervention during routine PDT therapy are poorly described. OBJECTIVES: To describe the consequences of pain during PDT by describing the use of pain......-reducing interventions in routine use. We studied the frequency as well as level of pain-reducing intervention. METHODS: Descriptive data from PDT treated patients. The level of pain-reducing intervention was graded 0, no intervention; +, cold water spray and ++, pause or nerve block. RESULTS: Data from 983 PDT...

"How Was Your Weekend?": Developing the Interactional Competence in Managing Routine Inquiries

Science.gov (United States)

Waring, Hansun Zhang

2013-01-01

Given the cross-cultural differences underlying interactional routines such as "How are you?" or "How was your weekend?", managing such routine inquiries can be problematic for second language learners. Based on data from an adult ESL (English as a second language) class, this conversation analytic study shows how learners develop their competence…

Socioeconomic Segregation of Activity Spaces in Urban Neighborhoods: Does Shared Residence Mean Shared Routines?

Directory of Open Access Journals (Sweden)

Christopher R. Browning

2017-02-01

Full Text Available Residential segregation by income and education is increasing alongside slowly declining black-white segregation. Segregation in urban neighborhood residents’ nonhome activity spaces has not been explored. How integrated are the daily routines of people who live in the same neighborhood? Are people with different socioeconomic backgrounds that live near one another less likely to share routine activity locations than those of similar education or income? Do these patterns vary across the socioeconomic continuum or by neighborhood structure? The analyses draw on unique data from the Los Angeles Family and Neighborhood Survey that identify the location where residents engage in routine activities. Using multilevel p2 (network models, we analyze pairs of households in the same neighborhood and examine whether the dyad combinations across three levels of SES conduct routine activities in the same location, and whether neighbor socioeconomic similarity in the co-location of routine activities is dependent on the level of neighborhood socioeconomic inequality and trust. Results indicate that, on average, increasing SES diminishes the likelihood of sharing activity locations with any SES group. This pattern is most pronounced in neighborhoods characterized by high levels of socioeconomic inequality. Neighborhood trust explains a nontrivial proportion of the inequality effect on the extent of routine activity sorting by SES. Thus stark, visible neighborhood-level inequality by SES may lead to enhanced effects of distrust on the willingness to share routines across class.

[Use of routine data from statutory health insurances for federal health monitoring purposes].

Science.gov (United States)

Ohlmeier, C; Frick, J; Prütz, F; Lampert, T; Ziese, T; Mikolajczyk, R; Garbe, E

2014-04-01

Federal health monitoring deals with the state of health and the health-related behavior of populations and is used to inform politics. To date, the routine data from statutory health insurances (SHI) have rarely been used for federal health monitoring purposes. SHI routine data enable analyses of disease frequency, risk factors, the course of the disease, the utilization of medical services, and mortality rates. The advantages offered by SHI routine data regarding federal health monitoring are the intersectoral perspective and the nearly complete absence of recall and selection bias in the respective population. Further, the large sample sizes and the continuous collection of the data allow reliable descriptions of the state of health of the insurants, even in cases of multiple stratification. These advantages have to be weighed against disadvantages linked to the claims nature of the data and the high administrative hurdles when requesting the use of SHI routine data. Particularly in view of the improved availability of data from all SHI insurants for research institutions in the context of the "health-care structure law", SHI routine data are an interesting data source for federal health monitoring purposes.

Practical issues in implementing whole-genome-sequencing in routine diagnostic microbiology.

Science.gov (United States)

Rossen, J W A; Friedrich, A W; Moran-Gilad, J

2018-04-01

Next generation sequencing (NGS) is increasingly being used in clinical microbiology. Like every new technology adopted in microbiology, the integration of NGS into clinical and routine workflows must be carefully managed. To review the practical aspects of implementing bacterial whole genome sequencing (WGS) in routine diagnostic laboratories. Review of the literature and expert opinion. In this review, we discuss when and how to integrate whole genome sequencing (WGS) in the routine workflow of the clinical laboratory. In addition, as the microbiology laboratories have to adhere to various national and international regulations and criteria for their accreditation, we deliberate on quality control issues for using WGS in microbiology, including the importance of proficiency testing. Furthermore, the current and future place of this technology in the diagnostic hierarchy of microbiology is described as well as the necessity of maintaining backwards compatibility with already established methods. Finally, we speculate on the question of whether WGS can entirely replace routine microbiology in the future and the tension between the fact that most sequencers are designed to process multiple samples in parallel whereas for optimal diagnosis a one-by-one processing of the samples is preferred. Special reference is made to the cost and turnaround time of WGS in diagnostic laboratories. Further development is required to improve the workflow for WGS, in particular to shorten the turnaround time, reduce costs, and streamline downstream data analyses. Only when these processes reach maturity will reliance on WGS for routine patient management and infection control management become feasible, enabling the transformation of clinical microbiology into a genome-based and personalized diagnostic field. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Implementation of Health Information Technology in Routine Care for Fibromyalgia: Pilot Study.

Science.gov (United States)

Sparks, Toni; Kawi, Jennifer; Menzel, Nancy Nivison; Hartley, Kendall

2016-02-01

Fibromyalgia management remains complicated and challenging. Health information technology is an evidence-based, nonpharmacological self and symptom management strategy, but few studies have evaluated its feasibility for managing fibromyalgia patients in clinical practice. FibroGuide is an example of an evidence-based, interactive, and computer-based program comprised of 10 educational modules on fibromyalgia. Study aims were to: (1) develop a process for implementing FibroGuide into the routine care of patients with fibromyalgia, (2) evaluate the overall impact on fibromyalgia before and after a 12-week implementation, and (3) assess patient perspectives on using FibroGuide health information technology to assist in self-management. In this pilot study, 35 participants with fibromyalgia were recruited from an Advanced Practice Registered Nurse's outpatient clinic. Using a descriptive design, quantitative data analysis was employed to address study aims. Based on data collection pre- and post-intervention using paired samples testing, a statistically significant change (p = .017) was observed in overall fibromyalgia impact (improved symptom severity, activity, and function). Majority felt that FibroGuide was helpful as part of their routine care, and nearly half reported that it assisted in their self-management. Although 65% noted that technology was an effective and efficient way to receive education for fibromyalgia management, 57% preferred talking to healthcare providers. Larger longitudinal studies are needed on the use of health information technology in fibromyalgia, evaluating both statistical and clinical significance, while decreasing barriers to participant use for this promising adjunct to clinical management. Providers need to be well educated on supporting self-management strategies and health information technology. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Accuracy and Quality of Routine Immunisation Data Monitoring ...

African Journals Online (AJOL)

TNHJOURNALPH

Accuracy and Quality of Routine Immunisation Data Monitoring. System in two South-Eastern Districts of Nigeria. AkinolaAyoola Fatiregun, CeciliaAwogu. Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of. Medicine, University ofibadan, Ibadan, Nigeria. ABSTRACT. BACKGROUND.

Implementing a routine, voluntary HIV testing program in a Massachusetts county prison.

Science.gov (United States)

Liddicoat, Rebecca V; Zheng, Hui; Internicola, Jeanne; Werner, Barbara G; Kazianis, Arthur; Golan, Yoav; Rubinstein, Eric P; Freedberg, Kenneth A; Walensky, Rochelle P

2006-11-01

Although U.S. prison inmates have higher rates of HIV infection than the general population, most inmates are not routinely tested for HIV infection at prison entry. The study objective was to implement a routine, voluntary HIV testing program in a Massachusetts county prison. During admission, inmates were given group HIV pre-test counseling and were subsequently offered private HIV testing. This intervention was compared to a control period during which HIV testing was provided only upon inmate or physician request. Between November 2004 and April 2005, 1,004 inmates met inclusion criteria and were offered routine, voluntary HIV testing. Of these, 734 (73.1%) accepted, 2 (0.3%) were HIV-infected, and 457 (45.5%) had been tested for HIV in the previous year. The testing rate of 73.1% was significantly increased from the rate of 18.0% (318 of 1,723) during the control period (pprison setting. Careful attention should be paid to prevent redundancy of testing efforts in the prison population. Implementing a routine HIV testing program among prison inmates greatly increased testing rates compared to on-request testing.

Measuring anteversion in the femoral neck from routine radiographs

International Nuclear Information System (INIS)

Hermann, K.L.; Egund, N.

1998-01-01

Purpose: To describe a new method for measuring femoral neck anteversion (FNA) that requires only one lateral radiograph of the knee in addition to routine radiographs of the hip for evaluation of total hip replacement; and to compare the proposed method with FNA measurement by means of 3D CT. Material and Methods: In 18 femoral specimens, radiographic examinations of the hip and knee, in three different rotational positions, and one CT examination were made, and the measurements of FNA were compared. Similarly, in 38 patients with 40 total hip replacements, measurements form routine radiographic examinations of the hip and knee and from CT examinations were compared. The accuracy and reproducibility of the FNA measurements produced by this proposed method were calculated. Results: Accuracy and reproducibility were 2 and 2 for the proposed method in the femoral specimen study, and accuracy was 4 in the hip patient study. The proposed method had a minor flaw that was caused almost solely by differences in knee size at inward rotation of the femur. Conclusion: FNA measurement can be made from a routine radiographic examination of the hip and a lateral view of the knee. This method achieves an acceptable level of accuracy and reproducibility. (orig.)

The 9 to 5 routine: advancing the understanding of occupational transition for new immigrants.

Science.gov (United States)

Movsessian, Yeraz

2013-01-01

This paper offers a reflection on temporal routines that underscore daily work life and work transitions. This reflection includes views of a Canadian student who examines work transitions through lived experiences and observation of the Chilean work/home routine. A narrative reflection on lived experience is used to examine 9 to 5 work transitions. There is a blending of work and daily life routines that provide a balance for workers in Chile and there are differences across countries in the valuing of work and daily life routines. Narrative reflections about work and work transitions can highlight differences at the macro level that can yield personal insights into challenges in transitioning into work for new immigrants.

Master schedule for CY-1984 Hanford environmental surveillance routine sampling program

International Nuclear Information System (INIS)

Blumer, P.J.; Price, K.R.; Eddy, P.A.; Carlile, J.M.V.

1983-12-01

This report provides the current schedule of data collection for the routine Hanford environmental surveillance and ground-water Monitoring Programs at the Hanford Site. The purpose is to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs. The routine sampling schedule provided herein does not include samples that are planned to be collected during FY-1984 in support of special studies, special contractor support programs, or for quality control purposes

Clinical relevance of routinely measured vital signs in hospitalized patients: a systematic review

NARCIS (Netherlands)

Storm-Versloot, Marja N.; Verweij, Lotte; Lucas, Cees; Ludikhuize, Jeroen; Goslings, J. Carel; Legemate, Dink A.; Vermeulen, Hester

2014-01-01

Conflicting evidence exists on the effectiveness of routinely measured vital signs on the early detection of increased probability of adverse events. To assess the clinical relevance of routinely measured vital signs in medically and surgically hospitalized patients through a systematic review.

The cost of routine Aedes aegypti control and of insecticide-treated curtain implementation.

Science.gov (United States)

Baly, Alberto; Flessa, Steffen; Cote, Marilys; Thiramanus, Thirapong; Vanlerberghe, Veerle; Villegas, Elci; Jirarojwatana, Somchai; Van der Stuyft, Patrick

2011-05-01

Insecticide-treated curtains (ITCs) are promoted for controlling the Dengue vector Aedes aegypti. We assessed the cost of the routine Aedes control program (RACP) and the cost of ITC implementation through the RACP and health committees in Venezuela and through health volunteers in Thailand. The yearly cost of the RACP per household amounted to US$2.14 and $1.89, respectively. The ITC implementation cost over three times more, depending on the channel used. In Venezuela the RACP was the most efficient implementation-channel. It spent US$1.90 (95% confidence interval [CI]: 1.83; 1.97) per curtain distributed, of which 76.9% for the curtain itself. Implementation by health committees cost significantly (P = 0.02) more: US$2.32 (95% CI: 1.93; 2.61) of which 63% for the curtain. For ITC implementation to be at least as cost-effective as the RACP, at equal effectiveness and actual ITC prices, the attained curtain coverage and the adulticiding effect should last for 3 years.

The Balancing Act: Student Classroom Placement Routines and the Uses of Data in Elementary Schools

Science.gov (United States)

Park, Vicki; St. John, Elise; Datnow, Amanda; Choi, Bailey

2017-01-01

Purpose: The purpose of this paper is to examine how data are used in classroom placement routines. The authors explore educators' assumptions about the purposes of the classroom placement routine, detailing the ostensive (i.e. structure and template) and performative aspects of the routine itself, and the implications of data use for equity and…

Routine Activities and Sexual Harassment in the Workplace.

Science.gov (United States)

De Coster, Stacy; Estes, Sarah Beth; Mueller, Charles W.

1999-01-01

In criminology, routine activities of potential victims can be used to predict victimization. Application to organizational sexual harassment data shows that organizational features (proximity in job location, supervisor or work group guardianship) and individual characteristics (target attractiveness) can predict sexual harassment victimization,…

Biomarkers in routine diagnosis of pleural effusions

Directory of Open Access Journals (Sweden)

Tiva Nemanič

2018-03-01

Full Text Available Background: Pleural fluid biochemical analysis is the first step in pleural effusion (PE diagnostics. Our purpose was to analyse the utility of the biomarkers used at our clinic in the routine diagnosis of PE. Methods: We retrospectively reviewed the PE levels of proteins, lactate dehydrogenase (LDH, alpha amylase (AA, pH and glucose in 433 patients who were treated at the University Clinic Golnik in a one-year period and compared these values with the final identified aetiology of the effusions. Results: The majority of the effusions were determined to be a consequence of malignancy (n = 154 or infection (n = 108. In 94 cases the aetiology of the effusions was heart failure and in 54 cases other diseases, while 23 effusions remained aetiologically undetermined. Considering Light’s criteria, the vast majority of the effusions were correctly classified as exudates or transudates (97.1 %. Comparing paramalignant and malignant effusions, we detected significantly lower values of pleural fluid LDH (p < 0.0005 and proteins (p < 0.0005, and higher pH (p < 0.0005 values in the paramalignant effusions. Conclusion: We have found that pleural LDH and proteins are the most helpful biochemical parameters in our routine diagnosis of pleural effusions and helped us to correctly narrow the aetiological spectrum. Furthermore, significantly higher pleural LDH and protein values and a pH below 7.32 additionally facilitated distinguishing between malignant and paramalignant effusions. Parameters such as glucose and AA are useful in selected cases and have a limited role in routine diagnostics.

ESTIMATION OF ROUTINE DISCHARGE OF RADIONUCLIDES ON POWER REACTOR EXPERIMENTAL RDE

Directory of Open Access Journals (Sweden)

P.M. Udiyani

2017-02-01

Full Text Available Experimental power reactor (RDE which is planned to be constructed by BATAN is a kind of High Temperature Gas Cooled Reactor (HTGR with 10 MWth power. HTGR is a helium gas-cooled reactor with TRISO-coated fuel that is able to confine fission products remained in the core. Although the fission products released into the environment are very small, in order to comply the regulations the study about environmental radiation on normal or routine operation condition need to be performed. Estimation of radiology in the environment involves the source term released into the environment under routine operation condition. The purpose of this study is to estimate the source term released into the environment based on postulation of normal or routine operations of RDE. The research approach starts with an assumption that there are defects and impurities in the TRISO fuel because of limitation during the fabrication. Mechanism of fission products release from the fuel to the environment was created based on the safety features design of RDE. Radionuclides inventories in the reactor were calculated using ORIGEN-2 whose library has been modified for HTGR type, and the assumptions of defects of the TRISO fuel and release fraction for each compartment of RDE safety system used a reference parameter. The results showed that the important source terms of RDE are group of noble gases (Kr and Xe, halogen (I, Sr, Cs, H-3, and Ag. Activities of RDE source terms for routine operations have no significant difference with the HTGR source terms with the same power. Keywords: routine discharge, radionuclide, source term, RDE, HTGR

Investigations of CR39 dosimeters for neutron routine dosimetry

International Nuclear Information System (INIS)

Weinstein, M.; Abraham, A.; Tshuva, A.; German, U.

2004-01-01

CR-39 is a polymeric nuclear track detector which is widely used for neutron dosimetry. CR-39 detector development was conducted at a number of laboratories throughout the world(1,2) , and was accepted also for routine dosimetry. However, there are shortcomings which must be taken into consideration the lack of a dosimetry grade material which causes batch variations, significant angular dependence and a moderate sensitivity. CR-39 also under-responds for certain classes of neutron spectra (lower energy neutrons from reactors or high energy accelerator-produced neutrons).In order to introduce CR-39 as a routine dosimeter at NRCN, a series of checks were performed. The present work describes the results of some of our checks, to characterize the main properties of CR-39 dosimeters

Application of Hybrid Genetic Algorithm Routine in Optimizing Food and Bioengineering Processes

Directory of Open Access Journals (Sweden)

Jaya Shankar Tumuluru

2016-11-01

Full Text Available Optimization is a crucial step in the analysis of experimental results. Deterministic methods only converge on local optimums and require exponentially more time as dimensionality increases. Stochastic algorithms are capable of efficiently searching the domain space; however convergence is not guaranteed. This article demonstrates the novelty of the hybrid genetic algorithm (HGA, which combines both stochastic and deterministic routines for improved optimization results. The new hybrid genetic algorithm developed is applied to the Ackley benchmark function as well as case studies in food, biofuel, and biotechnology processes. For each case study, the hybrid genetic algorithm found a better optimum candidate than reported by the sources. In the case of food processing, the hybrid genetic algorithm improved the anthocyanin yield by 6.44%. Optimization of bio-oil production using HGA resulted in a 5.06% higher yield. In the enzyme production process, HGA predicted a 0.39% higher xylanase yield. Hybridization of the genetic algorithm with a deterministic algorithm resulted in an improved optimum compared to statistical methods.

Diagnostic accuracy of routine postoperative body temperature measurements

NARCIS (Netherlands)

Vermeulen, Hester; Storm-Versloot, Marja N.; Goossens, Astrid; Speelman, Peter; Legemate, Dink A.

2005-01-01

BACKGROUND: On surgical wards, body temperature is routinely measured, but there is no proof that this is useful for detecting postoperative infection. The aim of this study was to compare temperature measurements (the test) with the confirmed absence or presence of a postoperative infection (the

ORIGINAL ARTICLES Acceptability, feasibility and impact of routine ...

African Journals Online (AJOL)

programme, leading to the identification of children with previously undiagnosed HIV ... We explored the acceptability and feasibility of routine HIV screening in ... proportion of previously undiagnosed HIV-positive children aged ..... primary healthcare facilities in South Africa: Attitudes of nurses and child caregivers. Soc Sci ...

Routine hemoglobin electrophoresis for pediatric surgery day case ...

African Journals Online (AJOL)

Background: Hemoglobin electrophoresis (HBE) is a part of the preoperative routine requested by anesthetists. However, the prevalence of hemoglobinopathy in the population is low. This study aims to determine the clinical risk factors for hemoglobinopathies and propose clinical guidelines for preoperative screening of ...

THERMAL: A routine designed to calculate neutron thermal scattering. Revision 1

International Nuclear Information System (INIS)

Cullen, D.E.

1995-01-01

THERMAL is designed to calculate neutron thermal scattering that is elastic and isotropic in the center of mass system. At low energy thermal motion will be included. At high energies the target nuclei are assumed to be stationary. The point of transition between low and high energies has been defined to insure a smooth transition. It is assumed that at low energy the elastic cross section is constant in the relative system. At high energy the cross section can be of any form. You can use this routine for all energies where the elastic scattering is isotropic in the center of mass system. In most materials this will be a fairly high energy, e.g., the keV energy range. The THERMAL method is simple, clean, easy to understand, and most important very efficient; on a SUN SPARC-10 workstation, at low energies with thermal scattering it can do almost 6 million scatters a minute and at high energy over 13 million. Warning: This version of THERMAL completely supersedes the original version described in the same report number, dated February 24, 1995. The method used in the original code is incorrect, as explained in this report

Validating soil phosphorus routines in the SWAT model

Science.gov (United States)

Phosphorus transfer from agricultural soils to surface waters is an important environmental issue. Commonly used models like SWAT have not always been updated to reflect improved understanding of soil P transformations and transfer to runoff. Our objective was to validate the ability of the P routin...

Daily medication routine of adolescents with HIV/AIDS

Directory of Open Access Journals (Sweden)

Cristiane Cardoso de Paula

2013-12-01

Full Text Available The objective of this study was to describe the sociodemographic, clinical, and behavioral characteristics of the daily medication routine of adolescents with HIV/AIDS of ages 13 to 19 years, followed at a reference service. This descriptive cross-sectional study was performed with 23 adolescents, using a quantitative approach. Data were collected using a form during appointments at the outpatient clinic. Univariate analysis revealed: females, in the initial phase of adolescence, and vertical transmission. The highlights were: lack of assiduity to appointments; unprotected sex; and consumption of alcohol. Regarding the daily medication routine, subjects depend on their parents or guardians, use strategies to remember to take the medications, and are unaware about the laboratory test for disease management and treatment. There is a need for educative intervention using information and communication technology, such as the Internet, to promote health and autonomy among adolescents. Descriptors: Acquired Immunodeficiency Syndrome; Adolescent Health; Antiretroviral Therapy, Highly Active; Nursing.

Electronic medical records and efficiency and productivity during office visits.

Science.gov (United States)

Furukawa, Michael F

2011-04-01

To estimate the relationship between electronic medical record (EMR) use and efficiency of utilization and provider productivity during visits to US office-based physicians. Cross-sectional analysis of the 2006-2007 National Ambulatory Medical Care Survey. The sample included 62,710 patient visits to 2625 physicians. EMR systems included demographics, clinical notes, prescription orders, and laboratory and imaging results. Efficiency was measured as utilization of examinations, laboratory tests, radiology procedures, health education, nonmedication treatments, and medications. Productivity was measured as total services provided per 20-minute period. Survey-weighted regressions estimated association of EMR use with services provided, visit intensity/duration, and productivity. Marginal effects were estimated by averaging across all visits and by major reason for visit. EMR use was associated with higher probability of any examination (7.7%, 95% confidence interval [CI] = 2.4%, 13.1%); any laboratory test (5.7%, 95% CI = 2.6%, 8.8%); any health education (4.9%, 95% CI = 0.2%, 9.6%); and fewer laboratory tests (-7.1%, 95% CI = -14.2%, -0.1%). During pre/post surgery visits, EMR use was associated with 7.3% (95% CI= -12.9%, -1.8%) fewer radiology procedures. EMR use was not associated with utilization of nonmedication treatments and medications, or visit duration. During routine visits for a chronic problem, EMR use was associated with 11.2% (95% CI = 5.7%, 16.8%) more diagnostic/screening services provided per 20-minute period. EMR use had a mixed association with efficiency and productivity during office visits. EMRs may improve provider productivity, especially during visits for a new problem and routine chronic care.

Routine one-stage exchange for chronic infection after total hip replacement.

Science.gov (United States)

Jenny, Jean-Yves; Lengert, Régis; Diesinger, Yann; Gaudias, Jeannot; Boeri, Cyril; Kempf, Jean-François

2014-12-01

We hypothesized that a routine one-stage exchange for treatment of chronically infected total hip replacement (THR) will lead to (1) a higher rate of infection recurrence and (2) a poorer hip outcome than the published rates after two-stage exchange. Sixty-five cases have been treated consecutively with one-stage exchange. All patients have been followed for a period of three to six years or until death or infection recurrence. The five-year rate for infection recurrence was 16%. The five-year survival rate for recurrence of the index infection was 8%. Forty-two percent of the hips had a good or excellent PMA score, and 46% a good or excellent OH score. Routine one-stage exchange was not associated with a higher recurrence rate and a poorer hip function than previously published series of two-stage exchange. Therefore, there is little support to choose two-stage exchange as the routine treatment for management of chronically infected THR.

A modified space charge routine for high intensity bunched beams

International Nuclear Information System (INIS)

Lapostolle, P.; Garnett, R.W.; Wangler, T.P.

1996-01-01

In 1991 a space charge calculation for bunched beam with a three-dimensional ellipsoid was proposed, replacing the usual SCHEFF routines. It removes the cylindrical symmetry required in SCHEFF and avoids the point to point interaction computation, whose number of simulation points is limited. This routine has now been improved with the introduction of two or three ellipsoids giving a good representation of the complex non-symmetrical form of the bunch (unlike the 3-d ellipsoidal assumption). The ellipsoidal density distributions are computed with a new method, avoiding the difficulty encountered near the centre (the axis in 2-d problems) by the previous method. It also provides a check of the ellipsoidal symmetry for each part of the distribution. Finally, the Fourier analysis reported in 1991 has been replaced by a very convenient Hermite expansion, which gives a simple but accurate representation of practical distributions. Comparisons with other space charge routines have been made, particularly with the ones applying other techniques such as SCHEFF. Introduced in the versatile beam dynamics code DYNAC, it should provide a good tool for the study of the various parameters responsible for the halo formation in high intensity linacs. (orig.)

Generic environmental statement on the routine use of plutonium-powered cardiac pacemakers

International Nuclear Information System (INIS)

Shoup, R.L.; Robinson, T.W.; O'Donnell, F.R.

1976-01-01

The purpose of a continuing program at ORNL is to provide technical assistance to the NRC on writing and editing of the final environmental statement on the routine use of nuclear-powered (primarily 238 Pu) cardiac pacemakers. This environmental statement defines the safety and reliability standards that nuclear-powered pacemakers are required to meet. All aspects of the risks to the patients, the public, and the environment are evaluated both for the routine use of plutonium-powered pacemakers and for postulated accidents involving pacemaker patients. Benefits derived from the use of plutonium-powered units are discussed and weighed against the risks in order to determine whether routine use is justified. Available alternative pacemakers with various performance characteristics are compared with respect to costs and to the needs of pacemaker patients

Implementing components of the routines-based model

OpenAIRE

McWilliam, Robin; Fernández Valero, Rosa

2015-01-01

The MBR is comprised of 17 components that can generally be grouped into practices related to (a) functional assessment and intervention planning (for example, Routines-Based Interview), (b) organization of services (including location and staffing), (c) service delivery to children and families (using a consultative approach with families and teachers, integrated therapy), (d) classroom organization (for example, classroom zones), and (e) supervision and training through ch...

Patient's needs and preferences in routine follow-up after treatment for breast cancer

NARCIS (Netherlands)

de Bock, GH; Bonnema, J; Zwaan, RE; de Velde, CJH; Kievit, J; Stiggelbout, AM

2004-01-01

The purpose of the study was to analyse the needs of women who participated in a routine follow-up programme after treatment for primary breast cancer. A cross-sectional survey was conducted using a postal questionnaire among women without any sign of relapse during the routine follow-up period. The

Antibody response to routine measles vaccination among a ...

African Journals Online (AJOL)

owner

2013-02-08

Feb 8, 2013 ... Abstract Background: Despite a global decline in mortality and morbidity from measles in the last decade, outbreaks continue to occur in some parts of the world including Nigeria. Objective: To determine antibody response to routine measles vacci- nation in Nigerian children and evaluate vaccine potency.

Clinical Outcome of Degenerative Mitral Regurgitation: Critical Importance of Echocardiographic Quantitative Assessment in Routine Practice.

Science.gov (United States)

Antoine, Clemence; Benfari, Giovanni; Michelena, Hector I; Malouf, Joseph F; Nkomo, Vuyisile T; Thapa, Prabin; Enriquez-Sarano, Maurice

2018-05-31

Background -Echocardiographic quantitation of degenerative mitral regurgitation (DMR) is recommended whenever possible in clinical guidelines but is criticized and its scalability to routine clinical practice doubted. We hypothesized that echocardiographic DMR quantitation, performed in routine clinical practice by multiple practitioners predicts independently long-term survival, and thus is essential to DMR management. Methods -We included patients diagnosed with isolated mitral-valve-prolapse 2003-2011 and any degree of MR quantified by any physician/sonographer in routine clinical practice. Clinical/echocardiographic data acquired at diagnosis were retrieved electronically. Endpoint was mortality under medical treatment analyzed by Kaplan-Meir method and Proportional-Hazard models. Results -The cohort included 3914 patients (55% male) aged 62±17 years, with left ventricular ejection fraction (LVEF) 63±8% and routinely measured effective regurgitant orifice area (EROA) 19[0-40] mm 2 During follow-up (6.7±3.1 years) 696 patients died under medical management and 1263 underwent mitral surgery. In multivariate analysis, routinely measured EROA was associated with mortality (adjusted-hazard-ratio 1.19[1.13-1.24] p 40 mm 2 threshold. Conclusions -Echocardiographic DMR quantitation is scalable to routine practice and is independently associated with clinical outcome. Routinely measured EROA is strongly associated with long-term survival under medical treatment. Excess mortality vs. the general population appears in the "moderate" DMR range and steadily increases with higher EROA. Hence, individual EROA values should be integrated into therapeutic considerations, additionally to categorical DMR grading.

Cost-effectiveness of routine imaging of suspected appendicitis.

Science.gov (United States)

D'Souza, N; Marsden, M; Bottomley, S; Nagarajah, N; Scutt, F; Toh, S

2018-01-01

Introduction The misdiagnosis of appendicitis and consequent removal of a normal appendix occurs in one in five patients in the UK. On the contrary, in healthcare systems with routine cross-sectional imaging of suspected appendicitis, the negative appendicectomy rate is around 5%. If we could reduce the rate in the UK to similar numbers, would this be cost effective? This study aimed to calculate the financial impact of negative appendicectomy at the Queen Alexandra Hospital and to explore whether a policy of routine imaging of such patients could reduce hospital costs. Materials and methods We performed a retrospective analysis of all appendicectomies over a 1-year period at our institution. Data were extracted on outcomes including appendix histology, operative time and length of stay to calculate the negative appendicectomy rate and to analyse costs. Results A total of 531 patients over 5 years of age had an appendicectomy. The negative appendicectomy rate was 22% (115/531). The additional financial costs of negative appendicectomy to the hospital during this period were £270,861. Universal imaging of all patients with right iliac fossa pain that could result in a 5% negative appendicectomy rate would cost between £67,200 and £165,600 per year but could save £33,896 (magnetic resonance imaging), £105,896 (computed tomography) or £132,296 (ultrasound) depending on imaging modality used. Conclusions Negative appendicectomy is still too frequent and results in additional financial burden to the health service. Routine imaging of patients with suspected appendicitis would not only reduce the negative appendicectomy rate but could lead to cost savings and a better service for our patients.

Improved discrete ordinate solutions in the presence of an anisotropically reflecting lower boundary: Upgrades of the DISORT computational tool

International Nuclear Information System (INIS)

Lin, Z.; Stamnes, S.; Jin, Z.; Laszlo, I.; Tsay, S.-C.; Wiscombe, W.J.; Stamnes, K.

2015-01-01

A successor version 3 of DISORT (DISORT3) is presented with important upgrades that improve the accuracy, efficiency, and stability of the algorithm. Compared with version 2 (DISORT2 released in 2000) these upgrades include (a) a redesigned BRDF computation that improves both speed and accuracy, (b) a revised treatment of the single scattering correction, and (c) additional efficiency and stability upgrades for beam sources. In DISORT3 the BRDF computation is improved in the following three ways: (i) the Fourier decomposition is prepared “off-line”, thus avoiding the repeated internal computations done in DISORT2; (ii) a large enough number of terms in the Fourier expansion of the BRDF is employed to guarantee accurate values of the expansion coefficients (default is 200 instead of 50 in DISORT2); (iii) in the post-processing step the reflection of the direct attenuated beam from the lower boundary is included resulting in a more accurate single scattering correction. These improvements in the treatment of the BRDF have led to improved accuracy and a several-fold increase in speed. In addition, the stability of beam sources has been improved by removing a singularity occurring when the cosine of the incident beam angle is too close to the reciprocal of any of the eigenvalues. The efficiency for beam sources has been further improved from reducing by a factor of 2 (compared to DISORT2) the dimension of the linear system of equations that must be solved to obtain the particular solutions, and by replacing the LINPAK routines used in DISORT2 by LAPACK 3.5 in DISORT3. These beam source stability and efficiency upgrades bring enhanced stability and an additional 5–7% improvement in speed. Numerical results are provided to demonstrate and quantify the improvements in accuracy and efficiency of DISORT3 compared to DISORT2. - Highlights: • We present a successor version 3 of DISORT (DISORT3) with important upgrades. • Redesigned BRDF computation improves both

Families experiencing housing instability: the effects of housing programs on family routines and rituals.

Science.gov (United States)

Mayberry, Lindsay Satterwhite; Shinn, Marybeth; Benton, Jessica Gibbons; Wise, Jasmine

2014-01-01

Maintenance of family processes can protect parents, children, and families from the detrimental effects of extreme stressors, such as homelessness. When families cannot maintain routines and rituals, the stressors of poverty and homelessness can be compounded for both caregivers and children. However, characteristics of living situations common among families experiencing homelessness present barriers to the maintenance of family routines and rituals. We analyzed 80 in-depth interviews with parents who were experiencing or had recently experienced an instance of homelessness. We compared their assessments of challenges to family schedules, routines, and rituals across various living situations, including shelter, transitional housing programs, doubled-up (i.e., living temporarily with family or friends), and independent housing. Rules common across shelters and transitional housing programs impeded family processes, and parents felt surveilled and threatened with child protective service involvement in these settings. In doubled-up living situations, parents reported adapting their routines to those of the household and having parenting interrupted by opinions of friends and family members. Families used several strategies to maintain family routines and rituals in these living situations and ensure consistency and stability for their children during an otherwise unstable time. (c) 2014 APA, all rights reserved.

FeetForward: On Blending New Classroom Technologies into Secondary School Teachers’ Routines

OpenAIRE

An , Pengcheng; Bakker , Saskia; Eggen , Berry

2017-01-01

Part 5: Interaction at the Workplace; International audience; Secondary school teachers have complex, intensive and dynamic routines in their classrooms, which makes their attentional resources limited for human-computer interaction. Leveraging principles of peripheral interaction can reduce attention demanded by technologies and interactions could blend more seamlessly into the everyday routine. We present the design and deployment of FeetForward - an open-ended, and foot-based peripheral in...

Pre-procedural scout radiographs are unnecessary for routine pediatric fluoroscopic examinations

Energy Technology Data Exchange (ETDEWEB)

Creeden, Sean G.; Rao, Anil G.; Eklund, Meryle J.; Hill, Jeanne G.; Thacker, Paul G. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

2017-03-15

Although practice patterns vary, scout radiographs are often routinely performed with pediatric fluoroscopic studies. However few studies have evaluated their utility in routine pediatric fluoroscopy. To evaluate the value of scout abdomen radiographs in routine barium or water-soluble enema, upper gastrointestinal (GI) series, and voiding cystourethrogram pediatric fluoroscopic procedures. We retrospectively evaluated 723 barium or water-soluble enema, upper GI series, and voiding cystourethrogram fluoroscopic procedures performed at our institution. We assessed patient history and demographics, clinical indication for the examination, prior imaging findings and impressions, scout radiograph findings, additional findings provided by the scout radiograph that were previously unknown, and whether the scout radiograph contributed any findings that significantly changed management. We retrospectively evaluated 723 fluoroscopic studies (368 males and 355 females) in pediatric patients. Of these, 700 (96.8%) had a preliminary scout radiograph. Twenty-three (3.2%) had a same-day radiograph substituted as a scout radiograph. Preliminary scout abdomen radiographs/same-day radiographs showed no new significant findings in 719 (99.4%) studies. New but clinically insignificant findings were seen in 4 (0.6%) studies and included umbilical hernia, inguinal hernia and hip dysplasia. No findings were found on the scout radiographs that would either alter the examination performed or change management with regard to the exam. Pre-procedural scout abdomen radiographs are unnecessary in routine barium and water-soluble enema, upper GI series, and voiding cystourethrogram pediatric fluoroscopic procedures and can be substituted with a spot fluoroscopic last-image hold. (orig.)

The Utrecht Health Project: Optimization of routine healthcare data for research

International Nuclear Information System (INIS)

Grobbee, Diederick E.; Hoes, Arno W.; Verheij, Theo J. M.; Schrijvers, Augustinus J. P.; Ameijden, Erik J. C. van; Numans, Mattijs E.

2005-01-01

Background. Research on the impact of changes in healthcare policy, developments in community and public health and determinants of health and disease during lifetime may effectively make use of routine healthcare data. These data, however, need to meet minimal criteria for quality and completeness. Research opportunities are further improved when routine data are supplemented with a standardized 'baseline' assessment of the full population. This formed the basis for a new study initiated in a newly developed large residential area in Leidsche Rijn, part of the city of Utrecht, the Netherlands.Methods. All new inhabitants are invited by their general practitioner to participate in the Utrecht Health Project (UHP). Informed consent is obtained and an individual health profile (IHP) is made by dedicated research nurses. The IHP is the starting point for the UHP research database as well as for the primary care electronic medical records. Follow-up data are collected through continuous linkage with the computerized medical files recorded by the general practitioners. UHP staff in each practice takes care of quality management of registration as well as data handling.Results. Currently, over 60 of invited new residents in the area have given informed consent with participation steadily increasing. Discussion. The Utrecht Health Project combines key elements of traditional epidemiologic cohort studies with the current power of routine electronic medical record keeping in primary care. The research approach optimizes routine health care data for use in scientific research

Ethnographic study of ICT-supported collaborative work routines in general practice.

Science.gov (United States)

Swinglehurst, Deborah; Greenhalgh, Trisha; Myall, Michelle; Russell, Jill

2010-12-29

Health informatics research has traditionally been dominated by experimental and quasi-experimental designs. An emerging area of study in organisational sociology is routinisation (how collaborative work practices become business-as-usual). There is growing interest in the use of ethnography and other in-depth qualitative approaches to explore how collaborative work routines are enacted and develop over time, and how electronic patient records (EPRs) are used to support collaborative work practices within organisations. Following Feldman and Pentland, we will use 'the organisational routine' as our unit of analysis. In a sample of four UK general practices, we will collect narratives, ethnographic observations, multi-modal (video and screen capture) data, documents and other artefacts, and analyse these to map and compare the different understandings and enactments of three common routines (repeat prescribing, coding and summarising, and chronic disease surveillance) which span clinical and administrative spaces and which, though 'mundane', have an important bearing on quality and safety of care. In a detailed qualitative analysis informed by sociological theory, we aim to generate insights about how complex collaborative work is achieved through the process of routinisation in healthcare organisations. Our study offers the potential not only to identify potential quality failures (poor performance, errors, failures of coordination) in collaborative work routines but also to reveal the hidden work and workarounds by front-line staff which bridge the model-reality gap in EPR technologies and via which "automated" safety features have an impact in practice.

Enhancing parallelism of tile bidiagonal transformation on multicore architectures using tree reduction

KAUST Repository

Ltaief, Hatem

2012-01-01

The objective of this paper is to enhance the parallelism of the tile bidiagonal transformation using tree reduction on multicore architectures. First introduced by Ltaief et. al [LAPACK Working Note #247, 2011], the bidiagonal transformation using tile algorithms with a two-stage approach has shown very promising results on square matrices. However, for tall and skinny matrices, the inherent problem of processing the panel in a domino-like fashion generates unnecessary sequential tasks. By using tree reduction, the panel is horizontally split, which creates another dimension of parallelism and engenders many concurrent tasks to be dynamically scheduled on the available cores. The results reported in this paper are very encouraging. The new tile bidiagonal transformation, targeting tall and skinny matrices, outperforms the state-of-the-art numerical linear algebra libraries LAPACK V3.2 and Intel MKL ver. 10.3 by up to 29-fold speedup and the standard two-stage PLASMA BRD by up to 20-fold speedup, on an eight socket hexa-core AMD Opteron multicore shared-memory system. © 2012 Springer-Verlag.

Development and Validation of NODAL-LAMBDA Program for the Calculation of the Sub-criticality of LAMDA MODES By Nodal Methods in BWR reactors

International Nuclear Information System (INIS)

Munoz-Cobo, J. L.; Merino, R.; Escriva, A.; Melara, J.; Concejal, A.

2014-01-01

We have developed a 3D code with two energy groups and diffusion theory that is capable of calculating eigenvalues lambda of a BWR reactor using nodal methods and boundary conditions that calculates ALBEDO NODAL-LAMBDA from the properties of the reflector code itself. The code calculates the sub-criticality of the first harmonic, which is involved in the stability against oscillations reactor out of phase, and which is needed for calculating the decay rate for data out of phase oscillations. The code is very fast and in a few seconds is able to make a calculation of the first eigenvalues and eigenvectors, discretized solving the problem with different matrix elements zero. The code uses the LAPACK and ARPACK libraries. It was necessary to modify the LAPACK library to perform various operations with five non-diagonal matrices simultaneously in order to reduce the number of calls to bookstores and simplify the procedure for calculating the matrices in compressed format CSR. The code is validated by comparing it with the results for SIMULATE different cases and making 3D BENCHMAR of the IAEA. (Author)

PELLET: a computer routine for modeling pellet fueling in tokamak plasmas

International Nuclear Information System (INIS)

Houlberg, W.A.; Iskra, M.A.; Howe, H.C.; Attenberger, S.E.

1979-01-01

Recent experimental results of frozen hydrogenic pellet injection into hot tokamak plasmas and substantial agreement with theoretical predictions have led to a much greater interest in pellets as a means of refueling plasmas. The computer routine PELLET has been developed and used as an aid in assessing pellet ablation models and the effects of pellets on plasma behavior. PELLET provides particle source profiles under various options for the ablation model and can be coupled either to a fluid transport code or to a brief routine which supplies the required input parameters

Evaluation of Legionella real-time PCR against traditional culture for routine and public health testing of water samples.

Science.gov (United States)

Collins, S; Stevenson, D; Walker, J; Bennett, A

2017-06-01

To evaluate the usefulness of Legionella qPCR alongside traditional culture for enumeration of Legionella from water samples as part of both routine and public health investigation testing. Routine water samples (n = 2002) and samples from public health investigations (n = 215) were analysed by culture and qPCR for Legionella spp., Legionella pneumophila and L. pneumophila sg-1. A negative qPCR result was highly predictive of a negative culture result for all water systems (negative predictive values, NPV from 97·4 to 100%). Positive predictive values (PPV) were lower (0-50%). Results for qPCR were generally larger than culture with average log 10 differences of 1·1 for Legionella spp. and 1·2 for L. pneumophila. Alert and action levels of 1000 and 10 000 GU per litre, respectively, are proposed for Legionella qPCR for hot and cold water systems (HCWS). The use of qPCR significantly reduced the time to results for public health investigations by rapidly identifying potential sources and ruling out others, thus enabling a more rapid and efficient response. The high NPV of qPCR supports its use to rapidly screen out negative samples without culture. Alert and action levels for Legionella qPCR for HCWS are proposed. Quantitative PCR will be a valuable tool for both routine and public health testing. This study generated comparative data of >2000 water samples by qPCR and culture. Action and alert levels have been recommended that could enable duty holders to interpret qPCR results to facilitate timely Legionella control and public health protection. © 2017 Crown copyright. Journal of Applied Microbiology © 2017 The Society for Applied Microbiology.

Changing in Convergence: The Impact of TV News Routines on the Usage of Online UGC Sources

Directory of Open Access Journals (Sweden)

Huei-Ling Liu

2014-10-01

Full Text Available Online videos, or so called user-generated content, have been used in TV news frequently because of recent media convergence. This study examined whether this phenomenon influences news routines, and whether new characteristics of news routines have emerged because of the dependency on UGC sources. A qualitative research method was adopted, and 15 Taiwanese TV journalists were interviewed. The results show that the high dependence on the Internet for obtaining news has encouraged journalists producing news without having to leave newsroom. New routines have been formed in new production. At organizational levels, the search for online materials has been routinized, Journalist’ newsgathering and reporting are no longer original and initial but follow the hit topics on the Internet, Moreover, and news coverage currently focuses on format instead of meaning. At interorganizational level, TV news organizations monitor and imitate each other to adjust their routines. This paper shows that some unprofessional behaviors of journalists have become reasonable because of news routines changed. Consequently, the ethical and professional controversies have been ignored in newsroom.

The (Proper) Microfoundations of Routines and Capabilities

DEFF Research Database (Denmark)

Felin, Teppo; Foss, Nicolai Juul

2012-01-01

Sidney Winter (2011), Brian Pentland (2011), and Geoffrey Hodgson and Thorbjørn Knudsen (2011) take issue with the arguments in Teppo Felin and Nicolai J. Foss (2011), along with more generally critiquing the ‘microfoundations project’ related to routines and capabilities. In this rejoinder we ar...... chauvinism; (3) models of mind and man; (4) levels of analysis; (5) agency and uncaused causes; and then further discuss (6) a rationalist alternative....

Utility of routine postoperative chest radiography in pediatric tracheostomy.

Science.gov (United States)

Genther, Dane J; Thorne, Marc C

2010-12-01

Routine chest radiography following pediatric tracheostomy is commonly performed in order to evaluate for air-tracking complications. Routine chest radiography affords disadvantages of radiation exposure and cost. The primary objective of this study was to determine the utility of routine postoperative chest radiography following tracheostomy in pediatric patients. Secondary objectives were to compare the rates of postoperative complications by various patient and surgeon characteristics. All infants and children 18 years of age or less (n=421) who underwent tracheostomy at a single tertiary-care medical center from January 2000 to April 2009 were included in the study. A combination of data obtained from billing and administrative systems and review of electronic medical records were recorded and compiled in a database for statistical analysis. Three air-tracking complications (2 pneumothoraces and 1 pneumomediastinum) were identified in our population of 421 pediatric patients, for an incidence of 0.71% (95% CI: 0.1-2.0%). No significant relationships were found between the incidence of air-tracking complication and surgical specialty, patient age, or type of procedure (elective, urgent/emergent). Our study identified a low rate of pneumothorax and pneumomediastinum following pediatric tracheostomy. In all three cases, the pneumothorax was suspected clinically. This finding suggests that postoperative chest radiography should be reserved for cases where there is suspicion of a complication on the basis of intraoperative findings or clinical parameters. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Examining daily activity routines of older adults using workflow.

Science.gov (United States)

Chung, Jane; Ozkaynak, Mustafa; Demiris, George

2017-07-01

We evaluated the value of workflow analysis supported by a novel visualization technique to better understand the daily routines of older adults and highlight their patterns of daily activities and normal variability in physical functions. We used a self-reported activity diary to obtain data from six community-dwelling older adults for 14 consecutive days. Workflow for daily routine was analyzed using the EventFlow tool, which aggregates workflow information to highlight patterns and variabilities. A total of 1453 events were included in the data analysis. To demonstrate the patterns and variability of each individual's daily activities, participant activity workflows were visualized and compared. The workflow analysis revealed great variability in activity types, regularity, frequency, duration, and timing of performing certain activities across individuals. Also, when workflow approach was applied to spatial information of activities, the analysis revealed the ability to provide meaningful data on individuals' mobility in different levels of life spaces from home to community. Results suggest that using workflows to characterize the daily activities of older adults will be helpful for clinicians and researchers in understanding their daily routines and preparing education and prevention strategies tailored to each individual's activity level. This tool also has the potential to be integrated into consumer informatics technologies, such as patient portals or personal health records, so that consumers may be encouraged to become actively involved in monitoring and managing their health. Copyright © 2017 Elsevier Inc. All rights reserved.

Perspex in the verification routines for accelerator beam

International Nuclear Information System (INIS)

Paredes G, L.; Genis S, R.

1998-01-01

It is analyzed the use of a perspex solid phantom, adequately referred to a water phantom, as an auxiliary alternative for the daily stability verification routines or constance of radiation beam, as an option in the case of radiotherapy installations with high charge of accelerator working and with basic dosimetry equipment. (Author)

The nexus between organizational routines and projects\\ud A goal-based perspective

OpenAIRE

Olufemi, Moses; Hope, Alex; Osborne, Allan

2015-01-01

It has long been established that routines can be sources of stability and change within organizations. It has been suggested however that an understanding of routines alone is not enough for explaining how new actions emerge in organizations. In arguing that traditional forms of organizational structure are not flexible enough to adapt to new actions (Ansoff, 1980), some theorists have proposed projects as management methods for adapting to fast changes occurring in the business environment....

Dual-Routine HCV/HIV Testing: Seroprevalence and Linkage to Care in Four Community Health Centers in Philadelphia, Pennsylvania.

Science.gov (United States)

Coyle, Catelyn; Kwakwa, Helena

2016-01-01

Despite common risk factors, screening for hepatitis C virus (HCV) and HIV at the same time as part of routine medical care (dual-routine HCV/HIV testing) is not commonly implemented in the United States. This study examined improvements in feasibility of implementation, screening increase, and linkage to care when a dual-routine HCV/HIV testing model was integrated into routine primary care. National Nursing Centers Consortium implemented a dual-routine HCV/HIV testing model at four community health centers in Philadelphia, Pennsylvania, on September 1, 2013. Routine HCV and opt-out HIV testing replaced the routine HCV and opt-in HIV testing model through medical assistant-led, laboratory-based testing and electronic medical record modification to prompt, track, report, and facilitate reimbursement for tests performed on uninsured individuals. This study examined testing, seropositivity, and linkage-to-care comparison data for the nine months before (December 1, 2012-August 31, 2013) and after (September 1, 2013-May 31, 2014) implementation of the dual-routine HCV/HIV testing model. A total of 1,526 HCV and 1,731 HIV tests were performed before, and 1,888 HCV and 3,890 HIV tests were performed after dual-routine testing implementation, resulting in a 23.7% increase in HCV tests and a 124.7% increase in HIV tests. A total of 70 currently HCV-infected and four new HIV-seropositive patients vs. 101 HCV-infected and 13 new HIV-seropositive patients were identified during these two periods, representing increases of 44.3% for HCV antibody-positive and RNA-positive tests and 225.0% for HIV-positive tests. Linkage to care increased from 27 currently infected HCV--positive and one HIV-positive patient pre-dual-routine testing to 39 HCV--positive and nine HIV-positive patients post-dual-routine testing. The dual-routine HCV/HIV testing model shows that integrating dual-routine testing in a primary care setting is possible and leads to increased HCV and HIV screening

Automated lung volumetry from routine thoracic CT scans: how reliable is the result?

Science.gov (United States)

Haas, Matthias; Hamm, Bernd; Niehues, Stefan M

2014-05-01

Today, lung volumes can be easily calculated from chest computed tomography (CT) scans. Modern postprocessing workstations allow automated volume measurement of data sets acquired. However, there are challenges in the use of lung volume as an indicator of pulmonary disease when it is obtained from routine CT. Intra-individual variation and methodologic aspects have to be considered. Our goal was to assess the reliability of volumetric measurements in routine CT lung scans. Forty adult cancer patients whose lungs were unaffected by the disease underwent routine chest CT scans in 3-month intervals, resulting in a total number of 302 chest CT scans. Lung volume was calculated by automatic volumetry software. On average of 7.2 CT scans were successfully evaluable per patient (range 2-15). Intra-individual changes were assessed. In the set of patients investigated, lung volume was approximately normally distributed, with a mean of 5283 cm(3) (standard deviation = 947 cm(3), skewness = -0.34, and curtosis = 0.16). Between different scans in one and the same patient the median intra-individual standard deviation in lung volume was 853 cm(3) (16% of the mean lung volume). Automatic lung segmentation of routine chest CT scans allows a technically stable estimation of lung volume. However, substantial intra-individual variations have to be considered. A median intra-individual deviation of 16% in lung volume between different routine scans was found. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Intentional Forgetting in Organizations: The Importance of Eliminating Retrieval Cues for Implementing New Routines

Directory of Open Access Journals (Sweden)

Annette Kluge

2018-02-01

Full Text Available To cope with the already large, and ever increasing, amount of information stored in organizational memory, “forgetting,” as an important human memory process, might be transferred to the organizational context. Especially in intentionally planned change processes (e.g., change management, forgetting is an important precondition to impede the recall of obsolete routines and adapt to new strategic objectives accompanied by new organizational routines. We first comprehensively review the literature on the need for organizational forgetting and particularly on accidental vs. intentional forgetting. We discuss the current state of the art of theory and empirical evidence on forgetting from cognitive psychology in order to infer mechanisms applicable to the organizational context. In this respect, we emphasize retrieval theories and the relevance of retrieval cues important for forgetting. Subsequently, we transfer the empirical evidence that the elimination of retrieval cues leads to faster forgetting to the forgetting of organizational routines, as routines are part of organizational memory. We then propose a classification of cues (context, sensory, business process-related cues that are relevant in the forgetting of routines, and discuss a meta-cue called the “situational strength” cue, which is relevant if cues of an old and a new routine are present simultaneously. Based on the classification as business process-related cues (information, team, task, object cues, we propose mechanisms to accelerate forgetting by eliminating specific cues based on the empirical and theoretical state of the art. We conclude that in intentional organizational change processes, the elimination of cues to accelerate forgetting should be used in change management practices.

Intentional Forgetting in Organizations: The Importance of Eliminating Retrieval Cues for Implementing New Routines.

Science.gov (United States)

Kluge, Annette; Gronau, Norbert

2018-01-01

To cope with the already large, and ever increasing, amount of information stored in organizational memory, "forgetting," as an important human memory process, might be transferred to the organizational context. Especially in intentionally planned change processes (e.g., change management), forgetting is an important precondition to impede the recall of obsolete routines and adapt to new strategic objectives accompanied by new organizational routines. We first comprehensively review the literature on the need for organizational forgetting and particularly on accidental vs. intentional forgetting. We discuss the current state of the art of theory and empirical evidence on forgetting from cognitive psychology in order to infer mechanisms applicable to the organizational context. In this respect, we emphasize retrieval theories and the relevance of retrieval cues important for forgetting. Subsequently, we transfer the empirical evidence that the elimination of retrieval cues leads to faster forgetting to the forgetting of organizational routines, as routines are part of organizational memory. We then propose a classification of cues (context, sensory, business process-related cues) that are relevant in the forgetting of routines, and discuss a meta-cue called the "situational strength" cue, which is relevant if cues of an old and a new routine are present simultaneously. Based on the classification as business process-related cues (information, team, task, object cues), we propose mechanisms to accelerate forgetting by eliminating specific cues based on the empirical and theoretical state of the art. We conclude that in intentional organizational change processes, the elimination of cues to accelerate forgetting should be used in change management practices.

Experience with a routine fecal sampling program for plutonium workers

International Nuclear Information System (INIS)

Bihl, D.E.; Buschbom, R.L.; Sula, M.J.

1993-01-01

A quarterly fecal sampling program was conducted at the U. S. Department of Energy's Hanford site for congruent to 100 workers at risk for an intake of plutonium oxide and other forms of plutonium. To our surprise, we discovered that essentially all of the workers were excreting detectable activities of plutonium. Further investigation showed that the source was frequent, intermittent intakes at levels below detectability by normal workplace monitoring, indicating the extraordinary sensitivity of fecal sampling. However, the experience of this study also indicated that the increased sensitivity of routine fecal sampling relative to more common bioassay methods is offset by many problems. These include poor worker cooperation; difficulty in distinguishing low-level chronic intakes from a more significant, acute intake; difficulty in eliminating interference from ingested plutonium; and difficulty in interpreting what a single void means in terms of 24-h excretion. Recommendations for a routine fecal program include providing good communication to workers and management about reasons and logistics of fecal sampling prior to starting, using annual (instead of quarterly) fecal sampling for class Y plutonium, collecting samples after workers have been away from plutonium exposure for a least 3 d, and giving serious consideration to improving urinalysis sensitivity rather than going to routine fecal sampling

POLAND' SYNDROME: An Incidental findings on routine medical ...

African Journals Online (AJOL)

Dr Hamidu

SM is a 20 year, old young man who came for routine medical check for recruitment into a local football club. Born to a 45 ... mimicking a radical mastectomy. A dense ascending line as a result of the absence of the ... centered around reconstructive surgical procedures on the hand. They may however be some functional.

Enabling affordable and efficiently deployed location based smart home systems.

Science.gov (United States)

Kelly, Damian; McLoone, Sean; Dishongh, Terry

2009-01-01

With the obvious eldercare capabilities of smart environments it is a question of "when", rather than "if", these technologies will be routinely integrated into the design of future houses. In the meantime, health monitoring applications must be integrated into already complete home environments. However, there is significant effort involved in installing the hardware necessary to monitor the movements of an elder throughout an environment. Our work seeks to address the high infrastructure requirements of traditional location-based smart home systems by developing an extremely low infrastructure localisation technique. A study of the most efficient method of obtaining calibration data for an environment is conducted and different mobile devices are compared for localisation accuracy and cost trade-off. It is believed that these developments will contribute towards more efficiently deployed location-based smart home systems.

DB90: A Fortran Callable Relational Database Routine for Scientific and Engineering Computer Programs

Science.gov (United States)

Wrenn, Gregory A.

2005-01-01

This report describes a database routine called DB90 which is intended for use with scientific and engineering computer programs. The software is written in the Fortran 90/95 programming language standard with file input and output routines written in the C programming language. These routines should be completely portable to any computing platform and operating system that has Fortran 90/95 and C compilers. DB90 allows a program to supply relation names and up to 5 integer key values to uniquely identify each record of each relation. This permits the user to select records or retrieve data in any desired order.

Design and implementation of the modified signed digit multiplication routine on a ternary optical computer.

Science.gov (United States)

Xu, Qun; Wang, Xianchao; Xu, Chao

2017-06-01

Multiplication with traditional electronic computers is faced with a low calculating accuracy and a long computation time delay. To overcome these problems, the modified signed digit (MSD) multiplication routine is established based on the MSD system and the carry-free adder. Also, its parallel algorithm and optimization techniques are studied in detail. With the help of a ternary optical computer's characteristics, the structured data processor is designed especially for the multiplication routine. Several ternary optical operators are constructed to perform M transformations and summations in parallel, which has accelerated the iterative process of multiplication. In particular, the routine allocates data bits of the ternary optical processor based on digits of multiplication input, so the accuracy of the calculation results can always satisfy the users. Finally, the routine is verified by simulation experiments, and the results are in full compliance with the expectations. Compared with an electronic computer, the MSD multiplication routine is not only good at dealing with large-value data and high-precision arithmetic, but also maintains lower power consumption and fewer calculating delays.

Screen Exposure During Daily Routines and a Young Child's Risk for Having Social-Emotional Delay.

Science.gov (United States)

Raman, Sajani; Guerrero-Duby, Sara; McCullough, Jennifer L; Brown, Miraides; Ostrowski-Delahanty, Sarah; Langkamp, Diane; Duby, John C

2017-11-01

This cross-sectional study assessed associations between social-emotional development in young children and their number of daily routines involving an electronic screen. We hypothesized children with poor social-emotional development have a significant portion of daily routines occurring with a screen. Two hundred and ten female caregivers of typically developing children 12 to 36 months old completed the Ages and Stages Questionnaire: Social-Emotional (ASQ: SE) and a media diary. Caregivers completed the diary for 1 day around 10 daily routines (Waking Up, Diapering/Toileting, Dressing, Breakfast, Lunch, Naptime, Playtime, Dinner, Bath, and Bedtime). Median number of daily routines occurring with a screen for children at risk and not at risk for social-emotional delay (as defined by the ASQ: SE) was 7 versus 5. Children at risk for social-emotional delay were 5.8 times more likely to have ≥5 routines occurring with a screen as compared to children not at risk for delay (χ 1 2 = 9.28, N = 210, P = .002; 95% confidence interval = 1.66-20.39).

Ethnographic study of ICT-supported collaborative work routines in general practice

Science.gov (United States)

2010-01-01

Background Health informatics research has traditionally been dominated by experimental and quasi-experimental designs. An emerging area of study in organisational sociology is routinisation (how collaborative work practices become business-as-usual). There is growing interest in the use of ethnography and other in-depth qualitative approaches to explore how collaborative work routines are enacted and develop over time, and how electronic patient records (EPRs) are used to support collaborative work practices within organisations. Methods/design Following Feldman and Pentland, we will use 'the organisational routine' as our unit of analysis. In a sample of four UK general practices, we will collect narratives, ethnographic observations, multi-modal (video and screen capture) data, documents and other artefacts, and analyse these to map and compare the different understandings and enactments of three common routines (repeat prescribing, coding and summarising, and chronic disease surveillance) which span clinical and administrative spaces and which, though 'mundane', have an important bearing on quality and safety of care. In a detailed qualitative analysis informed by sociological theory, we aim to generate insights about how complex collaborative work is achieved through the process of routinisation in healthcare organisations. Discussion Our study offers the potential not only to identify potential quality failures (poor performance, errors, failures of coordination) in collaborative work routines but also to reveal the hidden work and workarounds by front-line staff which bridge the model-reality gap in EPR technologies and via which "automated" safety features have an impact in practice. PMID:21190583

Screening for post 32-week preterm birth risk: how helpful is routine perinatal data collection?

Directory of Open Access Journals (Sweden)

Wei Luo

2016-06-01

Conclusions: For multiparous women, the routine data contains information comparable to some purposely-collected data for predicting preterm risk. But for nulliparous women, the routine data contains insufficient data related to antenatal complications.

Diabetes that impacts on routine activities predicts slower recovery after total knee arthroplasty: an observational study

Directory of Open Access Journals (Sweden)

Nurudeen Amusat

2014-12-01

Full Text Available Question: In the 6 months after total knee arthroplasty (TKA, what is the pattern of pain resolution and functional recovery in people without diabetes, with diabetes that does not impact on routine activities, and with diabetes that does impact on routine activities? Is diabetes that impacts on routine activities an independent predictor of slower resolution of pain and functional recovery after TKA? Design: Community-based prospective observational study. Participants: A consecutive cohort of 405 people undergoing primary TKA, of whom 60 (15% had diabetes. Participants with diabetes were also asked preoperatively whether diabetes impacted on their routine activities. Participants were categorised into three groups: no diabetes (n = 345, diabetes with no impact on activities (n = 41, and diabetes that impacted activities (n = 19. Outcome measures: Pain and function were measured using the Western Ontario and McMaster Universities (WOMAC Osteoarthritis Index within the month before surgery and 1, 3 and 6 months after surgery. Demographic, medical and surgical factors were also measured, along with depression, social support and health-related quality of life. Results: No baseline differences in pain and function were seen among the three groups (p > 0.05. Adjusting for age, gender and contralateral joint involvement across the 6 postoperative months, participants with diabetes that impacted on routine activities had pain scores that were 8.3 points higher (indicating greater pain and function scores that were 5.4 points higher (indicating lower function than participants without diabetes. Participants with diabetes that doesn’t impact on routine activities had similar recovery to those without diabetes. Conclusion: People undergoing TKA who report preoperatively that diabetes impacts on their routine activities have less recovery over 6 months than those without diabetes or those with diabetes that does not impact on routine activities

Cyber Journalism: Journal writing’s digitizing, Neo routines and Job stress

Directory of Open Access Journals (Sweden)

Mariana Loreta Magallanes Udovicich

2015-02-01

Full Text Available This paper analyzes the institutional and professional reorganization of Diagonales Journal’s newsroom, La Plata, Buenos Aires, Argentina, in its digitization context since December 2011. Based on deep interviews done to employees and former employees, this paper retrieves the professional experience of Cyber Journalism as part of emerging work routines. At the same time this article aims to approach the personal consequences that these processes have caused to the professionals involved. In this context, we recover some factors that, according to the interviews, have been identified as newsroom's routine stressors during the transition to digital edition.

[Routine oral examinations and specific after-care for removable partial dentures].

Science.gov (United States)

de Baat, C; Witter, D J; Keltjens, H M A M; Creugers, N H J

2011-01-01

Following treatment with a removable partial denture, routine oral examinations are required to stabilize the existing condition in a sustainable way and to make possible the timely treatment of anomalies which have appeared. In cases of problems assessed during a routine oral examination in relation to the removable partial dentures, maintenance, restorative and prosthetic treatment may be indicated. Maintenance treatments are indicated for small and easily retrievable alterations. In removable partial denture treatment, adequate space between prepared tooth and denture is essential. Possible prosthetic treatments of a removable partial denture are relining, rebasing, improving or renewing the maxillomandibular relation, repairment, and extension.

Efficiency Optimization by Considering the High Voltage Flyback Transformer Parasitics using an Automatic Winding Layout Technique

DEFF Research Database (Denmark)

Thummala, Prasanth; Schneider, Henrik; Zhang, Zhe

2015-01-01

.The energy efficiency is optimized using a proposed new automatic winding layout (AWL) technique and a comprehensive loss model.The AWL technique generates a large number of transformer winding layouts.The transformer parasitics such as dc resistance, leakage inductance and self-capacitance are calculated...... for each winding layout.An optimization technique is formulated to minimize the sum of energy losses during charge and discharge operations.The efficiency and energy loss distribution results from the optimization routine provide a deep insight into the high voltage transformer designand its impact...

Very poor agreement between routine outpatient clinic office and ambulatory blood pressure: time to improve an old hospital outpatient clinic routine?

Science.gov (United States)

Reinhard, Mark; Poulsen, Per L; Christensen, Kent L

2016-12-01

We investigated the agreement between elevated outpatient clinic office blood pressure (OC-OBP) as measured in the daily routine in our University Hospital Cardiology Outpatient Clinic and subsequent awake ambulatory blood pressure (AABP). In all patients referred for ambulatory blood pressure monitoring from our Cardiology Outpatient Clinic, we identified OC-OBP and changes in medication in the period from 1 January 2014 to 15 September 2015. The AABP was used as a reference measurement for the OC-OBP. A total of 183 patients were included in the study. Their mean age was 62.1±14.0 years and 49% were women. The mean systolic OC-OBP was 166.8±17.9 mmHg and the difference between the mean systolic OC-OBP and AABP was 28.0±19.5 mmHg (Pclinic agrees poorly with AABP and may lead to unnecessary treatment and pharmacologically induced symptomatic hypotension, particularly in elderly patients. The results of this study urgently call for alternative solutions to routine OC-OBP in hospital outpatient clinics.

Correlation of routine haematological parameters between normal maternal blood and the cord blood of healthy newborns in selected hospitals of karachi

International Nuclear Information System (INIS)

Qaiser, D.H.; Ghori, G.M.; Sandila, M.P.; Omair, A.

2013-01-01

Objective: To determine any significant correlation between the routine haematological parameters of maternal blood and umbilical cord blood of their respective newborns. Study Design: Cross sectional study. Place and Duration of Study: The study was conducted at four public and private hospitals of Karachi including Sindh Government Qatar Hospital, Sindh Government Hospital, Liaquatabad, Ziauddin University Hospital and Chinniot Maternity and Child Hospital, respectively from July 2006 to April 2008. Methodology: Three milliliters venous blood was collected in EDTA containing tube for complete blood count of mothers before delivery. Five milliliters cord blood was collected from the umbilical cord of the babies immediately after delivery by clamping and cutting the babies' end of the cord. For haematological parameters a standard coultergram was done including haemoglobin, RBCs count, haematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), white blood cell count, differential leukocyte count and platelet count. Pearson's correlation co-efficient was used to determine an association between the maternal and cord blood parameters. Results: A total of 404 maternal and umbilical cord blood samples were analyzed. All the blood parameters including haemoglobin, RBCs count, HCT, MCV, MCH, white blood cell count, differential leukocyte count and platelet count were found to be high in cord blood as compared to the maternal blood, but they showed a very weak to negligible correlation. Mean Corpuscular Haemoglobin Concentration (MCHC), showed a moderate correlation. Conclusion: Routine haematological parameters of newborns are independent of maternal routine haematological parameters. (author)

Treatment goals in psoriasis routine care.

Science.gov (United States)

Radtke, M A; Reich, K; Spehr, C; Augustin, Matthias

2015-07-01

The treatment goal algorithm for psoriasis, first originated in 2007, has ever since been adopted into treatment guidelines. It remained unclear how many patients have experienced the use of treatment goals in routine care and how these are perceived. The aim of the pilot study was to get first insight in the use and impact of therapeutic goals in a large cohort of patients with psoriasis in routine care. This study is a multicenter, non-interventional, cross-sectional health care study in n = 213 dermatology centers across Germany. A standardized physician and patient questionnaire was used, including demographics, disease and treatment characteristics. To evaluate patient treatment perception and satisfaction, a questionnaire (PsoSat) addressing 8 specific items was designed. Consistency and validity of the questionnaire were controlled by factor analyses and reliability tests. In total n = 1,883 patients were included for analysis (54.2% male). Mean age was 52 years, mean disease duration 19 years. In total 45.5% (n = 856) stated an improvement of psoriatic symptoms in the last 4 weeks. In patients including treatment goals, the course of psoriasis in the last 4 weeks was rated significantly better and predicted significantly higher patient satisfaction. Patients reporting periodic outcomes measurement of psoriasis treatment, also had significantly better course of disease, higher satisfaction and a lower psoriasis severity. A majority of patients experienced the use of treatment goals in practice. The association of using treatment goals with clinical outcomes and treatment satisfaction was markedly positive. These findings indicate that the use of treatment goals and outcome measurements in fact improve psoriasis management.

Quality of routine spirometry tests in Dutch general practices.

NARCIS (Netherlands)

Schermer, T.R.J.; Crockett, A.J.; Poels, P.J.P.; Dijke, J.J. van; Akkermans, R.P.; Vlek, H.F.; Pieters, W.R.

2009-01-01

BACKGROUND: Spirometry is an indispensable tool for diagnosis and monitoring of chronic airways disease in primary care. AIM: To establish the quality of routine spirometry tests in general practice, and explore associations between test quality and patient characteristics. DESIGN OF STUDY: Analysis

The Diagnostic Value of Routine Contrast Esophagram in Anastomotic Leaks After Esophagectomy.

Science.gov (United States)

Hu, Zhongwu; Wang, Xiaowe; An, Xush; Li, Wenjin; Feng, Yun; You, Zhenbing

2017-08-01

Routine contrast esophagram has been shown to be increasingly limited in diagnosing anastomotic leaks after esophagectomy. Patients undergoing esophagectomy from 2013 to 2014 at Huai'an First Peoples' Hospital were identified. We retrospectively analyzed patients who underwent routine contrast esophagram on postoperative day 7 (range 6-10) to preclude anastomotic leaks after esophagectomy. In 846 patients who underwent esophagectomy, a cervical anastomosis was performed in 286 patients and an intrathoracic anastomosis in 560 patients. There were 57 (6.73%) cases with anastomotic leaks, including cervical leaks in 36 and intrathoracic leaks in 21 patients. In the cervical anastomotic leak patients, 13 were diagnosed by early local clinical symptoms and 23 underwent routine contrast esophagram. There were 7 (30.4%) true-positive, 11 (47.8%) false-negative, and five (21.8%) equivocal cases. In the intrathoracic anastomotic leak patients, four (19%) were diagnosed by clinical symptoms, 16 (76.2%) were true positives, and one (4.8%) was a false negative. Aspiration occurred in five patients with cervical anastomoses and in eight patients with intrathoracic anastomoses; aspiration pneumonitis did not occur in these cases. Gastrografin and barium are safe contrast agents to use in post-esophagectomy contrast esophagram. Because of the low sensitivity in detecting cervical anastomotic leaks, routine contrast esophagram is not advised. For patients with intrathoracic anastomoses, it is still an effective method for detecting anastomotic leaks.

Routine Early Angioplasty after Fibrinolysis

DEFF Research Database (Denmark)

Wang, Zhipeng; Liang, Bo; Mei, Qibing

2009-01-01

patients in the group that underwent routine early PCI than in the group that received standard treatment received clopidogrel (Ppatients who undergo PCI, as well as in those who do not, is well established,1...... with early beta-blocker therapy is taken into consideration.3 The overall benefit of clopidogrel and beta-blocker therapy could have influenced the outcome in patients who underwent early PCI. These facts leave the conclusion of the TRANSFER-AMI trial still highly uncertain.......To the Editor: Cantor et al. report that there is a significantly reduced rate of ischemic complications among patients with myocardial infarction with ST-segment elevation who are transferred for PCI within 6 hours after fibrinolysis. However, Table 2 of the article shows that significantly more...

Balancing enablers and constraints within organisational routines : A case-study of in-store goods flow at two IKEA stores in Europe

OpenAIRE

Arcidiacono, Fabio; Franssen, Rico

2016-01-01

Considering the importance of routine execution within firm replication, exploring the balance between organisational routine development in terms of variations and routine constraints of this variation, with the goal of allowing for improvements without deviating too far from the original routine that makes it a success. Aim: Shed light onto how routine variations are managed in the face of the two extremes; no routine development at all and too much routine development. Methodology: This qu...

Visual Thinking Routines: A Mixed Methods Approach Applied to Student Teachers at the American University in Dubai

Science.gov (United States)

Gholam, Alain

2017-01-01

Visual thinking routines are principles based on several theories, approaches, and strategies. Such routines promote thinking skills, call for collaboration and sharing of ideas, and above all, make thinking and learning visible. Visual thinking routines were implemented in the teaching methodology graduate course at the American University in…

Developing non-routine problems for assessing students’ mathematical literacy

Science.gov (United States)

Murdiyani, N. M.

2018-03-01

The purpose of this study is to develop non-routine problems for assessing the mathematics literacy skills of students, which is valid, practical, and effective. It is based on the previous research said that Indonesian students’ mathematical literacy is still low. The results of this study can be used as a guide in developing the evaluation questions that can train students to improve the ability of solving non-routine problems in everyday life. This research type is formative evaluation that consists of preliminary, self evaluation, expert reviews, one-to-one, small group, and field test. The sample of this research is grade 8 students at one of Junior High School in Yogyakarta. This study results in mathematics literacy problems prototype consisting of level 1 to level 6 problems similar to PISA problems. This study also discusses the examples of students’ answer and their reasoning.

A multicenter study of routine versus selective intraoperative leak testing for sleeve gastrectomy.

Science.gov (United States)

Bingham, Jason; Kaufman, Jedediah; Hata, Kai; Dickerson, James; Beekley, Alec; Wisbach, Gordon; Swann, Jacob; Ahnfeldt, Eric; Hawkins, Devon; Choi, Yong; Lim, Robert; Martin, Matthew

2017-09-01

Staple line leaks after sleeve gastrectomy are dreaded complications. Many surgeons routinely perform an intraoperative leak test (IOLT) despite little evidence to validate the reliability, clinical benefit, and safety of this procedure. To determine the efficacy of IOLT and if routine use has any benefit over selective use. Eight teaching hospitals, including private, university, and military facilities. A multicenter, retrospective analysis over a 5-year period. The efficacy of the IOLT for identifying unsuspected staple line defects and for predicting postoperative leaks was evaluated. An anonymous survey was also collected reflecting surgeons' practices and beliefs regarding IOLT. From January 2010 through December 2014, 4284 patients underwent sleeve gastrectomy. Of these, 37 patients (.9%) developed a postoperative leak, and 2376 patients (55%) received an IOLT. Only 2 patients (0.08%) had a positive finding. Subsequently, 21 patients with a negative IOLT developed a leak. IOLT demonstrated a sensitivity of only 8.7%. There was a nonsignificant trend toward increased leak rates when an IOLT was performed versus when IOLT was not performed. Leak rates were not statistically different between centers that routinely perform IOLT versus those that selectively perform IOLT. Routine IOLT had very poor sensitivity and was negative in 91% of patients who later developed postoperative leaks. The use of IOLT was not associated with a decrease in the incidence of postoperative leaks, and routine IOLT had no benefit over selective leak testing. IOLT should not be used as a quality indicator or "best practice" for bariatric surgery. Published by Elsevier Inc.

Routine-industrial planning in the ATOMMASh enterprise

International Nuclear Information System (INIS)

Zabara, V.N.; Kovalev, B.V.; Bobrov, A.A.; Gostishchev, V.S.; Edikhanov, V.P.

1987-01-01

Structure of automated system for routine-industrial planning, developed at the ATOMMASh enterprise is considered. 11 problems, enabling to calculate the duration of cycles of fabrication and lead of detail putting to departments, schedules of detail production in departments fo year, quater, mounth, production plans in norm-hours, equipment utilization, as well as problems, providing for schedule performance were developed. All operational data on the state of industry are concentrated in the data base of operational control

Routine antenatal syphilis screening in South West Nigeria - a ...

African Journals Online (AJOL)

Background: Untreated maternal syphilis is strongly associated with adverse birth outcomes, especially in women with high titre syphilis. The WHO recommends routine serological screening in pregnancy. Some workers have advised a reappraisal of this practice, having demonstrated low sero-prevalence in their antenatal ...

Daily Family Routines of Italian and Ecuadorian Immigrant Mothers in Everyday Life

Directory of Open Access Journals (Sweden)

Nadia Rania

2015-10-01

Full Text Available This study compares Italian mothers’ and Ecuadorian immigrant mothers’ daily family routines. Thirty mothers took part in this investigation: 15 Italians (M = 37.5 years, with ages ranging from 30 to 42 years and 15 Ecuadorians (M = 36.1 years, with ages ranging from 18 to 46 years and having lived in Italy for an average of 15 years, with children ranging in age from 4 to 8 years. The objective is to highlight the differences and similarities between the daily routines and family relations that characterize the lives of each of the two groups of participants. The instruments employed in service of these aims were in-depth interviews and diaries. The results showed similarities regarding the routines of Italian and Ecuadorian families. However, a relevant difference emerged regarding their perceptions of social support. Specifically, Italians receive more social support from their parents than do Ecuadorians, who are supported more by other relatives or by friends.

How does routinely delivered cognitive-behavioural therapy for gambling disorder compare to "gold standard" clinical trial?

Science.gov (United States)

Smith, David P; Fairweather-Schmidt, A Kate; Harvey, Peter W; Battersby, Malcolm W

2018-03-01

Currently, it is unknown whether treatment outcomes derived from randomized controlled trials (RCTs) of cognitive-behavioural therapy (CBT) for problem gamblers still hold when applied to patients seen in routine practice. Thus, data from an RCT of cognitive therapy versus exposure therapy for problem gambling versus patients of a gambling help service were compared. Assessments of problem gambling severity, psychosocial impairment, and alcohol use were undertaken at baseline and post-treatment and evaluated within a counterfactual framework. Findings showed that the contrast between routine CBT for pokies and horse betting had a significant effect, indicative of a 62% lower gambling urge score if routine CBT recipients had all been horse/track betters opposed to gambling with "pokies." However, the majority of contrasts indicated therapeutic outcomes achieved in routine CBT treatments were of equivalent robustness relative to RCT conditions. The present findings infer routine practice treatment outcomes are as efficacious as those generated in RCT contexts. Copyright © 2017 John Wiley & Sons, Ltd.

A comprehensive study of task coalescing for selecting parallelism granularity in a two-stage bidiagonal reduction

KAUST Repository

Haidar, Azzam

2012-05-01

We present new high performance numerical kernels combined with advanced optimization techniques that significantly increase the performance of parallel bidiagonal reduction. Our approach is based on developing efficient fine-grained computational tasks as well as reducing overheads associated with their high-level scheduling during the so-called bulge chasing procedure that is an essential phase of a scalable bidiagonalization procedure. In essence, we coalesce multiple tasks in a way that reduces the time needed to switch execution context between the scheduler and useful computational tasks. At the same time, we maintain the crucial information about the tasks and their data dependencies between the coalescing groups. This is the necessary condition to preserve numerical correctness of the computation. We show our annihilation strategy based on multiple applications of single orthogonal reflectors. Despite non-trivial characteristics in computational complexity and memory access patterns, our optimization approach smoothly applies to the annihilation scenario. The coalescing positively influences another equally important aspect of the bulge chasing stage: the memory reuse. For the tasks within the coalescing groups, the data is retained in high levels of the cache hierarchy and, as a consequence, operations that are normally memory-bound increase their ratio of computation to off-chip communication and become compute-bound which renders them amenable to efficient execution on multicore architectures. The performance for the new two-stage bidiagonal reduction is staggering. Our implementation results in up to 50-fold and 12-fold improvement (∼130 Gflop/s) compared to the equivalent routines from LAPACK V3.2 and Intel MKL V10.3, respectively, on an eight socket hexa-core AMD Opteron multicore shared-memory system with a matrix size of 24000 x 24000. Last but not least, we provide a comprehensive study on the impact of the coalescing group size in terms of cache

Limited utility of routine surveillance imaging for classical Hodgkin lymphoma patients in first complete remission.

Science.gov (United States)

Pingali, Sai Ravi; Jewell, Sarah W; Havlat, Luiza; Bast, Martin A; Thompson, Jonathan R; Eastwood, Daniel C; Bartlett, Nancy L; Armitage, James O; Wagner-Johnston, Nina D; Vose, Julie M; Fenske, Timothy S

2014-07-15

The objective of this study was to compare the outcomes of patients with classical Hodgkin lymphoma (cHL) who achieved complete remission with frontline therapy and then underwent either clinical surveillance or routine surveillance imaging. In total, 241 patients who were newly diagnosed with cHL between January 2000 and December 2010 at 3 participating tertiary care centers and achieved complete remission after first-line therapy were retrospectively analyzed. Of these, there were 174 patients in the routine surveillance imaging group and 67 patients in the clinical surveillance group, based on the intended mode of surveillance. In the routine surveillance imaging group, the intended plan of surveillance included computed tomography and/or positron emission tomography scans; whereas, in the clinical surveillance group, the intended plan of surveillance was clinical examination and laboratory studies, and scans were obtained only to evaluate concerning signs or symptoms. Baseline patient characteristics, prognostic features, treatment records, and outcomes were collected. The primary objective was to compare overall survival for patients in both groups. For secondary objectives, we compared the success of second-line therapy and estimated the costs of imaging for each group. After 5 years of follow-up, the overall survival rate was 97% (95% confidence interval, 92%-99%) in the routine surveillance imaging group and 96% (95% confidence interval, 87%-99%) in the clinical surveillance group (P = .41). There were few relapses in each group, and all patients who relapsed in both groups achieved complete remission with second-line therapy. The charges associated with routine surveillance imaging were significantly higher than those for the clinical surveillance strategy, with no apparent clinical benefit. Clinical surveillance was not inferior to routine surveillance imaging in patients with cHL who achieved complete remission with frontline therapy. Routine

Pharmaceutical care and the use of routine diagnostic tools by ...

African Journals Online (AJOL)

Purpose: To evaluate the use of routine diagnostic tools among community pharmacists in Ibadan,. Nigeria. ... measurement, and tests for serum cholesterol, capillary .... Development .... Duweijua M, Dodoo A, Plange R. Quality Counseling on.

Are daily routine chest radiographs useful in critically ill, mechanically ventilated patients? A randomized study.

Science.gov (United States)

Clec'h, Christophe; Simon, Paul; Hamdi, Aïcha; Hamza, Lilia; Karoubi, Philippe; Fosse, Jean-Philippe; Gonzalez, Frédéric; Vincent, François; Cohen, Yves

2008-02-01

Whether chest radiographs (CXRs) in mechanically ventilated patients should be routinely obtained or only when an abnormality is anticipated remains debated. We aimed to compare the diagnostic, therapeutic and outcome efficacy of a restrictive prescription of CXRs with that of a routine prescription, focusing on delayed diagnoses and treatments potentially related to the restrictive prescription. Randomized controlled trial. Intensive care unit of the Avicenne Teaching Hospital, Bobigny, France. All consecutive patients mechanically ventilated for > or = 48h between January and June 2006. Patients were randomly assigned to have daily routine CXRs (routine prescription group) or clinically indicated CXRs (restrictive prescription group). For each CXR, a questionnaire was completed addressing the reason for the CXR, the new findings, and any subsequent therapeutic intervention. The endpoints were the rates of new findings, the rates of new findings that prompted therapeutic intervention, the rate of delayed diagnoses, and mortality. Eighty-four patients were included in the routine prescription group and 81 in the restrictive prescription group. The rates of new findings and the rates of new findings that prompted therapeutic intervention in the restrictive prescription group and in the routine prescription group were 66% vs. 7.2% (p < 0.0001), and 56.4% vs. 5.5% (p < 0.0001) respectively. The rate of delayed diagnoses in the restrictive prescription group was 0.7%. Mortality was similar. Restrictive use of CXRs in mechanically ventilated patients was associated with better diagnostic and therapeutic efficacies without impairing outcome.

MALDI-TOF MS Andromas strategy for the routine identification of bacteria, mycobacteria, yeasts, Aspergillus spp. and positive blood cultures.

Science.gov (United States)

Bille, E; Dauphin, B; Leto, J; Bougnoux, M-E; Beretti, J-L; Lotz, A; Suarez, S; Meyer, J; Join-Lambert, O; Descamps, P; Grall, N; Mory, F; Dubreuil, L; Berche, P; Nassif, X; Ferroni, A

2012-11-01

All organisms usually isolated in our laboratory are now routinely identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) using the Andromas software. The aim of this study was to describe the use of this strategy in a routine clinical microbiology laboratory. The microorganisms identified included bacteria, mycobacteria, yeasts and Aspergillus spp. isolated on solid media or extracted directly from blood cultures. MALDI-TOF MS was performed on 2665 bacteria isolated on solid media, corresponding to all bacteria isolated during this period except Escherichia coli grown on chromogenic media. All acquisitions were performed without extraction. After a single acquisition, 93.1% of bacteria grown on solid media were correctly identified. When the first acquisition was not contributory, a second acquisition was performed either the same day or the next day. After two acquisitions, the rate of bacteria identified increased to 99.2%. The failures reported on 21 strains were due to an unknown profile attributed to new species (9) or an insufficient quality of the spectrum (12). MALDI-TOF MS has been applied to 162 positive blood cultures. The identification rate was 91.4%. All mycobacteria isolated during this period (22) were correctly identified by MALDI-TOF MS without any extraction. For 96.3% and 92.2% of yeasts and Aspergillus spp., respectively, the identification was obtained with a single acquisition. After a second acquisition, the overall identification rate was 98.8% for yeasts (160/162) and 98.4% (63/64) for Aspergillus spp. In conclusion, the MALDI-TOF MS strategy used in this work allows a rapid and efficient identification of all microorganisms isolated routinely. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.

SU-E-P-08: Establishment of Local Diagnostic Reference Levels of Routine Abdomen Exam in Computed Tomography According to Body Weight

International Nuclear Information System (INIS)

Wang, H; Wang, Y; Weng, H

2015-01-01

Purpose: The national diagnostic reference levels (NDRLs) is an efficient, concise and powerful standard for optimizing radiation protection of a patient. However, for each hospital the dose-reducing potential of focusing on establishment of local DRLs (LDRLs). A lot of study reported that Computed tomography exam contributed majority radiation dose in different medical modalities, therefore, routine abdomen CT exam was choose in initial pilot study in our study. Besides the mAs of routine abdomen CT exam was decided automatic exposure control by linear attenuation is relate to body shape of patient. In this study we would like to establish the local diagnostic reference levels of routine abdomen exam in computed tomography according to body weight of patient. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). The patient sample involved 82 adult patients of both sexes and divided into three groups by their body weight (50–60 kg, 60–70 kg, 70–80 kg).Carried out the routine abdomen examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. The average values were compared with the European DRLs. Results: The majority of patients (75%) were between 50–70 Kg of body weight, the numbers of patient in each group of weight were 40–50:7; 50–60:29; 60–70:33; 70–80:13. The LDRLs in each group were 10.81mGy, 14.46mGy, 20.27mGy and 21.04mGy, respectively. The DLP were 477mGy, 630mGy, 887mGy and 959mGy, respectively. No matter which group the LDRLs were lower than European DRLs. Conclusions: We would like to state that this was a pioneer work in local hospital in Chiayi. We hope that this may lead the way to further developments in Taiwan

SU-E-P-08: Establishment of Local Diagnostic Reference Levels of Routine Abdomen Exam in Computed Tomography According to Body Weight

Energy Technology Data Exchange (ETDEWEB)

Wang, H; Wang, Y; Weng, H [Chiayi Chang Gung Memorial Hospital of The C.G.M.F, Puzi City, Chiayi County, Taiwan (China)

2015-06-15

Purpose: The national diagnostic reference levels (NDRLs) is an efficient, concise and powerful standard for optimizing radiation protection of a patient. However, for each hospital the dose-reducing potential of focusing on establishment of local DRLs (LDRLs). A lot of study reported that Computed tomography exam contributed majority radiation dose in different medical modalities, therefore, routine abdomen CT exam was choose in initial pilot study in our study. Besides the mAs of routine abdomen CT exam was decided automatic exposure control by linear attenuation is relate to body shape of patient. In this study we would like to establish the local diagnostic reference levels of routine abdomen exam in computed tomography according to body weight of patient. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). The patient sample involved 82 adult patients of both sexes and divided into three groups by their body weight (50–60 kg, 60–70 kg, 70–80 kg).Carried out the routine abdomen examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. The average values were compared with the European DRLs. Results: The majority of patients (75%) were between 50–70 Kg of body weight, the numbers of patient in each group of weight were 40–50:7; 50–60:29; 60–70:33; 70–80:13. The LDRLs in each group were 10.81mGy, 14.46mGy, 20.27mGy and 21.04mGy, respectively. The DLP were 477mGy, 630mGy, 887mGy and 959mGy, respectively. No matter which group the LDRLs were lower than European DRLs. Conclusions: We would like to state that this was a pioneer work in local hospital in Chiayi. We hope that this may lead the way to further developments in Taiwan.

The birth and routinization of IVF in China

DEFF Research Database (Denmark)

Wahlberg, Ayo

2016-01-01

How can it be that China today is home to some of the world’s largest IVF clinics, carrying out as many as 30,000 cycles annually? In this article, I address how IVF was developed in China during the early 1980s only to be routinized during the exact same period that one of the world’s most compr...

How characteristic routines of clinical departments influence students' self-regulated learning : A grounded theory study

NARCIS (Netherlands)

Berkhout, J J; Slootweg, I. A.; Helmich, Esther; Teunissen, P W; van der Vleuten, C. P. M.; Jaarsma, A. D. C.

2017-01-01

Background: In clerkships, students are expected to self-regulate their learning. How clinical departments and their routine approach on clerkships influences students' self-regulated learning (SRL) is unknown.Aim: This study explores how characteristic routines of clinical departments influence

Errorless (re)learning of daily living routines by a woman with impaired memory and initiation: transferrable to a new home?

Science.gov (United States)

Ferland, Mark B; Larente, Johanne; Rowland, Julia; Davidson, Patrick S R

2013-01-01

To use errorless learning to train a memory- and initiation-impaired woman on two activities of daily living routines and then to transfer these routines to a new home. Single case quasi-experimental. Over 9 months, a young woman with an anterior cerebral haemorrhagic stroke (secondary to a ruptured arteriovenous malformation) was trained on routines of morning self-care and diabetes management, involving extensive practice on a structured series of steps with intervention as needed to prevent errors. Once routines were established, family members were trained in the supervision and rating of the routines at home. Following discharge, caregivers continued to monitor the routines daily for 3 months. Errorless learning of self-care and diabetes routines was successful. The routines were transferred to a new home environment and maintained at a near perfect level over a 3-month follow-up period. The patient remained severely memory-impaired, indicating that her functional gains were not attributable to any recovery of her memory abilities over time. This case offers evidence that even people with severe memory and initiation impairments can be trained on new routines using errorless learning and that, once learned, these routines can be carried out in novel contexts.

Radiation dose monitoring in the clinical routine

Energy Technology Data Exchange (ETDEWEB)

Guberina, Nika [UK Essen (Germany). Radiology

2017-04-15

Here we describe the first clinical experiences regarding the use of an automated radiation dose management software to monitor the radiation dose of patients during routine examinations. Many software solutions for monitoring radiation dose have emerged in the last decade. The continuous progress in radiological techniques, new scan features, scanner generations and protocols are the primary challenge for radiation dose monitoring software systems. To simulate valid dose calculations, radiation dose monitoring systems have to follow current trends and stay constantly up-to-date. The dose management software is connected to all devices at our institute and conducts automatic data acquisition and radiation dose calculation. The system incorporates 18 virtual phantoms based on the Cristy phantom family, estimating doses in newborns to adults. Dose calculation relies on a Monte Carlo simulation engine. Our first practical experiences demonstrate that the software is capable of dose estimation in the clinical routine. Its implementation and use have some limitations that can be overcome. The software is promising and allows assessment of radiation doses, like organ and effective doses according to ICRP 60 and ICRP 103, patient radiation dose history and cumulative radiation doses. Furthermore, we are able to determine local diagnostic reference doses. The radiation dose monitoring software systems can facilitate networking between hospitals and radiological departments, thus refining radiation doses and implementing reference doses at substantially lower levels.

Routine Violence Risk Assessment in Community Forensic Mental Healthcare

NARCIS (Netherlands)

van den Brink, Rob H. S.; Hooijschuur, Alex; van Os, Titus W. D. P.; Savenije, Wim; Wiersma, Durk

2010-01-01

We developed a method for periodic monitoring of violence risk, as part of routine community forensic mental healthcare. The feasibility of the method was tested, as well as its predictive validity for violent and risk enhancing behavior in the subsequent months. Participants were 83 clients who

Routine pharmacogenetic testing in clinical practice: dream or reality?

Science.gov (United States)

Grossman, Iris

2007-10-01

Pharmacogenetics (PGx) has become progressively popular in recent years, thanks to growing anticipation among scientists, healthcare providers and the general public for the incorporation of genetic tests into the diagnostic arsenal at the physician's disposal. Indeed, much research has been dedicated to elucidation of genetic determinants underlying interindividual variability in pharmacokinetic parameters, as well as drug safety and efficacy. However, few PGx applications have thus far been realized in healthcare management. This review uses examples from PGx research of psychiatric drugs to illustrate why the current published findings are inadequate and insufficient for utilization as routine clinical predictors of treatment safety, efficacy or dosing. I therefore suggest the necessary steps to demonstrate the validity, utility and cost-effectiveness of PGx. These recommendations include a whole range of aspects, starting from standardization of criteria and assessment of the technical quality of genotyping assays, up to design of prospective PGx studies, providing the basis for reimbursement programs to be recognized in routine clinical practice.

The routine use of modified Borelli's lactritmel agar (MBLA).

Science.gov (United States)

Kaminski, G W

1985-07-01

The original formula of Borelli's lactritmel agar (BLA)(3) which contains wheat flour, milk and honey, has been modified by replacing the wheat flour with dehydrated Bacto Corn Meal Agar (Difco) and by slightly altering the concentrations of the milk and honey. The modified medium (MBLA) is less turbid, less particulate, and easier to prepare than BLA. Although Trichophyton rubrum usually produces a wine-red pigment with BLA, most strains initially produce a yellow pigment, with the red pigment developing later. The corn meal in MBLA reduces this tendency and stimulates the early formation of deep wine red pigment, MBLA enhances sporulation of dermatophytes and various fungi which fail to sporulate on other media, and maintains characteristic growth without developing pleomorphic degeneration. It has been used routinely since 1972 as a reliable aid to the differentiation of T. rubrum and T. mentagrophytes. Since 1975 selective MBLA has been used as a routine primary isolation medium for dermatophytes, and has proved to be most useful.

Real-time whole-genome sequencing for routine typing, surveillance, and outbreak detection of verotoxigenic Escherichia coli.

OpenAIRE

Joensen, Katrine Grimstrup; Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf Sommer; Nielsen, Eva M.; Aarestrup, Frank Møller

2014-01-01

Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-prod...

Real-Time Whole-Genome Sequencing for Routine Typing, Surveillance, and Outbreak Detection of Verotoxigenic Escherichia coli

OpenAIRE

Joensen, Katrine Grimstrup; Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf S.; Nielsen, Eva M.; Aarestrup, Frank M.

2014-01-01

Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-prod...

Resolving DNA at Efficiencies of More than A Million Plates per Meter Using Bare Narrow Open Capillary without Sieving Matrix

OpenAIRE

Zhu, Zaifang; Liu, Lei; Wang, Wei; Lu, Joann J.; Wang, Xiayan; Liu, Shaorong

2013-01-01

We report a novel approach for effectively separating DNA molecules in free solution. The method uses a bare narrow open capillary without any sieving matrices to resolve a wide size-range of DNA fragments at efficiencies of more than a million plates per meter routinely.

Can complex health interventions be evaluated using routine clinical and administrative data? - a realist evaluation approach.

Science.gov (United States)

Riippa, Iiris; Kahilakoski, Olli-Pekka; Linna, Miika; Hietala, Minni

2014-12-01

Interventions aimed at improving chronic care typically consist of multiple interconnected parts, all of which are essential to the effect of the intervention. Limited attention has been paid to the use of routine clinical and administrative data in the evolution of these complex interventions. The purpose of this study is to examine the feasibility of routinely collected data when evaluating complex interventions and to demonstrate how a theory-based, realist approach to evaluation may increase the feasibility of routine data. We present a case study of evaluating a complex intervention, namely, the chronic care model (CCM), in Finnish primary health care. Issues typically faced when evaluating the effects of a complex intervention on health outcomes and resource use are identified by using routine data in a natural setting, and we apply context-mechanism-outcome (CMO) approach from the realist evaluation paradigm to improve the feasibility of using routine data in evaluating complex interventions. From an experimentalist approach that dominates the medical literature, routine data collected from a single centre offered a poor starting point for evaluating complex interventions. However, the CMO approach offered tools for identifying indicators needed to evaluate complex interventions. Applying the CMO approach can aid in a typical evaluation setting encountered by primary care managers: one in which the intervention is complex, the primary data source is routinely collected clinical and administrative data from a single centre, and in which randomization of patients into two research arms is too resource consuming to arrange. © 2014 John Wiley & Sons, Ltd.

SU-E-P-10: Establishment of Local Diagnostic Reference Levels of Routine Exam in Computed Tomography

International Nuclear Information System (INIS)

Yeh, M; Wang, Y; Weng, H

2015-01-01

Introduction National diagnostic reference levels (NDRLs) can be used as a reference dose of radiological examination can provide radiation dose as the basis of patient dose optimization. Local diagnostic reference levels (LDRLs) by periodically view and check doses, more efficiency to improve the way of examination. Therefore, the important first step is establishing a diagnostic reference level. Computed Tomography in Taiwan had been built up the radiation dose limit value,in addition, many studies report shows that CT scan contributed most of the radiation dose in different medical. Therefore, this study was mainly to let everyone understand DRL’s international status. For computed tomography in our hospital to establish diagnostic reference levels. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). Each exam each different body part, we collect 10 patients at least. Carried out the routine examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. Results: The majority of patients (75%) were between 60–70 Kg of body weight. There are 25 examinations in this study. Table 1 shows the LDRL of each CT routine examination. Conclusions: Therefore, this study would like to let everyone know DRL’s international status, but also establishment of computed tomography of the local reference levels for our hospital, and providing radiation reference, as a basis for optimizing patient dose

SU-E-P-10: Establishment of Local Diagnostic Reference Levels of Routine Exam in Computed Tomography

Energy Technology Data Exchange (ETDEWEB)

Yeh, M; Wang, Y; Weng, H [Chiayi Chang Gung Memorial Hospital of The C.G.M.F, Puzi City, Chiayi County, Taiwan (China)

2015-06-15

Introduction National diagnostic reference levels (NDRLs) can be used as a reference dose of radiological examination can provide radiation dose as the basis of patient dose optimization. Local diagnostic reference levels (LDRLs) by periodically view and check doses, more efficiency to improve the way of examination. Therefore, the important first step is establishing a diagnostic reference level. Computed Tomography in Taiwan had been built up the radiation dose limit value,in addition, many studies report shows that CT scan contributed most of the radiation dose in different medical. Therefore, this study was mainly to let everyone understand DRL’s international status. For computed tomography in our hospital to establish diagnostic reference levels. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). Each exam each different body part, we collect 10 patients at least. Carried out the routine examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. Results: The majority of patients (75%) were between 60–70 Kg of body weight. There are 25 examinations in this study. Table 1 shows the LDRL of each CT routine examination. Conclusions: Therefore, this study would like to let everyone know DRL’s international status, but also establishment of computed tomography of the local reference levels for our hospital, and providing radiation reference, as a basis for optimizing patient dose.

Factors Related to Women's Childbirth Satisfaction in Physiologic and Routine Childbirth Groups.

Science.gov (United States)

Jafari, Elham; Mohebbi, Parvin; Mazloomzadeh, Saeideh

2017-01-01

Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS), satisfied with birth setting, Labor Agentry Scale (LAS), and Visual Analogue Scale (VAS), which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t -test, analysis of variance, and linear, multivariate regression model at the significant level of P toward the recent pregnancy ( P = 0.007), and perceived severity of pain ( P = 0.016). However, in the routine group, satisfaction was related only to intentional pregnancy ( P = 0.002). In neither group, satisfaction was related to demographic characteristics, maternal parity, and participation in pregnancy and childbirth classes or maternal feelings toward the onset of childbirth ( P > 0.05). Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction.

Understanding Smart Home Sensor Data for Ageing in Place Through Everyday Household Routines: A Mixed Method Case Study.

Science.gov (United States)

van Kasteren, Yasmin; Bradford, Dana; Zhang, Qing; Karunanithi, Mohan; Ding, Hang

2017-06-13

An ongoing challenge for smart homes research for aging-in-place is how to make sense of the large amounts of data from in-home sensors to facilitate real-time monitoring and develop reliable alerts. The objective of our study was to explore the usefulness of a routine-based approach for making sense of smart home data for the elderly. Maximum variation sampling was used to select three cases for an in-depth mixed methods exploration of the daily routines of three elderly participants in a smart home trial using 180 days of power use and motion sensor data and longitudinal interview data. Sensor data accurately matched self-reported routines. By comparing daily movement data with personal routines, it was possible to identify changes in routine that signaled illness, recovery from bereavement, and gradual deterioration of sleep quality and daily movement. Interview and sensor data also identified changes in routine with variations in temperature and daylight hours. The findings demonstrated that a routine-based approach makes interpreting sensor data easy, intuitive, and transparent. They highlighted the importance of understanding and accounting for individual differences in preferences for routinization and the influence of the cyclical nature of daily routines, social or cultural rhythms, and seasonal changes in temperature and daylight hours when interpreting information based on sensor data. This research has demonstrated the usefulness of a routine-based approach for making sense of smart home data, which has furthered the understanding of the challenges that need to be addressed in order to make real-time monitoring and effective alerts a reality. ©Yasmin van Kasteren, Dana Bradford, Qing Zhang, Mohan Karunanithi, Hang Ding. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 13.06.2017.

Organizational routines, innovation, and flexibility: the application of narrative networks to dynamic workflow.

Science.gov (United States)

Hayes, Gillian R; Lee, Charlotte P; Dourish, Paul

2011-08-01

The purpose of this paper is to demonstrate how current visual representations of organizational and technological processes do not fully account for the variability present in everyday practices. We further demonstrate how narrative networks can augment these representations to indicate potential areas for successful or problematic adoption of new technologies and potential needs for additional training. We conducted a qualitative study of the processes and routines at a major academic medical center slated to be supported by the development and installation of a new comprehensive HIT system. We used qualitative data collection techniques including observations of the activities to be supported by the new system and interviews with department heads, researchers, and both clinical and non-clinical staff. We conducted a narrative network analysis of these data by choosing exemplar processes to be modeled, selecting and analyzing narrative fragments, and developing visual representations of the interconnection of these narratives. Narrative networks enable us to view the variety of ways work has been and can be performed in practice, influencing our ability to design for innovation in use. Narrative networks are a means for analyzing and visualizing organizational routines in concert with more traditional requirements engineering, workflow modeling, and quality improvement outcome measurement. This type of analysis can support a deeper and more nuanced understanding of how and why certain routines continue to exist, change, or stop entirely. At the same time, it can illuminate areas in which adoption may be slow, more training or communication may be needed, and routines preferred by the leadership are subverted by routines preferred by the staff. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

IT Infrastructure to Support the Secondary Use of Routinely Acquired Clinical Imaging Data for Research

NARCIS (Netherlands)

K.Y.E. Leung (Esther); F. van der Lijn (Fedde); H.A. Vrooman (Henri); M.C.J.M. Sturkenboom (Miriam); W.J. Niessen (Wiro)

2014-01-01

textabstractWe propose an infrastructure for the automated anonymization, extraction and processing of image data stored in clinical data repositories to make routinely acquired imaging data available for research purposes. The automated system, which was tested in the context of analyzing routinely

Types of and reasons for postoperative complications after routine ...

African Journals Online (AJOL)

Tooth extraction also called exodontia is one of the most common surgical procedures. This study was to assess the reasons and the types of wound healing complications arising after routine (intra alveolar dental extraction) in a General hospital in Lagos. Consecutive recruitment (convenient sampling) method was used to ...

Pitfalls in the routine diagnosis of Staphylococcus aureus | Bello ...

African Journals Online (AJOL)

Two hundred isolates of Presumed Staphylococcus aureus from routine clinical specimens, collected from two government hospitals in Abha, Saudi Arabia, had their identity verified. We used the tube coagulase test as our gold standard. Twenty (10%) of the isolates were mis-identified. Reliance by the two laboratories on ...

Adiponectin as a routine clinical biomarker.

Science.gov (United States)

Kishida, Ken; Funahashi, Tohru; Shimomura, Iichiro

2014-01-01

Adiponectin is a protein synthesized and secreted predominantly by adipocytes into the peripheral blood. However, circulating adiponectin level is inversely related with body weight, especially visceral fat accumulation. The mechanism of this paradoxical relation remains obscure. Low circulating adiponectin concentrations (hypoadiponectinemia; osteoporosis, and cancer (endometrial cancer, postmenopausal breast cancer, leukemia, colon cancer, gastric cancer, prostate cancer). On the other hand, hyperadiponectinemia is associated with cardiac, renal and pulmonary diseases. This review article focuses on the significance of adiponectin as a clinical biomarker of obesity-related diseases. Routine measurement of adiponectin in patients with lifestyle-related diseases is highly recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

Impact of routine cerebral CT angiography on treatment decisions in infective endocarditis.

Directory of Open Access Journals (Sweden)

Marwa Sayed Meshaal

Full Text Available Infective endocarditis (IE is commonly complicated by cerebral embolization and hemorrhage secondary to intracranial mycotic aneurysms (ICMAs. These complications are associated with poor outcome and may require diagnostic and therapeutic plans to be modified. However, routine screening by brain CT and CT angiography (CTA is not standard practice. We aimed to study the impact of routine cerebral CTA on treatment decisions for patients with IE.From July 2007 to December 2012, we prospectively recruited 81 consecutive patients with definite left-sided IE according to modified Duke's criteria. All patients had routine brain CTA conducted within one week of admission. All patients with ICMA underwent four-vessel conventional angiography. Invasive treatment was performed for ruptured aneurysms, aneurysms ≥ 5 mm, and persistent aneurysms despite appropriate therapy. Surgical clipping was performed for leaking aneurysms if not amenable to intervention.The mean age was 30.43 ± 8.8 years and 60.5% were males. Staph aureus was the most common organism (32.3%. Among the patients, 37% had underlying rheumatic heart disease, 26% had prosthetic valves, 23.5% developed IE on top of a structurally normal heart and 8.6% had underlying congenital heart disease. Brain CT/CTA revealed that 51 patients had evidence of cerebral embolization, of them 17 were clinically silent. Twenty-six patients (32% had ICMA, of whom 15 were clinically silent. Among the patients with ICMAs, 11 underwent endovascular treatment and 2 underwent neurovascular surgery. The brain CTA findings prompted different treatment choices in 21 patients (25.6%. The choices were aneurysm treatment before cardiac surgery rather than at follow-up, valve replacement by biological valve instead of mechanical valve, and withholding anticoagulation in patients with prosthetic valve endocarditis for fear of aneurysm rupture.Routine brain CT/CTA resulted in changes in the treatment plan in a significant

Pragmatic and cost efficient D and D

Energy Technology Data Exchange (ETDEWEB)

Morris, M. [Nuclear Fuel Services, Erwin, TN (United States)

1998-03-01

A great deal of effort is expended by remediation professionals in the pursuit of new technologies to assist them in performing their tasks more efficiently. These individuals understand the cost savings associated with volume reduction and waste minimization and routinely incorporate these practices into their planning. However, the largest cost component on many D and D projects is labor. Increasing the efficiency of work force utilization is frequently the most overlooked technique that can be instituted and which can easily offer major cost savings. Granted, some D and D jobs require highly specialized tools and equipment which are quite expensive. Decreasing these costs is often not an option or will yield minimal results. Conversely, the increase in worker efficiency can usually decrease costs dramatically. During the performance of the Safe Shutdown Project at the Fernald Environmental Management Project (the Fernald site), a process improvement initiative was instituted in support of the development of the Ten Year Plan. Costs associated with the removal of hundreds of thousands of pounds of nuclear material from formerly utilized equipment piping, and ductwork in nuclear facilities at the Fernald site were analyzed. This analysis indicated that the labor component was large enough to merit further inspection. A new approach to the activities was instituted and the results were significant. A macroscopic overview of all work activities utilized work evolution control (sequencing), building segmentation, and efficient use of engineering controls to streamline the D and D process. Overall costs on the first facility were reduced by over 20%. The increased labor efficiency resulted in decreased Personal Protective Equipment costs for field personnel. This approach will be discussed in detail.

Pragmatic and cost efficient D and D

International Nuclear Information System (INIS)

Morris, M.

1998-03-01

A great deal of effort is expended by remediation professionals in the pursuit of new technologies to assist them in performing their tasks more efficiently. These individuals understand the cost savings associated with volume reduction and waste minimization and routinely incorporate these practices into their planning. However, the largest cost component on many D and D projects is labor. Increasing the efficiency of work force utilization is frequently the most overlooked technique that can be instituted and which can easily offer major cost savings. Granted, some D and D jobs require highly specialized tools and equipment which are quite expensive. Decreasing these costs is often not an option or will yield minimal results. Conversely, the increase in worker efficiency can usually decrease costs dramatically. During the performance of the Safe Shutdown Project at the Fernald Environmental Management Project (the Fernald site), a process improvement initiative was instituted in support of the development of the Ten Year Plan. Costs associated with the removal of hundreds of thousands of pounds of nuclear material from formerly utilized equipment piping, and ductwork in nuclear facilities at the Fernald site were analyzed. This analysis indicated that the labor component was large enough to merit further inspection. A new approach to the activities was instituted and the results were significant. A macroscopic overview of all work activities utilized work evolution control (sequencing), building segmentation, and efficient use of engineering controls to streamline the D and D process. Overall costs on the first facility were reduced by over 20%. The increased labor efficiency resulted in decreased Personal Protective Equipment costs for field personnel. This approach will be discussed in detail

Supporting Classroom Transitions between Daily Routines: Strategies and Tips

Science.gov (United States)

Banerjee, Rashida; Horn, Eva

2013-01-01

The purpose of this article is to provide tools for preschool professionals to plan for transitions between daily routines, to identify challenging transitions during the day, and to offer strategies to support transitions in classrooms to prevent challenging behaviors from occurring due to frequent changes. Specifically, the authors answer three…

Factors related to women's childbirth satisfaction in physiologic and routine childbirth groups

Directory of Open Access Journals (Sweden)

Elham Jafari

2017-01-01

Full Text Available Background: Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. Materials and Methods: This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS, satisfied with birth setting, Labor Agentry Scale (LAS, and Visual Analogue Scale (VAS, which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t-test, analysis of variance, and linear, multivariate regression model at the significant level of P 0.05. Conclusions: Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction.

Master schedule for CY-1979 Hanford environmental surveillance routine program

International Nuclear Information System (INIS)

Blumer, P.J.; Houston, J.R.; Eddy, P.A.

1978-12-01

The current schedule of data collection for the routine environmental surveillance program at the Hanford Site, as conducted by the Environmental Evaluation Section of Battelle, Pacific Northwest Laboratory for the Department of Energy (DOE), is given. Modifications to the schedule are made during the year and special areas of study, usually of short duration, are not scheduled. The environmental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, and to monitor Hanford operations for compliance with applicable environmental criteria and Washington State Water Quality Standards. Air quality data are obtained in a separate program administered by the Hanford Environmental Health Foundation. The collection schedule for potable water is shown but it is not part of the routine environmental surveillance program. Water quality data for Hanford Site potable water systems are published each year by the Hanford Environmental Health Foundation. The data collected are available in routine reports issued by the Environmental Evaluations staff. Groundwater data and evaluation are reported in the series, ''Radiological Status of the Groundwater Beneath the Hanford Project for...,'' the latest issue being PNL-2624 for CY-1977. Data from locations within the plant boundaries are presented in the annual ''Environmental Status of the Hanford Site for...'' report series, the most recent report being PNL-2677 for 1977. Data from offsite locations are presented in the annual ''Environmental Surveillance at Hanford for...'' series of reports, the latest being PNL-2614 for 1977

Routine maintenance: safety term based work selection; Selecao de trabalho baseado no prazo seguro

Energy Technology Data Exchange (ETDEWEB)

Camargo, Albair de; Filho, Antnio S.; Brendler, Fabiano E.; Adamatti, Gilberto A.; Naruto, Itiro; Araujo, Luiz C.F.; Puerari, Roberto [PETROBRAS, Rio de Janeiro, RJ (Brazil)

2004-07-01

This work has objective to present the experience of improvement of routine maintenance system in some refineries of the PETROBRAS system, with the purpose to increase the efficiency in the Industrial Maintenance Management (cost), Utilization and HSE (Health, Safety and Environment), key of success of a petroleum company. The new system is based on the implantation of the culture of work selection in the safe period, through elaboration of new maintenance procedure, with emphasis in decisions shared between Operation and Maintenance Team, resulting in reduction of emergencies, making possible contract of services of maintenance for packages and improved allocation of resources. This work treat about improvement of the system in use, in view of that it has already taken in consideration the consequence of fail in the maintenance with participation of the operators. Besides of these challenge, this modification was made without causing riots in the process of implantation of SAP. As main result, financial profits had got better of resources with increase of safety, considering that they are analyzed in a way it that systematized potential risks. (author)

Diagnostic value of radionuclide imaging combined with routine CT in detecting hepatic focal nodular hyperplasia

International Nuclear Information System (INIS)

Lu Xuemin; Yu Shuhong; Han Jiankui

2011-01-01

Objective: To investigate radionuclide imaging and routine CT in diagnosing hepatic focal nodular hyperplasia (FNH) and the combined diagnostic value of the two modalities. Methods: Thirty-two patients with hepatic FNH were retrospectively studied. All patients underwent routine CT scan. Twenty-four patients were examined by 99 Tc m -sulfur colloid (SC) hepatic planar scintigraphy and SPECT/CT imaging, and then patients who had abnormal foci underwent 99 Tc m -diethyl iminodiacetic acid (EHIDA) triple-phase hepatobiliary imaging. χ 2 -test of four-table or Fisher exact probabilities in 2 × 2 table was applied for statistical analysis. Results: Of all 32 patients pathologically diagnosed as FNH with single solitary nodule, 25 were classified as classic type and the rest 7 as non-classic type. Although routine CT found all hepatic lesions, only 15 cases were diagnosed pathologically as FNH classic type but the rest were either misdiagnosed or left as indeterminate. On radionuclide imaging (hepatic colloid scintigraphy plus triple-phase hepatobiliary images), 11 patients with big foci (with maximal diameter >3 cm) out of 24 patients were correctly diagnosed as FNH, with 7 diagnosed as classic type FNH and 4 as non-classic. Other 13 patients were either misdiagnosed or simply missed. The diagnosing rates of routine CT and radionuclide imaging were 60.0% (15/25) and 38.9% (7/18) for FNH classic type, 0/7 and 4/6 for non-classic type, 50.0% (10/20) and 73.3% (11/15) for big foci, 41.7% (5/12) and 0/9 for small foci (with maximal diameter ≤3 cm), respectively. The total diagnosing rate of radionuclide imaging combined with routine CT was significantly higher than that of routine CT or radionuclide imaging alone (χ 2 =4.48, P<0.05; χ 2 =4.27, P<0.05). Conclusion: Radionuclide imaging in combination with routine CT may improve the diagnostic accuracy for hepatic FNH patients. (authors)

Stratification of type 2 diabetes based on routine clinical markers

DEFF Research Database (Denmark)

Safai, Narges; Ali, Ashfaq; Rossing, Peter

2018-01-01

AIMS: We hypothesized that patients with dysregulated type 2 diabetes may be stratified based on routine clinical markers. METHODS: In this retrospective cohort study, diabetes related clinical measures including age at onset, diabetes duration, HbA1c, BMI, HOMA2-β, HOMA2-IR and GAD65...... autoantibodies, were used for sub-grouping patients by K-means clustering and for adjusting. Probability of diabetes complications (95% confidence interval), were calculated using logistic regression. RESULTS: Based on baseline data from patients with type 2 diabetes (n=2,290), the cluster analysis suggested up....... CONCLUSIONS: Patients with type 2 diabetes cluster into clinically relevant sub-groups based on routine clinical markers. The prevalence of diabetes complications seems to be sub-group specific. Our data suggests the need for a tailored strategy for the treatment of type 2 diabetes....

Engineering Task Plan for Routine Engineering Support for Core Sampler System

International Nuclear Information System (INIS)

BOGER, R.M.

1999-01-01

Routine engineering support is required during normal operation of the core sampler trucks and associated ancillary equipment. This engineering support consists of, but is not limited to, troubleshooting operation problems, correcting minor design problems, assistance with work package preparation, assistance with procurement, fabrication shop support, planning of engineering tasks and preparation of associated Engineering Task Plans (ETP) and Engineering Service Requests (ESR). This ETP is the management plan document for implementing routine engineering support. Any additional changes to the scope of this ETP shall require a Letter of Instruction from Lockheed Martin Hanford Corp (LMHC). This document will also be the Work Planning Document for Development Control (HNF 1999a). The scope of this task will be to provide routine engineering support for Characterization equipment as required to support Characterization Operations. A task by task decision will be made by management to determine which tasks will be done per this ETP and if additional ETPs and/or ESRs are required. Due to the unique nature of this task, the only identifiable deliverable is to provide support as requested. Deliverables will be recorded in a task logbook as activities are identified. ESRs will be generated for tasks that require more than 40 person hours to complete, per Characterization Engineering Desk Instructions (DI 1999a)

Glogs as Non-Routine Problem Solving Tools in Mathematics

Science.gov (United States)

Devine, Matthew T.

2013-01-01

In mathematical problem solving, American students are falling behind their global peers because of a lack of foundational and reasoning skills. A specific area of difficulty with problem solving is working non-routine, heuristic-based problems. Many students are not provided with effective instruction and often grow frustrated and dislike math.…

Good Quality - the Routinization of Sperm Banking in China

DEFF Research Database (Denmark)

Wahlberg, Ayo

Good Quality is an assemblage ethnography of how sperm banking came to be routinized in China. Based on 8 years of episodic fieldwork at China’s oldest and largest sperm bank in Changsha, Hunan province, the book meticulously chronicles how, beginning in the early 1980s, a unique style of sperm b...

Analyzing Effectiveness of Routine Pleural Drainage After Nuss Procedure: A Randomized Study.

Science.gov (United States)

Pawlak, Krystian; Gąsiorowski, Łukasz; Gabryel, Piotr; Smoliński, Szymon; Dyszkiewicz, Wojciech

2017-12-01

The routine use of postoperative pleural cavity drainage after the Nuss procedure is not widely accepted, and its limited use depends on experience. This study analyzed the influence of pleural drainage in the surgical treatment of patients with pectus excavatum on the prevention of pneumothorax and the efficacy of using drainage after a corrective operation. From November 2013 to May 2015, 103 consecutive patients with pectus excavatum, aged 11 to 39 years, underwent surgical treatment by the Nuss procedure. Patients were prospectively randomized into two groups. In 58 patients, a 28F chest tube was routinely introduced into the right pleural cavity during procedure for 2 consecutive days (group I). In the remaining 45 patients, the drain was not inserted (group II). No statistically significant differences were found between the study groups, including sex, age, body mass index, or clinical subjective and objective factors in the preoperative evaluation. Group II manifested more complications in the early postoperative period; however, this was not statistically significant (group I vs group II; p = 0.0725). Pneumothorax requiring additional chest tube placement was statistically significant (group I vs group II; p = 0.0230). Other complications were also more frequent among patients from group II, although this did not reach statistical significance. Follow up was 22.9 ± 6.4 months. Routine drainage of the pleural cavity during the Nuss procedure significantly reduces the incidence of postoperative pneumothorax and should be considered as a routine procedure. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Improved method of producing satisfactory sections of whole eyeball by routine histology.

Science.gov (United States)

Arko-Boham, Benjamin; Ahenkorah, John; Hottor, Bismarck Afedo; Dennis, Esther; Addai, Frederick Kwaku

2014-02-01

To overcome the loss of structural integrity when eyeball sections are prepared by wax embedding, we experimentally modified the routine histological procedure and report satisfactorily well-preserved antero-posterior sections of whole eyeballs for teaching/learning purposes. Presently histological sections of whole eyeballs are not readily available because substantial structural distortions attributable to variable consistency of tissue components (and their undesired differential shrinkage) result from routine processing. Notably, at the dehydration stage of processing, the soft, gel-like vitreous humor considerably shrinks relative to the tough fibrous sclera causing collapse of the ocular globe. Additionally, the combined effects of fixation, dehydration, and embedding at 60°C renders the eye lens too hard for microtome slicing at thicknesses suitable for light microscopy. We satisfactorily preserved intact antero-posterior sections of eyeballs via routine paraffin wax processing procedure entailing two main modifications; (i) careful needle aspiration of vitreous humor and replacement with molten wax prior to wax infiltration; (ii) softening of lens in trimmed wax block by placing a drop of concentrated liquid phenol on it for 3 h during microtomy. These variations of the routine histological method produced intact whole eyeball sections with retinal detachment as the only structural distortion. Intact sections of the eyeball obtained compares well with the laborious, expensive, and 8-week long celloidin method. Our method has wider potential usability than costly freeze drying method which requires special skills and equipment (cryotome) and does not produce whole eyeball sections. Copyright © 2013 Wiley Periodicals, Inc.

Hematopoietic Progenitor Cell Mobilization with “Just-in-Time” Plerixafor Approach is a Cost Effective Alternative to Routine Plerixafor Use

Science.gov (United States)

Veltri, Lauren; Cumpston, Aaron; Shillingburg, Alexandra; Wen, Sijin; Luo, Jin; Leadmon, Sonia; Watkins, Kathy; Craig, Michael; Hamadani, Mehdi; Kanate, Abraham S.

2015-01-01

Hematopoietic progenitor cell (HPC) mobilization with granulocyte-colony stimulating factor (G-CSF) and plerixafor results in superior CD34+ cell yield, when compared to mobilization with G-CSF alone in patients with myeloma and lymphoma. However, plerixafor-based approaches are associated with high costs. To circumvent this, several institutions use a so-called “just-in-time” plerixafor (JIT-P) approach, where plerixafor is only administered to patients likely to fail mobilization with G-CSF alone. Whether such a JIT-P approach is cost effective has not been confirmed to date. We present here, results of 136 patients with myeloma or lymphoma who underwent mobilization with two different approaches of plerixafor utilization. Between Jan 2010-Oct 2012 (n=76) patients uniformly received mobilization with G-CSF and plerixafor (routine G+P cohort). To reduce mobilization costs, between Nov 2012-Jun 2014 (n=60) patients were mobilized with JIT-P where plerixafor was only administered to patients likely to fail mobilization with G-CSF alone. Patients in routine G+P group had a higher median peak peripheral blood CD34+ cell count (62 vs. 29 cells/μL, p<0.001) and a higher median day 1 CD34+ cell yield (2.9 × 106 CD34+ cells/kg vs. 2.1 × 106 CD34+ cells/kg, p=0.001). The median total CD34+ cell collection was also higher in routine G+P group (5.8 × 106 CD34+ cells/kg vs. 4.5 × 106 CD34+ cells/kg, p=0.007). In the JIT-P group 40% (n=24) completed adequate HPC collection without plerixafor. There was no difference in mobilization failure rates. The mean number of plerixafor doses utilized in JIT-P was lower (1.3 vs. 2.1, p=0.0002). The mean estimated cost in the routine G+P group was higher than that in the JIT-P group (USD 27,513 vs. USD 23,597, p=0.01). Our analysis demonstrates that mobilization with a JIT-P approach is a safe, effective and cost efficient strategy for HPC collection. PMID:26475754

Routine airway surveillance in pediatric tracheostomy patients.

Science.gov (United States)

Gergin, Ozgul; Adil, Eelam; Kawai, Kosuke; Watters, Karen; Moritz, Ethan; Rahbar, Reza

2017-06-01

The aim of this study is to review airway findings in children with tracheostomies who underwent surveillance direct laryngoscopy and bronchoscopy (DLB) to determine the yield of routine airway evaluation in these patients. Retrospective chart review at tertiary referral children's hospital. A retrospective chart review was conducted of all of the children with tracheostomies who underwent DLB after tracheostomy between 1984 and 2015. A total of 303 patients met inclusion criteria. The median time interval between tracheostomy and first follow-up DLB was 12.0 months (IQR 4.8-28.9 months). There was no significant difference in the incidence of airway lesions between patients who underwent endoscopy tracheostomy versus those who had a longer time interval between tracheostomy and DLB (p = 0.16). One hundred sixty seven patients (55.1%) were diagnosed with lesions, with suprastomal granulation (39.9%) being the most common. Symptomatic patients were significantly more likely to have an airway lesion identified (69.9% versus 42.0%; p tracheostomy were significantly more likely to have an airway lesion (p = 0.01). The high incidence of airway lesions noted during surveillance DLB support the utility of routine airway endoscopy in pediatric tracheostomy patients. Symptomatic patients, those with ventilator dependence, or cardiopulmonary or trauma indications for tracheostomy are more likely to have airway lesions and should be monitored closely. The ideal time interval between surveillance endoscopies needs to be examined further. Copyright © 2017. Published by Elsevier B.V.

Routine digital pathology workflow: The Catania experience

Directory of Open Access Journals (Sweden)

Filippo Fraggetta

2017-01-01

Full Text Available Introduction: Successful implementation of whole slide imaging (WSI for routine clinical practice has been accomplished in only a few pathology laboratories worldwide. We report the transition to an effective and complete digital surgical pathology workflow in the pathology laboratory at Cannizzaro Hospital in Catania, Italy. Methods: All (100% permanent histopathology glass slides were digitized at ×20 using Aperio AT2 scanners. Compatible stain and scanning slide racks were employed to streamline operations. eSlide Manager software was bidirectionally interfaced with the anatomic pathology laboratory information system. Virtual slide trays connected to the two-dimensional (2D barcode tracking system allowed pathologists to confirm that they were correctly assigned slides and that all tissues on these glass slides were scanned. Results: Over 115,000 glass slides were digitized with a scan fail rate of around 1%. Drying glass slides before scanning minimized them sticking to scanner racks. Implementation required introduction of a 2D barcode tracking system and modification of histology workflow processes. Conclusion: Our experience indicates that effective adoption of WSI for primary diagnostic use was more dependent on optimizing preimaging variables and integration with the laboratory information system than on information technology infrastructure and ensuring pathologist buy-in. Implementation of digital pathology for routine practice not only leveraged the benefits of digital imaging but also creates an opportunity for establishing standardization of workflow processes in the pathology laboratory.

Routine general practice care for panic disorder within the lifestyle approach to managing panic study

Directory of Open Access Journals (Sweden)

Rodney A. Lambert

2012-07-01

Full Text Available Routine general practice (GP care is rarely comprehensively described in clinical trials. This paper examines routine GP care within the lifestyle approach to managing panic (LAMP study. The aim of this paper is to describe/discuss routine GP care for panic disorder (PD patients within both study arms in the LAMP study. An unblinded pragmatic randomised controlled trial in 15 East of England GP practices (2 primary care trusts. Participants met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for PD with/without agoraphobia. Follow-up measures recorded at 20 weeks/10 months following randomisation. Control arm, unrestricted routine GP care (practice appointments, referrals and prescriptions. Trial arm, occupational therapyled lifestyle treatment comprising lifestyle review of fluid intake, diet pattern, exercise, caffeine, alcohol and nicotine. Primary outcome measure: beck anxiety inventory. At baseline, participants attended 2-3 times more GP appointments than population average, reducing at 10 months to 1.6 times population average for routine GP care and 0.97 population average for lifestyle arm. At 10 months, 33% fewer referrals (6 referrals; 0 mental health than at baseline (9 referrals; 2 mental health were made for lifestyle arm patients compared with 42% increase (from 12 referrals; 8 mental health at baseline to 17 referrals; 7 mental health in GP care arm. Selective serotonin reuptake inhibitors were prescribed most often. Benzodiazepines and beta-blockers were prescribed more often than tricyclic against current clinical guidelines. In conclusion, we found that PD patients at baseline were high healthcare resource users. Treatment in both study arms reduced resource use. Routine GP care requires further review for this patient group.

Diagnostic accuracy of routine blood examinations and CSF lactate level for post-neurosurgical bacterial meningitis.

Science.gov (United States)

Zhang, Yang; Xiao, Xiong; Zhang, Junting; Gao, Zhixian; Ji, Nan; Zhang, Liwei

2017-06-01

To evaluate the diagnostic accuracy of routine blood examinations and Cerebrospinal Fluid (CSF) lactate level for Post-neurosurgical Bacterial Meningitis (PBM) at a large sample-size of post-neurosurgical patients. The diagnostic accuracies of routine blood examinations and CSF lactate level to distinguish between PAM and PBM were evaluated with the values of the Area Under the Curve of the Receiver Operating Characteristic (AUC -ROC ) by retrospectively analyzing the datasets of post-neurosurgical patients in the clinical information databases. The diagnostic accuracy of routine blood examinations was relatively low (AUC -ROC CSF lactate level achieved rather high diagnostic accuracy (AUC -ROC =0.891; CI 95%, 0.852-0.922). The variables of patient age, operation duration, surgical diagnosis and postoperative days (the interval days between the neurosurgery and examinations) were shown to affect the diagnostic accuracy of these examinations. The variables were integrated with routine blood examinations and CSF lactate level by Fisher discriminant analysis to improve their diagnostic accuracy. As a result, the diagnostic accuracy of blood examinations and CSF lactate level was significantly improved with an AUC -ROC value=0.760 (CI 95%, 0.737-0.782) and 0.921 (CI 95%, 0.887-0.948) respectively. The PBM diagnostic accuracy of routine blood examinations was relatively low, whereas the accuracy of CSF lactate level was high. Some variables that are involved in the incidence of PBM can also affect the diagnostic accuracy for PBM. Taking into account the effects of these variables significantly improves the diagnostic accuracies of routine blood examinations and CSF lactate level. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Indirect orthodontic bonding - a modified technique for improved efficiency and precision

Directory of Open Access Journals (Sweden)

Lincoln Issamu Nojima

2015-06-01

Full Text Available INTRODUCTION: The indirect bonding technique optimizes fixed appliance installation at the orthodontic office, ensuring precise bracket positioning, among other advantages. In this laboratory clinical phase, material and methods employed in creating the transfer tray are decisive to accuracy. OBJECTIVE: This article describes a simple, efficient and reproducible indirect bonding technique that allows the procedure to be carried out successfully. Variables influencing the orthodontic bonding are analyzed and discussed in order to aid professionals wishing to adopt the indirect bonding technique routinely in their clinical practice.

Properties of electret ionization chambers for routine dosimetry in photon radiation fields

International Nuclear Information System (INIS)

Doerschel, B.; Pretzsch, G.

1985-01-01

The main properties of photon routine dosemeters are their energy and angular dependence as well as their measuring range and accuracy. The determination of radiation exposure from dosemeter response is based on the choice of an appropriate conversion factor taking into account the influence of body backscattering on the dosemeter response. Measuring range and accuracy of an electret ionization chamber first of all depend on electret stability, methods of charge measurement, and geometry of the chamber. The dosemeter performance is described for an electret ionization chamber which was designed for application to routine monitoring of radiation workers. (author)

The barriers and facilitators to routine outcome measurement by allied health professionals in practice: a systematic review

Directory of Open Access Journals (Sweden)

Duncan Edward AS

2012-05-01

Full Text Available Abstract Background Allied Health Professionals today are required, more than ever before, to demonstrate their impact. However, despite at least 20 years of expectation, many services fail to deliver routine outcome measurement in practice. This systematic review investigates what helps and hinders routine outcome measurement of allied health professionals practice. Methods A systematic review protocol was developed comprising: a defined search strategy for PsycINFO, MEDLINE and CINHAL databases and inclusion criteria and systematic procedures for data extraction and quality appraisal. Studies were included if they were published in English and investigated facilitators and/or barriers to routine outcome measurement by allied health professionals. No restrictions were placed on publication type, design, country, or year of publication. Reference lists of included publications were searched to identify additional papers. Descriptive methods were used to synthesise the findings. Results 960 papers were retrieved; 15 met the inclusion criteria. Professional groups represented were Physiotherapy, Occupational Therapy, and Speech and Language Therapy. The included literature varied in quality and design. Facilitators and barriers to routine outcome measurement exist at individual, managerial and organisational levels. Key factors affecting professionals’ use of routine outcome measurement include: professionals’ level of knowledge and confidence about using outcome measures, and the degree of organisational and peer-support professionals received with a view to promoting their work in practice. Conclusions Whilst the importance of routinely measuring outcomes within the allied health professions is well recognised, it has largely failed to be delivered in practice. Factors that influence clinicians’ ability and desire to undertake routine outcome measurement are bi-directional: they can act as either facilitators or barriers. Routine outcome

A new generation videokymography for routine clinical vocal fold examination

NARCIS (Netherlands)

Qiu, Qingjun; Schutte, Harm K.

2006-01-01

Objective. This study aims to introduce a new-generation videokymographic system, which provides simultaneous laryngoscopic and kymographic image, for routine clinical vocal fold examination. Study Design: The authors explored a new imaging method for diagnosis and evaluation of voice disorders.

ROUTINE IMMUNIZATION IN INDIA: A PERSPECTIVE

Directory of Open Access Journals (Sweden)

G Taneja

2013-08-01

Full Text Available The Universal Immunization Programme is possibly the longest and one of the biggest public health intervention measures undertaken in India. To improve immunization coverage in the country various initiatives have been undertaken since the inception of the programme in 1985; key inputs being strengthening and expanding the cold chain system, establishing a network of outreach immunization sites, alternate vaccine delivery model, capacity building of health functionaries and medical officers and intensified polio control measures. Introduction of new and underutilized vaccines, drafting of the national vaccine policy, tracking of beneficiaries through the Maternal and Child Tracking system are some of the recent developments. However in spite of more than 25 years since inception the programme is still adversely impacted by challenges across key thematic areas of programme management, cold chain and vaccine management, recording and reporting and injection safety. To further strengthen and improve service delivery 2012-13 has been declared as the “Year of Intensification of Routine Immunization” with the objective of improving immunization coverage rates across poor performing districts and states so as to attain Global Immunization Vision and Strategy goals of 90% coverage at national and more than 80% coverage at district level. Key activities planned during the year include sustained advocacy at all levels, improved communication and social mobilization, robust and regular program reviews, comprehensive microplanning, strengthening cold chain and vaccine logistics system, special catch up rounds through immunization weeks, piloting the teeka express, improved surveillance systems, strengthened partnerships and operational research activities. The current review pertains to the existing scenario of Universal Immunization Program in the country with impetus on the existing challenges, progress achieved till date as a result of various

Routine dental x-ray : a health hazards

International Nuclear Information System (INIS)

Parthasarathy, K.S.

1978-01-01

In orthopantography (OPG) technique, a single panoramic x-ray replaces a dozen or so conventional x-ray exposures required for a full-mouth examination. OPG, thus, reduces radiation dose to the patients. However, the very simplicity of the OPG technique may lead to its misuse. The dentists are tempted to take too many OPG films and thus exposing the patients unnecessarily to X radiation. Dentists are advised against making dental x-radiography a routine part of examinations. Greater care should be exercised particularly in the case of children while using OPG. (M.G.B.)

Parents’ Traditional Cultural Values and Mexican-Origin Young Adults’ Routine Health and Dental Care

Science.gov (United States)

Updegraff, Kimberly A.; Kuo, Sally I-Chun; McHale, Susan M.; Umaña-Taylor, Adriana J.; Wheeler, Lorey A.

2017-01-01

Purpose To investigate the prospective associations between Mexican-origin mothers’ and fathers’ traditional cultural values and young adults’ health and dental care utilization and to test the moderating role of youth gender. Methods Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents’ cultural values (time 1) and young adults’ health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents’ traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents’ cultural values and young adults’ routine care. Results Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23–9.83, p = .019). Furthermore, for females only, mothers’ more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08–.64, p = .005) and dental care (OR = .26; 95% CI: .09–.75, p = .012) in young adulthood. Conclusions Our findings highlight the importance of examining intragroup variability in culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. PMID:27988108

Parents' Traditional Cultural Values and Mexican-Origin Young Adults' Routine Health and Dental Care.

Science.gov (United States)

Updegraff, Kimberly A; Kuo, Sally I-Chun; McHale, Susan M; Umaña-Taylor, Adriana J; Wheeler, Lorey A

2017-05-01

To investigate the prospective associations between Mexican-origin mothers' and fathers' traditional cultural values and young adults' health and dental care utilization and to test the moderating role of youth gender. Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents' cultural values (time 1) and young adults' health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents' traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents' cultural values and young adults' routine care. Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23-9.83, p = .019). Furthermore, for females only, mothers' more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08-.64, p = .005) and dental care (OR = .26; 95% CI: .09-.75, p culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Reduction efficiency prediction of CENIBRA's recovery boiler by direct minimization of gibbs free energy

Directory of Open Access Journals (Sweden)

W. L. Silva

2008-09-01

Full Text Available The reduction efficiency is an important variable during the black liquor burning process in the Kraft recovery boiler. This variable value is obtained by slow experimental routines and the delay of this measure disturbs the pulp and paper industry customary control. This paper describes an optimization approach for the reduction efficiency determination in the furnace bottom of the recovery boiler based on the minimization of the Gibbs free energy. The industrial data used in this study were directly obtained from CENIBRA's data acquisition system. The resulting approach is able to predict the steady state behavior of the chemical composition of the furnace recovery boiler, - especially the reduction efficiency when different operational conditions are used. This result confirms the potential of this approach in the analysis of the daily operation of the recovery boiler.

Quality of routine spirometry tests in Dutch general practices

Science.gov (United States)

Schermer, Tjard RJ; Crockett, Alan J; Poels, Patrick JP; van Dijke, Jacob J; Akkermans, Reinier P; Vlek, Hans F; Pieters, Willem R

2009-01-01

Background Spirometry is an indispensable tool for diagnosis and monitoring of chronic airways disease in primary care. Aim To establish the quality of routine spirometry tests in general practice, and explore associations between test quality and patient characteristics. Design of study Analysis of routine spirometry test records. Setting Fifteen general practices which had a working agreement with a local hospital pulmonary function laboratory for spirometry assessment regarding test quality and interpretation. Method Spirometry tests were judged by a pulmonary function technician and a chest physician. Proportions of test adequacy were analysed using markers for manoeuvre acceptability and test reproducibility derived from the 1994 American Thoracic Society spirometry guideline. Associations between quality markers and age, sex, and severity of obstruction were examined using logistic regression. Results Practices performed a mean of four (standard deviation = 2) spirometry tests per week; 1271 tests from 1091 adult patients were analysed; 96.4% (95% confidence interval [CI] = 95.6 to 97.2) of all tests consisted of ≥3 blows. With 60.6% of tests, forced expiratory time was the marker with the lowest acceptability rate. An overall 38.8% (95% CI = 36.0 to 41.6) of the tests met the acceptability as well as reproducibility criteria. Age, sex, and severity of obstruction were associated with test quality markers. Conclusion The quality of routine spirometry tests was better than in previous reports from primary care research settings, but there is still substantial room for improvement. Sufficient duration of forced expiratory time is the quality marker with the highest rate of inadequacy. Primary care professionals should be aware of patient characteristics that may diminish the quality of their spirometry tests. Further research is needed to establish to what extent spirometry tests that are inadequate, according to stringent international expert criteria

Skin dose assessment in routine personnel beta/gamma dosimetry

International Nuclear Information System (INIS)

Christensen, P.

1980-01-01

The International Commission on Radiological Protection (Publication 26) has recommended a tissue depth of 5 to 10 mg.cm -2 for skin dose assessments. This requirement is generally not fulfilled by routine monitoring procedures because of practical difficulties in using very thin dosemeters with low sensitivity and therefore a high minimum detectable dose. Especially for low-energy beta-ray exposures underestimations of the skin dose by a factor of more than ten may occur. Low-transparent graphite-mixed sintered LiF and Li 2 B 4 0 7 : Mn dosemeters were produced which show a skin-equivalent response to beta and gamma exposures over a wide range of energies. These have found wide-spread application for extremity dosimetry but have not yet been generally introduced in routine personnel beta/gamma monitoring. The following adaptations of existing routine monitoring systems for improved skin dose assessments have been investigated: 1) Placement of a supplementary, thin, skin-dose equivalent dosemeter in the TLD badge to give additional information on low-energy exposures. 2) Introduction of a second photomultiplier in the read-out chamber which enables a simultaneous determination of emitted TL from both sides of the dosemeter separately. This method makes use of the selfshielding of the dosemeter to give information on the low-energy dose contribution. 3) By diffusion of Li 2 B 4 0 7 into solid LiF-dosemeters it was possible to produce a surface layer with a new distinct glow-peak at about 340 deg C which is not present in the undiffused part of the LiF chip, and which can be utilized for the assessment of the skin-dose. Data on energy response and accuracy of dose measurement for beta/gamma exposures are given for the three methods and advantages and disadvantages are discussed (H.K.)

The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

Directory of Open Access Journals (Sweden)

Stephan Brenner

Full Text Available A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs, a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC, the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example.We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi.Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks.The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining

The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

Science.gov (United States)

Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S

2015-01-01

A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining MNH program

Lifestyles and routine activities of South African teenagers at risk of being trafficked for involuntary prostitution.

Science.gov (United States)

Lutya, Thozama Mandisa

2010-12-01

The United Nations estimates that 79% of teenage girls trafficked globally every year are forced into involuntary prostitution. About 247 000 South African children work in exploitative conditions; about 40 000 South African female teenagers work as prostitutes. This paper investigates lifestyles and routine activities of teenagers at risk of being trafficked for involuntary prostitution. The key concepts involuntary prostitution, intergenerational sex and exploitative conditions are defined in relation to the lifestyles and routine activities of South African female teenagers. Human trafficking for involuntary prostitution is described, based on a literature review. Lifestyle exposure and routine activities theories help to explain the potential victimisation of these teenagers in human trafficking for involuntary prostitution. Actual lifestyle and routine activities of South African teenagers and risky behaviours (substance abuse, intergenerational sex and child prostitution) are discussed as factors that make teens vulnerable to such trafficking. This paper recommends that human trafficking prevention efforts (awareness programmes and information campaigns) be directed at places frequented by human traffickers and teenagers in the absence of a capable guardian to reduce victimisation, as traffickers analyse the lifestyles and routine activities of their targets. South Africa should also interrogate entrenched practices such as intergenerational sex.

Learning and remembering strategies of novice and advanced jazz dancers for skill level appropriate dance routines.

Science.gov (United States)

Poon, P P; Rodgers, W M

2000-06-01

This study examined the influence of the challenge level of to-be-learned stimulus on learning strategies in novice and advanced dancers. In Study 1, skill-level appropriate dance routines were developed for novice and advanced jazz dancers. In Study 2, 8 novice and 9 advanced female jazz dancers attempted to learn and remember the two routines in mixed model factorial design, with one between-participants factor: skill level (novice or advanced) and two within-participants factors: routine (easy or difficult) and performance (immediate or delayed). Participants were interviewed regarding the strategies used to learn and remember the routines. Results indicated that advanced performers used atypical learning strategies for insufficiently challenging stimuli, which may reflect characteristics of the stimuli rather than the performer. The qualitative data indicate a clear preference of novice and advanced performers for spatial compatibility of stimuli and response.

A preliminary study to understand tacit knowledge and visual routines of medical experts through gaze tracking.

Science.gov (United States)

Anderson, Blake; Shyu, Chi-Ren

2010-11-13

Many decisions made by medical experts are based on scans from advanced imaging technologies. Interpreting a medical image is a trained, systematic procedure and an excellent target for identifying potential visual routines through image informatics. These visual routines derived from experts contain many clues about visual knowledge and its representation. This study uses an inexpensive webcam-based gaze tracking method to collect data from multiple technologists' survey of medical and non-medical images. Through computational analysis of the results, we expect to provide insight into the behaviors and properties related to medical visual routines. Discovering the visual processes associated with medical images will help us recognize and understand the tacit knowledge gained from extensive experience with medical imagery. These expert routines could potentially be used to reduce medical error, train new experts, and provide an understanding of the human visual system in medicine.

Radiographic demonstration of small intestinal villi on routine clinical studies

International Nuclear Information System (INIS)

Gelfand, D.W.; Ott, D.J.

1981-01-01

The radiographic demonstration of the small intestinal villi is reported. The villi were demonstrable with both single- and double-contrast methods on routine clinical studies. The primary requirement for their delineation appears to be employment of a high-resolution radiographic system. (orig.) [de

Circulating tumor cell isolation and diagnostics: toward routine clinical use

NARCIS (Netherlands)

Stolpe, van de A.; Pantel, K.; Sleijfer, S.; Terstappen, L.W.; Toonder, den J.M.J.

2011-01-01

From February 7–11, 2011, the multidisciplinary Lorentz Workshop Circulating Tumor Cell (CTC) Isolation and Diagnostics: Toward Routine Clinical Use was held in Leiden (The Netherlands) to discuss progress and define challenges and potential solutions for development of clinically useful circulating

Sugammadex compared with neostigmine/glycopyrrolate for routine reversal of neuromuscular block: a systematic review and economic evaluation†

Science.gov (United States)

Paton, F.; Paulden, M.; Chambers, D.; Heirs, M.; Duffy, S.; Hunter, J. M.; Sculpher, M.; Woolacott, N.

2010-01-01

Summary The cost-effectiveness of sugammadex for the routine reversal of muscle relaxation produced by rocuronium or vecuronium in UK practice is uncertain. We performed a systematic review of randomized controlled trials of sugammadex compared with neostigmine/glycopyrrolate and an economic assessment of sugammadex for the reversal of moderate or profound neuromuscular block (NMB) produced by rocuronium or vecuronium. The economic assessment aimed to establish the reduction in recovery time and the ‘value of time saved’ which would be necessary for sugammadex to be potentially cost-effective compared with existing practice. Three trials indicated that sugammadex 2 mg kg−1 (4 mg kg−1) produces more rapid recovery from moderate (profound) NMB than neostigmine/glycopyrrolate. The economic assessment indicated that if the reductions in recovery time associated with sugammadex in the trials are replicated in routine practice, sugammadex would be cost-effective if those reductions are achieved in the operating theatre (assumed value of staff time, £4.44 per minute), but not if they are achieved in the recovery room (assumed value of staff time, £0.33 per minute). However, there is considerable uncertainty in these results. Sugammadex has the potential to be cost-effective compared with neostigmine/glycopyrrolate for the reversal of rocuronium-induced moderate or profound NMB, provided that the time savings observed in trials can be achieved and put to productive use in clinical practice. Further research is required to evaluate the effects of sugammadex on patient safety, predictability of recovery from NMB, patient outcomes, and efficient use of resources. PMID:20935005

An efficient parallel algorithm for the calculation of canonical MP2 energies.

Science.gov (United States)

Baker, Jon; Pulay, Peter

2002-09-01

We present the parallel version of a previous serial algorithm for the efficient calculation of canonical MP2 energies (Pulay, P.; Saebo, S.; Wolinski, K. Chem Phys Lett 2001, 344, 543). It is based on the Saebo-Almlöf direct-integral transformation, coupled with an efficient prescreening of the AO integrals. The parallel algorithm avoids synchronization delays by spawning a second set of slaves during the bin-sort prior to the second half-transformation. Results are presented for systems with up to 2000 basis functions. MP2 energies for molecules with 400-500 basis functions can be routinely calculated to microhartree accuracy on a small number of processors (6-8) in a matter of minutes with modern PC-based parallel computers. Copyright 2002 Wiley Periodicals, Inc. J Comput Chem 23: 1150-1156, 2002

Intentional Forgetting in Organizations: The Importance of Eliminating Retrieval Cues for Implementing New Routines

OpenAIRE

Kluge, Annette; Gronau, Norbert

2018-01-01

To cope with the already large, and ever increasing, amount of information stored in organizational memory, “forgetting,” as an important human memory process, might be transferred to the organizational context. Especially in intentionally planned change processes (e.g., change management), forgetting is an important precondition to impede the recall of obsolete routines and adapt to new strategic objectives accompanied by new organizational routines. We first comprehensively review the liter...

Use of Songs to Promote Independence in Morning Greeting Routines for Young Children with Autism

Science.gov (United States)

Kern, Petra; Wolery, Mark; Aldridge, David

2007-01-01

This study evaluated the effects of individually composed songs on the independent behaviors of two young children with autism during the morning greeting/entry routine into their inclusive classrooms. A music therapist composed a song for each child related to the steps of the morning greeting routine and taught the children's teachers to sing…

Summary of typical routine maintenance activities at Tokai Reprocessing Plant. Supplement (March, 2002)

International Nuclear Information System (INIS)

2002-03-01

Typical maintenance activities, such as replacement of worn out parts and cleaning of filter elements, routinely performed during steady operation are summarized. [The Summary of Typical Routine Maintenance Activities at Tokai Reprocessing Plant] (JNC TN 8450 2001-006) was already prepared in September, 2001. The purpose of this summary is to give elementary understanding on these activities to people who are responsible for explanation them to the public. At this time, the same kind of summary is prepared as a supplement of the previous one. (author)

LOW AND MEAN RADIATION DOSES IMPACT ON THE CEREBRAL TRACTS STRUCTURE OF THE CHERNOBYL ACCIDENT LIQUIDATORS IN THE REMOTE PERIOD (BASED ON ROUTINE AND DIFFUSION-TENSOR MAGNETIC RESONANCE IMAGING DATA)

OpenAIRE

I. M. Levashkina; S. S. Aleksanin; S. V. Serebryakova; T. G. Gribanova

2017-01-01

To evaluate correlation between brain structural damages and radiation exposure level for the Chernobyl nuclear power plant accident liquidators, routine and diffusion tensor magnetic resonance imaging methods are efficient to visualize and evaluate those damages; it is also important to compare magnetic resonance imaging data of liquidators with results, received for people of the same age and the same stage of cerebral vascular disease (the discirculatory encephalopathy of I and II stage), ...

Imaging features suggestive of a conjoined nerve root on routine axial MRI

Energy Technology Data Exchange (ETDEWEB)

Song, Su Jin; Lee, Joon Woo; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Gyeongi-do (Korea); Choi, Ja-Young; Hong, Sung Hwan; Kim, Na Ra [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea); Kim, Ki-Jeong; Chung, Sang-Ki; Kim, Hyun-Jib [Seoul National University Bundang Hospital, Department of Neurosurgery, Gyeongi-Do (Korea)

2008-02-15

The purpose of our study is to evaluate imaging features suggestive of a conjoined nerve root on routine axial MRI. Two radiologists and two surgeons retrospectively reviewed the MRI of three cases in which a conjoined nerve root was discovered during operation and found three suggestive signs on routine axial MR images: ''corner'' (asymmetric morphology of the anterolateral corner of the dural sac), ''fat crescent'' (intervening extradural fat between the asymmetric dura and the nerve root), and ''parallel'' signs (visualization of the entire parallel course of the nerve root at the disc level). Two radiologists prospectively found these signs during routine MRI interpretation sessions over a period of 6 months. If one or a combination of signs were noted on axial MR images, contiguous axial scans were additionally obtained. Three cases that were previously found during operations were also included. Prevalence and confidence scores for each sign were assessed on axial T1- and T2-weighted images. Twelve patients showed one or a combination of the three signs, 9 had contiguous axial MR scans. Five cases were confirmed by operation. The prevalence of the corner, fat crescent, and parallel signs were 12 out of 12 (100%), 6 out of 12 (50%), and 8 out of 12 (67.7%) on axial T1-weighted images. The overall diagnostic confidence was higher on T1- than on T2-weighted images (P < 0.05). On routine axial L-spine MRI, corner, fat crescent, and parallel signs are suggestive of and assist in the recognition of a conjoined nerve root. (orig.)

A Computer-Controlled SEM-EDX Routine for Characterizing Respirable Coal Mine Dust

Directory of Open Access Journals (Sweden)

Victoria Johann-Essex

2017-01-01

Full Text Available A recent resurgence in coal workers’ pneumoconiosis (or “black lung” and concerns over other related respiratory illnesses have highlighted the need to elucidate characteristics of airborne particulates in occupational environments. A better understanding of particle size, aspect ratio, or chemical composition may offer new insights regarding causal factors of such illnesses. Scanning electron microscopy analysis using energy dispersive X-ray (SEM-EDX can be used to estimate these particle characteristics. If conducted manually, such work can be very time intensive, limiting the number of particles that can be analyzed. Moreover, potential exists for user bias in interpretation of EDX spectra. A computer-controlled (CC routine, on the other hand, can allow similar analysis at a much faster rate, increasing total particle counts and reproducibility of results. This paper describes a CCSEM-EDX routine specifically developed for analysis of respirable dust samples from coal mines. The routine is verified based on reliability of results obtained on samples of known materials, and reproducibility of results obtained on a set of 10 dust samples collected in the field. The characteristics of the field samples are also discussed with respect to mine occupational environments.

Routine environmental audit of the K-25 Site, Oak Ridge, Tennessee

Energy Technology Data Exchange (ETDEWEB)

1994-02-01

This report documents the results of the Routine Environmental Audit of the K-25 Site in Oak Ridge, Tennessee, conducted February 14 through February 25, 1994, by the US Department of Energy`s (DOE`s) Office of Environmental Audit (EH-24) located within the Office of Environment, Safety and Health (EH). The Routine Environmental Audit for the K-25 site was conducted as an environmental management assessment, supported through reviews of the Waste Management Program and the Decontamination and Decommissioning Program. The assessment was conducted jointly with, and built upon, the results provided by the ``DOE Oak Ridge Operations Office Environment, Safety, health and Quality Assurance Appraisal at the K-25 Site.`` DOE 5482.1B, ``Environment, Safety and Health Appraisal Program,`` established the mission of EH-24 to provide comprehensive, independent oversight of Department-wide environmental programs on behalf of the Secretary of Energy. The purpose of this assessment is to provide the Secretary of Energy and senior DOE managers with concise independent information as part of DOE`s continuing effort to improve environmental program performance. The ultimate goal of EH-24 is enhancement of environmental protection and the minimization of risk to public health and the environment. The routine environmental audit is one method by which EH-24 accomplishes its mission, utilizing systematic and periodic evaluations of the Department`s environmental programs within line organizations.

Realism versus simplicity in the snow routine of the HBV model

Science.gov (United States)

Girons Lopez, Marc; Vis, Marc; Seibert, Jan

2017-04-01

The HBV model still enjoys great popularity, in part because of its simplicity. Depicting the hydrological processes in a catchment in a simple way reduces data requirements and minimises parameter uncertainty. However, the representation of some processes might benefit from an increased model complexity. This is, for instance, the case of snow routine in the HBV-light version of the HBV model. HBV-light uses a degree-day method with a single threshold parameter to distinguish between rain and snow and simulate snow melt. Recent research has shown that hydrological models with a more realistic representation of snow processes might be more successful in estimating runoff. In this study we explore and test different improvements to the HBV-light snow routine design by considering different threshold temperature values for rain and snow distinction as well as for the beginning of snow melt, and introducing gradual transitions instead of the current sharp threshold. The use of radiation data, which recently became available as gridded data product in Switzerland, is an additional possibility. These modifications would allow for a more realistic depiction of important hydrological processes in alpine and other snow-covered areas while preserving the characteristic simplicity of HBV. Furthermore, in this contribution we evaluate the balance between introducing more realism into the snow routine of the HBV model and keeping the number of parameters as low as possible.

Routine environmental audit of the K-25 Site, Oak Ridge, Tennessee

International Nuclear Information System (INIS)

1994-02-01

This report documents the results of the Routine Environmental Audit of the K-25 Site in Oak Ridge, Tennessee, conducted February 14 through February 25, 1994, by the US Department of Energy's (DOE's) Office of Environmental Audit (EH-24) located within the Office of Environment, Safety and Health (EH). The Routine Environmental Audit for the K-25 site was conducted as an environmental management assessment, supported through reviews of the Waste Management Program and the Decontamination and Decommissioning Program. The assessment was conducted jointly with, and built upon, the results provided by the ''DOE Oak Ridge Operations Office Environment, Safety, health and Quality Assurance Appraisal at the K-25 Site.'' DOE 5482.1B, ''Environment, Safety and Health Appraisal Program,'' established the mission of EH-24 to provide comprehensive, independent oversight of Department-wide environmental programs on behalf of the Secretary of Energy. The purpose of this assessment is to provide the Secretary of Energy and senior DOE managers with concise independent information as part of DOE's continuing effort to improve environmental program performance. The ultimate goal of EH-24 is enhancement of environmental protection and the minimization of risk to public health and the environment. The routine environmental audit is one method by which EH-24 accomplishes its mission, utilizing systematic and periodic evaluations of the Department's environmental programs within line organizations

Routine operation of an Elliott 903 computer in a clinical chemistry laboratory

Science.gov (United States)

Whitby, L. G.; Simpson, D.

1973-01-01

Experience gained in the last four years concerning the capabilities and limitations of an 8K Elliott 903 (18-bit word) computer with magnetic tape backing store in the routine operation of a clinical chemistry laboratory is described. Designed as a total system, routine operation has latterly had to be confined to data acquisition and process control functions, due primarily to limitations imposed by the choice of hardware early in the project. In this final report of a partially successful experiment the opportunity is taken to review mistakes made, especially at the start of the project, to warn potential computer users of pitfalls to be avoided. PMID:4580240

Routine imaging for diffuse large B-cell lymphoma in first remission is not associated with better survival

DEFF Research Database (Denmark)

El-Galaly, Tarec; Jakobsen, Lasse Hjort; Hutchings, Martin

2015-01-01

Background: Routine surveillance imaging plays a limited role in detecting recurrent diffuse large B-cell lymphoma (DLBCL), and the value of routine imaging is controversial. The present population-based study compares the post-remission survival of Danish and Swedish DLBCL patients-two neighbour......Background: Routine surveillance imaging plays a limited role in detecting recurrent diffuse large B-cell lymphoma (DLBCL), and the value of routine imaging is controversial. The present population-based study compares the post-remission survival of Danish and Swedish DLBCL patients...... are fully publicly funded. Follow-up (FU) for Swedish patients included symptom assessment, clinical examinations, and blood tests with 3-month intervals for 2 years and with longer intervals later in follow-up. Imaging was only performed in response to suspected relapse. FU for Danish patients...... was equivalent but included additional routine surveillance imaging (usually half-yearly CT for 2 years as a minimum). Clinico-pathological features were retrieved from the national lymphoma registries, and vital status was updated using the civil registries. OS was defined as the time from end of treatment...

Avian Influenza Virus A (H5N1), Detected through Routine Surveillance, in Child, Bangladesh

Science.gov (United States)

Alamgir, A.S.M.; Sultana, Rebecca; Islam, M. Saiful; Rahman, Mustafizur; Fry, Alicia M.; Shu, Bo; Lindstrom, Stephen; Nahar, Kamrun; Goswami, Doli; Haider, M. Sabbir; Nahar, Sharifun; Butler, Ebonee; Hancock, Kathy; Donis, Ruben O.; Davis, Charles T.; Zaman, Rashid Uz; Luby, Stephen P.; Uyeki, Timothy M.; Rahman, Mahmudur

2009-01-01

We identified avian influenza virus A (H5N1) infection in a child in Bangladesh in 2008 by routine influenza surveillance. The virus was of the same clade and phylogenetic subgroup as that circulating among poultry during the period. This case illustrates the value of routine surveillance for detection of novel influenza virus. PMID:19751601

Routine perinatal and paediatric post-mortem radiography: detection rates and implications for practice

Energy Technology Data Exchange (ETDEWEB)

Arthurs, Owen J. [NHS Foundation Trust, Department of Radiology Great Ormond Street Hospital for Children, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Calder, Alistair D. [NHS Foundation Trust, Department of Radiology Great Ormond Street Hospital for Children, London (United Kingdom); Kiho, Liina [Camelia Botnar Laboratories Great Ormond Street Hospital for Children, Department of Paediatric Pathology, London (United Kingdom); Taylor, Andrew M. [Great Ormond Street Hospital for Children, Cardiorespiratory Unit, London (United Kingdom); UCL Institute of Cardiovascular Science, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Sebire, Neil J. [Camelia Botnar Laboratories Great Ormond Street Hospital for Children, Department of Paediatric Pathology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom)

2014-03-15

Routine perinatal and paediatric post-mortem plain radiography allows for the diagnosis and assessment of skeletal dysplasias, fractures and other bony abnormalities. The aim of this study was to review the diagnostic yield of this practice. We identified 1,027 cases performed in a single institution over a 21/2-year period, including babygrams (whole-body examinations) and full skeletal surveys. Images were reported prior to autopsy in all cases. Radiology findings were cross-referenced with the autopsy findings using an autopsy database. We scored each case from 0 to 4 according to the level of diagnostic usefulness. The overall abnormality rate was 126/1,027 (12.3%). There was a significantly higher rate of abnormality when a skeletal survey was performed (18%) rather than a babygram (10%; P < 0.01); 90% (665/739) of babygrams were normal. Of the 74 abnormal babygrams, we found 33 incidental non-contributory cases, 19 contributory, 20 diagnostic, and 2 false-positive cases. There were only 2 cases out of 739 (0.27%) in whom routine post-mortem imaging identified potentially significant abnormalities that would not have been detected if only selected imaging had been performed. A policy of performing selected, rather than routine, foetal post-mortem radiography could result in a significant cost saving. Routine post-mortem paediatric radiography in foetuses and neonates is neither diagnostically useful nor cost-effective. A more evidence-based, selective protocol should yield significant cost savings. (orig.)

Routine perinatal and paediatric post-mortem radiography: detection rates and implications for practice

International Nuclear Information System (INIS)

Arthurs, Owen J.; Calder, Alistair D.; Kiho, Liina; Taylor, Andrew M.; Sebire, Neil J.

2014-01-01

Routine perinatal and paediatric post-mortem plain radiography allows for the diagnosis and assessment of skeletal dysplasias, fractures and other bony abnormalities. The aim of this study was to review the diagnostic yield of this practice. We identified 1,027 cases performed in a single institution over a 21/2-year period, including babygrams (whole-body examinations) and full skeletal surveys. Images were reported prior to autopsy in all cases. Radiology findings were cross-referenced with the autopsy findings using an autopsy database. We scored each case from 0 to 4 according to the level of diagnostic usefulness. The overall abnormality rate was 126/1,027 (12.3%). There was a significantly higher rate of abnormality when a skeletal survey was performed (18%) rather than a babygram (10%; P < 0.01); 90% (665/739) of babygrams were normal. Of the 74 abnormal babygrams, we found 33 incidental non-contributory cases, 19 contributory, 20 diagnostic, and 2 false-positive cases. There were only 2 cases out of 739 (0.27%) in whom routine post-mortem imaging identified potentially significant abnormalities that would not have been detected if only selected imaging had been performed. A policy of performing selected, rather than routine, foetal post-mortem radiography could result in a significant cost saving. Routine post-mortem paediatric radiography in foetuses and neonates is neither diagnostically useful nor cost-effective. A more evidence-based, selective protocol should yield significant cost savings. (orig.)

Teaching problem solving using non-routine tasks

Science.gov (United States)

Chong, Maureen Siew Fang; Shahrill, Masitah; Putri, Ratu Ilma Indra; Zulkardi

2018-04-01

Non-routine problems are related to real-life context and require some realistic considerations and real-world knowledge in order to resolve them. This study examines several activity tasks incorporated with non-routine problems through the use of an emerging mathematics framework, at two junior colleges in Brunei Darussalam. The three sampled teachers in this study assisted in selecting the topics and the lesson plan designs. They also recommended the development of the four activity tasks: incorporating the use of technology; simulation of a reality television show; designing real-life sized car park spaces for the school; and a classroom activity to design a real-life sized dustpan. Data collected from all four of the activity tasks were analyzed based on the students' group work. The findings revealed that the most effective activity task in teaching problem solving was to design a real-life sized car park. This was because the use of real data gave students the opportunity to explore, gather information and give or receive feedback on the effect of their reasons and proposed solutions. The second most effective activity task was incorporating the use of technology as it enhanced the students' understanding of the concepts learnt in the classroom. This was followed by the classroom activity that used real data as it allowed students to work and assess the results mathematically. The simulation of a television show was found to be the least effective since it was viewed as not sufficiently challenging to the students.

A randomized controlled trial of cell salvage in routine cardiac surgery.

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Klein, Andrew A; Nashef, Samer A M; Sharples, Linda; Bottrill, Fiona; Dyer, Matthew; Armstrong, Johanna; Vuylsteke, Alain

2008-11-01

Previous trials have indicated that cell salvage may reduce allogeneic blood transfusion during cardiac surgery, but these studies have limitations, including inconsistent use of other blood transfusion-sparing strategies. We designed a randomized controlled trial to determine whether routine cell salvage for elective uncomplicated cardiac surgery reduces blood transfusion and is cost effective in the setting of a rigorous transfusion protocol and routine administration of antifibrinolytics. Two-hundred-thirteen patients presenting for first-time coronary artery bypass grafting and/or cardiac valve surgery were prospectively randomized to control or cell salvage groups. The latter group had blood aspirate during surgery and mediastinal drainage the first 6 h after surgery processed in a cell saver device and autotransfused. All patients received tranexamic acid and were subjected to an algorithm for red blood cell and hemostatic blood factor transfusion. There was no difference between the two groups in the proportion of patients exposed to allogeneic blood (32% in both groups, relative risk 1.0 P = 0.89). At current blood products and cell saver prices, the use of cell salvage increased the costs per patient by a minimum of $103. When patients who had mediastinal re-exploration for bleeding were excluded (as planned in the protocol), significantly fewer units of allogeneic red blood cells were transfused in the cell salvage compared with the control group (65 vs 100 U, relative risk 0.71 P = 0.04). In patients undergoing routine first-time cardiac surgery in an institution with a rigorous blood conservation program, the routine use of cell salvage does not further reduce the proportion of patients exposed to allogeneic blood transfusion. However, patients who do not have excessive bleeding after surgery receive significantly fewer units of blood with cell salvage. Although the use of cell savage may reduce the demand for blood products during cardiac surgery, this

Bayesian estimation of test characteristics of real-time PCR, bacteriological culture and California mastitis test for diagnosis of intramammary infections with Staphylococcus aureus in dairy cattle at routine milk recordings.

Science.gov (United States)

Mahmmod, Yasser S; Toft, Nils; Katholm, Jørgen; Grønbæk, Carsten; Klaas, Ilka C

2013-11-01

Danish farmers can order a real-time PCR mastitis diagnostic test on routinely taken cow-level samples from milk recordings. Validation of its performance in comparison to conventional mastitis diagnostics under field conditions is essential for efficient control of intramammary infections (IMI) with Staphylococcus aureus (S. aureus). Therefore, the objective of this study was to estimate the sensitivity (Se) and specificity (Sp) of real-time PCR, bacterial culture (BC) and California mastitis test (CMT) for the diagnosis of the naturally occurring IMI with S. aureus in routinely collected milk samples using latent class analysis (LCA) to avoid the assumption of a perfect reference test. Using systematic random sampling, a total of 609 lactating dairy cows were selected from 6 dairy herds with bulk tank milk PCR cycle threshold (Ct) value ≤39 for S. aureus. At routine milk recordings, automatically obtained cow-level (composite) milk samples were analyzed by PCR and at the same milking, 2436 quarter milk samples were collected aseptically for BC and CMT. Results showed that 140 cows (23%) were positive for S. aureus IMI by BC while 170 cows (28%) were positive by PCR. Estimates of Se and Sp for PCR were higher than test estimates of BC and CMT. SeCMT was higher than SeBC however, SpBC was higher than SpCMT. SePCR was 91%, while SeBC was 53%, and SeCMT was 61%. SpPCR was 99%, while SpBC was 89%, and SpCMT was 65%. In conclusion, PCR has a higher performance than the conventional diagnostic tests (BC and CMT) suggesting its usefulness as a routine test for accurate diagnosis of S. aureus IMI from dairy cows at routine milk recordings. The use of LCA provided estimates of the test characteristics for two currently diagnostic tests (BC, CMT) and a novel technique (real-time PCR) for diagnosing S. aureus IMI under field conditions at routine milk recordings in Denmark. Copyright © 2013 Elsevier B.V. All rights reserved.

Fitting model-based psychometric functions to simultaneity and temporal-order judgment data: MATLAB and R routines.

Science.gov (United States)

Alcalá-Quintana, Rocío; García-Pérez, Miguel A

2013-12-01

Research on temporal-order perception uses temporal-order judgment (TOJ) tasks or synchrony judgment (SJ) tasks in their binary SJ2 or ternary SJ3 variants. In all cases, two stimuli are presented with some temporal delay, and observers judge the order of presentation. Arbitrary psychometric functions are typically fitted to obtain performance measures such as sensitivity or the point of subjective simultaneity, but the parameters of these functions are uninterpretable. We describe routines in MATLAB and R that fit model-based functions whose parameters are interpretable in terms of the processes underlying temporal-order and simultaneity judgments and responses. These functions arise from an independent-channels model assuming arrival latencies with exponential distributions and a trichotomous decision space. Different routines fit data separately for SJ2, SJ3, and TOJ tasks, jointly for any two tasks, or also jointly for the three tasks (for common cases in which two or even the three tasks were used with the same stimuli and participants). Additional routines provide bootstrap p-values and confidence intervals for estimated parameters. A further routine is included that obtains performance measures from the fitted functions. An R package for Windows and source code of the MATLAB and R routines are available as Supplementary Files.

Making sense of the shadows: priorities for creating a learning healthcare system based on routinely collected data.

Science.gov (United States)

Deeny, Sarah R; Steventon, Adam

2015-08-01

Socrates described a group of people chained up inside a cave, who mistook shadows of objects on a wall for reality. This allegory comes to mind when considering 'routinely collected data'-the massive data sets, generated as part of the routine operation of the modern healthcare service. There is keen interest in routine data and the seemingly comprehensive view of healthcare they offer, and we outline a number of examples in which they were used successfully, including the Birmingham OwnHealth study, in which routine data were used with matched control groups to assess the effect of telephone health coaching on hospital utilisation.Routine data differ from data collected primarily for the purposes of research, and this means that analysts cannot assume that they provide the full or accurate clinical picture, let alone a full description of the health of the population. We show that major methodological challenges in using routine data arise from the difficulty of understanding the gap between patient and their 'data shadow'. Strategies to overcome this challenge include more extensive data linkage, developing analytical methods and collecting more data on a routine basis, including from the patient while away from the clinic. In addition, creating a learning health system will require greater alignment between the analysis and the decisions that will be taken; between analysts and people interested in quality improvement; and between the analysis undertaken and public attitudes regarding appropriate use of data. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

One-dimensional nodal neutronics routines for the TRAC-BD1 thermal-hydraulics program

International Nuclear Information System (INIS)

Nigg, D.W.

1983-09-01

Nuclear reactor core transient neutronic behavior is currently modeled in the TRAC-BD1 code using a point-reactor kinetics formulation. This report describes a set of subroutines based on the Analytic Nodal Method that were written to provide TRAC-BD1 with a one-dimensional space-dependent neutronics capability. Use of the routines is illustrated with several test problems. The results of these problems show that the Analytic Nodal neutronics routines have desirable accuracy and computing time characteristics and should be a useful addition to TRAC-BD1

Collaborative Referencing between Individuals with Aphasia and Routine Communication Partners.

Science.gov (United States)

Hengst, Julie A.

2003-01-01

This study examined how four adults with aphasia collaborated with routine communication partners. Overall, these pairs completed the referencing task trials with accuracy and displayed referencing processes that conformed to the collaborative referencing model of communication. However, the pairs also used diverse verbal and nonverbal resources,…

Master schedule for CY-1981 Hanford environmental surveillance routine program

International Nuclear Information System (INIS)

Blumer, P.J.; Sula, M.J.; Eddy, P.A.

1980-12-01

The current schedule of data collection for the routine environmental surveillance program at the Hanford Site is provided. Questions about specific entries should be referred to the authors since modifications to the schedule are made during the year and special areas of study, usually of short duration, are not scheduled. The environmental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in Manual Chapter 0513, and to monitor Hanford operations for compliance with applicable environmental criteria given in Manual Chapter 0524 and Washington State Water Quality Standards. Air quality data obtained in a separate program are also reported. The collection schedule for potable water is shown but it is not part of the routine environmental surveillance program. Schedules are presented for the following subjects: air, Columbia River, sanitary water, surface water, ground water, foodstuffs, wildlife, soil and vegetation, external radiation measurement, portable instrument surveys, and surveillance of waste disposal sites

Impact of measles supplementary immunization activities on reaching children missed by routine programs.

Science.gov (United States)

Portnoy, Allison; Jit, Mark; Helleringer, Stéphane; Verguet, Stéphane

2018-01-02

Measles supplementary immunization activities (SIAs) are vaccination campaigns that supplement routine vaccination programs with a recommended second dose opportunity to children of different ages regardless of their previous history of measles vaccination. They are conducted every 2-4 years and over a few weeks in many low- and middle-income countries. While SIAs have high vaccination coverage, it is unclear whether they reach the children who miss their routine measles vaccine dose. Determining who is reached by SIAs is vital to understanding their effectiveness, as well as measure progress towards measles control. We examined SIAs in low- and middle-income countries from 2000 to 2014 using data from the Demographic and Health Surveys. Conditional on a child's routine measles vaccination status, we examined whether children participated in the most recent measles SIA. The average proportion of zero-dose children (no previous routine measles vaccination defined as no vaccination date before the SIA) reached by SIAs across 14 countries was 66%, ranging from 28% in São Tomé and Príncipe to 91% in Nigeria. However, when also including all children with routine measles vaccination data, this proportion decreased to 12% and to 58% when imputing data for children with vaccination reported by the mother and vaccination marks on the vaccination card across countries. Overall, the proportions of zero-dose children reached by SIAs declined with increasing household wealth. Some countries appeared to reach a higher proportion of zero-dose children using SIAs than others, with proportions reached varying according to the definition of measles vaccination (e.g., vaccination dates on the vaccination card, vaccination marks on the vaccination card, and/or self-reported data). This suggests that some countries could improve their targeting of SIAs to children who miss other measles vaccine opportunities. Across all countries, SIAs played an important role in reaching

Family routines within the ecological niche: An analysis of the psychological well-being of U.S. caregivers of children with disabilities

Directory of Open Access Journals (Sweden)

Elizabeth Ann Larson

2014-05-01

Full Text Available Using mixed methods, this study examined the relationship of caregivers of children with disabilities’ psychological well-being and their orchestration of daily routines within their ecological niche. Thirty-nine U.S. caregivers completed in-depth interviews, Psychological Well-being Scales (PWB, and Family Time and Routines Index (FTRI. We used a multi-step analysis. Interview data was coded and vignettes created without knowledge of PWB and FTRI ratings. Next, the relationship of quantitative measures was analyzed. Four groups were created using FTRI-extent and PWB means: (1 low routine-low PWB, (2 low routine-high PWB, (3 high routine-low PWB, and (4 high routine-high PWB. We examined qualitative differences in key features between groups. Findings: Total PWB and FTRI scores were not significantly correlated, PWB Purpose in Life and FTRI-extent scores were moderately positively correlated, and PWB Environmental Mastery and FTRI-extent correlation approached significance. Qualitative findings describe caregivers’ structuring of routines, intensity of oversight, support in routines, management of dinner, paid work, and needs for respite. The four groups differed in paid work, household support, degree the child could self-occupy, Environmental Mastery, and opportunities to recuperate. Caregivers with higher levels of well-being and more regular routines did paid work, had supportive spouses, had children who more often could follow routines, had higher Environmental Mastery, could orchestrate a family meal, and had breaks from care in either work or leisure. All Native American caregivers and Mexican American caregivers with spouses were in the high routine-high PWB group. Insight into this complex negotiation between family members within daily routines may provide practitioners a better understanding of how to work within family circles to foster therapeutic alliances, identify focused intervention targets, and promote positive family

Virtual microscopy: an evaluation of its validity and diagnostic performance in routine histologic diagnosis of skin tumors

DEFF Research Database (Denmark)

Nielsen, Patricia Switten; Lindebjerg, Jan; Rasmussen, Jan

2010-01-01

Digitization of histologic slides is associated with many advantages, and its use in routine diagnosis holds great promise. Nevertheless, few articles evaluate virtual microscopy in routine settings. This study is an evaluation of the validity and diagnostic performance of virtual microscopy...... in routine histologic diagnosis of skin tumors. Our aim is to investigate whether conventional microscopy of skin tumors can be replaced by virtual microscopy. Ninety-six skin tumors and skin-tumor-like changes were consecutively gathered over a 1-week period. Specimens were routinely processed, and digital...... slides were captured on Mirax Scan (Carl Zeiss MicroImaging, Göttingen, Germany). Four pathologists evaluated the 96 virtual slides and the associated 96 conventional slides twice with intermediate time intervals of at least 3 weeks. Virtual slides that caused difficulties were reevaluated to identify...

Parallelization of applications for networks with homogeneous and heterogeneous processors; Parallelisation d`applications pour des reseaux de processeurs homogenes ou heterogenes

Energy Technology Data Exchange (ETDEWEB)

Colombet, L

1994-10-07

The aim of this thesis is to study and develop efficient methods for parallelization of scientific applications on parallel computers with distributed memory. The first part presents two libraries of PVM (Parallel Virtual Machine) and MPI (Message Passing Interface) communication tools. They allow implementation of programs on most parallel machines, but also on heterogeneous computer networks. This chapter illustrates the problems faced when trying to evaluate performances of networks with heterogeneous processors. To evaluate such performances, the concepts of speed-up and efficiency have been modified and adapted to account for heterogeneity. The second part deals with a study of parallel application libraries such as ScaLAPACK and with the development of communication masking techniques. The general concept is based on communication anticipation, in particular by pipelining message sending operations. Experimental results on Cray T3D and IBM SP1 machines validates the theoretical studies performed on basic algorithms of the libraries discussed above. Two examples of scientific applications are given: the first is a model of young stars for astrophysics and the other is a model of photon trajectories in the Compton effect. (J.S.). 83 refs., 65 figs., 24 tabs.

Parallelization of applications for networks with homogeneous and heterogeneous processors

International Nuclear Information System (INIS)

Colombet, L.

1994-01-01

The aim of this thesis is to study and develop efficient methods for parallelization of scientific applications on parallel computers with distributed memory. The first part presents two libraries of PVM (Parallel Virtual Machine) and MPI (Message Passing Interface) communication tools. They allow implementation of programs on most parallel machines, but also on heterogeneous computer networks. This chapter illustrates the problems faced when trying to evaluate performances of networks with heterogeneous processors. To evaluate such performances, the concepts of speed-up and efficiency have been modified and adapted to account for heterogeneity. The second part deals with a study of parallel application libraries such as ScaLAPACK and with the development of communication masking techniques. The general concept is based on communication anticipation, in particular by pipelining message sending operations. Experimental results on Cray T3D and IBM SP1 machines validates the theoretical studies performed on basic algorithms of the libraries discussed above. Two examples of scientific applications are given: the first is a model of young stars for astrophysics and the other is a model of photon trajectories in the Compton effect. (J.S.). 83 refs., 65 figs., 24 tabs

Effects of polio eradication activities on routine immunization: lessons from the 2013 outbreak response in Somali region of Ethiopia.

Science.gov (United States)

Tafesse, Belete; Tekle, Ephrem; Wondwossen, Liya; Bogale, Mengistu; Fiona, Braka; Nsubuga, Peter; Tomas, Karengera; Kassahun, Aron; Kathleen, Gallagher; Teka, Aschalew

2017-01-01

Ethiopia experienced several WPV importations with a total of 10 WPV1 cases confirmed during the 2013 outbreak alone before it is closed in 2015. We evaluated supplemental immunization activities (SIAs), including lessons learned for their effect on the routine immunization program during the 2013 polio outbreak in Somali regional state. We used descriptive study to review documents and analyse routine health information system reports from the polio outbreak affected Somali regional state. All data and technical reports of the 15 rounds of polio SIAs from June 2013 through June 2015 and routine immunization coverages for DPT-Hib-HepB 3 and measles were observed. More than 93% of the SIAs were having administrative coverage above 95%. The trend of routine immunization for the two antigens, over the five years (2011 through 2015) did not show a consistent pattern against the number of SIAs. Documentations showed qualitative positive impacts of the SIAs strengthening the routine immunization during all courses of the campaigns. The quantitative impact of polio SIAs on routine immunization remained not so impressive in this study. Clear planning, data consistencies and completeness issues need to be cleared for the impact assessment in quantitative terms, in polio legacy planning as well as for the introduction of injectable polio vaccine through the routine immunization.

Quantum efficiency harmonic analysis of exciton annihilation in organic light emitting diodes

Energy Technology Data Exchange (ETDEWEB)

Price, J. S.; Giebink, N. C., E-mail: ncg2@psu.edu [Department of Electrical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802 (United States)

2015-06-29

Various exciton annihilation processes are known to impact the efficiency roll-off of organic light emitting diodes (OLEDs); however, isolating and quantifying their contribution in the presence of other factors such as changing charge balance continue to be a challenge for routine device characterization. Here, we analyze OLED electroluminescence resulting from a sinusoidal dither superimposed on the device bias and show that nonlinearity between recombination current and light output arising from annihilation mixes the quantum efficiency measured at different dither harmonics in a manner that depends uniquely on the type and magnitude of the annihilation process. We derive a series of analytical relations involving the DC and first harmonic external quantum efficiency that enable annihilation rates to be quantified through linear regression independent of changing charge balance and evaluate them for prototypical fluorescent and phosphorescent OLEDs based on the emitters 4-(dicyanomethylene)-2-methyl-6-(4-dimethylaminostyryl)-4H-pyran and platinum octaethylporphyrin, respectively. We go on to show that, in most cases, it is sufficient to calculate the needed quantum efficiency harmonics directly from derivatives of the DC light versus current curve, thus enabling this analysis to be conducted solely from standard light-current-voltage measurement data.

Diagnostic accuracy of routine blood examinations and CSF lactate level for post-neurosurgical bacterial meningitis

Directory of Open Access Journals (Sweden)

Yang Zhang

2017-06-01

Conclusions: The PBM diagnostic accuracy of routine blood examinations was relatively low, whereas the accuracy of CSF lactate level was high. Some variables that are involved in the incidence of PBM can also affect the diagnostic accuracy for PBM. Taking into account the effects of these variables significantly improves the diagnostic accuracies of routine blood examinations and CSF lactate level.

Modeling the Structure and Complexity of Engineering Routine Design Problems

NARCIS (Netherlands)

Jauregui Becker, Juan Manuel; Wits, Wessel Willems; van Houten, Frederikus J.A.M.

2011-01-01

This paper proposes a model to structure routine design problems as well as a model of its design complexity. The idea is that having a proper model of the structure of such problems enables understanding its complexity, and likewise, a proper understanding of its complexity enables the development

A Sudden Total Loss of Vision After Routine Cataract Surgery ...

African Journals Online (AJOL)

We share our experience of a 50-year-old controlled hypertensive woman who had routine cataract surgery in her left eye. She was given retrobulbar Xylocaine with adrenalin and postoperative gentamycin. She subsequently became blind in the operated eye after developing macular infarction by the first day post ...

Analysis of routine EEG usage in a general adult ICU.

LENUS (Irish Health Repository)

McHugh, J C

2009-09-01

Non-convulsive seizures and status epilepticus are common in brain-injured patients in intensive care units. Continuous electroencephalography (cEEG) monitoring is the most sensitive means of their detection. In centres where cEEG is unavailable, routine EEG is often utilized for diagnosis although its sensitivity is lower.

Scientific computing vol II - eigenvalues and optimization

CERN Document Server

Trangenstein, John A

2017-01-01

This is the second of three volumes providing a comprehensive presentation of the fundamentals of scientific computing. This volume discusses more advanced topics than volume one, and is largely not a prerequisite for volume three. This book and its companions show how to determine the quality of computational results, and how to measure the relative efficiency of competing methods. Readers learn how to determine the maximum attainable accuracy of algorithms, and how to select the best method for computing problems. This book also discusses programming in several languages, including C++, Fortran and MATLAB. There are 49 examples, 110 exercises, 66 algorithms, 24 interactive JavaScript programs, 77 references to software programs and 1 case study. Topics are introduced with goals, literature references and links to public software. There are descriptions of the current algorithms in LAPACK, GSLIB and MATLAB. This book could be used for a second course in numerical methods, for either upper level undergraduate...

Development, validation and routine control of a radiation process

International Nuclear Information System (INIS)

Kishor Mehta

2010-01-01

Today, radiation is used in industrial processing for variety of applications; from low doses for blood irradiation to very high doses for materials modification and even higher for gemstone colour enhancement. At present, radiation is mainly provided by either radionuclides or machine sources; cobalt-60 is the most predominant radionuclide in use. Currently, there are several hundred irradiation facilities worldwide. Similar to other industries, quality management systems can assist radiation processing facilities in enhancing customer satisfaction and maintaining and improving product quality. To help fulfill quality management requirements, several national and international organizations have developed various standards related to radiation processing. They all have requirements and guidelines for development, validation and routine control of the radiation process. For radiation processing, these three phases involve the following activities. Development phase includes selecting the type of radiation source, irradiation facility and the dose required for the process. Validation phase includes conducting activities that give assurance that the process will be successful. Routine control then involves activities that provide evidence that the process has been successfully realized. These standards require documentary evidence that process validation and process control have been followed. Dosimetry information gathered during these processes provides this evidence. (authors)

Value of routine blood tests for prediction of mortality risk in hip fracture patients

DEFF Research Database (Denmark)

Mosfeldt, Mathias; Pedersen, Ole Birger Vesterager; Riis, Troels

2012-01-01

There is a 5- to 8-fold increased risk of mortality during the first 3 months after a hip fracture. Several risk factors are known. We studied the predictive value (for mortality) of routine blood tests taken on admission.......There is a 5- to 8-fold increased risk of mortality during the first 3 months after a hip fracture. Several risk factors are known. We studied the predictive value (for mortality) of routine blood tests taken on admission....

Are routine pelvic radiographs in major pediatric blunt trauma necessary?

Science.gov (United States)

Lagisetty, Jyothi; Slovis, Thomas; Thomas, Ronald; Knazik, Stephen; Stankovic, Curt

2012-07-01

Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients.

Innovative Telemonitoring System for Cardiology: From Science to Routine Operation

Science.gov (United States)

Kastner, P.; Morak, J.; Modre, R.; Kollmann, A.; Ebner, C.; Fruhwald, FM.; Schreier, G.

2010-01-01

Objective Results of the Austrian MOBITEL (MOBIle phone based TELemonitoring for heart failure patients) trial indicate that home-based telemonitoring improves outcome of chronic heart failure (CHF) patients and reduces both frequency and duration of hospitalizations. Based on lessons learned, we assessed the weak points to clear the way for routine operations. Methods We analyzed the system with respect to recommendations of the ESC Guidelines and experiences gained throughout the trial to identify potential improvements. The following components have been identified: a patient terminal with highest usability, integrated way to document drug-intake and well-being, and automated event detection for worsening of CHF. As a consequence the system was extended by Near Field Communication (NFC) technology and by an event management tool. Results Usability evaluation with 30 adults (14f, median 51y. IQR[45-65]) showed that 21 (8f) were able to immediately operate the system after reading a step-by-step manual. Eight (6f) needed one time demonstration and one man (80y) failed to operate the blood pressure meter. Routine operation of the revised system started in March 2009. Within 9 months, 15 patients (4f, median 74y. IQR[71-83], all NYHA-III) transmitted 17,149 items. 43 events were detected because of body weight gain of more then 2kg within 2 days. 49 therapy adjustments were documented. Three patients stopped using the system, two (1f) because of non-compliance and one (m, 82y) because of death. Overall, the rate of adherence to daily data transfer was 78%. Conclusion First results confirm the applicability of the revised telemonitoring system in routine operation. PMID:23616835

Real-Time Whole-Genome Sequencing for Routine Typing, Surveillance, and Outbreak Detection of Verotoxigenic Escherichia coli

Science.gov (United States)

Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf S.; Nielsen, Eva M.; Aarestrup, Frank M.

2014-01-01

Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-producing Escherichia coli (VTEC). In Denmark, the Statens Serum Institut (SSI) routinely receives all suspected VTEC isolates. During a 7-week period in the fall of 2012, all incoming isolates were concurrently subjected to WGS using IonTorrent PGM. Real-time bioinformatics analysis was performed using web-tools (www.genomicepidemiology.org) for species determination, multilocus sequence type (MLST) typing, and determination of phylogenetic relationship, and a specific VirulenceFinder for detection of E. coli virulence genes was developed as part of this study. In total, 46 suspected VTEC isolates were characterized in parallel during the study. VirulenceFinder proved successful in detecting virulence genes included in routine typing, explicitly verocytotoxin 1 (vtx1), verocytotoxin 2 (vtx2), and intimin (eae), and also detected additional virulence genes. VirulenceFinder is also a robust method for assigning verocytotoxin (vtx) subtypes. A real-time clustering of isolates in agreement with the epidemiology was established from WGS, enabling discrimination between sporadic and outbreak isolates. Overall, WGS typing produced results faster and at a lower cost than the current routine. Therefore, WGS typing is a superior alternative to conventional typing strategies. This approach may also be applied to typing and surveillance of other pathogens. PMID:24574290

Real-time whole-genome sequencing for routine typing, surveillance, and outbreak detection of verotoxigenic Escherichia coli.

Science.gov (United States)

Joensen, Katrine Grimstrup; Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf S; Nielsen, Eva M; Aarestrup, Frank M

2014-05-01

Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-producing Escherichia coli (VTEC). In Denmark, the Statens Serum Institut (SSI) routinely receives all suspected VTEC isolates. During a 7-week period in the fall of 2012, all incoming isolates were concurrently subjected to WGS using IonTorrent PGM. Real-time bioinformatics analysis was performed using web-tools (www.genomicepidemiology.org) for species determination, multilocus sequence type (MLST) typing, and determination of phylogenetic relationship, and a specific VirulenceFinder for detection of E. coli virulence genes was developed as part of this study. In total, 46 suspected VTEC isolates were characterized in parallel during the study. VirulenceFinder proved successful in detecting virulence genes included in routine typing, explicitly verocytotoxin 1 (vtx1), verocytotoxin 2 (vtx2), and intimin (eae), and also detected additional virulence genes. VirulenceFinder is also a robust method for assigning verocytotoxin (vtx) subtypes. A real-time clustering of isolates in agreement with the epidemiology was established from WGS, enabling discrimination between sporadic and outbreak isolates. Overall, WGS typing produced results faster and at a lower cost than the current routine. Therefore, WGS typing is a superior alternative to conventional typing strategies. This approach may also be applied to typing and surveillance of other pathogens.

How characteristic routines of clinical departments influence students' self-regulated learning: A grounded theory study.

Science.gov (United States)

Berkhout, J J; Slootweg, I A; Helmich, E; Teunissen, P W; van der Vleuten, C P M; Jaarsma, A D C

2017-11-01

In clerkships, students are expected to self-regulate their learning. How clinical departments and their routine approach on clerkships influences students' self-regulated learning (SRL) is unknown. This study explores how characteristic routines of clinical departments influence medical students' SRL. Six focus groups including 39 purposively sampled participants from one Dutch university were organized to study how characteristic routines of clinical departments influenced medical students' SRL from a constructivist paradigm, using grounded theory methodology. The focus groups were audio recorded, transcribed verbatim and were analyzed iteratively using constant comparison and open, axial and interpretive coding. Students described that clinical departments influenced their SRL through routines which affected the professional relationships they could engage in and affected their perception of a department's invested effort in them. Students' SRL in a clerkship can be supported by enabling them to engage others in their SRL and by having them feel that effort is invested in their learning. Our study gives a practical insight in how clinical departments influenced students' SRL. Clinical departments can affect students' motivation to engage in SRL, influence the variety of SRL strategies that students can use and how meaningful students perceive their SRL experiences to be.

Routine clinical heart examinations using SQUID magnetocardiography at University of Tsukuba Hospital

Science.gov (United States)

Inaba, T.; Nakazawa, Y.; Yoshida, K.; Kato, Y.; Hattori, A.; Kimura, T.; Hoshi, T.; Ishizu, T.; Seo, Y.; Sato, A.; Sekiguchi, Y.; Nogami, A.; Watanabe, S.; Horigome, H.; Kawakami, Y.; Aonuma, K.

2017-11-01

A 64-channel Nb-based DC-SQUID magnetocardiography (MCG) system was installed at the University of Tsukuba Hospital (UTH) in March 2007 after obtaining Japanese pharmaceutical approval and insurance reimbursement approval. In the period between 2008 and 2016, the total number of patients was 10 085. The heart diseases diagnosed in fetuses as well as adults are mainly atrial arrhythmia, abnormal repolarization, ventricular arrhythmia, and fetal arrhythmia. In most cases of insufficient diagnostic accuracy with electrocardiography, SQUID MCG precisely revealed these heart diseases as an abnormal electrical current distribution. Based on success in routine examinations, SQUID MCG is now an indispensable clinical instrument with diagnostic software tuned up during routine use at UTH.

Routine HIV testing in Botswana: a population-based study on attitudes, practices, and human rights concerns.

Directory of Open Access Journals (Sweden)

Sheri D Weiser

2006-07-01

Full Text Available The Botswana government recently implemented a policy of routine or "opt-out" HIV testing in response to the high prevalence of HIV infection, estimated at 37% of adults.We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana to assess knowledge of and attitudes toward routine testing, correlates of HIV testing, and barriers and facilitators to testing, 11 months after the introduction of this policy. Most participants (81% reported being extremely or very much in favor of routine testing. The majority believed that this policy would decrease barriers to testing (89%, HIV-related stigma (60%, and violence toward women (55%, and would increase access to antiretroviral treatment (93%. At the same time, 43% of participants believed that routine testing would lead people to avoid going to the doctor for fear of testing, and 14% believed that this policy could increase gender-based violence related to testing. The prevalence of self-reported HIV testing was 48%. Adjusted correlates of testing included female gender (AOR = 1.5, 95% CI = 1.1-1.9, higher education (AOR = 2.0, 95% CI = 1.5-2.7, more frequent healthcare visits (AOR = 1.9, 95% CI = 1.3-2.7, perceived access to HIV testing (AOR = 1.6, 95% CI = 1.1-2.5, and inconsistent condom use (AOR = 1.6, 95% CI = 1.2-2.1. Individuals with stigmatizing attitudes toward people living with HIV and AIDS were less likely to have been tested for HIV/AIDS (AOR = 0.7, 95% CI = 0.5-0.9 or to have heard of routine testing (AOR = 0.59, 95% CI = 0.45-0.76. While experiences with voluntary and routine testing overall were positive, 68% felt that they could not refuse the HIV test. Key barriers to testing included fear of learning one's status (49%, lack of perceived HIV risk (43%, and fear of having to change sexual practices with a positive HIV test (33%.Routine testing appears to be widely supported and may reduce barriers to testing in Botswana. As routine testing is

Practising Homelessness: A Typology Approach to Young People's Daily Routines

Science.gov (United States)

Mallett, Shelley; Rosenthal, Doreen; Myers, Paul; Milburn, Norweeta; Rotheram-Borus, Mary Jane

2004-01-01

In a study exploring the relationship between typology and risk, we investigated the daily routines of a heterogeneous sample of young men and women from two sites who had been homeless for varying periods (N=1289). Cluster analysis yielded four groups--"Partnered", "Socially engaged", "Service connected-harm avoidant", and "Transgressive"--based…

Creating Masterpieces: How Course Structures and Routines Enable Student Performance

Science.gov (United States)

Dean, Kathy Lund; Fornaciari, Charles J.

2014-01-01

Over a five-year period, we made a persistent observation: Course structures and routines, such as assignment parameters, student group process rules, and grading schemes were being consistently ignored. As a result, we got distracted by correcting these structural issues and were spending less time on student assignment performance. In this…

Accuracy of routine cytology and immunocytochemistry in preoperative diagnosis of oral amelanotic melanomas in dogs.

Science.gov (United States)

Przeździecki, Rafał; Czopowicz, Michał; Sapierzyński, Rafał

2015-12-01

Amelanotic melanomas are one of the most common oral malignancies. The cytologic and histopathologic differentiation between amelanotic melanoma, sarcoma, and poorly differentiated carcinoma is often difficult or even impossible. The aim of this study was to assess the reliability of routine cytology and immunocytochemistry in preoperative diagnosis of canine oral amelanotic melanoma. Cytologic preparations from undifferentiated canine oral tumors were stained with Giemsa and by immunocytochemistry (ICC) using anti-cytokeratin, anti-vimentin, and anti-Melan A antibodies. The final cytologic diagnosis (including ICC) was compared to the final diagnosis based on histopathology and immunohistochemistry (IHC) results, and sensitivity and specificity of cytologic examination were determined. Final cytologic diagnoses of 38 cases agreed well with the histopathologic/immunohistochemical diagnoses, thus both specificity and sensitivity of combined routine cytology and ICC were 100% (95% confidence interval 90.8-100%). Of 32 oral tumors, diagnosis of amelanotic melanoma, sarcoma, and carcinoma was made using routine cytology and ICC. In 4 of 6 aspirates taken from lymph nodes, a preliminary diagnosis of metastatic amelanotic melanoma corresponded with the final diagnosis. Both sensitivity and specificity of routine cytology in diagnosis of amelanotic melanomas were considered moderate (66.7% and 85.7%, respectively). In conclusion, routine cytology is a reliable diagnostic method for canine oral amelanotic melanoma and metastatic amelanotic melanoma, and ICC, using anti-cytokeratin, anti-vimentin, and anti-Melan A antibodies, is an excellent supporting method for presurgical diagnosis of poorly differentiated oral malignancies in dogs. © 2015 American Society for Veterinary Clinical Pathology.

Institutionalized unpredictability and café routines: The case of young people in Bosnia and Herzegovina

Directory of Open Access Journals (Sweden)

Čelebičić Vanja

2017-01-01

Full Text Available When life is very unpredictable or uncertain, a routine set of practices may become a very significant element in a person’s daily life, as it may allow a sense of protection from the unknown (Ehn & Löfgren 2010 and encourage feelings of belonging (Rapport & Dawson 1998. In this article I explore how people relate to the immediate future when their presents are filled with unpredictability. More specifically, I explore the everyday practices around café routines of some young people living in Bihać, a town in northwestern Bosnia- Herzegovina (BiH. Popular discourses often link between young people's tendencies to spend time in cafés with apathy and letargy, or alternativley with bad economic conditions. However, these views, whether empathetic or critical, are neither adeqate nor very empowering. Instead, I suggest that we must view café routines within the context of what I call ‘institutionalized unpredictability’. This allows us to distance ourselves from thinking about young people’s practices through dominant paradigms of engagement and disengagement and opens up the possibility to view café routines as ‘radically unpolitical' acts (Farthing 2010. I argue that café routines are both young people’s response to ‘institutionalized unpredictability’, as well as their way to criticize and reproduce it. I further show how institutionalized unpredictability was shaping and shaped by both state and nonstate related practices, relationships, processes and aspirations, suggesting that this is precisely what made it so powerfully pervasive and debilitating.

Routine colonic endoscopic evaluation following resolution of acute diverticulitis: Is it necessary?

Science.gov (United States)

Agarwal, Amit K; Karanjawala, Burzeen E; Maykel, Justin A; Johnson, Eric K; Steele, Scott R

2014-01-01

Diverticular disease incidence is increasing up to 65% by age 85 in industrialized nations, low fiber diets, and in younger and obese patients. Twenty-five percent of patients with diverticulosis will develop acute diverticulitis. This imposes a significant burden on healthcare systems, resulting in greater than 300000 admissions per year with an estimated annual cost of $3 billion USD. Abdominal computed tomography (CT) is the diagnostic study of choice, with a sensitivity and specificity greater than 95%. Unfortunately, similar CT findings can be present in colonic neoplasia, especially when perforated or inflamed. This prompted professional societies such as the American Society of Colon Rectal Surgeons to recommend patients undergo routine colonoscopy after an episode of acute diverticulitis to rule out malignancy. Yet, the data supporting routine colonoscopy after acute diverticulitis is sparse and based small cohort studies utilizing outdated technology. While any patient with an indication for a colonoscopy should undergo appropriate endoscopic evaluation, in the era of widespread use of high-resolution computed tomography, routine colonic endoscopic evaluation following resolution of acute uncomplicated diverticulitis poses additional costs, comes with inherent risks, and may require further study. In this manuscript, we review the current data related to this recommendation. PMID:25253951

Routine road maintenance water quality and habitat guide : best management practices

Science.gov (United States)

2009-01-01

Since June 9, 1999 the Oregon Department of Transportation (ODOT) has implemented the Routine Road Maintenance: Water Quality and Habitat Guide Best Management Practices (the Guide), and is considered the cornerstone of the ODOT'd Office of Maintenan...

Comparison of land use regression models for NO2 based on routine and campaign monitoring data from an urban area of Japan.

Science.gov (United States)

Kashima, Saori; Yorifuji, Takashi; Sawada, Norie; Nakaya, Tomoki; Eboshida, Akira

2018-08-01

Typically, land use regression (LUR) models have been developed using campaign monitoring data rather than routine monitoring data. However, the latter have advantages such as low cost and long-term coverage. Based on the idea that LUR models representing regional differences in air pollution and regional road structures are optimal, the objective of this study was to evaluate the validity of LUR models for nitrogen dioxide (NO 2 ) based on routine and campaign monitoring data obtained from an urban area. We selected the city of Suita in Osaka (Japan). We built a model based on routine monitoring data obtained from all sites (routine-LUR-All), and a model based on campaign monitoring data (campaign-LUR) within the city. Models based on routine monitoring data obtained from background sites (routine-LUR-BS) and based on data obtained from roadside sites (routine-LUR-RS) were also built. The routine LUR models were based on monitoring networks across two prefectures (i.e., Osaka and Hyogo prefectures). We calculated the predictability of the each model. We then compared the predicted NO 2 concentrations from each model with measured annual average NO 2 concentrations from evaluation sites. The routine-LUR-All and routine-LUR-BS models both predicted NO 2 concentrations well: adjusted R 2 =0.68 and 0.76, respectively, and root mean square error=3.4 and 2.1ppb, respectively. The predictions from the routine-LUR-All model were highly correlated with the measured NO 2 concentrations at evaluation sites. Although the predicted NO 2 concentrations from each model were correlated, the LUR models based on routine networks, and particularly those based on all monitoring sites, provided better visual representations of the local road conditions in the city. The present study demonstrated that LUR models based on routine data could estimate local traffic-related air pollution in an urban area. The importance and usefulness of data from routine monitoring networks should be

Intake of Po-210 into the body through the damaged skin and efficiency of some methods in preventing its absorption

International Nuclear Information System (INIS)

Ilyin, L.A.; Ivannikov, A.T.; Bazhin, A.G.; Konstantinova, T.P.; Altukhova, G.A.

1977-01-01

The metabolic behaviour of 210 Po nitrate arising from contamination of damaged skin (stabbed, cutaneous and muscular wounds and abrasions) of rats and the efficiency of some methods of decontaminating the wounds and stimulating 210 Po removal from the body, have been studied. The decontamination efficiency obtained, by wiping and washing the wound surface with oxatiol, by surgical incision of the wounds, and by parenteral oxatiol injections, are compared. The accumulation of 210 Po in various organs and tissues of rats after the different decontamination routines had been carried out are shown tabulated. (U.K.)

The clinical value of daily routine chest radiographs in a mixed medical-surgical intensive care unit is low.

Science.gov (United States)

Graat, Marleen E; Choi, Goda; Wolthuis, Esther K; Korevaar, Johanna C; Spronk, Peter E; Stoker, Jaap; Vroom, Margreeth B; Schultz, Marcus J

2006-02-01

The clinical value of daily routine chest radiographs (CXRs) in critically ill patients is unknown. We conducted this study to evaluate how frequently unexpected predefined major abnormalities are identified with daily routine CXRs, and how often these findings lead to a change in care for intensive care unit (ICU) patients. This was a prospective observational study conducted in a 28-bed, mixed medical-surgical ICU of a university hospital. Over a 5-month period, 2,457 daily routine CXRs were done in 754 consecutive ICU patients. The majority of these CXRs did not reveal any new predefined major finding. In only 5.8% of daily routine CXRs (14.3% of patients) was one or more new and unexpected abnormality encountered, including large atelectases (24 times in 20 patients), large infiltrates (23 in 22), severe pulmonary congestion (29 in 25), severe pleural effusion (13 in 13), pneumothorax/pneumomediastinum (14 in 13), and malposition of the orotracheal tube (32 in 26). Fewer than half of the CXRs with a new and unexpected finding were ultimately clinically relevant; in only 2.2% of all daily routine CXRs (6.4% of patients) did these radiologic abnormalities result in a change to therapy. Subgroup analysis revealed no differences between medical and surgical patients with regard to the incidence of new and unexpected findings on daily routine CXRs and the effect of new and unexpected CXR findings on daily care. In the ICU, daily routine CXRs seldom reveal unexpected, clinically relevant abnormalities, and they rarely prompt action. We propose that this diagnostic examination be abandoned in ICU patients.

Implementation of TMA and digitalization in routine diagnostics of breast pathology

DEFF Research Database (Denmark)

Rossing, Henrik Holm; Talman, Maj-Lis; Laenkholm, Anne-Vibeke

2012-01-01

To ensure optimal treatment of breast cancer patients, breast tumours are classified based on clinico-pathological features. As part of this process, routine diagnostics of breast tumours includes histological typing and grading, as well as profiling by use of an immunohistochemistry panel...... of antibodies, probes and in situ hybridization. This will, as a minimum, include assessment of oestrogen receptor (OR) and HER2. The individual preparation and staining of many breast tumours in a large laboratory with this standard panel is thus time consuming and costly. Herein, we show that in breast cancer...... routine diagnostics the use of the tissue microarray technique in combination with digitalization of the stained multi-slides is not only economical, with a considerable cost reduction, but it also enhances standardization of tumour profiling. We demonstrate that 2 mm breast tumour cores correlate...

Autovalidation and automation of the postanalytical phase of routine hematology and coagulation analyses in a university hospital laboratory.

Science.gov (United States)

Mlinaric, Ana; Milos, Marija; Coen Herak, Désirée; Fucek, Mirjana; Rimac, Vladimira; Zadro, Renata; Rogic, Dunja

2018-02-23

The need to satisfy high-throughput demands for laboratory tests continues to be a challenge. Therefore, we aimed to automate postanalytical phase in hematology and coagulation laboratory by autovalidation of complete blood count (CBC) and routine coagulation test results (prothrombin time [PT], international normalized ratio [PT-INR], activated partial thromboplastin time [APTT], fibrinogen, antithrombin activity [AT] and thrombin time [TT]). Work efficacy and turnaround time (TAT) before and after implementation of automated solutions will be compared. Ordering panels tailored to specific patient populations were implemented. Rerun and reflex testing rules were set in the respective analyzers' software (Coulter DxH Connectivity 1601, Beckman Coulter, FL, USA; AutoAssistant, Siemens Healthcare Diagnostics, Germany), and sample status information was transferred into the laboratory information system. To evaluate if the automation improved TAT and efficacy, data from manually verified results in September and October of 2015 were compared with the corresponding period in 2016 when autovalidation was implemented. Autovalidation rates of 63% for CBC and 65% for routine coagulation test results were achieved. At the TAT of 120 min, the percentage of reported results increased substantially for all analyzed tests, being above 90% for CBC, PT, PT-INR and fibrinogen and 89% for APTT. This output was achieved with three laboratory technicians less compared with the period when the postanalytical phase was not automated. Automation allowed optimized laboratory workflow for specific patient populations, thereby ensuring standardized results reporting. Autovalidation of test results proved to be an efficient tool for improvement of laboratory work efficacy and TAT.

An evaluation of routine specialist palliative care for patients on the Liverpool Care Pathway

OpenAIRE

Thompson, Jo; Brown, Jayne; Davies, Andrew

2014-01-01

Introduction: This report describes a service evaluation of the 'added value' of routine specialist palliative care team (SPCT) involvement with patients on the Liverpool Care Pathway for the Dying Patient (LCP). Methods: In the authors' hospital, patients that are commenced on the LCP are routinely referred to the SPCT. They are reviewed on the day of referral and then at least every other day, depending on the clinical situation. The data for this report was obtained by reviewing the S...

ACCULIB, Program Library of Mathematical Routines

International Nuclear Information System (INIS)

Van Kats, J.M.; Rusman, C.J.; Van der Vorst, H.A.

1987-01-01

Description of program or function - ACCULIB is a collection of programs and subprograms for: - approximation and interpolation problems; - the evaluation of series of orthogonal polynomials; - evaluation of the complementary error function; - sorting problems and permutations; - differential equation problems; - linear algebra eigenvalue problems; - optimization problems; - fast Fourier transformations and Fourier series; - numerical quadrature of continuous functions; - linear systems and other linear algebra problems; - bit manipulation and character handling/transmission; - systems of nonlinear equations, in particular the determination of zeros of polynomials; - solution of over-complete systems; - plotting routines for contouring and surface representation; - statistical investigation of data. In addition, many utilities such as code conversion, microfiche production, disk file surveys, layout improvements for ALGOL60 and FORTRAN programs, and the conversion of IBM FORTRAN programs to CDC FORTRAN are included in the collection

ITMETH, Iterative Routines for Linear System

International Nuclear Information System (INIS)

Greenbaum, A.

1989-01-01

1 - Description of program or function: ITMETH is a collection of iterative routines for solving large, sparse linear systems. 2 - Method of solution: ITMETH solves general linear systems of the form AX=B using a variety of methods: Jacobi iteration; Gauss-Seidel iteration; incomplete LU decomposition or matrix splitting with iterative refinement; diagonal scaling, matrix splitting, or incomplete LU decomposition with the conjugate gradient method for the problem AA'Y=B, X=A'Y; bi-conjugate gradient method with diagonal scaling, matrix splitting, or incomplete LU decomposition; and ortho-min method with diagonal scaling, matrix splitting, or incomplete LU decomposition. ITMETH also solves symmetric positive definite linear systems AX=B using the conjugate gradient method with diagonal scaling or matrix splitting, or the incomplete Cholesky conjugate gradient method

Introducing routine enquiry about domestic violence in a paediatric setting.

Science.gov (United States)

Asiegbunam, Nkiru

2018-02-01

Implementation of routine enquiry (RE) about domestic abuse in the multidisciplinary Evelina London Guys and St. Thomas Trust (GSTT) Community Health Services (CHS). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A system for tumor heterogeneity evaluation and diagnosis based on tumor markers measured routinely in the laboratory.

Science.gov (United States)

Hui, Liu; Rixv, Liu; Xiuying, Zhou

2015-12-01

To develop an efficient and reliable approach to estimate tumor heterogeneity and improve tumor diagnosis using multiple tumor markers measured routinely in the clinical laboratory. A total of 161 patients with different cancers were recruited as the cancer group, and 91 patients with non-oncological conditions were required as the non-oncological disease group. The control group comprised 90 randomly selected healthy subjects. AFP, CEA, CYFRA, CA125, CA153, CA199, CA724, and NSE levels were measured in all these subjects with a chemiluminescent microparticle immunoassay. The tumor marker with the maximum S/CO value (sample test value:cutoff value for discriminating individuals with and without tumors) was considered as a specific tumor marker (STM) for an individual. Tumor heterogeneity index (THI)=N/P (N: number of STMs; P: percentage of individuals with STMs in a certain tumor population) was used to quantify tumor heterogeneity: high THI indicated high tumor heterogeneity. The tumor marker index (TMI), TMI = STM×(number of positive tumor markers+1), was used for diagnosis. The THIs of lung, gastric, and liver cancers were 8.33, 9.63, and 5.2, respectively, while the ROC-areas under the curve for TMI were 0.862, 0.809, and 0.966. In this study, we developed a novel index for tumor heterogeneity based on the expression of various routinely evaluated serum tumor markers. Development of an evaluation system for tumor heterogeneity on the basis of this index could provide an effective diagnostic tool for some cancers. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Adaptive intrusion data system (AIDS) software routines

International Nuclear Information System (INIS)

Corlis, N.E.

1980-07-01

An Adaptive Intrusion Data System (AIDS) was developed to collect information from intrusion alarm sensors as part of an evaluation system to improve sensor performance. AIDS is a unique digital data-compression, storage, and formatting system; it also incorporates a capability for video selection and recording for assessment of the sensors monitored by the system. The system is software reprogrammable to numerous configurations that may be used for the collection of environmental, bilevel, analog, and video data. This report describes the software routines that control the different AIDS data-collection modes, the diagnostic programs to test the operating hardware, and the data format. Sample data printouts are also included

Routine environmental audit of Ames Laboratory, Ames, Iowa

International Nuclear Information System (INIS)

1994-09-01

This document contains the findings identified during the routine environmental audit of Ames Laboratory, Ames, Iowa, conducted September 12--23, 1994. The audit included a review of all Ames Laboratory operations and facilities supporting DOE-sponsored activities. The audit's objective is to advise the Secretary of Energy, through the Assistant Secretary for Environment, Safety and Health, as to the adequacy of the environmental protection programs established at Ames Laboratory to ensure the protection of the environment, and compliance with Federal, state, and DOE requirements

Synthesis procedure for routine production of [carbonyl-{sup 11}C]desmethyl-WAY-100635

Energy Technology Data Exchange (ETDEWEB)

Maiti, Dilip K. [Department of Pediatrics, School of Medicine, PET Center, Children' s Hospital of Michigan, Wayne State University, 3901 Beaubien Blvd., Detroit, MI 48201 (United States); Chakraborty, Pulak K. [Department of Radiology, School of Medicine, PET Center, Children' s Hospital of Michigan, Wayne State University, 3901 Beaubien Blvd., Detroit, MI 48201 (United States)]. E-mail: pulak@pet.wayne.edu; Chugani, Diane C. [Department of Pediatrics, School of Medicine, PET Center, Children' s Hospital of Michigan, Wayne State University, 3901 Beaubien Blvd., Detroit, MI 48201 (United States); Department of Radiology, School of Medicine, PET Center, Children' s Hospital of Michigan, Wayne State University, 3901 Beaubien Blvd., Detroit, MI 48201 (United States); Muzik, Otto [Department of Pediatrics, School of Medicine, PET Center, Children' s Hospital of Michigan, Wayne State University, 3901 Beaubien Blvd., Detroit, MI 48201 (United States); Department of Radiology, School of Medicine, PET Center, Children' s Hospital of Michigan, Wayne State University, 3901 Beaubien Blvd., Detroit, MI 48201 (United States); Mangner, Thomas J. [Department of Radiology, School of Medicine, PET Center, Children' s Hospital of Michigan, Wayne State University, 3901 Beaubien Blvd., Detroit, MI 48201 (United States); Chugani, Harry T. [Department of Pediatrics, School of Medicine, PET Center, Children' s Hospital of Michigan, Wayne State University, 3901 Beaubien Blvd., Detroit, MI 48201 (United States); Department of Radiology, School of Medicine, PET Center, Children' s Hospital of Michigan, Wayne State University, 3901 Beaubien Blvd., Detroit, MI 48201 (United States); Department of Neurology, School of Medicine, PET Center, Children' s Hospital of Michigan, Wayne State University, 3901 Beaubien Blvd., Detroit, MI 48201 (United States)

2005-05-01

An improved one-pot synthesis procedure for routine production of [carbonyl-{sup 11}C]desmethyl-WAY-100635 ([{sup 11}C]DWAY) is described. An efficient purification of the crude product has also been developed and was accomplished by C-18 reversed-phase semi-preparative HPLC using 55/45 EtOH-NaH{sub 2}PO{sub 4} buffer (20mM, pH=6.5) as the eluent. The desired product fraction was collected in a 2.0-2.5mL volume and formulated with 11mL of 0.9% saline. The radioligand was ready for human use in 45min (EOB). The product was obtained with a radiochemical yield of 11.1+/-1.8% (EOB, n=15) with a radiochemical purity of >99%. Specific activity was 133.2-185.0GBq/{mu}mol (3.6-5.0Ci/{mu}mol, EOS, n=2) when ca. 37.0GBq (ca. 1.0Ci) of starting [{sup 11}C]CO{sub 2} was used. Unlabeled mass of [{sup 11}C]DWAY was found to be 0.15-0.24{mu}g/mL and the precursor was present in less than 50ng/mL in final production solution.

Estimated routine radiation doses to transportation workers in alternative spent-fuel transportation systems

International Nuclear Information System (INIS)

Schneider, K.J.; Smith, R.I.; Daling, P.M.; Ross, W.A.; McNair, G.W.

1988-01-01

The federal system for the management of spent fuel and high-level radioactive waste includes the acceptance by the US Department of Energy (DOE) of the spent fuel or waste loaded in casks at the reactor or other waste generators, its transportation to a repository, and its handling and final emplacement in the repository. The DOE plans to implement a transportation system that is safe, secure, efficient, and cost-effective and will meet applicable regulatory safety and security requirements. The DOE commissioned the Pacific Northwest Laboratory (PNL) to develop estimates of the routine radiation doses that would result from the operation of a system postulated using current designs and practices. From that evaluation, PNL identified activities/operations that result in the higher fraction of doses, proposed conceptual alternatives that would effectively reduce such exposures, and evaluated the cost-effectiveness of such alternatives. The study is one of a series used in making overall system design and operational decisions in the development of the DOE's spent-fuel/high-level waste transportation system. This paper contains the highlights from the PNL study of the estimated radiation doses to the transportation workers in a postulated reference transportation system and potential alternatives to that system

Practical issues in implementing whole-genome-sequencing in routine diagnostic microbiology

NARCIS (Netherlands)

Rossen, J. W. A.; Friedrich, A. W.; Moran-Gilad, J.

Background: Next generation sequencing (NGS) is increasingly being used in clinical microbiology. Like every new technology adopted in microbiology, the integration of NGS into clinical and routine workflows must be carefully managed. Aim: To review the practical aspects of implementing bacterial

The effectiveness of online cognitive behavioral treatment in routine clinical practice

NARCIS (Netherlands)

Ruwaard, Jeroen; Lange, Alfred; Schrieken, Bart; Dolan, Conor V; Emmelkamp, Paul

2012-01-01

CONTEXT: Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders. OBJECTIVE: To assess the effectiveness of online CBT for different mental disorders in routine clinical practice. DESIGN: An

The effectiveness of online cognitive behavioral treatment in routine clinical practice

NARCIS (Netherlands)

Ruwaard, J.; Lange, A.; Schrieken, B.; Dolan, C.V.; Emmelkamp, P.

2012-01-01

Context Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders. Objective To assess the effectiveness of online CBT for different mental disorders in routine clinical practice. Design An

Cost-effectiveness of duloxetine versus routine treatment for U.S. patients with diabetic peripheral neuropathic pain.

Science.gov (United States)

Wu, Eric Q; Birnbaum, Howard G; Mareva, Milena N; Le, T Kim; Robinson, Rebecca L; Rosen, Amy; Gelwicks, Steve

2006-06-01

The purpose of this study was to compare the cost-effectiveness of duloxetine versus routine treatment in management of diabetic peripheral neuropathic pain (DPNP). Two hundred thirty-three patients with DPNP who completed a 12-week, double-blind, placebo-controlled, randomized, multicenter duloxetine trial were re-randomized into a 52-week, open-label trial of duloxetine 60 mg twice daily versus routine treatment. Routine treatment included pain management therapies. Effectiveness was measured by using the bodily pain domain (BP) of the Medical Outcomes Study Short Form 36 (SF-36). Costs were analyzed from 3 perspectives: third party payer (direct medical costs), employer (direct and indirect medical costs), and societal (patient's out-of-pocket costs and total medical costs). Costs of study medications were not included because of limited data. Bootstrap method was applied to calculate statistical inference of the incremental cost-effectiveness ratio (ICER). Routine treatment most frequently used included gabapentin (56%), venlafaxine (36%), and amitripytline (15%). From employer and societal perspectives, duloxetine was cost-effective (ICER= -342 dollars and -429 dollars, respectively, per unit of SF-36 BP; both P routine DPNP treatment (both P < .05). From payer perspective, duloxetine trended toward cost-effectiveness (ICER= -249 dollars per unit of SF-36 BP; P routine treatment in management of DPNP.

Does routine gowning reduce nosocomial infection and mortality rates in a neonatal nursery? A Singapore experience.

Science.gov (United States)

Tan, S G; Lim, S H; Malathi, I

1995-11-01

A 1 year prospective study on routine gowning before entering a neonatal unit was conducted in a maternity hospital in Singapore. This study was done based on previous work by Donowitz, Haque and Chagla and Agbayani et al., as there have been no known studies done in Singapore. The aim of the study was to test the hypothesis that routine gowning before entering a neonatal nursery does not reduce nosocomial infection and mortality rate. A total of 212 neonates from the neonatal intensive care unit (NICU) and 1694 neonates from the neonatal special care unit (NSCU) were studied. Neonates admitted during the 1 year study were assigned to the gowning (control) and no routine gowning (trial) group on every alternate 2 months. The hospital infection control nurse provided data on nosocomial infection. The overall nosocomial infection rate in the NICU was 24% (25 of 104 admissions) during gowning periods compared to 16.6% (18 of 108 admissions) when plastic aprons were not worn before entry. In the NSCU, the overall infection rate was 1.5% (12 of 800 admissions) during gowning periods compared to 2.1% (19 of 894 admissions) when no gown was worn before entry. Results of the study found no significant differences in the incidences of nosocomial infection and mortality in the neonates. The cost of gowns used during the no routine gowning periods was S$2012.8 compared to S$3708 used during the routine gowning procedure. The investigators recommend that routine gowning before entering a neonatal unit is not essential and cost effective for the purpose of reducing infection. Rather the focus should be on adequate handwashing by all hospital personnel and visitors before handling neonates.

Completeness and accuracy of data transfer of routine maternal health services data in the greater Accra region

NARCIS (Netherlands)

Amoakoh-Coleman, Mary; Kayode, Gbenga A.; Brown-Davies, Charles; Agyepong, Irene Akua; Grobbee, DE; Klipstein-Grobusch, Kerstin; Ansah, Evelyn K.

2015-01-01

Background: High quality routine health system data is essential for tracking progress towards attainment of the Millennium Development Goals 4 & 5. This study aimed to determine the completeness and accuracy of transfer of routine maternal health service data at health facility, district and

Comparing routine neurorehabilitation program with trunk exercises based on Bobath concept in multiple sclerosis: pilot study.

Science.gov (United States)

Keser, Ilke; Kirdi, Nuray; Meric, Aydin; Kurne, Asli Tuncer; Karabudak, Rana

2013-01-01

This study compared trunk exercises based on the Bobath concept with routine neurorehabilitation approaches in multiple sclerosis (MS). Bobath and routine neurorehabilitation exercises groups were evaluated. MS cases were divided into two groups. Both groups joined a 3 d/wk rehabilitation program for 8 wk. The experimental group performed trunk exercises based on the Bobath concept, and the control group performed routine neurorehabilitation exercises. Additionally, both groups performed balance and coordination exercises. All patients were evaluated with the Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), International Cooperative Ataxia Rating Scale (ICARS), and Multiple Sclerosis Functional Composite (MSFC) before and after the physiotherapy program. In group analysis, TIS, BBS, ICARS, and MSFC scores and strength of abdominal muscles were significantly different after treatment in both groups (p 0.05). Although trunk exercises based on the Bobath concept are rarely applied in MS rehabilitation, the results of this study show that they are as effective as routine neurorehabilitation exercises. Therefore, trunk exercises based on the Bobath concept can be beneficial in MS rehabilitation programs.

An implementation analysis of the linear discontinuous finite element method

International Nuclear Information System (INIS)

Becker, T. L.

2013-01-01

This paper provides an implementation analysis of the linear discontinuous finite element method (LD-FEM) that spans the space of (l, x, y, z). A practical implementation of LD includes 1) selecting a computationally efficient algorithm to solve the 4 x 4 matrix system Ax = b that describes the angular flux in a mesh element, and 2) choosing how to store the data used to construct the matrix A and the vector b to either reduce memory consumption or increase computational speed. To analyze the first of these, three algorithms were selected to solve the 4 x 4 matrix equation: Cramer's rule, a streamlined implementation of Gaussian elimination, and LAPACK's Gaussian elimination subroutine dgesv. The results indicate that Cramer's rule and the streamlined Gaussian elimination algorithm perform nearly equivalently and outperform LAPACK's implementation of Gaussian elimination by a factor of 2. To analyze the second implementation detail, three formulations of the discretized LD-FEM equations were provided for implementation in a transport solver: 1) a low-memory formulation, which relies heavily on 'on-the-fly' calculations and less on the storage of pre-computed data, 2) a high-memory formulation, which pre-computes much of the data used to construct A and b, and 3) a reduced-memory formulation, which lies between the low - and high-memory formulations. These three formulations were assessed in the Jaguar transport solver based on relative memory footprint and computational speed for increasing mesh size and quadrature order. The results indicated that the memory savings of the low-memory formulation were not sufficient to warrant its implementation. The high-memory formulation resulted in a significant speed advantage over the reduced-memory option (10-50%), but also resulted in a proportional increase in memory consumption (5-45%) for increasing quadrature order and mesh count; therefore, the practitioner should weigh the system memory constraints against any

An implementation analysis of the linear discontinuous finite element method

Energy Technology Data Exchange (ETDEWEB)

Becker, T. L. [Bechtel Marine Propulsion Corporation, Knolls Atomic Power Laboratory, P.O. Box 1072, Schenectady, NY 12301-1072 (United States)

2013-07-01

This paper provides an implementation analysis of the linear discontinuous finite element method (LD-FEM) that spans the space of (l, x, y, z). A practical implementation of LD includes 1) selecting a computationally efficient algorithm to solve the 4 x 4 matrix system Ax = b that describes the angular flux in a mesh element, and 2) choosing how to store the data used to construct the matrix A and the vector b to either reduce memory consumption or increase computational speed. To analyze the first of these, three algorithms were selected to solve the 4 x 4 matrix equation: Cramer's rule, a streamlined implementation of Gaussian elimination, and LAPACK's Gaussian elimination subroutine dgesv. The results indicate that Cramer's rule and the streamlined Gaussian elimination algorithm perform nearly equivalently and outperform LAPACK's implementation of Gaussian elimination by a factor of 2. To analyze the second implementation detail, three formulations of the discretized LD-FEM equations were provided for implementation in a transport solver: 1) a low-memory formulation, which relies heavily on 'on-the-fly' calculations and less on the storage of pre-computed data, 2) a high-memory formulation, which pre-computes much of the data used to construct A and b, and 3) a reduced-memory formulation, which lies between the low - and high-memory formulations. These three formulations were assessed in the Jaguar transport solver based on relative memory footprint and computational speed for increasing mesh size and quadrature order. The results indicated that the memory savings of the low-memory formulation were not sufficient to warrant its implementation. The high-memory formulation resulted in a significant speed advantage over the reduced-memory option (10-50%), but also resulted in a proportional increase in memory consumption (5-45%) for increasing quadrature order and mesh count; therefore, the practitioner should weigh the system memory

Effectiveness and cost of atypical versus typical antipsychotic treatment for schizophrenia in routine care.

Science.gov (United States)

Stargardt, Tom; Weinbrenner, Susanne; Busse, Reinhard; Juckel, Georg; Gericke, Christian A

2008-06-01

In two recent randomised clinical trials, a meta-analysis and in an effectiveness study analysing routine data from the U.S. Veterans Administration the superiority of the newer atypical drugs over typical antipsychotic drugs, concerning both their efficacy and their side-effect profile, has been questioned. To analyse the effectiveness and cost of atypical versus typical antipsychotic treatment for schizophrenia in routine care. Cohort study using routine care data from a statutory sickness fund with 5.4 million insured in Germany. To be included, patients had to be discharged with a diagnosis of schizophrenia in 2003 and fulfil membership criteria. Main outcome measures were rehospitalisation rates, mean hospital bed days, mean length of stay, cost of inpatient and pharmaceutical care to the sickness fund during follow-up and medication used to treat side-effects. 3121 patients were included into the study. There were no statistically significant differences in the effectiveness of atypical and typical antipsychotics on rehospitalisation during follow-up (rehospitalisation rate ratio 1.07, 95% confidence interval 0.86 to 1.33). However, there were consistent observations of atypical antipsychotics being more effective for severe cases of schizophrenia (14.6% of study population; >61 prior bed days per year in 2000-2002) in the follow-up period, whereas for the other severity strata typical antipsychotics seemed more effective in reducing various rehospitalisation outcomes. Patients treated with atypical antipsychotics received significantly less prescriptions for anticholinergics or tiaprid (relative risk 0.26, 95% confidence interval 0.18 to 0.38). The effectiveness of atypical antipsychotics for schizophrenia on rehospitalisation measures appeared similar to that of typical antipsychotics. With the exception of severe cases, the higher costs for atypical antipsychotics were not offset by savings from reduced inpatient care. Major limitations include the lack of

Advance Care Planning: Understanding Clinical Routines and Experiences of Interprofessional Team Members in Diverse Health Care Settings.

Science.gov (United States)

Arnett, Kelly; Sudore, Rebecca L; Nowels, David; Feng, Cindy X; Levy, Cari R; Lum, Hillary D

2017-12-01

Interprofessional health care team members consider advance care planning (ACP) to be important, yet gaps remain in systematic clinical routines to support ACP. A clearer understanding of the interprofessional team members' perspectives on ACP clinical routines in diverse settings is needed. One hundred eighteen health care team members from community-based clinics, long-term care facilities, academic clinics, federally qualified health centers, and hospitals participated in a 35-question, cross-sectional online survey to assess clinical routines, workflow processes, and policies relating to ACP. Respondents were 53% physicians, 18% advanced practice nurses, 11% nurses, and 18% other interprofessional team members including administrators, chaplains, social workers, and others. Regarding clinical routines, respondents reported that several interprofessional team members play a role in facilitating ACP (ie, physician, social worker, nurse, others). Most (62%) settings did not have, or did not know of, policies related to ACP documentation. Only 14% of settings had a patient education program. Two-thirds of the respondents said that addressing ACP is a high priority and 85% felt that nonphysicians could have ACP conversations with appropriate training. The clinical resources needed to improve clinical routines included training for providers and staff, dedicated staff to facilitate ACP, and availability of patient/family educational materials. Although interprofessional health care team members consider ACP a priority and several team members may be involved, clinical settings lack systematic clinical routines to support ACP. Patient educational materials, interprofessional team training, and policies to support ACP clinical workflows that do not rely solely on physicians could improve ACP across diverse clinical settings.

Comparison of two oestrus synchronisation protocols administered to dairy cows during routine reproduction services

DEFF Research Database (Denmark)

Viora, L; Denwood, M; Ellis, K

2015-01-01

Progesterone-based oestrus synchronisation protocols are frequently used for treatment of cows presented for examination during routine reproduction management service. This study aimed to evaluate the effect of the addition of gonadotrophin-releasing hormone (GnRH) at the start of a progesterone......-based oestrus synchronisation protocol for cows presented for examination during routine veterinary service on a commercial dairy farm over 10 months. Overall 139 animals were retained in the study, of which 78 received a standard progesterone-based treatment (STD) and 61 received the same treatment...

Eosinophilia in routine blood samples as a biomarker for solid tumor development

DEFF Research Database (Denmark)

Andersen, Christen Bertel L; Siersma, V.D.; Hasselbalch, H.C.

2014-01-01

eosinophilia in routine blood samples as a potential biomarker of solid tumor development in a prospective design. MATERIAL AND METHODS: From the Copenhagen Primary Care Differential Count (CopDiff) Database, we identified 356 196 individuals with at least one differential cell count (DIFF) encompassing...... was increased with mild eosinophilia [OR 1.93 (CI 1.29-2.89), p = 0.0013]. No associations with eosinophilia were observed for the remaining solid cancers. CONCLUSION: We demonstrate that eosinophilia in routine blood samples associates with an increased risk of bladder cancer. Our data emphasize...... that additional preclinical studies are needed in order to shed further light on the role of eosinophils in carcinogenesis, where it is still unknown whether the cells contribute to tumor immune surveillance or neoplastic evolution....

The cognitive role of routine activities: the case of familiar field interventions in nuclear power plants

International Nuclear Information System (INIS)

Noizet, A.

2000-01-01

Routine works incorporate part of the environment as their own control (exo-monitoring). The routine activity is itself in the self-monitoring situation of a cognitive control, which moves with the constraints, and which is not in direct relation with the errors made and detected, but which is in relation with the check of mastery. (J.S.)

Routine intraoperative leak testing for sleeve gastrectomy: is the leak test full of hot air?

Science.gov (United States)

Bingham, Jason; Lallemand, Michael; Barron, Morgan; Kuckelman, John; Carter, Preston; Blair, Kelly; Martin, Matthew

2016-05-01

Staple line leak after sleeve gastrectomy (SG) is a rare but dreaded complication with a reported incidence of 0% to 8%. Many surgeons routinely test the staple line with an intraoperative leak test (IOLT), but there is little evidence to validate this practice. In fact, there is a theoretical concern that the leak test may weaken the staple line and increase the risk of a postop leak. Retrospective review of all SGs performed over a 7-year period was conducted. Cases were grouped by whether an IOLT was performed, and compared for the incidence of postop staple line leaks. The ability of the IOLT for identifying a staple line defect and for predicting a postoperative leak was analyzed. Five hundred forty-two SGs were performed between 2007 and 2014. Thirteen patients (2.4%) developed a postop staple line leak. The majority of patients (n = 494, 91%) received an IOLT, including all 13 patients (100%) who developed a subsequent clinical leak. There were no (0%) positive IOLTs and no additional interventions were performed based on the IOLT. The IOLT sensitivity and positive predictive value were both 0%. There was a trend, although not significant, to increase leak rates when a routine IOLT was performed vs no routine IOLT (2.6% vs 0%, P = .6). The performance of routine IOLT after SG provided no actionable information, and was negative in all patients who developed a postoperative leak. The routine use of an IOLT did not reduce the incidence of postop leak, and in fact was associated with a higher leak rate after SG. Published by Elsevier Inc.

Practical Issues in Implementing Whole-Genome-Sequencing in Routine Diagnostic Microbiology

NARCIS (Netherlands)

Rossen, John W A; Friedrich, Alexander W; Moran-Gilad, Jacob

BACKGROUND: next generation sequencing (NGS) is increasingly being used in clinical microbiology. Like every new technology that is being adopted in microbiology, the integration of NGS into clinical and routine workflows needs to be carefully managed. AIM: to review the practical aspects of

47 CFR 0.457 - Records not routinely available for public inspection.

Science.gov (United States)

2010-10-01

... inspection. 0.457 Section 0.457 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION General Information Public Information and Inspection of Records § 0.457 Records not routinely... a determination is pending. (b) Materials that are related solely to the internal personnel rules...

Longitudinal evaluation of a training program to promote routine antenatal enquiry for domestic violence by midwives.

Science.gov (United States)

Baird, Kathleen; Creedy, Debra K; Saito, Amornrat S; Eustace, Jennifer

2018-01-15

Routine enquiry about domestic violence during pregnancy is accepted best practice. Training is essential to improve knowledge and practice. Few studies have undertaken a comprehensive evaluation of training impact over time. To evaluate the longitudinal impact of a domestic violence training and support program to promote midwives' routine antenatal enquiry for domestic violence using a mixed methods design. Data sources included (1) surveys of midwives at 6 months post-training, (2) interviews with key stakeholders at 12 months, (3) chart audit data of screening, risk, and disclosure rates (for 16 months). Measures included midwives' knowledge, preparation for routine enquiry, knowledge of domestic violence and perceptions of impact of the training and support for practice change. Forty (out of 83) participant surveys could be matched and responses compared to baseline and post-training scores. Wilcoxon signed-rank test identified that all 6-month follow-up scores were significantly higher than those at baseline. Level of preparedness increased from 42.3 to 51.05 (Z=4.88, p90%) reported improved confidence to undertake routine inquiry. A chart audit of screening rates revealed that of the 6671 women presenting for antenatal care, nearly 90% were screened. Disclosure of domestic violence was low (<2%) with most women at risk or experiencing violence declining referral. Training, support processes, and referral pathways, contributed to midwives' sustained preparedness and knowledge to conduct routine enquiry and support women disclosing domestic violence. Copyright © 2018. Published by Elsevier Ltd.

The art and science of using routine outcome measurement in mental health benchmarking.

Science.gov (United States)

McKay, Roderick; Coombs, Tim; Duerden, David

2014-02-01

To report and critique the application of routine outcome measurement data when benchmarking Australian mental health services. The experience of the authors as participants and facilitators of benchmarking activities is augmented by a review of the literature regarding mental health benchmarking in Australia. Although the published literature is limited, in practice, routine outcome measures, in particular the Health of the National Outcomes Scales (HoNOS) family of measures, are used in a variety of benchmarking activities. Use in exploring similarities and differences in consumers between services and the outcomes of care are illustrated. This requires the rigour of science in data management and interpretation, supplemented by the art that comes from clinical experience, a desire to reflect on clinical practice and the flexibility to use incomplete data to explore clinical practice. Routine outcome measurement data can be used in a variety of ways to support mental health benchmarking. With the increasing sophistication of information development in mental health, the opportunity to become involved in benchmarking will continue to increase. The techniques used during benchmarking and the insights gathered may prove useful to support reflection on practice by psychiatrists and other senior mental health clinicians.

The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD statement.

Directory of Open Access Journals (Sweden)

Eric I Benchimol

2015-10-01

Full Text Available Routinely collected health data, obtained for administrative and clinical purposes without specific a priori research goals, are increasingly used for research. The rapid evolution and availability of these data have revealed issues not addressed by existing reporting guidelines, such as Strengthening the Reporting of Observational Studies in Epidemiology (STROBE. The REporting of studies Conducted using Observational Routinely collected health Data (RECORD statement was created to fill these gaps. RECORD was created as an extension to the STROBE statement to address reporting items specific to observational studies using routinely collected health data. RECORD consists of a checklist of 13 items related to the title, abstract, introduction, methods, results, and discussion section of articles, and other information required for inclusion in such research reports. This document contains the checklist and explanatory and elaboration information to enhance the use of the checklist. Examples of good reporting for each RECORD checklist item are also included herein. This document, as well as the accompanying website and message board (http://www.record-statement.org, will enhance the implementation and understanding of RECORD. Through implementation of RECORD, authors, journals editors, and peer reviewers can encourage transparency of research reporting.

The efficiency of routine endotracheal aspirate cultures compared to ...

African Journals Online (AJOL)

Objective: Ventilator-associated pneumonia (VAP) is the most common ... diagnosis, acute physiology and chronic health evaluation II score, and sequential organ ... cultures, pre-VAP EA identified the same microorganism with the same ..... hospital‑acquired, ventilatorassociated and healthcare‑associated pneumonia.

The efficiency of routine endotracheal aspirate cultures compared to ...

African Journals Online (AJOL)

Acinetobacter baumannii was the most frequently isolated microorganism from BAL cultures (n = 21, 51%). The diagnostic value of pre.VAP EA results in predicting A. baumannii VAP documented with the following values (sensitivity: 62%; specificity: 95%, positive predictive value: 87%, negative predictive value: 82%).

Routine clinical application of virtual reality in abdominal surgery.

Science.gov (United States)

Sampogna, Gianluca; Pugliese, Raffaele; Elli, Marco; Vanzulli, Angelo; Forgione, Antonello

2017-06-01

The advantages of 3D reconstruction, immersive virtual reality (VR) and 3D printing in abdominal surgery have been enunciated for many years, but still today their application in routine clinical practice is almost nil. We investigate their feasibility, user appreciation and clinical impact. Fifteen patients undergoing pancreatic, hepatic or renal surgery were studied realizing a 3D reconstruction of target anatomy. Then, an immersive VR environment was developed to import 3D models, and some details of the 3D scene were printed. All the phases of our workflow employed open-source software and low-cost hardware, easily implementable by other surgical services. A qualitative evaluation of the three approaches was performed by 20 surgeons, who filled in a specific questionnaire regarding a clinical case for each organ considered. Preoperative surgical planning and intraoperative guidance was feasible for all patients included in the study. The vast majority of surgeons interviewed scored their quality and usefulness as very good. Despite extra time, costs and efforts necessary to implement these systems, the benefits shown by the analysis of questionnaires recommend to invest more resources to train physicians to adopt these technologies routinely, even if further and larger studies are still mandatory.

The prevalence of adrenal incidentaloma in routine clinical practice.

LENUS (Irish Health Repository)

Davenport, Colin

2012-02-01

The prevalence of adrenal incidentaloma (AI) on computed tomography (CT) in the general population has been reported to be as high as 4.2%. However, many of the previous studies in this field utilised a prospective approach with analysis of CT scans performed by one or more radiologists with a specialist interest in adrenal tumours and a specific focus on identifying the presence of an adrenal mass. A typical radiology department, with a focus on the patient\\'s presenting complaint as opposed to the adrenal gland, may not be expected to diagnose as many adrenal incidentalomas as would be identified in a dedicated research protocol. We hypothesised that the number of AI reported in routine clinical practice is significantly lower than the published figures would suggest. We retrospectively reviewed the reports of all CT thorax and abdomen scans performed in our hospital over a 2 year period. 3,099 patients underwent imaging, with 3,705 scans performed. The median age was 63 years (range 18-98). Thirty-seven true AI were diagnosed during the time period studied. Twenty-two were diagnosed by CT abdomen (22\\/2,227) and 12 by CT thorax (12\\/1,478), a prevalence of 0.98 and 0.81% with CT abdomen and thorax, respectively, for AI in routine clinical practice.

Monitoring patients with rheumatoid arthritis in routine care

DEFF Research Database (Denmark)

Hetland, Merete Lund; Jensen, Dorte Vendelbo; Krogh, Niels Steen

2014-01-01

OBJECTIVES: Advances in aggressive use of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) as well as biological DMARDs (bDMARDs) have improved the treatment armamentarium for rheumatologists, and modern treatment principles include a treat-to-target (T2T) strategy. However......, little is known about the feasibility of a T2T strategy in patients with rheumatoid arthritis (RA) treated in routine care. The aim of the present study was to (i) present the annual number of patients included in DANBIO between 2006 and 2013 and their disease characteristics and (ii) estimate coverage...

Routine use of daily oral vitamin K to treat infants with cystic fibrosis.

Science.gov (United States)

Cottam, Sophie T; Connett, Gary J

2015-10-01

Vitamin K is routinely administered after birth in the UK to prevent haemorrhagic disease of the newborn. Despite this, vitamin K-deficient coagulopathy still occurs in infants with high morbidity and mortality. Up to 50% of late onset bleeding presents with intracranial haemorrhage. The risk of developing vitamin K coagulopathy is higher in infants with cystic fibrosis (CF) and those that are exclusively breast fed due to low vitamin K levels in breast milk and intestinal changes in bacterial flora. Oral vitamin K supplementation is a simple addition to routine CF treatment during infancy to prevent complications from significant coagulopathy. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Magnitude of Hemoglobin–Drop in Obstetrics and Gynecologic Operations (Is Routine Hb Check Necessary?)

OpenAIRE

J. Nasohi; B. Falakaflaki

2004-01-01

Routine hemoglobin check after obstetrics and gynecologic operations is common and recommended by textbooks, but there are just few literatures regarding to the value of routine Hb check. The purpose of this study was to determine the changes of hemoglobin and it’s effects on clinical management after obstetrics and gynecologic operations . This study was undertaken on low risk patients who underwent hysterectomy, removal of dnexal mass , C-Section , A.P repair , tub...

Experience of domestic violence routine screening in Family Planning NSW clinics.

Science.gov (United States)

Hunter, Tara; Botfield, Jessica R; Estoesta, Jane; Markham, Pippa; Robertson, Sarah; McGeechan, Kevin

2017-04-01

This study reviewed implementation of the Domestic Violence Routine Screening (DVRS) program at Family Planning NSW and outcomes of screening to determine the feasibility of routine screening in a family planning setting and the suitability of this program in the context of women's reproductive and sexual health. A retrospective review of medical records was undertaken of eligible women attending Family Planning NSW clinics between 1 January and 31 December 2015. Modified Poisson regression was used to estimate prevalence ratios and assess association between binary outcomes and client characteristics. Of 13440 eligible women, 5491 were screened (41%). Number of visits, clinic attended, age, employment status and disability were associated with completion of screening. In all, 220 women (4.0%) disclosed domestic violence. Factors associated with disclosure were clinic attended, age group, region of birth, employment status, education and disability. Women who disclosed domestic violence were more likely to have discussed issues related to sexually transmissible infections in their consultation. All women who disclosed were assessed for any safety concerns and offered a range of suitable referral options. Although routine screening may not be appropriate in all health settings, given associations between domestic violence and sexual and reproductive health, a DVRS program is considered appropriate in sexual and reproductive health clinics and appears to be feasible in a service such as Family Planning NSW. Consistent implementation of the program should continue at Family Planning NSW and be expanded to other family planning services in Australia to support identification and early intervention for women affected by domestic violence.

Quartz fast component opticallystimulated luminescence: Towards routine extraction for dating applications

International Nuclear Information System (INIS)

Shen, Zhixiong; Lang, Andreas

2016-01-01

Using an uncontaminated fast component is a key for improving the reliability of quartz OSL dating for many deposits. So far no approach to extract the fast component of quartz OSL has routinely been adopted for dating practice. Key challenges for extracting fast components are (1) the difficulty of finding a unique solution in curve-fitting deconvolution of OSL decay curves and (2) the relatively poor dating precision when using experimental fast component extraction. Here, a simple mathematic solution for fast component extraction is presented that is not relying on curve-fitting deconvolution and can easily be adopted into routine dating practices. By using specifically selected data points from smoothed OSL decay curves, the precision of equivalent doses calculated using the extracted fast component can be improved over equivalent doses calculated using bulk OSL. The fast component extraction is tested on a group of age-constrained samples containing both insufficiently bleached and sufficiently bleached deposits. Fast component OSL ages are as accurate as bulk OSL ages for the sufficiently bleached deposits, but more accurate for samples where bulk OSL is affected by insufficient bleaching. We also demonstrate how using a curve smoothing procedure can improve dating precision in case of both sufficiently and insufficiently bleached deposits. - Highlights: • A simple mathematical method to extract quartz OSL fast component is presented. • The method can be adopted in D_e calculation programs for routine extraction. • The method leads to an increase in accuracy and precision of D_e. • The method works for relatively dim samples with low signal-to-noise ratios.

Rigidity in routines and the development of resistance to change in individuals with Prader-Willi syndrome.

Science.gov (United States)

Haig, E L; Woodcock, K A

2017-05-01

Individuals with Prader-Willi syndrome (PWS) commonly show debilitating resistance to change, which has been linked to cognitive deficits in task switching. Anecdotal reports suggest that exposure to flexibility in routines during development may be beneficial for limiting subsequent resistance to change in people with PWS, which is consistent with a beneficial role of such exposure on the development of task switching, highlighted in typical children. Here, we aim to investigate the development of resistance to change in individuals with PWS and hypothesise that exposure to increased rigidity in routines will be associated with increased subsequent resistance to change. An author-compiled informant report interview and two previously validated questionnaires were administered to the caregivers of 10 individuals with PWS (5-23 years). The interview examined rigidity in routines and resistance to change across life stages defined by easily distinguishable events (before school, during primary school, during secondary school, after school, currently), using open-ended and structured yes/no and 5-point Likert questions. Open-ended data were coded using an author-compiled system. Responses from two additional informants and data from the questionnaires were used to assess inter-informant reliability and concurrent validity of the structured questions. The validity of the interview was supported by acceptable inter-rater reliability of the open-ended coding system and inter-informant reliability, internal consistency and concurrent validity of structured questions. Descriptive analyses of ratings of behaviour change showed a pattern of increasing resistance to change over the life course for the four oldest individuals, who had all been exposed to substantial rigidity in routines before and during primary school. Furthermore, only one individual - currently in primary school - was exposed to very little rigidity in routines before and during primary school, and he had

Going outside in Winter: A Qualitative Study of Preschool Dressing Routines

Science.gov (United States)

Hatcher, Beth; Squibb, Betsy

2011-01-01

The exploratory study focused on describing typical routines of preparing for winter outdoor play with preschool children and their teachers. Naturalistic observations, interviews and photographs resulted in extensive examples of children's development in cognitive understanding of winter and winter-related concepts. Observations of teachers and…

Resistentie tegen antibiotica bij routine-isolaten van bacterien in zeven streeklaboratoria

NARCIS (Netherlands)

de Neeling AJ; Hemmes JH; van Klingeren B

1993-01-01

In 1990-1992 seven regional Public Health Laboratories sent the results of all their routine determinations of antibiotic susceptibility to the RIVM. Each year data from approximately 125000 isolates were collected on floppy disks. During the investigation no striking changes in the level of

Logistic Regression Analysis of Operational Errors and Routine Operations Using Sector Characteristics

National Research Council Canada - National Science Library

Pfleiderer, Elaine M; Scroggins, Cheryl L; Manning, Carol A

2009-01-01

...) and routine operation (RO) traffic samples. OE data were derived from SATORI re-creations of OEs occurring at the Indianapolis Air Route Traffic Control Center between 9/17/2001 and 12/10/2003...

Development of iodimetric redox method for routine estimation of ascorbic acid from fresh fruit and vegetables

International Nuclear Information System (INIS)

Munir, M.; Baloch, A. K.; Khan, W. A.; Ahmad, F.; Jamil, M.

2013-01-01

The iodimetric method (Im) is developed for rapid estimation of ascorbic acid from fresh fruit and vegetables. The efficiency of Im was compared with standard with standard dye method (Dm) utilizing a variety of model solutions and aqueous extracts from fresh fruit and vegetables of different colors. The Im presented consistently accurate and precise results from colorless to colored model solutions and from fruit/vegetable extracts with standard deviation (Stdev) in the range of +-0.013 - +-0.405 and +-0.019 - +-0.428 respectively with no significant difference between the replicates. The Dm worked also satisfactorily for colorless model solutions and extracts (Stdev range +-0.235 - +-0.309) while producing unsatisfactory results (+-0.464 - +-3.281) for colored counterparts. Severe discrepancies/ overestimates continued to pileup (52% to 197%) estimating the nutrient from high (3.0 mg/10mL) to low (0.5 mg/10mL) concentration levels, respectively. On the basis of precision and reliability, the Im technique is suggested for adoption in general laboratories for routine estimation of ascorbic acid from fruit and vegetables possessing any shade. (author)

Burst suppression in sleep in a routine outpatient EEG ?

OpenAIRE

Kheder, Ammar; Bianchi, Matt T.; Westover, M. Brandon

2014-01-01

Burst suppression (BS) is an electroencephalogram (EEG) pattern that is characterized by brief bursts of spikes, sharp waves, or slow waves of relatively high amplitude alternating with periods of relatively flat EEG or isoelectric periods. The pattern is usually associated with coma, severe encephalopathy of various etiologies, or general anesthesia. We describe an unusual case of anoxic brain injury in which a BS pattern was seen during behaviorally defined sleep during a routine outpatient...

The Quality of Clinical Maternal and Neonatal Healthcare – A Strategy for Identifying ‘Routine Care Signal Functions’

Science.gov (United States)

Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S.

2015-01-01

Background A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the ‘EmOC signal functions’, a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. Methods We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Results Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants’ adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. Conclusion The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes

Valeur de l'endoscopie de routine dans le diagnostic de la gastrite ...

African Journals Online (AJOL)

Valeur de l'endoscopie de routine dans le diagnostic de la gastrite chronique antrale à Yaoundé. D Noah Noah, F Ankouane Andoulo, SAF Eloumou Bagnaka, PJA Atangana, C Tzeuton, EC Ndjitoyap Ndam ...

[Everyday stress, routines and bipolar spectrum].

Science.gov (United States)

Gindre, C; Swendsen, J

2010-06-01

Bipolar patients relapse more frequently under conditions of stress, even when compliant with prescribed medication. Although the biological bases of stress reactivity remain widely debated, the disruption of biological or circadian rhythms has been suggested as one possible mechanism through which stress increases the risk of episodes. This hypothesis has gained support from recent evidence demonstrating that the disruption of social rhythms is particularly implicated in the onset of manic episodes. However, it is currently unknown to what extent bipolar patients may differ from normal controls in terms of the basic prevalence and nature of daily life routines, or if such individuals are more sensitive to the disruption of such rhythms following exposure to stress. Using a dimensional perspective of bipolar disorder, 1728 French university students were first screened concerning diverse psychological and clinical characteristics. Two hundred and twelve individuals at high or low-risk for mood and substance use disorders were then invited to participate in a week-long period of ambulatory monitoring using the experience sampling method (ESM). During this phase, participants were given a preprogrammed PDA microcomputer which provided ambulatory assessments of behaviour and stress at fixed intervals (randomized across participants). At the end of the ESM phase, the microcomputers were collected and structured diagnostic interviews were administered to each participant. For the purposes of the current study, analyses focused on a subsample of 92 individuals, reflecting the 28 participants who met lifetime criteria for a manic (n=15) or hypomanic episode (n=13), and the 64 individuals who were free of any lifetime disorder. Data were analyzed using hierarchical nonlinear (Bernoulli) models for repeated measures. Covariates included age, sex, frequency of substance use and cognitive vulnerabilities assessed at screening. A Bonferroni correction was applied to adjust

A Power Efficient Exaflop Computer Design for Global Cloud System Resolving Climate Models.

Science.gov (United States)

Wehner, M. F.; Oliker, L.; Shalf, J.

2008-12-01

Exascale computers would allow routine ensemble modeling of the global climate system at the cloud system resolving scale. Power and cost requirements of traditional architecture systems are likely to delay such capability for many years. We present an alternative route to the exascale using embedded processor technology to design a system optimized for ultra high resolution climate modeling. These power efficient processors, used in consumer electronic devices such as mobile phones, portable music players, cameras, etc., can be tailored to the specific needs of scientific computing. We project that a system capable of integrating a kilometer scale climate model a thousand times faster than real time could be designed and built in a five year time scale for US$75M with a power consumption of 3MW. This is cheaper, more power efficient and sooner than any other existing technology.

42 CFR 413.314 - Determining payment amounts: Routine per diem rate.

Science.gov (United States)

2010-10-01

... Prospectively Determined Payment Rates for Low-Volume Skilled Nursing Facilities, for Cost Reporting Periods... reflect area wage differences and the cost reporting period beginning date (if necessary) and is subject... appropriate wage index; and (ii) A nonlabor-related portion. (2) A routine capital-related cost portion. (3...

Stress steroid levels and the short-term impact of routine dehorning ...

African Journals Online (AJOL)

Routine dehorning procedures resulted in a short-term stress response expressed by a significant increase in fGCM levels 48 h post-dehorning, with stress steroid levels returning to pre-dehorning concentrations 72 h after the procedure. Keywords: faecal glucocorticoid metabolites, non-invasive hormone monitoring, ...

Problems of integrated palliative care: a Dutch case study of routines and cooperation in the region of Arnhem.

Science.gov (United States)

van Raak, Arno; Paulus, Aggie; Cuijpers, Rianne; Te Velde, Clary

2008-12-01

Cooperation in networks of providers of palliative care in Europe is problematic. Based on the concept of routines (patterns of behavior) and data about a Dutch network, we developed an explanation of this problem, in order to better understand the conditions for cooperation. Although more research is needed, the study suggests that disparate matches (divergence) between routines of the network members hampers cooperation. To promote cooperation, divergence, and legislation that stabilizes existing routines, must be identified. Divergence must be overcome and negotiations and transformational leadership, which require power sources, may be useful for this.

The impact of routine open nonsuction drainage on fluid accumulation after thyroid surgery: a prospective randomised clinical trial.

LENUS (Irish Health Repository)

Neary, Peter M

2012-01-01

Thyroid drains following thyroid surgery are routinely used despite minimal supportive evidence. Our aim in this study is to determine the impact of routine open drainage of the thyroid bed postoperatively on ultrasound-determined fluid accumulation at 24 hours.

Development and validation of MyLifeTracker: a routine outcome measure for youth mental health

Directory of Open Access Journals (Sweden)

Kwan B

2018-04-01

Full Text Available Benjamin Kwan,1 Debra J Rickwood,1,2 Nic R Telford2 1Faculty of Health, University of Canberra, Bruce, ACT, 2headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia Purpose: Routine outcome measures are now being designed for session-by-session use, with emphasis on clinically meaningful items and sensitivity to change. Despite an increasing mental health service focus for young people aged 12–25 years, there is a lack of outcome measures that are designed to be used across this age group. Consequently, MyLifeTracker (MLT was developed as a brief mental health outcome measure designed for young people for routine use. It consists of the following five items targeting areas of importance to young people: general well-being, day-to-day activities, relationships with friends, relationships with family, and general coping. Participants and methods: The measure was tested with 75,893 young people aged 12–25 years attending headspace centers across Australia for mental health-related issues. Results: MLT showed a robust unidimensional factor structure and appropriate reliability. It exhibited good concurrent validity against well-validated measures of psychological distress, well-being, functioning, and life satisfaction. The measure was further demonstrated to be sensitive to change. Conclusion: MLT provides a psychometrically sound mental health outcome measure for young people. The measure taps into items that are meaningful to young people and provides an additional clinical support tool for clinicians and clients during therapy. The measure is brief and easy to use and has been incorporated into an electronic system that routinely tracks session-by-session change and produces time-series charts for the ease of use and interpretation. Keywords: MyLifeTracker, youth mental health, routine outcome measure, routine outcome monitoring, adolescent and young adult

Hematopoietic progenitor cell mobilization with "just-in-time" plerixafor approach is a cost-effective alternative to routine plerixafor use.

Science.gov (United States)

Veltri, Lauren; Cumpston, Aaron; Shillingburg, Alexandra; Wen, Sijin; Luo, Jin; Leadmon, Sonia; Watkins, Kathy; Craig, Michael; Hamadani, Mehdi; Kanate, Abraham S

2015-12-01

Hematopoietic cell mobilization with granulocyte-colony stimulating factor (G-CSF) and plerixafor results in superior CD34+ cell yield compared with G-CSF alone in patients with myeloma and lymphoma. However, plerixafor-based approaches may be associated with high costs. Several institutions use a "just-in-time" plerixafor approach, in which plerixafor is only administered to patients likely to fail mobilization with G-CSF alone. Whether such an approach is cost-effective is unknown. We evaluated 136 patients with myeloma or lymphoma who underwent mobilization with 2 approaches of plerixafor utilization. Between January 2010 and October 2012, 76 patients uniformly received mobilization with G-CSF and plerixafor. Between November 2012 and June 2014, 60 patients were mobilized with plerixafor administered only to those patients likely to fail mobilization with G-CSF alone. The routine plerixafor group had a higher median peak peripheral blood CD34+ cell count (62 versus 29 cells/μL, P just-in-time" group, 40% (n = 24) completed adequate collection without plerixafor. There was no difference in mobilization failure rates. The mean plerixafor doses used was lower with "just-in-time" approach (1.3 versus 2.1, P = 0.0002). The mean estimated cost in the routine plerixafor group was higher (USD 27,513 versus USD 23,597, P = 0.01). Our analysis demonstrates that mobilization with a just-in-time plerixafor approach is a safe, effective, and cost-efficient strategy for HPC collection. Copyright © 2015 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

an evaluation of the routine use of syntometrine with the delivery of ...

African Journals Online (AJOL)

oxytocic administration at the end of the second sta.ge was ... mmcular ergometrine with hyalase and later intramuscular ... described a technique of lifting the uterus abdominally, ... universally accepted, is the routine use of oxytocic drugs.

Gastro-oesophageal reflux symptoms and coeliac disease: no role for routine duodenal biopsy.

Science.gov (United States)

Mooney, Peter D; Evans, Kate E; Kurien, Matthew; Hopper, Andrew D; Sanders, David S

2015-06-01

Coeliac disease (CD) has been linked to gastro-oesophageal reflux disease (GORD). Previous studies have demonstrated an increased prevalence of reflux in patients with CD. However data on the risk for CD in patients presenting with reflux are conflicting. The aim of this study was to establish the prevalence of CD in patients with GORD and to elucidate the mechanisms for reflux symptoms in newly diagnosed CD patients. Group A: patients who had undergone routine duodenal biopsy were prospectively recruited between 2004 and 2014. Diagnostic yield was compared with that of a screening cohort. Group B: 32 patients with newly diagnosed CD who had undergone oesophageal manometry and 24-h pH studies were prospectively recruited. Group A: 3368 patients (58.7% female, mean age 53.4 years) underwent routine duodenal biopsy. Of these patients, 850 (25.2%) presented with GORD. The prevalence of CD among GORD patients was 1.3% (0.7-2.4%), which was not significantly higher than that in the general population (P=0.53). Within the context of routine duodenal biopsy at endoscopy (when corrected for concurrent symptoms, age and sex), reflux was found to be negatively associated with CD [adjusted odds ratio 0.12 (0.07-0.23), Preflux. On manometry, 9% had a hypotensive lower oesophageal sphincter and 40.6% had oesophageal motor abnormalities, with 25% significantly hypocontractile. On pH studies, 33% demonstrated reflux episodes. The prevalence of undiagnosed CD among GORD patients is similar to that in the general population, and routine duodenal biopsy cannot be recommended. A significant number of patients with newly diagnosed CD were found to have reflux and/or oesophageal dysmotility on pH/manometry studies; this may explain the high prevalence of reflux symptoms in CD.

Burst suppression in sleep in a routine outpatient EEG

Directory of Open Access Journals (Sweden)

Ammar Kheder

2014-01-01

Full Text Available Burst suppression (BS is an electroencephalogram (EEG pattern that is characterized by brief bursts of spikes, sharp waves, or slow waves of relatively high amplitude alternating with periods of relatively flat EEG or isoelectric periods. The pattern is usually associated with coma, severe encephalopathy of various etiologies, or general anesthesia. We describe an unusual case of anoxic brain injury in which a BS pattern was seen during behaviorally defined sleep during a routine outpatient EEG study.

A 'Puff' dispersion model for routine and accidental releases

International Nuclear Information System (INIS)

Grsic, Z.; Rajkovic, B.; Milutinovic, P.

1999-01-01

A Puff dispersion model for accidental or routine releases is presented. This model was used as a constitutive part of an automatic meteorological station.All measured quantities are continuously displayed on PC monitor in a digital and graphical form, they are averaging every 10 minutes and sending to the civil information center of Belgrade. In the paper simulation of a pollutant plume dispersion from The oil refinery 'Pancevo', on April 18 th 1999 is presented. (author)

[Use of PubMed to improve evidence-based medicine in routine urological practice].

Science.gov (United States)

Rink, M; Kluth, L A; Shariat, S F; Chun, F K; Fisch, M; Dahm, P

2013-03-01

Applying evidence-based medicine in daily clinical practice is the basis of patient-centered medicine and knowledge of accurate literature acquisition skills is necessary for informed clinical decision-making. PubMed is an easy accessible, free bibliographic database comprising over 21 million citations from the medical field, life-science journals and online books. The article summarizes the effective use of PubMed in routine urological clinical practice based on a common case scenario. This article explains the simple use of PubMed to obtain the best search results with the highest evidence. Accurate knowledge about the use of PubMed in routine clinical practice can improve evidence-based medicine and also patient treatment.

A first step towards miniaturized HPLC systems in analytical routine laboratories

NARCIS (Netherlands)

Straten, van M.A.; Vermeer, E.A.; Claessens, H.A.

1996-01-01

This article shows that the first step towards the miniaturization of HPLC systems can be made without any, or only slight, modification to conventional equipment. Minor (less expensive) equipment modifications, particularly the use of micro-detector cells, allow the routine use of 3.2- and 2.1-mm

Engaging adolescents with LD in higher order thinking about history concepts using integrated content enhancement routines.

Science.gov (United States)

Bulgren, Janis; Deshler, Donald D; Lenz, B Keith

2007-01-01

The understanding and use of historical concepts specified in national history standards pose many challenges to students. These challenges include both the acquisition of content knowledge and the use of that knowledge in ways that require higher order thinking. All students, including adolescents with learning disabilities (LD), are expected to understand and use concepts of history to pass high-stakes assessments and to participate meaningfully in a democratic society. This article describes Content Enhancement Routines (CERs) to illustrate instructional planning, teaching, and assessing for higher order thinking with examples from an American history unit. Research on the individual components of Content Enhancement Routines will be illustrated with data from 1 of the routines. The potential use of integrated sets of materials and procedures across grade levels and content areas will be discussed.

Comparison of Shoulder Strength in Routinely Trained Badminton Players and Non-Badminton Players

Directory of Open Access Journals (Sweden)

Wong Zhen Feng

2017-06-01

Full Text Available Background: Shoulder pain is a common reason for patients to seek medical help in any healthcare center. Shoulder pain is influenced by a few factors such as gender, posture during daily activities, aging and psychological factors. Based on the study of Epidemiology of Injuries and Prevention Strategies in Competitive Swimmers, shoulder pain due to shoulder injuries can be reduced by strengthening the shoulder muscle. Badminton has become one of the most popular sports in Asia, especially in Indonesia. This study was conducted to determine if badmintonis able to strengthen the shoulder muscle group. Methods: A cross-sectional analytic experimental study was conducted on September 2015 at Lodaya Badminton Training Center and Bale Padjadjaran of Universitas Padjadjaran. Subjects were 30 healthy male routinely trained badminton players and 30 non-badminton players who voluntarily follow the rstudy procedures. Strength measurement procedures were provided to the subjects after getting informed consent.  Data analysis was performed using T-test. Results: The shoulder strength  in routinely trained badminton players was significantly different from  non-badminton players (P<0.05. Conclusions: Shoulder strength can be improved through routine training of badminton to reduce risk of shoulder injury.   DOI: 10.15850/amj.v4n2.1083

What do stakeholders need to implement shared decision making in routine cancer care? A qualitative needs assessment.

Science.gov (United States)

Müller, Evamaria; Hahlweg, Pola; Scholl, Isabelle

2016-12-01

Shared decision making (SDM) is particularly relevant in oncology, where complex treatment options with varying side effects may lead to meaningful changes in the patient's quality of life. For several years, health policies have called for the implementation of SDM, but SDM remains poorly implemented in routine clinical practice. Implementation science has highlighted the importance of assessing stakeholders' needs to inform the development of implementation programs. Thus, the aim of the present study was to assess different stakeholders' needs regarding the implementation of SDM in routine care. A qualitative study using focus groups and interviews was conducted. Focus groups were carried out with junior physicians, senior physicians, nurses and other healthcare providers (HPCs) (e.g. psycho-oncologists, physiotherapists), patients and family members. Head physicians as well as other HPCs in management positions were interviewed. Audiotapes of focus groups and interviews were transcribed verbatim and analyzed using content analysis. Six focus groups with a total of n = 42 stakeholders as well as n = 17 interviews were conducted. Focus groups and interviews revealed five main categories of needs to be fulfilled in order to achieve a better implementation of SDM in routine cancer care: 1) changes in communication, 2) involvement of other parties, 3) a trustful patient-physician relationship, 4) culture change and 5) structural changes. Stakeholders discussed four clusters of intervention strategies that could foster the implementation of SDM in routine cancer care: 1) clinician-mediated interventions, 2) patient-mediated interventions, 3) provision of patient information material and 4) the establishment of a patient advocate. Study results show that stakeholders voiced a diversity of needs to foster implementation of SDM in routine cancer care, of which some can be directly addressed by intervention strategies. Present results can be used to develop an