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Sample records for electronic prescribing project

  1. Electronic prescribing reduces prescribing error in public hospitals.

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    Shawahna, Ramzi; Rahman, Nisar-Ur; Ahmad, Mahmood; Debray, Marcel; Yliperttula, Marjo; Declèves, Xavier

    2011-11-01

    To examine the incidence of prescribing errors in a main public hospital in Pakistan and to assess the impact of introducing electronic prescribing system on the reduction of their incidence. Medication errors are persistent in today's healthcare system. The impact of electronic prescribing on reducing errors has not been tested in developing world. Prospective review of medication and discharge medication charts before and after the introduction of an electronic inpatient record and prescribing system. Inpatient records (n = 3300) and 1100 discharge medication sheets were reviewed for prescribing errors before and after the installation of electronic prescribing system in 11 wards. Medications (13,328 and 14,064) were prescribed for inpatients, among which 3008 and 1147 prescribing errors were identified, giving an overall error rate of 22·6% and 8·2% throughout paper-based and electronic prescribing, respectively. Medications (2480 and 2790) were prescribed for discharge patients, among which 418 and 123 errors were detected, giving an overall error rate of 16·9% and 4·4% during paper-based and electronic prescribing, respectively. Electronic prescribing has a significant effect on the reduction of prescribing errors. Prescribing errors are commonplace in Pakistan public hospitals. The study evaluated the impact of introducing electronic inpatient records and electronic prescribing in the reduction of prescribing errors in a public hospital in Pakistan. © 2011 Blackwell Publishing Ltd.

  2. Automation bias in electronic prescribing.

    Science.gov (United States)

    Lyell, David; Magrabi, Farah; Raban, Magdalena Z; Pont, L G; Baysari, Melissa T; Day, Richard O; Coiera, Enrico

    2017-03-16

    Clinical decision support (CDS) in e-prescribing can improve safety by alerting potential errors, but introduces new sources of risk. Automation bias (AB) occurs when users over-rely on CDS, reducing vigilance in information seeking and processing. Evidence of AB has been found in other clinical tasks, but has not yet been tested with e-prescribing. This study tests for the presence of AB in e-prescribing and the impact of task complexity and interruptions on AB. One hundred and twenty students in the final two years of a medical degree prescribed medicines for nine clinical scenarios using a simulated e-prescribing system. Quality of CDS (correct, incorrect and no CDS) and task complexity (low, low + interruption and high) were varied between conditions. Omission errors (failure to detect prescribing errors) and commission errors (acceptance of false positive alerts) were measured. Compared to scenarios with no CDS, correct CDS reduced omission errors by 38.3% (p < .0001, n = 120), 46.6% (p < .0001, n = 70), and 39.2% (p < .0001, n = 120) for low, low + interrupt and high complexity scenarios respectively. Incorrect CDS increased omission errors by 33.3% (p < .0001, n = 120), 24.5% (p < .009, n = 82), and 26.7% (p < .0001, n = 120). Participants made commission errors, 65.8% (p < .0001, n = 120), 53.5% (p < .0001, n = 82), and 51.7% (p < .0001, n = 120). Task complexity and interruptions had no impact on AB. This study found evidence of AB omission and commission errors in e-prescribing. Verification of CDS alerts is key to avoiding AB errors. However, interventions focused on this have had limited success to date. Clinicians should remain vigilant to the risks of CDS failures and verify CDS.

  3. The social act of electronic medication prescribing.

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    Aarts, Jos

    2013-01-01

    Prescribing medication is embedded in social norms and cultures. In modern Western health care professionals and policy makers have attempted to rationalize medicine by addressing cost-effectiveness of diagnostic and therapeutic treatments and the development of guidelines and protocols based on the outcomes of clinical studies. These notions of cost-effectiveness and evidence-based medicine have also been embedded in technology such as electronic prescribing systems. Such constraining systems may clash with the reality of clinical practice, where formal boundaries of responsibility and authorization are often blurred. Such systems may therefore even impede patient care. Medication is seen as the essence of medical practice. Prescribing is a social act. In a hospital medications may be aimed at treating a patient for a specific condition, in primary care the professional often meets the patient with her or his social and cultural notions of a health problem. The author argues that the design and implementation of electronic prescribing systems should address the social and cultural context of prescribing. Especially in primary care, where health problems are often ill defined and evidence-based medicine guidelines do not always work as intended, studies need to take into account the sociotechnical character of electronic prescribing systems.

  4. Beyond the basics: refills by electronic prescribing.

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    Goldman, Roberta E; Dubé, Catherine; Lapane, Kate L

    2010-07-01

    E-prescribing is part of a new generation of electronic solutions for the medical industry that may have great potential for improving work flow and communication between medical practices and pharmacies. In the US, it has been introduced with minimal monitoring of errors and general usability. This paper examines refill functionality in e-prescribing software. A mixed method study including focus groups and surveys was conducted. Qualitative data were collected in on-site focus groups or individual interviews with clinicians and medical office staff at 64 physician office practices. Focus group participants described their experiences with the refill functionality of e-prescribing software, provided suggestions for improving it, and suggested improvements in office procedures and software functionality. Overall, approximately 50% reduction in time spent each day on refills was reported. Overall reports of refill functionality were positive; but clinicians and staff identified numerous difficulties and glitches associated managing prescription refills. These glitches diminished over time. Benefits included time saved as well as patient convenience. Potential for refilling without thought because of the ease of use was noted. Clinicians and staff appreciated the ability to track whether patients are filling and refilling prescriptions. E-prescribing software for managing medication refills has not yet reached its full potential. To reduce work flow barriers and medication errors, software companies need to develop error reporting systems and response teams to deal effectively with problems experienced by users. Examining usability issues on both the medical office and pharmacy ends is required to identify the behavioral and cultural changes that accompany technological innovation and ease the transition to full use of e-prescribing software. 2010 Elsevier Ireland Ltd. All rights reserved.

  5. Modeling of outpatient prescribing process in iran: a gateway toward electronic prescribing system.

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    Ahmadi, Maryam; Samadbeik, Mahnaz; Sadoughi, Farahnaz

    2014-01-01

    Implementation of electronic prescribing system can overcome many problems of the paper prescribing system, and provide numerous opportunities of more effective and advantageous prescribing. Successful implementation of such a system requires complete and deep understanding of work content, human force, and workflow of paper prescribing. The current study was designed in order to model the current business process of outpatient prescribing in Iran and clarify different actions during this process. In order to describe the prescribing process and the system features in Iran, the methodology of business process modeling and analysis was used in the present study. The results of the process documentation were analyzed using a conceptual model of workflow elements and the technique of modeling "As-Is" business processes. Analysis of the current (as-is) prescribing process demonstrated that Iran stood at the first levels of sophistication in graduated levels of electronic prescribing, namely electronic prescription reference, and that there were problematic areas including bottlenecks, redundant and duplicated work, concentration of decision nodes, and communicative weaknesses among stakeholders of the process. Using information technology in some activities of medication prescription in Iran has not eliminated the dependence of the stakeholders on paper-based documents and prescriptions. Therefore, it is necessary to implement proper system programming in order to support change management and solve the problems in the existing prescribing process. To this end, a suitable basis should be provided for reorganization and improvement of the prescribing process for the future electronic systems.

  6. The social act of electronic medication prescribing

    NARCIS (Netherlands)

    J.E.C.M. Aarts (Jos)

    2013-01-01

    markdownabstract__Abstract__ Prescribing medication is embedded in social norms and cultures. In modern Western health care professionals and policy makers have attempted to rationalize medicine by addressing cost-effectiveness of diagnostic and therapeutic treatments and the development of

  7. Evaluation of a diabetes nurse specialist prescribing project.

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    Wilkinson, Jill; Carryer, Jenny; Adams, Jeffery

    2014-08-01

    To evaluate the diabetes nurse specialist prescribing project with the aim of determining whether diabetes nurse specialist prescribing is safe and effective and to inform the implementation and extension of registered nurse prescribing. Registered nurses in many countries are able to prescribe medicines, but in New Zealand, prior to the diabetes nurse specialist project, nurse practitioners were the only nurses who could prescribe medicines. New regulations allowed the nurses to prescribe a limited number of prescription medicines. The study was a process and outcome clinical programme evaluation. The project took place between April-September 2011 and involved 12 diabetes nurse specialist in four localities. Quantitative data were collected from clinical records maintained by the diabetes nurse specialist for the project (1274 patients and 3402 prescribing events), from surveys with stakeholders (general practitioners, n = 30; team members, n = 19; and patients, n = 89) and audits from patient notes (n = 117) and prescriptions (n = 227), and qualitative data from interviews with project participants (n = 18) and patients (n = 19). All data were analysed descriptively. Diabetes nurse specialist prescribing was determined to be safe, of high quality and appropriate. It brought important benefits to the effectiveness of specialist diabetes services, was acceptable to patients and was supported by the wider healthcare team. These findings are consistent with the findings reported in the international literature about nurse prescribing in a range of different practice areas. Clarification of the education and competence requirements and resourcing for the ongoing supervision of nurses is recommended if the prescribing model is to be extended. Diabetes nurse specialist prescribing improved access to medicines by providing a more timely service. Nurses felt more satisfied with their work because they could independently provide a complete episode of care

  8. Optimization of electronic prescribing in pediatric patients

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    Maat, B.

    2014-01-01

    Improving pediatric patient safety by preventing medication errors that may result in adverse drug events and consequent healthcare expenditure,is a worldwide challenge to healthcare. In pediatrics, reported medication error rates in general, and prescribing error rates in particular, vary between

  9. Impact of generic substitution decision support on electronic prescribing behavior.

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    Stenner, Shane P; Chen, Qingxia; Johnson, Kevin B

    2010-01-01

    To evaluate the impact of generic substitution decision support on electronic (e-) prescribing of generic medications. The authors analyzed retrospective outpatient e-prescribing data from an academic medical center and affiliated network for July 1, 2005-September 30, 2008 using an interrupted time-series design to assess the rate of generic prescribing before and after implementing generic substitution decision support. To assess background secular trends, e-prescribing was compared with a concurrent random sample of hand-generated prescriptions. Proportion of generic medications prescribed before and after the intervention, evaluated over time, and compared with a sample of prescriptions generated without e-prescribing. The proportion of generic medication prescriptions increased from 32.1% to 54.2% after the intervention (22.1% increase, 95% CI 21.9% to 22.3%), with no diminution in magnitude of improvement post-intervention. In the concurrent control group, increases in proportion of generic prescriptions (29.3% to 31.4% to 37.4% in the pre-intervention, post-intervention, and end-of-study periods, respectively) were not commensurate with the intervention. There was a larger change in generic prescribing rates among authorized prescribers (24.6%) than nurses (18.5%; adjusted OR 1.38, 95% CI 1.17 to 1.63). Two years after the intervention, the proportion of generic prescribing remained significantly higher for e-prescriptions (58.1%; 95% CI 57.5% to 58.7%) than for hand-generated prescriptions ordered at the same time (37.4%; 95% CI 34.9% to 39.9%) (p<0.0001). Generic prescribing increased significantly in every specialty. Implementation of generic substitution decision support was associated with dramatic and sustained improvements in the rate of outpatient generic e-prescribing across all specialties.

  10. Prescriber and staff perceptions of an electronic prescribing system in primary care: a qualitative assessment

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    Sittig Dean F

    2010-11-01

    Full Text Available Abstract Background The United States (US Health Information Technology for Economic and Clinical Health Act of 2009 has spurred adoption of electronic health records. The corresponding meaningful use criteria proposed by the Centers for Medicare and Medicaid Services mandates use of computerized provider order entry (CPOE systems. Yet, adoption in the US and other Western countries is low and descriptions of successful implementations are primarily from the inpatient setting; less frequently the ambulatory setting. We describe prescriber and staff perceptions of implementation of a CPOE system for medications (electronic- or e-prescribing system in the ambulatory setting. Methods Using a cross-sectional study design, we conducted eight focus groups at three primary care sites in an independent medical group. Each site represented a unique stage of e-prescribing implementation - pre/transition/post. We used a theoretically based, semi-structured questionnaire to elicit physician (n = 17 and staff (n = 53 perceptions of implementation of the e-prescribing system. We conducted a thematic analysis of focus group discussions using formal qualitative analytic techniques (i.e. deductive framework and grounded theory. Two coders independently coded to theoretical saturation and resolved discrepancies through discussions. Results Ten themes emerged that describe perceptions of e-prescribing implementation: 1 improved availability of clinical information resulted in prescribing efficiencies and more coordinated care; 2 improved documentation resulted in safer care; 3 efficiencies were gained by using fewer paper charts; 4 organizational support facilitated adoption; 5 transition required time; resulted in workload shift to staff; 6 hardware configurations and network stability were important in facilitating workflow; 7 e-prescribing was time-neutral or time-saving; 8 changes in patient interactions enhanced patient care but required education; 9 pharmacy

  11. 42 CFR 423.160 - Standards for electronic prescribing.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Standards for electronic prescribing. 423.160 Section 423.160 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

  12. Hospital staff views of prescribing and discharge communication before and after electronic prescribing system implementation.

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    Mills, Pamela Ruth; Weidmann, Anita Elaine; Stewart, Derek

    2017-12-01

    Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital. Methods Semi-structured face-to-face qualitative interviews with a purposive sample of hospital staff involved in the prescribing and discharge communication process. Interviews transcribed verbatim and coded using the Framework Approach. Behavioural aspects mapped to Theoretical Domains Framework (TDF) to highlight associated behavioural change determinants. Main outcome measure Staff perceptions before and after implementation. Results Nineteen hospital staff (consultant doctors, junior doctors, pharmacists and advanced nurse practitioners) participated before and after implementation. Pre-implementation main themes were inpatient chart and discharge letter design and discharge communication process with issues of illegible and inaccurate information. Improved safety was anticipated after implementation. Post-implementation themes were improved inpatient chart clarity and discharge letter quality. TDF domains relevant to staff behavioural determinants preimplementation were knowledge (task or environment); skills (competence); social/professional roles and identity; beliefs about capabilities; environmental context and resources (including incidents). An additional two were relevant post-implementation: social influences and behavioural regulation (including self-monitoring). Participants described challenges and patient safety concerns pre-implementation which were mostly resolved post-implementation. Conclusion HEPMA implementation

  13. Electronic prescribing: criteria for evaluating handheld prescribing systems and an evaluation of a new, handheld, wireless wide area network (WWAN) prescribing system.

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    Goldblum, O M

    2001-02-01

    The objectives of this study were: 1) to establish criteria for evaluating handheld computerized prescribing systems; and 2) to evaluate out-of-box performance and features of a new, Palm Operating System (OS)-based, handheld, wireless wide area network (WWAN) prescribing system. The system consisted of a Palm Vx handheld organizer, a Novatel Minstrel V wireless modem, OmniSky wireless internet access and ePhysician ePad 1.1, the Palm OS electronic prescribing software program. A dermatologist familiar with healthcare information technology conducted an evaluation of the performance and features of a new, handheld, WWAN electronic prescribing system in an office practice during a three-month period in 2000. System performance, defined as transmission success rate, was determined from data collected during the three-month trial. Evaluation criteria consisted of an analysis of features found in electronic prescribing systems. All prescriptions written for all patients seen during a three-month period (August - November, 2000) were eligible for inclusion. Prescriptions written for patients who intended to fill them at pharmacies without known facsimile receiving capabilities were excluded from the study. The performance of the system was evaluated using data collected during the study. Criteria for evaluating features of electronic prescribing systems were developed and used to analyze the system employed in this study. During this three-month trial, 200 electronic prescriptions were generated for 132 patients included in the study. Of these prescriptions, 92.5 percent were successfully transmitted to pharmacies. Transmission failures resulted from incorrect facsimile numbers and non-functioning facsimile machines. Criteria established for evaluation of electronic prescribing systems included System (Hardware & Software), Costs, System Features, Printing & Transmission, Formulary & Insurance, Customization, Drug Safety and Security. This study is the first effort to

  14. Beginning analog electronics through projects

    CERN Document Server

    Singmin, Andrew

    2001-01-01

    Analog electronics is the simplest way to start a fun, informative, learning program. Beginning Analog Electronics Through Projects, Second Edition was written with the needs of beginning hobbyists and students in mind. This revision of Andrew Singmin's popular Beginning Electronics Through Projects provides practical exercises, building techniques, and ideas for useful electronics projects. Additionally, it features new material on analog and digital electronics, and new projects for troubleshooting test equipment.Published in the tradition of Beginning Electronics Through Projects an

  15. Unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in the outpatient pharmacy.

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    Nanji, Karen C; Rothschild, Jeffrey M; Boehne, Jennifer J; Keohane, Carol A; Ash, Joan S; Poon, Eric G

    2014-01-01

    Electronic prescribing systems have often been promoted as a tool for reducing medication errors and adverse drug events. Recent evidence has revealed that adoption of electronic prescribing systems can lead to unintended consequences such as the introduction of new errors. The purpose of this study is to identify and characterize the unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in an outpatient pharmacy. A multidisciplinary team conducted direct observations of workflow in an independent pharmacy and semi-structured interviews with pharmacy staff members about their perceptions of the unrealized potential and residual consequences of electronic prescribing systems. We used qualitative methods to iteratively analyze text data using a grounded theory approach, and derive a list of major themes and subthemes related to the unrealized potential and residual consequences of electronic prescribing. We identified the following five themes: Communication, workflow disruption, cost, technology, and opportunity for new errors. These contained 26 unique subthemes representing different facets of our observations and the pharmacy staff's perceptions of the unrealized potential and residual consequences of electronic prescribing. We offer targeted solutions to improve electronic prescribing systems by addressing the unrealized potential and residual consequences that we identified. These recommendations may be applied not only to improve staff perceptions of electronic prescribing systems but also to improve the design and/or selection of these systems in order to optimize communication and workflow within pharmacies while minimizing both cost and the potential for the introduction of new errors.

  16. Electronic prescribing in pediatrics: toward safer and more effective medication management.

    Science.gov (United States)

    Johnson, Kevin B; Lehmann, Christoph U

    2013-04-01

    This technical report discusses recent advances in electronic prescribing (e-prescribing) systems, including the evidence base supporting their limitations and potential benefits. Specifically, this report acknowledges that there are limited but positive pediatric data supporting the role of e-prescribing in mitigating medication errors, improving communication with dispensing pharmacists, and improving medication adherence. On the basis of these data and on the basis of federal statutes that provide incentives for the use of e-prescribing systems, the American Academy of Pediatrics recommends the adoption of e-prescribing systems with pediatric functionality. This report supports the accompanying policy statement from the American Academy of Pediatrics recommending the adoption of e-prescribing by pediatric health care providers.

  17. Getting started with electronic projects

    CERN Document Server

    Pretty, Bill

    2015-01-01

    This book is aimed at hobbyists with basic knowledge of electronics circuits. Whether you are a novice electronics project builder, a ham radio enthusiast, or a BeagleBone tinkerer, you will love this book.

  18. Reduction in alert fatigue in an assisted electronic prescribing system, through the Lean Six Sigma methodology.

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    Cuéllar Monreal, Mª Jesús; Reig Aguado, Jorge; Font Noguera, Isabel; Poveda Andrés, José Luis

    2017-01-01

    To reduce the alert fatigue in our Assisted Electronic Prescribing System (AEPS), through the Lean Six Sigma (LSS) methodology. An observational (transversal) and retrospective study, in a general hospital with 850 beds and AEPS. The LSS methodology was followed in order to evaluate the alert fatigue situation in the AEPS system, to implement improvements, and to assess outcomes. The alerts generated during two trimesters studied (before and after the intervention) were analyzed. In order to measure the qualitative indicators, the most frequent alert types were analyzed, as well as the molecules responsible for over 50% of each type of alert. The action by the prescriber was analyzed in a sample of 496 prescriptions that generated such alerts. For each type of alert and molecule, there was a prioritization of the improvements to be implemented according to the alert generated and its quality. A second survey evaluated the pharmacist action for the alerts most highly valued by physicians. The problem, the objective, the work team and the project schedule were defined. A survey was designed in order to understand the opinion of the client about the alert system in the program. Based on the surveys collected (n = 136), the critical characteristics and the quanti/qualitative indicators were defined. Sixty (60) fields in the alert system were modified, corresponding to 32 molecules, and this led to a 28% reduction in the total number of alerts. Regarding quality indicators, false po sitive results were reduced by 25% (p < 0.05), 100% of those alerts ignored with justification were sustained, and there were no significant differences in user adherence to the system. The project improvements and outcomes were reviewed by the work team. LSS methodology has demonstrated being a valid tool for the quantitative and qualitative improvement of the alert system in an Assisted Electronic Prescription Program, thus reducing alert fatigue. Copyright AULA MEDICA EDICIONES 2014

  19. Workarounds to hospital electronic prescribing systems: a qualitative study in English hospitals.

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    Cresswell, Kathrin M; Mozaffar, Hajar; Lee, Lisa; Williams, Robin; Sheikh, Aziz

    2017-07-01

    Concerns with the usability of electronic prescribing (ePrescribing) systems can lead to the development of workarounds by users. To investigate the types of workarounds users employed, the underlying reasons offered and implications for care provision and patient safety. We collected a large qualitative data set, comprising interviews, observations and project documents, as part of an evaluation of ePrescribing systems in five English hospitals, which we conceptualised as case studies. Data were collected at up to three different time points throughout implementation and adoption. Thematic analysis involving deductive and inductive approaches was facilitated by NVivo 10. Our data set consisted of 173 interviews, 24 rounds of observation and 17 documents. Participating hospitals were at various stages of implementing a range of systems with differing functionalities. We identified two types of workarounds: informal and formal. The former were informal practices employed by users not approved by management, which were introduced because of perceived changes to professional roles, issues with system usability and performance and challenges relating to the inaccessibility of hardware. The latter were formalised practices that were promoted by management and occurred when systems posed threats to patient safety and organisational functioning. Both types of workarounds involved using paper and other software systems as intermediaries, which often created new risks relating to a lack of efficient transfer of real-time information between different users. Assessing formal and informal workarounds employed by users should be part of routine organisational implementation strategies of major health information technology initiatives. Workarounds can create new risks and present new opportunities for improvement in system design and integration. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. [Perceptions on electronic prescribing by primary care physicians in madrid healthcare service].

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    Villímar Rodríguez, A I; Gangoso Fermoso, A B; Calvo Pita, C; Ariza Cardiel, G

    To investigate the opinion of Primary Care physicians regarding electronic prescribing. Descriptive study by means of a questionnaire sent to 527 primary care physicians. June 2014. The questionnaire included closed questions about interest shown, satisfaction, benefits, weaknesses, and barriers, and one open question about difficulties, all of them referred to electronic prescribing. Satisfaction was measured using 1-10 scale, and benefits, weaknesses, and barriers were evaluated by a 5-ítems Likert scale. Interest was measured using both methods. The questionnaire was sent by e-mail for on line response through Google Drive® tool. A descriptive statistical analysis was performed. The response rate was 47% (248/527). Interest shown was 8.7 (95% CI; 8.5-8.9) and satisfaction was 7.9 (95% CI; 7.8-8). The great majority 87.9% (95% CI; 83.8-92%) of respondents used electronic prescribing where possible. Most reported benefits were: 73.4% (95% CI; 67.8-78.9%) of respondents considered that electronic prescribing facilitated medication review, and 59.3% (95% CI; 53.1-65.4) of them felt that it reduced bureaucratic burden. Among the observed weaknesses, they highlighted the following: 87.9% (95% CI; 83.8-92%) of respondents believed specialist care physicians should also be able to use electronic prescribing. Concerning to barriers: 30.2% (95% CI; 24.5-36%) of respondents think that entering a patient into the electronic prescribing system takes too much time, and 4% (95% CI; 1.6-6.5%) of them perceived the application as difficult to use. Physicians showed a notable interest in using electronic prescribing and high satisfaction with the application performance. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. An electronic intervention to improve safety for pain patients co-prescribed chronic opioids and benzodiazepines.

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    Zaman, Tauheed; Rife, Tessa L; Batki, Steven L; Pennington, David L

    2018-03-29

    Co-prescribing opioids and benzodiazepines increases overdose risk. A paucity of literature exists evaluating strategies to improve safety of co-prescribing. This study evaluated an electronic intervention to improve safety for patients co-prescribed chronic opioids for pain and benzodiazepines at 3 and 6 months. A prospective cohort study was conducted from December 2015 through May 2016 at San Francisco Veterans Affairs Health Care System. A clinical dashboard identified 145 eligible patients prescribed chronic opioids and benzodiazepines. Individualized taper and safety recommendations were communicated to prescribers via electronic medical record progress note and encrypted e-mail at baseline. Primary outcome was number of patients co-prescribed chronic opioids and benzodiazepines. Secondary outcomes included daily dose of opioids and benzodiazepines and number prescribed ≥100 mg morphine equivalent daily dose. Safety outcomes included number with opioid overdose education and naloxone distribution, annual urine drug screening, annual prescription drug monitoring program review, and signed opioid informed consent. Linear mixed models and generalized estimating equations were used to examine within-group change in outcomes between baseline and 3 and 6 months. Among the 145 patients, mean (standard deviation) age was 62 (11) years and 91.7% (133/145) were male. Number co-prescribed significantly decreased from 145/145 (100%) at baseline to 93/139 (67%) at 6-month follow-up (odds ratio [OR] = 0.53, 95% confidence interval [CI]: 0.34-0.81, P = .003). Mean opioid and benzodiazepine doses significantly decreased from 84.61 to 65.63 mg (95% CI: 8.32-27.86, P improve safety for patients co-prescribed chronic opioids for pain and benzodiazepines.

  2. The Challenges of Electronic Health Records and Diabetes Electronic Prescribing: Implications for Safety Net Care for Diverse Populations

    Directory of Open Access Journals (Sweden)

    Neda Ratanawongsa

    2017-01-01

    Full Text Available Widespread electronic health record (EHR implementation creates new challenges in the diabetes care of complex and diverse populations, including safe medication prescribing for patients with limited health literacy and limited English proficiency. This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, we present evidence for (1 the adoption of RxNorm; (2 standardized naming and picklist options for high alert medications such as insulin; (3 the widespread implementation of universal medication schedule and language-concordant labels, with the expansion of electronic prescription 140-character limit; (4 enhanced bidirectional communication with pharmacy partners; and (5 informatics and implementation research in safety net healthcare systems to examine how EHR tools and practices affect diverse vulnerable populations.

  3. The Value of Electronically Extracted Data for Auditing Outpatient Antimicrobial Prescribing.

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    Livorsi, Daniel J; Linn, Carrie M; Alexander, Bruce; Heintz, Brett H; Tubbs, Traviss A; Perencevich, Eli N

    2018-01-01

    OBJECTIVE The optimal approach to auditing outpatient antimicrobial prescribing has not been established. We assessed how different types of electronic data-including prescriptions, patient-visits, and International Classification of Disease, Tenth Revision (ICD-10) codes-could inform automated antimicrobial audits. DESIGN Outpatient visits during 2016 were retrospectively reviewed, including chart abstraction, if an antimicrobial was prescribed (cohort 1) or if the visit was associated with an infection-related ICD-10 code (cohort 2). Findings from cohorts 1 and 2 were compared. SETTING Primary care clinics and the emergency department (ED) at the Iowa City Veterans Affairs Medical Center. RESULTS In cohort 1, we reviewed 2,353 antimicrobial prescriptions across 52 providers. ICD-10 codes had limited sensitivity and positive predictive value (PPV) for validated cases of cystitis and pneumonia (sensitivity, 65.8%, 56.3%, respectively; PPV, 74.4%, 52.5%, respectively). The volume-adjusted antimicrobial prescribing rate was 13.6 per 100 ED visits and 7.5 per 100 primary care visits. In cohort 2, antimicrobials were not indicated in 474 of 851 visits (55.7%). The antimicrobial overtreatment rate was 48.8% for the ED and 59.7% for primary care. At the level of the individual prescriber, there was a positive correlation between a provider's volume-adjusted antimicrobial prescribing rate and the individualized rates of overtreatment in both the ED (r=0.72; P<.01) and the primary care setting (r=0.82; P=0.03). CONCLUSIONS In this single-center study, ICD-10 codes had limited sensitivity and PPV for 2 infections that typically require antimicrobials. Electronically extracted data on a provider's rate of volume-adjusted antimicrobial prescribing correlated with the frequency at which unnecessary antimicrobials were prescribed, but this may have been driven by outlier prescribers. Infect Control Hosp Epidemiol 2018;39:64-70.

  4. Connecting primary care clinics and community pharmacies through a nationwide electronic prescribing network: A qualitative study

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    Marie-Pierre Gagnon

    2015-10-01

    Full Text Available Background The use of medication is at the heart of primary care, but is also the cause for major health concerns. It is therefore important to examine the prescription of medication process.Objective This study identifies the barriers and facilitators perceived by community pharmacists and primary care physicians concerning the adoption of a nationwide electronic prescribing (e-prescribing network in the province of Quebec, Canada.Methods We used purposive sampling to identify the most intensive users of the e-prescribing network. We conducted phone and in-person interviews. Interviews were transcribed, and we analysed their content with NVivo, using the clinical adoption framework (CAF for the codification of the data.Results We interviewed 33 pharmacists, 2 pharmacy technicians, 11 physicians and 3 clinic managers. Adoption of the e-prescribing network was fairly low. The respondents underlined adaptation of their work environment, openness to change and perception of benefits as facilitators to the adoption of the network. However, important barriers were perceived, including system quality issues and paper prescriptions being the only legal document in the prescribing process. Even if respondents recognised that the e-prescribing network can offer substantial benefits to the prescribing process, issues still persisted and raised barriers to the full use of such a network, especially in a context where different local information systems are connected within a nationwide e-prescribing network.Conclusion This study, based on the CAF, provides a better understanding of the factors related to the adoption of a nationwide e-prescribing network connecting primary care clinics and community pharmacies. 

  5. The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study.

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    Franklin, Bryony Dean; O'Grady, Kara; Donyai, Parastou; Jacklin, Ann; Barber, Nick

    2007-08-01

    To assess the impact of a closed-loop electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on prescribing and administration errors, confirmation of patient identity before administration, and staff time. Before-and-after study in a surgical ward of a teaching hospital, involving patients and staff of that ward. Closed-loop electronic prescribing, automated dispensing, barcode patient identification and EMAR system. Percentage of new medication orders with a prescribing error, percentage of doses with medication administration errors (MAEs) and percentage given without checking patient identity. Time spent prescribing and providing a ward pharmacy service. Nursing time on medication tasks. Prescribing errors were identified in 3.8% of 2450 medication orders pre-intervention and 2.0% of 2353 orders afterwards (pMedical staff required 15 s to prescribe a regular inpatient drug pre-intervention and 39 s afterwards (p = 0.03; t test). Time spent providing a ward pharmacy service increased from 68 min to 98 min each weekday (p = 0.001; t test); 22% of drug charts were unavailable pre-intervention. Time per drug administration round decreased from 50 min to 40 min (p = 0.006; t test); nursing time on medication tasks outside of drug rounds increased from 21.1% to 28.7% (p = 0.006; chi(2) test). A closed-loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication-related tasks increased.

  6. The impact of a closed‐loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before‐and‐after study

    Science.gov (United States)

    Franklin, Bryony Dean; O'Grady, Kara; Donyai, Parastou; Jacklin, Ann; Barber, Nick

    2007-01-01

    Objectives To assess the impact of a closed‐loop electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on prescribing and administration errors, confirmation of patient identity before administration, and staff time. Design, setting and participants Before‐and‐after study in a surgical ward of a teaching hospital, involving patients and staff of that ward. Intervention Closed‐loop electronic prescribing, automated dispensing, barcode patient identification and EMAR system. Main outcome measures Percentage of new medication orders with a prescribing error, percentage of doses with medication administration errors (MAEs) and percentage given without checking patient identity. Time spent prescribing and providing a ward pharmacy service. Nursing time on medication tasks. Results Prescribing errors were identified in 3.8% of 2450 medication orders pre‐intervention and 2.0% of 2353 orders afterwards (pMedical staff required 15 s to prescribe a regular inpatient drug pre‐intervention and 39 s afterwards (p = 0.03; t test). Time spent providing a ward pharmacy service increased from 68 min to 98 min each weekday (p = 0.001; t test); 22% of drug charts were unavailable pre‐intervention. Time per drug administration round decreased from 50 min to 40 min (p = 0.006; t test); nursing time on medication tasks outside of drug rounds increased from 21.1% to 28.7% (p = 0.006; χ2 test). Conclusions A closed‐loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication‐related tasks increased. PMID:17693676

  7. Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study.

    Science.gov (United States)

    Galvin, Sandra; Callan, Aoife; Cormican, Martin; Duane, Sinead; Bennett, Kathleen; Murphy, Andrew W; Vellinga, Akke

    2015-07-02

    The increase in the spread of antimicrobial resistance (AMR) in bacterial pathogens and limited availability of new antimicrobials places immense pressure on general practitioners (GPs) to prescribe appropriately. Currently, electronic antimicrobial prescribing data is not routinely collected from GPs in Ireland for surveillance purposes to assess regional specific fluctuations or trends in antimicrobial prescribing. The current study aimed to address this issue by assessing the feasibility of remotely extracting antimicrobial prescribing data from primary care practices in Ireland, for the purpose of assessing prescribing quality using the European Surveillance of Antimicrobial Consumption (ESAC) drug specific quality indicators. Participating practices (n = 30) uploaded data to the Irish Primary Care Research Network (IPCRN). The IPCRN data extraction facility is integrated within the practice patient management software system and permitted the extraction of anonymised patient prescriptions for a one year period, from October 2012 to October 2013. The quality of antimicrobial prescribing was evaluated using the twelve ESAC drug specific quality indicators using the defined daily dose (DDD) per 1,000 inhabitants per day (DID) methodology. National and European prescribing surveillance data (based on total pharmacy sales) was obtained for a comparative analysis. Antimicrobial prescriptions (n = 57,079) for 27,043 patients were obtained from the thirty study practices for a one year period. On average, study practices prescribed a greater proportion of quinolones (37 % increase), in summer compared with winter months, a variation which was not observed in national and European data. In comparison with national data, study practices prescribed higher proportions of β-lactamase-sensitive penicillins (4.98 % vs. 4.3 %) and a greater use of broad spectrum compared to narrow-spectrum antimicrobials (ratio = 9.98 vs. 6.26) was observed. Study practices exceeded the

  8. Use of Electronic Health Record Tools to Facilitate and Audit Infliximab Prescribing.

    Science.gov (United States)

    Sharpless, Bethany R; Del Rosario, Fernando; Molle-Rios, Zarela; Hilmas, Elora

    2018-01-01

    The objective of this project was to assess a pediatric institution's use of infliximab and develop and evaluate electronic health record tools to improve safety and efficiency of infliximab ordering through auditing and improved communication. Best use of infliximab was defined through a literature review, analysis of baseline use of infliximab at our institution, and distribution and analysis of a national survey. Auditing and order communication were optimized through implementation of mandatory indications in the infliximab orderable and creation of an interactive flowsheet that collects discrete and free-text data. The value of the implemented electronic health record tools was assessed at the conclusion of the project. Baseline analysis determined that 93.8% of orders were dosed appropriately according to the findings of a literature review. After implementation of the flowsheet and indications, the time to perform an audit of use was reduced from 60 minutes to 5 minutes per month. Four months post implementation, data were entered by 60% of the pediatric gastroenterologists at our institution on 15.3% of all encounters for infliximab. Users were surveyed on the value of the tools, with 100% planning to continue using the workflow, and 82% stating the tools frequently improve the efficiency and safety of infliximab prescribing. Creation of a standard workflow by using an interactive flowsheet has improved auditing ability and facilitated the communication of important order information surrounding infliximab. Providers and pharmacists feel these tools improve the safety and efficiency of infliximab ordering, and auditing data reveal that the tools are being used.

  9. Adoption of electronic prescribing for controlled substances among providers and pharmacies.

    Science.gov (United States)

    Hufstader Gabriel, Meghan; Yang, Yi; Vaidya, Varun; Wilkins, Tricia Lee

    2014-11-01

    Electronic prescribing for Schedule II through V controlled substances was legalized in the United States by the Drug Enforcement Administration in June 2010. However, little information exists about adoption and use of the electronic prescribing of controlled substances (EPCS) at the national level. Therefore, the objective of this study is to present the first information about national trends surrounding the adoption and use of the newly allowed EPCS by providers and pharmacies in the United States. Trends of EPCS adoption and use were examined for the number of EPCS, number of pharmacies enabled to accept EPCS, and the number of providers prescribing controlled substances electronically. Using nationally representative transactional Surescripts data from July 2012 to December 2013, we examined EPCS trends. During the study period, the total number of EPCS increased from 1535 to 52,423, and the number and percentage of all pharmacies enabled for EPCS increased from 8768 (13%) to 20,498 pharmacies (30%). The proportion of all providers prescribing controlled substances electronically is currently 1%, but increasing steadily each month. There is a positive national growth for EPCS in pharmacy preparedness to accept EPCS, the number of EPCS prescriptions sent each month, and the number of providers with the ability to send EPCS.

  10. Using an electronic prescribing system to ensure accurate medication lists in a large multidisciplinary medical group.

    Science.gov (United States)

    Stock, Ron; Scott, Jim; Gurtel, Sharon

    2009-05-01

    Although medication safety has largely focused on reducing medication errors in hospitals, the scope of adverse drug events in the outpatient setting is immense. A fundamental problem occurs when a clinician lacks immediate access to an accurate list of the medications that a patient is taking. Since 2001, PeaceHealth Medical Group (PHMG), a multispecialty physician group, has been using an electronic prescribing system that includes medication-interaction warnings and allergy checks. Yet, most practitioners recognized the remaining potential for error, especially because there was no assurance regarding the accuracy of information on the electronic medical record (EMR)-generated medication list. PeaceHealth developed and implemented a standardized approach to (1) review and reconcile the medication list for every patient at each office visit and (2) report on the results obtained within the PHMG clinics. In 2005, PeaceHealth established the ambulatory medication reconciliation project to develop a reliable, efficient process for maintaining accurate patient medication lists. Each of PeaceHealth's five regions created a medication reconciliation task force to redesign its clinical practice, incorporating the systemwide aims and agreed-on key process components for every ambulatory visit. Implementation of the medication reconciliation process at the PHMG clinics resulted in a substantial increase in the number of accurate medication lists, with fewer discrepancies between what the patient is actually taking and what is recorded in the EMR. The PeaceHealth focus on patient safety, and particularly the reduction of medication errors, has involved a standardized approach for reviewing and reconciling medication lists for every patient visiting a physician office. The standardized processes can be replicated at other ambulatory clinics-whether or not electronic tools are available.

  11. Comparison of Prescribed and Measured Dialysate Sodium: A Quality Improvement Project.

    Science.gov (United States)

    Gul, Ambreen; Miskulin, Dana C; Paine, Susan S; Narsipur, Sriram S; Arbeit, Leonard A; Harford, Antonia M; Weiner, Daniel E; Schrader, Ronald; Horowitz, Bruce L; Zager, Philip G

    2016-03-01

    There is controversy regarding the optimal dialysate sodium concentration for hemodialysis patients. Dialysate sodium concentrations of 134 to 138 mEq/L may decrease interdialytic weight gain and improve hypertension control, whereas a higher dialysate sodium concentration may offer protection to patients with low serum sodium concentrations and hypotension. We conducted a quality improvement project to explore the hypothesis that prescribed and delivered dialysate sodium concentrations may differ significantly. Cross-sectional quality improvement project. 333 hemodialysis treatments in 4 facilities operated by Dialysis Clinic, Inc. Measure dialysate sodium to assess the relationships of prescribed and measured dialysate sodium concentrations. Magnitude of differences between prescribed and measured dialysate sodium concentrations. Dialysate sodium measured pre- and late dialysis. The least square mean of the difference between prescribed minus measured dialysate sodium concentration was -2.48 (95% CI, -2.87 to -2.10) mEq/L. Clinics with a greater number of different dialysate sodium prescriptions (clinic 1, n=8; clinic 2, n=7) and that mixed dialysate concentrates on site had greater differences between prescribed and measured dialysate sodium concentrations. Overall, 57% of measured dialysate sodium concentrations were within ±2 mEq/L of the prescribed dialysate sodium concentration. Differences were greater at higher prescribed dialysate sodium concentrations. We only studied 4 facilities and dialysate delivery machines from 2 manufacturers. Because clinics using premixed dialysate used the same type of machine, we were unable to independently assess the impact of these factors. Pressures in dialysate delivery loops were not measured. There were significant differences between prescribed and measured dialysate sodium concentrations. This may have beneficial or deleterious effects on clinical outcomes, as well as confound results from studies assessing the

  12. Operational and customer relationship management considerations of electronic prescribing among pharmacists.

    Science.gov (United States)

    Smith, Alan D; Motley, Darlene

    2009-01-01

    Technology in healthcare environments has increasingly become a vital way to communicate vital information in a safe, reliable, precise and secure manner. Healthcare is an arena that is constantly changing and very fast paced, but adoption of electronic prescribing (e-prescribing) has been comparatively slow and painful in the USA. Medical professionals need a system to communicate medications and diagnosis, with patients' safety as the major consideration, especially with the many complexities associated with drug-interactions and allergies. Via multivariate analysis and linear regression analysis, it was found that degree of e-prescribing acceptance is highly predictable by constructs of Technological Sophistication, Operational Factors and Maturity Factors, which are very stable ease-of-use variables derived from the TAM Model by Davis (1989).

  13. Positron--Electron Project (PEP)

    International Nuclear Information System (INIS)

    Rees, J.R.

    1977-01-01

    PEP, an 18-GeV electron-positron colliding-beam storage ring facility at SLAC, is being built by a team from LBL and SLAC. Construction is under way and completion is scheduled for Fall of 1979. A summary is given of the design of the facility, and the status of the project is reported

  14. Prescribing of Electronic Activity Monitors in Cardiometabolic Diseases: Qualitative Interview-Based Study.

    Science.gov (United States)

    Bellicha, Alice; Macé, Sandrine; Oppert, Jean-Michel

    2017-09-23

    The prevalence of noncommunicable diseases, including those such as type 2 diabetes, obesity, dyslipidemia, and hypertension, so-called cardiometabolic diseases, is high and is increasing worldwide. Strong evidence supports the role of physical activity in management of these diseases. There is general consensus that mHealth technology, including electronic activity monitors, can potentially increase physical activity in patients, but their use in clinical settings remains limited. Practitioners' requirements when prescribing electronic activity monitors have been poorly described. The aims of this qualitative study were (1) to explore how specialist physicians prescribe electronic activity monitors to patients presenting with cardiometabolic conditions, and (2) to better understand their motivation for and barriers to prescribing such monitors. We conducted qualitative semistructured interviews in March to May 2016 with 11 senior physicians from a public university hospital in France with expertise in management of cardiometabolic diseases (type 1 and type 2 diabetes, obesity, hypertension, and dyslipidemia). Interviews lasted 45 to 60 minutes and were audiotaped, transcribed verbatim, and analyzed using directed content analysis. We report our findings following the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Most physicians we interviewed had never prescribed electronic activity monitors, whereas they frequently prescribed blood glucose or blood pressure self-monitoring devices. Reasons for nonprescription included lack of interest in the data collected, lack of evidence for data accuracy, concern about work overload possibly resulting from automatic data transfer, and risk of patients becoming addicted to data. Physicians expected future marketing of easy-to-use monitors that will accurately measure physical activity duration and intensity and provide understandable motivating feedback. Features of electronic activity monitors

  15. Qualitative analysis of multi-disciplinary round-table discussions on the acceleration of benefits and data analytics through hospital electronic prescribing (ePrescribing) systems.

    Science.gov (United States)

    Cresswell, Kathrin; Coleman, Jamie; Smith, Pam; Swainson, Charles; Slee, Ann; Sheikh, Aziz

    2016-07-04

    Electronic systems that facilitate prescribing, administration and dispensing of medicines (ePrescribing systems) are at the heart of international efforts to improve the safety, quality and efficiency of medicine management. Considering the initial costs of procuring and maintaining ePrescribing systems, there is a need to better understand how to accelerate and maximise the financial benefits associated with these systems. We sought to investigate how different sectors are approaching the realisation of returns on investment from ePrescribing systems in U.K. hospitals and what lessons can be learned for future developments and implementation strategies within healthcare settings. We conducted international, multi-disciplinary, round-table discussions with 21 participants from different backgrounds including policy makers, healthcare organisations, academic researchers, vendors and patient representatives. The discussions were audio-recorded, transcribed and then thematically analysed with the qualitative analysis software NVivo10. There was an over-riding concern that realising financial returns from ePrescribing systems was challenging. The underlying reasons included substantial fixed costs of care provision, the difficulties in radically changing the medicines management process and the lack of capacity within NHS hospitals to analyse and exploit the digital data being generated. Any future data strategy should take into account the need to collect and analyse local and national data (i.e. within and across hospitals), setting comparators to measure progress (i.e. baseline measurements) and clear standards guiding data management so that data are comparable across settings. A more coherent national approach to realising financial benefits from ePrescribing systems is needed as implementations progress and the range of tools to collect information will lead to exponential data growth. The move towards more sophisticated closed-loop systems that integrate

  16. Final Report for SERDP Project RC-1649: Advanced Chemical Measurements of Smoke from DoD-prescribed Burns

    Science.gov (United States)

    T.J. Johnson; R.J. Yokelson; S.K. Akagi; I.R. Burling; D.R. Weise; S.P. Urbanski; C.E. Stockwell; J. Reardon; E.N. Lincoln; L.T.M. Profeta; A. Mendoza; M.D.W. Schneider; R.L. Sams; S.D. Williams; C.E. Wold; D.W.T. Griffith; M. Cameron; J.B. Gilman; C. Warneke; J.M. Roberts; P. Veres; W.C. Kuster; J de Gouw

    2014-01-01

    Project RC-1649, "Advanced Chemical Measurement of Smoke from DoD-prescribed Burns" was undertaken to use advanced instrumental techniques to study in detail the particulate and vapor-phase chemical composition of the smoke that results from prescribed fires used as a land management tool on DoD bases, particularly bases in the southeastern U.S. The statement...

  17. Medication errors with electronic prescribing (eP): Two views of the same picture

    Science.gov (United States)

    2010-01-01

    Background Quantitative prospective methods are widely used to evaluate the impact of new technologies such as electronic prescribing (eP) on medication errors. However, they are labour-intensive and it is not always feasible to obtain pre-intervention data. Our objective was to compare the eP medication error picture obtained with retrospective quantitative and qualitative methods. Methods The study was carried out at one English district general hospital approximately two years after implementation of an integrated electronic prescribing, administration and records system. Quantitative: A structured retrospective analysis was carried out of clinical records and medication orders for 75 randomly selected patients admitted to three wards (medicine, surgery and paediatrics) six months after eP implementation. Qualitative: Eight doctors, 6 nurses, 8 pharmacy staff and 4 other staff at senior, middle and junior grades, and 19 adult patients on acute surgical and medical wards were interviewed. Staff interviews explored experiences of developing and working with the system; patient interviews focused on experiences of medicine prescribing and administration on the ward. Interview transcripts were searched systematically for accounts of medication incidents. A classification scheme was developed and applied to the errors identified in the records review. Results The two approaches produced similar pictures of the drug use process. Interviews identified types of error identified in the retrospective notes review plus two eP-specific errors which were not detected by record review. Interview data took less time to collect than record review, and provided rich data on the prescribing process, and reasons for delays or non-administration of medicines, including "once only" orders and "as required" medicines. Conclusions The qualitative approach provided more understanding of processes, and some insights into why medication errors can happen. The method is cost-effective and

  18. The effect of electronic medical record system use on communication between pharmacists and prescribers.

    Science.gov (United States)

    Singer, Alexander; Duarte Fernandez, Roberto

    2015-10-28

    The Electronic Medical Record (EMR) is becoming increasingly common in health care settings. Research shows that EMRs have the potential to reduce instances of medication errors and improve communication between pharmacists and prescribers; however, more research is required to demonstrate whether this is true. This study aims to determine the effect of a newly implemented EMR system on communication between pharmacists and primary care clinicians. A retrospective chart analysis of primary care EMR data comparing faxed pharmacy communications captured before and after the implementation of an EMR system at an academic family medicine clinic. Communication requests were classified into the following various categories: refill accepted, refill denied, clarification, incorrect dose, interaction, drug insurance/coverage application, new prescription request, supplies request, continued care information, duplicate fax substitution, opioid early release request, confirmation by phone call, and other. The number and percentage of clarification requests, interaction notifications, and incorrect dose notifications were lower after the implementation of the EMR system. The number and percentage of refills accepted and new prescription requests increased after the implementation of the EMR system. The implementation of an EMR in an academic family medicine clinic had a significant effect on the volume of communication between pharmacists and prescribers. The amount of clarification requests and incorrect dosing communications decreased after EMR implementation. This suggests that EMRs improve prescribing safety. The increased amount of refills accepted and new prescription requests post EMR implementation suggests that the EMR is capable of changing prescription patterns.

  19. Impact of Internally Developed Electronic Prescription on Prescribing Errors at Discharge from the Emergency Department.

    Science.gov (United States)

    Hitti, Eveline; Tamim, Hani; Bakhti, Rinad; Zebian, Dina; Mufarrij, Afif

    2017-08-01

    Medication errors are common, with studies reporting at least one error per patient encounter. At hospital discharge, medication errors vary from 15%-38%. However, studies assessing the effect of an internally developed electronic (E)-prescription system at discharge from an emergency department (ED) are comparatively minimal. Additionally, commercially available electronic solutions are cost-prohibitive in many resource-limited settings. We assessed the impact of introducing an internally developed, low-cost E-prescription system, with a list of commonly prescribed medications, on prescription error rates at discharge from the ED, compared to handwritten prescriptions. We conducted a pre- and post-intervention study comparing error rates in a randomly selected sample of discharge prescriptions (handwritten versus electronic) five months pre and four months post the introduction of the E-prescription. The internally developed, E-prescription system included a list of 166 commonly prescribed medications with the generic name, strength, dose, frequency and duration. We included a total of 2,883 prescriptions in this study: 1,475 in the pre-intervention phase were handwritten (HW) and 1,408 in the post-intervention phase were electronic. We calculated rates of 14 different errors and compared them between the pre- and post-intervention period. Overall, E-prescriptions included fewer prescription errors as compared to HW-prescriptions. Specifically, E-prescriptions reduced missing dose (11.3% to 4.3%, p prescriptions, however, were associated with a significant increase in duplication errors, specifically with home medication (1.7% to 3%, p=0.02). A basic, internally developed E-prescription system, featuring commonly used medications, effectively reduced medication errors in a low-resource setting where the costs of sophisticated commercial electronic solutions are prohibitive.

  20. Communication failure: analysis of prescribers' use of an internal free-text field on electronic prescriptions.

    Science.gov (United States)

    Ai, Angela; Wong, Adrian; Amato, Mary; Wright, Adam

    2018-06-01

    Electronic prescribing promises to improve the safety and clarity of prescriptions. However, it also can introduce miscommunication between prescribers and pharmacists. There are situations where information that is meant to be sent to pharmacists is not sent to them, which has the potential for dangerous errors. To examine how frequently prescribers or administrative personnel put information intended for pharmacists in a field not sent to pharmacists, classify the type of information included, and assess the potential harm associated with these missed messages. Medication record data from our legacy electronic health record were requested for ambulatory care patients seen at an academic medical center from January 1, 2000, to May 31, 2015 (20 123 881 records). From this database, 6 060 272 medication orders met our inclusion criteria. We analyzed a random sample of 10 000 medication orders with internal comments. Reviewers classified internal comments for intent. Comments intended for pharmacists were also sorted into descriptive categories and analyzed for the potential for patient harm. We found that 11.7% of the prescriptions in our sample contained comments that were intended to be sent to pharmacists. Many comments contained information about the dose, route, or duration of the prescription (38.0%). Approximately a third of the comments intended for pharmacists contained information that had the potential for significant or severe harm if not communicated. We found undelivered comments that were clearly intended for pharmacists and contained important information for either pharmacists or patients. This poses a legitimate safety concern, as a portion of comments contained information that could have prevented severe or significant harm.

  1. Qualitative analysis of multi-disciplinary round-table discussions on the acceleration of benefits and data analytics through hospital electronic prescribing (ePrescribing systems

    Directory of Open Access Journals (Sweden)

    Kathrin Cresswell

    2016-07-01

    Full Text Available Background: Electronic systems that facilitate prescribing, administration and dispensing of medicines (ePrescribing systems are at the heart of international efforts to improve the safety, quality and efficiency of medicine management. Considering the initial costs of procuring and maintaining ePrescribing systems, there is a need to better understand how to accelerate and maximise the financial benefits associated with these systems. Objectives: We sought to investigate how different sectors are approaching the realisation of returns on investment from ePrescribing systems in U.K. hospitals and what lessons can be learned for future developments and implementation strategies within healthcare settings. Methods: We conducted international, multi-disciplinary, round-table discussions with 21 participants from different backgrounds including policy makers, healthcare organisations, academic researchers, vendors and patient representatives. The discussions were audio-recorded, transcribed and then thematically analysed with the qualitative analysis software NVivo10. Results: There was an over-riding concern that realising financial returns from ePrescribing systems was challenging. The underlying reasons included substantial fixed costs of care provision, the difficulties in radically changing the medicines management process and the lack of capacity within NHS hospitals to analyse and exploit the digital data being generated. Any future data strategy should take into account the need to collect and analyse local and national data (i.e. within and across hospitals, setting comparators to measure progress (i.e. baseline measurements and clear standards guiding data management so that data are comparable across settings. Conclusions: A more coherent national approach to realising financial benefits from ePrescribing systems is needed as implementations progress and the range of tools to collect information will lead to exponential data growth. The

  2. Core drug-drug interaction alerts for inclusion in pediatric electronic health records with computerized prescriber order entry.

    Science.gov (United States)

    Harper, Marvin B; Longhurst, Christopher A; McGuire, Troy L; Tarrago, Rod; Desai, Bimal R; Patterson, Al

    2014-03-01

    The study aims to develop a core set of pediatric drug-drug interaction (DDI) pairs for which electronic alerts should be presented to prescribers during the ordering process. A clinical decision support working group composed of Children's Hospital Association (CHA) members was developed. CHA Pharmacists and Chief Medical Information Officers participated. Consensus was reached on a core set of 19 DDI pairs that should be presented to pediatric prescribers during the order process. We have provided a core list of 19 high value drug pairs for electronic drug-drug interaction alerts to be recommended for inclusion as high value alerts in prescriber order entry software used with a pediatric patient population. We believe this list represents the most important pediatric drug interactions for practical implementation within computerized prescriber order entry systems.

  3. Thinning and prescribed fire and projected trends in wood product potential, financial return, and fire hazard in New Mexico.

    Science.gov (United States)

    Roger D. Fight; R. James Barbour; Glenn Christensen; Guy L. Pinjuv; Rao V. Nagubadi

    2004-01-01

    This work was undertaken under a joint fire science project "Assessing the need, costs, and potential benefits of prescribed fire and mechanical treatments to reduce fire hazard." This paper compares the future mix of timber projects under two treatment scenarios for New Mexico.We developed and demonstrated an analytical method that uses readily available...

  4. Prescribing Data in General Practice Demonstration (PDGPD project - a cluster randomised controlled trial of a quality improvement intervention to achieve better prescribing for chronic heart failure and hypertension

    Directory of Open Access Journals (Sweden)

    Williamson Margaret

    2012-08-01

    project that will contribute to the development of acceptable and sustainable methods to promote QI activities within routine general practice, enhance prescribing practices and improve patient outcomes in the context of CHF and HT. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR, Trial # 320870.

  5. Potential value of electronic prescribing in health economic and outcomes research

    Directory of Open Access Journals (Sweden)

    Catherine E Cooke

    2010-11-01

    Full Text Available Catherine E Cooke1, Brian J Isetts2, Thomas E Sullivan3, Maren Fustgaard4, Daniel A Belletti51PosiHealth Inc., Ellicott City, MD, USA; 2Department of Pharmaceutical Care and Health Systems, University of Minnesota College of Pharmacy, Minneapolis, MN, USA; 3Women’s Health Center, Danvers, MA, USA; 4Assistant Director for Regional Outcomes Research, 5Associate Director for Regional Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USAAbstract: Improving access and quality while reducing expenditures in the United States health system is expected to be a priority for many years. The use of health information technology (HIT, including electronic prescribing (eRx, is an important initiative in efforts aimed at improving safety and outcomes, increasing quality, and decreasing costs. Data from eRx has been used in studies that document reductions in medication errors, adverse drug events, and pharmacy order-processing time. Evaluating programs and initiatives intended to improve health care can be facilitated through the use of HIT and eRx. eRx data can be used to conduct research to answer questions about the outcomes of health care products, services, and new clinical initiatives with the goal of providing guidance for clinicians and policy makers. Given the recent explosive growth of eRx in the United States, the purpose of this manuscript is to assess the value and suggest enhanced uses and applications of eRx to facilitate the role of the practitioner in contributing to health economics and outcomes research.Keywords: electronic prescribing, outcomes research, health information technology

  6. Electronic Resources Management Project Presentation 2012

    KAUST Repository

    Ramli, Rindra M.

    2012-01-01

    This presentation describes the electronic resources management project undertaken by the KAUST library. The objectives of this project is to migrate information from MS Sharepoint to Millennium ERM module. One of the advantages of this migration

  7. Economic impact of electronic prescribing in the hospital setting: A systematic review.

    Science.gov (United States)

    Ahmed, Zamzam; Barber, Nick; Jani, Yogini; Garfield, Sara; Franklin, Bryony Dean

    2016-04-01

    To examine evidence on the economic impact of electronic prescribing (EP) systems in the hospital setting. We conducted a systematic search of MEDLINE, EMBASE, PsycINFO, International Pharmaceutical Abstracts, the NHS Economic Evaluation Database, the European Network of Health Economic Evaluation Database and Web of Science from inception to October 2013. Full and partial economic evaluations of EP or computerized provider order entry were included. We excluded studies assessing prescribing packages for specific drugs, and monetary outcomes that were not related to medicines. A checklist was used to evaluate risk of bias and evidence quality. The search yielded 1160 articles of which three met the inclusion criteria. Two were full economic evaluations and one a partial economic evaluation. A meta-analysis was not appropriate as studies were heterogeneous in design, economic evaluation method, interventions and outcome measures. Two studies investigated the financial impact of reducing preventable adverse drug events. The third measured savings related to various aspects of the system including those related to medication. Two studies reported positive financial effects. However the overall quality of the economic evidence was low and key details often not reported. There seems to be some evidence of financial benefits of EP in the hospital setting. However, it is not clear if evidence is transferable to other settings. Research is scarce and limited in quality, and reported methods are not always transparent. Further robust, high quality research is required to establish if hospital EP is cost effective and thus inform policy makers' decisions. Copyright © 2016. Published by Elsevier Ireland Ltd.

  8. Electronic Resources Management Project Presentation 2012

    KAUST Repository

    Ramli, Rindra M.

    2012-11-05

    This presentation describes the electronic resources management project undertaken by the KAUST library. The objectives of this project is to migrate information from MS Sharepoint to Millennium ERM module. One of the advantages of this migration is to consolidate all electronic resources into a single and centralized location. This would allow for better information sharing among library staff.

  9. New Project System for Undergraduate Electronic Engineering

    Science.gov (United States)

    Chiu, Dirk M.; Chiu, Shen Y.

    2005-01-01

    A new approach to projects for undergraduate electronic engineering in an Australian university has been applied successfully for over 10 years. This approach has a number of projects running over three year period. Feedback from past graduates and their managers has confirmed that these projects train the students well, giving them the ability…

  10. Thinning and prescribed fire and projected trends in wood product potential, financial return, and fire hazard in Montana.

    Science.gov (United States)

    R. James Barbour; Roger D. Fight; Glenn A. Christensen; Guy L. Pinjuv; Rao V. Nagubadi

    2004-01-01

    This work was undertaken under a joint fire science project "Assessing the need, costs, and potential benefits of prescribed fire and mechanical treatments to reduce fire hazard." This paper compares the future mix of timber products under two treatment scenarios for the state of Montana. We developed and demonstrated an analytical method that uses readily...

  11. Identification of features of electronic prescribing systems to support quality and safety in primary care using a modified Delphi process.

    Science.gov (United States)

    Sweidan, Michelle; Williamson, Margaret; Reeve, James F; Harvey, Ken; O'Neill, Jennifer A; Schattner, Peter; Snowdon, Teri

    2010-04-15

    Electronic prescribing is increasingly being used in primary care and in hospitals. Studies on the effects of e-prescribing systems have found evidence for both benefit and harm. The aim of this study was to identify features of e-prescribing software systems that support patient safety and quality of care and that are useful to the clinician and the patient, with a focus on improving the quality use of medicines. Software features were identified by a literature review, key informants and an expert group. A modified Delphi process was used with a 12-member multidisciplinary expert group to reach consensus on the expected impact of the features in four domains: patient safety, quality of care, usefulness to the clinician and usefulness to the patient. The setting was electronic prescribing in general practice in Australia. A list of 114 software features was developed. Most of the features relate to the recording and use of patient data, the medication selection process, prescribing decision support, monitoring drug therapy and clinical reports. The expert group rated 78 of the features (68%) as likely to have a high positive impact in at least one domain, 36 features (32%) as medium impact, and none as low or negative impact. Twenty seven features were rated as high positive impact across 3 or 4 domains including patient safety and quality of care. Ten features were considered "aspirational" because of a lack of agreed standards and/or suitable knowledge bases. This study defines features of e-prescribing software systems that are expected to support safety and quality, especially in relation to prescribing and use of medicines in general practice. The features could be used to develop software standards, and could be adapted if necessary for use in other settings and countries.

  12. Using 'nudge' principles for order set design: a before and after evaluation of an electronic prescribing template in critical care.

    Science.gov (United States)

    Bourdeaux, Christopher P; Davies, Keith J; Thomas, Matthew J C; Bewley, Jeremy S; Gould, Timothy H

    2014-05-01

    Computerised order sets have the potential to reduce clinical variation and improve patient safety but the effect is variable. We sought to evaluate the impact of changes to the design of an order set on the delivery of chlorhexidine mouthwash and hydroxyethyl starch (HES) to patients in the intensive care unit. The study was conducted at University Hospitals Bristol NHS Foundation Trust, UK. Our intensive care unit uses a clinical information system (CIS). All drugs and fluids are prescribed with the CIS and drug and fluid charts are stored within a database. Chlorhexidine mouthwash was added as a default prescription to the prescribing template in January 2010. HES was removed from the prescribing template in April 2009. Both interventions were available to prescribe manually throughout the study period. We conducted a database review of all patients eligible for each intervention before and after changes to the configuration of choices within the prescribing system. 2231 ventilated patients were identified as appropriate for treatment with chlorhexidine, 591 before the intervention and 1640 after. 55.3% were prescribed chlorhexidine before the change and 90.4% after (p<0.001). 6199 patients were considered in the HES intervention, 2177 before the intervention and 4022 after. The mean volume of HES infused per patient fell from 630 mL to 20 mL after the change (p<0.001) and the percentage of patients receiving HES fell from 54.1% to 3.1% (p<0.001). These results were well sustained with time. The presentation of choices within an electronic prescribing system influenced the delivery of evidence-based interventions in a predictable way and the effect was well sustained. This approach has the potential to enhance the effectiveness of computerised order sets.

  13. Electronic Government : Caribbean Pilot Project | IDRC ...

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

    Electronic Government : Caribbean Pilot Project. Caribbean countries are increasingly adopting information and communication technologies (ICTs) in ... The Government of Jamaica is willing to donate the solution to other ... Related content ...

  14. 76 FR 31547 - Medicare Program; Proposed Changes to the Electronic Prescribing (eRx) Incentive Program

    Science.gov (United States)

    2011-06-01

    ... Independence Avenue, SW., Washington, DC 20201. (Because access to the interior of the Hubert H. Humphrey... is, written or acoustic signals to warn the prescriber of possible undesirable or unsafe situations...

  15. Prescribed burning in the Kings River Ecosystem Project Area: lessons learned

    Science.gov (United States)

    David S. McCandliss

    2002-01-01

    The prescribed fire program on the Sierra National Forest is in its infancy. Prescription burning was initiated in 1994 in two 32,000-acre watersheds in the Kings River District of the Sierra National Forest. Primary objectives are to return fire to a more historical role in forest ecosystems and to provide opportunities for scientists from the Pacific Southwest...

  16. ELECTRONIC COMPLIANCE AND APPROVAL PROJECT (ECAP)

    Energy Technology Data Exchange (ETDEWEB)

    Hope Morgan; Richard A. Varela; Deborah LaHood; Susan Cisco; Mary Ann Benavides; Donna Burks

    2002-11-01

    The Texas Railroad Commission (RRC), working in partnership with the United States Department of Energy and the oil and gas industry it regulates, is implementing a strategy for improving efficiency in regulations and significantly reducing administrative operating costs through the Electronic Compliance and Approval Process (ECAP). The project will streamline regulatory compliance and reporting by providing the ability to electronically submit, process, and query oil and gas applications and reports through the Internet-based ECAP system. Implementation of an ECAP drilling permit pilot project began September 1999 after funding resources were secured--a $700,000 grant from the U.S. Department of Energy and an appropriation of $1.4 million from the Texas Legislature. The pilot project involves creating the ability to file, review, and approve a well's drilling permit application through a completely electronic process. The pilot project solution will ultimately provide the infrastructure, technology, and electronic modules to enable the filing of all compliance permits and performance reports through the internet from a desktop computer. The pilot project was conducted in three phases. The first phase, implemented May 2000, provided the infrastructure that allows the electronic filing and approval of simple drilling permit applications, associated fees, and attachments. The official ''roll-out'' of ECAP and the first electronically filed drilling permit application occurred on May 11, 2000 in Dallas in conjunction with an Internet Workshop sponsored by the Petroleum Technology Transfer Council. After the completion of Phase I, the ECAP team conducted an extensive review of progress to date and analyzed requirements and opportunities for future steps. The technical team identified core infrastructure modifications that would facilitate and better support future development and expansion of the ECAP system and work began on database structure

  17. ANP applied to electronics engineering project selection

    International Nuclear Information System (INIS)

    Habib, M.

    2010-01-01

    Project selection in Electronics engineering is a complex decision-making process. This research paper illustrates an application of ANP/AHP process. The AHP (Analytic Hierarchy Process) is employed to break down large unstructured decision problems into manageable and measureable components. The ANP, as the general form of AHP, is powerful to deal with complex decisions where interdependence exists in a decision model. The research paper discusses the use of the ANP, a general form of Saaty's analytic Network process, as a model to evaluate the value of competing Electronics projects. The research paper concludes with a case study describing the implementation of this model at an engineering college, including data based on the actual use of the decision making model. The case study helps to verify that AHP is an effective and efficient decision-making tool. A major contribution of this work is to provide a methodology for assessing the best project. Despite a number of publications applying AHP in project selection, this is probably the first time that an attempt has been made to apply AHP in an electronics project selection in an engineering university environment. (author)

  18. Projected quasiparticle theory for molecular electronic structure

    Science.gov (United States)

    Scuseria, Gustavo E.; Jiménez-Hoyos, Carlos A.; Henderson, Thomas M.; Samanta, Kousik; Ellis, Jason K.

    2011-09-01

    We derive and implement symmetry-projected Hartree-Fock-Bogoliubov (HFB) equations and apply them to the molecular electronic structure problem. All symmetries (particle number, spin, spatial, and complex conjugation) are deliberately broken and restored in a self-consistent variation-after-projection approach. We show that the resulting method yields a comprehensive black-box treatment of static correlations with effective one-electron (mean-field) computational cost. The ensuing wave function is of multireference character and permeates the entire Hilbert space of the problem. The energy expression is different from regular HFB theory but remains a functional of an independent quasiparticle density matrix. All reduced density matrices are expressible as an integration of transition density matrices over a gauge grid. We present several proof-of-principle examples demonstrating the compelling power of projected quasiparticle theory for quantum chemistry.

  19. Demagnifying electron projection with grid masks

    International Nuclear Information System (INIS)

    Politycki, A.; Meyer, A.

    1978-01-01

    Tightly toleranced micro- and submicrostructures with smooth edges were realized by using transmission masks with an improved supporting grid (width of traverses 0.8 μm). Local edge shift due to the proximity effect is kept at a minimum. Supporting grids with stil narrower traverses (0.5 μm) were prepared by generating the grid pattern by electron beam writing. Masks of this kind allow projection at a demagnification ratio of 1:4, resulting in large image fields. (orig.) [de

  20. Qualitative analysis of round-table discussions on the business case and procurement challenges for hospital electronic prescribing systems.

    Directory of Open Access Journals (Sweden)

    Kathrin M Cresswell

    Full Text Available There is a pressing need to understand the challenges surrounding procurement of and business case development for hospital electronic prescribing systems, and to identify possible strategies to enhance the efficiency of these processes in order to assist strategic decision making.We organized eight multi-disciplinary round-table discussions in the United Kingdom. Participants included policy makers, representatives from hospitals, system developers, academics, and patients. Each discussion was digitally audio-recorded, transcribed verbatim and, together with accompanying field notes, analyzed thematically with NVivo9.We drew on data from 17 participants (approximately eight per roundtable, six hours of discussion, and 15 pages of field notes. Key challenges included silo planning with systems not being considered as part of an integrated organizational information technology strategy, lack of opportunity for interactions between customers and potential suppliers, lack of support for hospitals in choosing appropriate systems, difficulty of balancing structured planning with flexibility, and the on-going challenge of distinguishing "wants" and aspirations from organizational "needs".Development of business cases for major investments in information technology does not take place in an organizational vacuum. Building on previously identified potentially transferable dimensions to the development and execution of business cases surrounding measurements of costs/benefits and risk management, we have identified additional components relevant to ePrescribing systems. These include: considerations surrounding strategic context, case for change and objectives, future service requirements and options appraisal, capital and revenue implications, timescale and deliverability, and risk analysis and management.

  1. Final Report for SERDP Project RC-1649: Advanced Chemical Measurements of Smoke from DoD-prescribed Burns

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Timothy J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Weise, David [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Lincoln, E. N. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sams, Robert L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Cameron, Melanie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Veres, Patrick [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Yokelson, Robert J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Urbanski, Shawn [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Profeta, Luisa T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Williams, S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Gilman, Jessica [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Kuster, W. C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Akagi, Sheryl [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stockwell, Chelsea E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Mendoza, Albert [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wold, Cyle E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Warneke, Carsten [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); de Gouw, Joost A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Burling, Ian R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Reardon, James [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Schneider, Matthew D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Griffith, David W.T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Roberts, James M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2013-12-17

    Objectives: Project RC-1649, “Advanced Chemical Measurement of Smoke from DoD-prescribed Burns” was undertaken to use advanced instrumental techniques to study in detail the particulate and vapor-phase chemical composition of the smoke that results from prescribed fires used as a land management tool on DoD bases, particularly bases in the southeastern U.S. The statement of need (SON) called for “(1) improving characterization of fuel consumption” and “(2) improving characterization of air emissions under both flaming and smoldering conditions with respect to volatile organic compounds, heavy metals, and reactive gases.” The measurements and fuels were from several bases throughout the southeast (Camp Lejeune, Ft. Benning, and Ft. Jackson) and were carried out in collaboration and conjunction with projects 1647 (models) and 1648 (particulates, SW bases). Technical Approach: We used an approach that featured developing techniques for measuring biomass burning emission species in both the laboratory and field and developing infrared (IR) spectroscopy in particular. Using IR spectroscopy and other methods, we developed emission factors (EF, g of effluent per kg of fuel burned) for dozens of chemical species for several common southeastern fuel types. The major measurement campaigns were laboratory studies at the Missoula Fire Sciences Laboratory (FSL) as well as field campaigns at Camp Lejeune, NC, Ft. Jackson, SC, and in conjunction with 1648 at Vandenberg AFB, and Ft. Huachuca. Comparisons and fusions of laboratory and field data were also carried out, using laboratory fuels from the same bases. Results: The project enabled new technologies and furthered basic science, mostly in the area of infrared spectroscopy, a broadband method well suited to biomass burn studies. Advances in hardware, software and supporting reference data realized a nearly 20x improvement in sensitivity and now provide quantitative IR spectra for potential detection of ~60 new

  2. Qualitative Analysis of Round-Table Discussions on the Business Case and Procurement Challenges for Hospital Electronic Prescribing Systems

    Science.gov (United States)

    Cresswell, Kathrin M.; Slee, Ann; Coleman, Jamie; Williams, Robin; Bates, David W.; Sheikh, Aziz

    2013-01-01

    Objectives There is a pressing need to understand the challenges surrounding procurement of and business case development for hospital electronic prescribing systems, and to identify possible strategies to enhance the efficiency of these processes in order to assist strategic decision making. Materials and Methods We organized eight multi-disciplinary round-table discussions in the United Kingdom. Participants included policy makers, representatives from hospitals, system developers, academics, and patients. Each discussion was digitally audio-recorded, transcribed verbatim and, together with accompanying field notes, analyzed thematically with NVivo9. Results We drew on data from 17 participants (approximately eight per roundtable), six hours of discussion, and 15 pages of field notes. Key challenges included silo planning with systems not being considered as part of an integrated organizational information technology strategy, lack of opportunity for interactions between customers and potential suppliers, lack of support for hospitals in choosing appropriate systems, difficulty of balancing structured planning with flexibility, and the on-going challenge of distinguishing “wants” and aspirations from organizational “needs”. Discussion and conclusions Development of business cases for major investments in information technology does not take place in an organizational vacuum. Building on previously identified potentially transferable dimensions to the development and execution of business cases surrounding measurements of costs/benefits and risk management, we have identified additional components relevant to ePrescribing systems. These include: considerations surrounding strategic context, case for change and objectives, future service requirements and options appraisal, capital and revenue implications, timescale and deliverability, and risk analysis and management. PMID:24260213

  3. Establishing data-intensive healthcare: the case of Hospital Electronic Prescribing and Medicines Administration systems in Scotland

    Directory of Open Access Journals (Sweden)

    Kathrin Cresswell

    2016-10-01

    Full Text Available Background Creating learning health systems, characterised by the use and repeated reuse of demographic, process and clinical data to improve the safety, quality and efficiency of care, is a key aim in realising the potential benefits and efficiency savings associated with the implementation of health information technology. Objectives We sought to investigate stakeholder perspectives on and experiences of the implementation of hospital electronic prescribing and medicines administration (HEPMA systems in Scotland and use these to inform political decisions on approaches to promoting the use and reuse of digitised prescribing and medication administration data in order to improve care processes and outcomes. Methods We identified and recruited key national stakeholders involved in implementing and/or using HEPMA data from generic and specialty systems. These included representatives from healthcare settings (i.e. doctors, pharmacists and nurses, managers of existing national databases, policy makers, healthcare analytics companies, system suppliers and patient representatives. We conducted multi-disciplinary focus group discussions, audio-recorded these, transcribed data verbatim and thematically analysed the transcripts with the help of NVivo10. In analysing the data, we drew on theoretical and previous empirical work on information infrastructures. Results We identified the following key themes: 1 micro-factors – usability of systems and motivating users to input data; 2 meso-factors – developing technical and organisational infrastructures to facilitate the aggregation of data; and 3 macro-factors – facilitating interoperability and data reuse at larger scales to ensure that data are effectively generated and used. Conclusions This work is relevant not only to countries in the early stages of data strategy development but also to countries aiming to aggregate data at national levels. An overall shared vision of a learning health system

  4. Quality of Co-Prescribing NSAID and Gastroprotective Medications for Elders in The Netherlands and Its Association with the Electronic Medical Record

    NARCIS (Netherlands)

    Opondo, Dedan; Visscher, Stefan; Eslami, Saeid; Verheij, Robert A.; Korevaar, Joke C.; Abu-Hanna, Ameen

    2015-01-01

    To assess guideline adherence of co-prescribing NSAID and gastroprotective medications for elders in general practice over time, and investigate its potential association with the electronic medical record (EMR) system brand used. We included patients 65 years and older who received NSAIDs between

  5. Quality of co-prescribing NSAID and gastroprotective medications for elders in The Netherlands and its association with the electronic medical record.

    NARCIS (Netherlands)

    Opondo, D.; Visscher, S.; Eslami, S.; Verheij, R.A.; Korevaar, J.C.; Abu-Hanna, A.

    2015-01-01

    Objective: To assess guideline adherence of co-prescribing NSAID and gastroprotective medications for elders in general practice over time, and investigate its potential association with the electronic medical record (EMR) system brand used. Methods: We included patients 65 years and older who

  6. Design and Evaluation of an Electronic Override Mechanism for Medication Alerts to Facilitate Communication Between Prescribers and Pharmacists.

    Science.gov (United States)

    Russ, Alissa L; Chen, Siying; Melton, Brittany L; Saleem, Jason J; Weiner, Michael; Spina, Jeffrey R; Daggy, Joanne K; Zillich, Alan J

    2015-07-01

    Computerized medication alerts can often be bypassed by entering an override rationale, but prescribers' override reasons are frequently ambiguous to pharmacists who review orders. To develop and evaluate a new override mechanism for adverse reaction and drug-drug interaction alerts. We hypothesized that the new mechanism would improve usability for prescribers and increase the clinical appropriateness of override reasons. A counterbalanced, crossover study was conducted with 20 prescribers in a simulated prescribing environment. We modified the override mechanism timing, navigation, and text entry. Instead of free-text entry, the new mechanism presented prescribers with a predefined set of override reasons. We assessed usability (learnability, perceived efficiency, and usability errors) and used a priori criteria to evaluate the clinical appropriateness of override reasons entered. Prescribers rated the new mechanism as more efficient (Wilcoxon signed-rank test, P = 0.032). When first using the new design, 5 prescribers had difficulty finding the new mechanism, and 3 interpreted the navigation to mean that the alert could not be overridden. The number of appropriate override reasons significantly increased with the new mechanism compared with the original mechanism (median change of 3.0; interquartile range = 3.0; P < 0.0001). When prescribers were given a menu-based choice for override reasons, clinical appropriateness of these reasons significantly improved. Further enhancements are necessary, but this study is an important first step toward a more standardized menu of override choices. Findings may be used to improve communication through e-prescribing systems between prescribers and pharmacists. © The Author(s) 2015.

  7. Drug prescribing data used in the assessment of general practitioners’ treatment of asthma and urinary tract infection – Experience from the European Drug Education Project

    Directory of Open Access Journals (Sweden)

    Per Lagerløv

    2009-11-01

    Full Text Available  ABSTRACTDescribing drug treatment given by general practitioners, and quantifying changes in their prescribingbehaviour due to educational intervention, were important parts of the method developed and appliedby the European Drug Education Project. Based on the physicians’ prescription data, individual patientswere defined as having either asthma or urinary tract infections. Prescribing indicators were establishedfor assessing the quality (acceptable or unacceptable of the drug treatment. The diagnose definitionsand prescribing indicators are discussed in more detail in relation to feeding back individual prescribingdata to educational groups of physicians to improve the quality of their drug therapy.

  8. Prescribed fire research in Pennsylvania

    Science.gov (United States)

    Patrick Brose

    2009-01-01

    Prescribed fire in Pennsylvania is a relatively new forestry practice because of the State's adverse experience with highly destructive wildfires in the early 1900s. The recent introduction of prescribed fire raises a myriad of questions regarding its correct and safe use. This poster briefly describes the prescribed fire research projects of the Forestry Sciences...

  9. Rationalising prescribing

    DEFF Research Database (Denmark)

    Wadmann, Sarah; Bang, Lia Evi

    2015-01-01

    Initiatives in the name of 'rational pharmacotherapy' have been launched to alter what is seen as 'inappropriate' prescribing practices of physicians. Based on observations and interviews with 20 general practitioners (GPs) in 2009-2011, we explored how attempts to rationalise prescribing interac...

  10. Using Computer Conferencing and Electronic Mail to Facilitate Group Projects.

    Science.gov (United States)

    Anderson, Margaret D.

    1996-01-01

    Reports on the use of electronic mail and an electronic conferencing system to conduct group projects in three educational psychology courses at the State University of New York College at Cortland. Course design is explained and group project design is described, including assignments and oral presentations during regular class sessions.…

  11. TRISTAN, electron-positron colliding beam project

    International Nuclear Information System (INIS)

    1987-03-01

    In this report e + e - colliding beam program which is now referred to as TRISTAN Project will be described. A brief chronology and outline of TRISTAN Project is given in Chapter 1. Chapter 2 of this article gives a discussion of physics objectives at TRISTAN. Chapter 3 treats the overall description of the accelerators. Chapter 4 describes design of each of the accelerator systems. In Chapter 5, detector facilities are discussed in some detail. A description of accelerator tunnels, experimental areas, and utilities are given in Chapter 6. In the Appendix, the publications on the TRISTAN Project are listed. (author)

  12. Enhancing system-wide implementation of opioid prescribing guidelines in primary care: protocol for a stepped-wedge quality improvement project.

    Science.gov (United States)

    Zgierska, Aleksandra E; Vidaver, Regina M; Smith, Paul; Ales, Mary W; Nisbet, Kate; Boss, Deanne; Tuan, Wen-Jan; Hahn, David L

    2018-06-05

    Systematic implementation of guidelines for opioid therapy management in chronic non-cancer pain can reduce opioid-related harms. However, implementation of guideline-recommended practices in routine care is subpar. The goal of this quality improvement (QI) project is to assess whether a clinic-tailored QI intervention improves the implementation of a health system-wide, guideline-driven policy on opioid prescribing in primary care. This manuscript describes the protocol for this QI project. A health system with 28 primary care clinics caring for approximately 294,000 primary care patients developed and implemented a guideline-driven policy on long-term opioid therapy in adults with opioid-treated chronic non-cancer pain (estimated N = 3980). The policy provided multiple recommendations, including the universal use of treatment agreements, urine drug testing, depression and opioid misuse risk screening, and standardized documentation of the chronic pain diagnosis and treatment plan. The project team drew upon existing guidelines, feedback from end-users, experts and health system leadership to develop a robust QI intervention, targeting clinic-level implementation of policy-directed practices. The resulting multi-pronged QI intervention included clinic-wide and individual clinician-level educational interventions. The QI intervention will augment the health system's "routine rollout" method, consisting of a single educational presentation to clinicians in group settings and a separate presentation for staff. A stepped-wedge design will enable 9 primary care clinics to receive the intervention and assessment of within-clinic and between-clinic changes in adherence to the policy items measured by clinic-level electronic health record-based measures and process measures of the experience with the intervention. Developing methods for a health system-tailored QI intervention required a multi-step process to incorporate end-user feedback and account for the needs of

  13. Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records

    Directory of Open Access Journals (Sweden)

    Mia Tyrstrup

    2016-11-01

    Full Text Available Abstract Background Swedish studies on antibiotic use in primary care have been based on one-week registrations of infections. In order to study adherence to guidelines, analyses based on large databases that provide information on diagnosis linked prescriptions, are needed. This study describes trends in management of infections in Swedish primary care particularly with regards to antibiotic prescribing and adherence to national guidelines. Methods A descriptive study of Sweden’s largest database regarding diagnosis linked antibiotic prescription data, the Primary care Record of Infections in Sweden (PRIS, for the years 2008, 2010 and 2013. Results Although the consultation rate for all infections remained around 30% each year, antibiotic prescribing rates decreased significantly over the years from 53.7% in 2008, to 45.5% in 2010, to 38.6% in 2013 (p = .032. The antibiotic prescribing rate for respiratory tract infections (RTIs decreased from 40.5% in 2008 to 24.9% in 2013 while those for urinary tract infections and skin and soft tissue infections were unchanged. For most RTI diagnoses there was a decrease in prescription rate from 2008 to 2013, particularly for the age group 0–6 years. Phenoxymethylpenicillin (PcV was the antibiotic most often prescribed, followed by tetracycline. Tonsillitis and acute otitis media were the two RTI diagnoses with the highest number of prescriptions per 1000 patient years (PY. For these diagnoses an increase in adherence to national guidelines was seen, with regards to treatment frequency, choice of antibiotics and use of rapid antigen detection test. The frequency in antibiotic prescribing varied greatly between different Primary Healthcare Centres (PHCCs. Conclusion Falling numbers of consultations and decreased antibiotic prescription rates for RTIs have reduced the antibiotic use in Swedish primary care substantially. Overprescribing of antibiotics could still be suspected due to large variability

  14. Using electronic document management systems to manage highway project files.

    Science.gov (United States)

    2011-12-12

    "WisDOTs Bureau of Technical Services is interested in learning about the practices of other state departments of : transportation in developing and implementing an electronic document management system to manage highway : project files"

  15. Deep Trek High Temperature Electronics Project

    Energy Technology Data Exchange (ETDEWEB)

    Bruce Ohme

    2007-07-31

    This report summarizes technical progress achieved during the cooperative research agreement between Honeywell and U.S. Department of Energy to develop high-temperature electronics. Objects of this development included Silicon-on-Insulator (SOI) wafer process development for high temperature, supporting design tools and libraries, and high temperature integrated circuit component development including FPGA, EEPROM, high-resolution A-to-D converter, and a precision amplifier.

  16. Prescribing procrastination

    Science.gov (United States)

    Thomson, George H.

    1979-01-01

    In his everyday work the family physician sees many patients whose problems have been diagnosed but for whom postponement of an active treatment plan is indicated. The physician must therefore prescribe procrastination in a carefully planned way. I describe some ideas and practical methods for doing this. PMID:529244

  17. Implicación de la enfermera en la prescripción electrónica segura Involvement of the nurse in secure electronic prescribing

    Directory of Open Access Journals (Sweden)

    Manel Quintanilla Martínez

    2012-09-01

    Full Text Available Revisamos la inminente implantación de la receta electrónica, elemento imprescindible para mejorar la calidad en la atención sanitaria, así como herramienta clave para controlar el gasto sanitario. Se hace necesario identificar el papel que deben tener los diferentes agentes de salud implicados en su desarrollo. Por ello, hemos de conocer y, posiblemente después, analizar los resultados de las experiencias piloto llevadas a cabo en las diferentes autonomías implicadas en el proyecto, para dar respuesta a los interrogantes que su aplicación tienen en los diferentes colectivos implicados: médicos, enfermeras, farmacéuticos, colegios profesionales y laboratorios. Una faceta muy importante es la informatización y compatibilidad con plena seguridad entre todos ellos, garantizando todo lo relativo a la confidencialidad y seguridad de las transacciones. Ello será posible si definimos el papel que han de tener los agentes de salud según los resultados obtenidos en los proyectos piloto puestos en marcha por las comunidades para implantar la e-receta; partiendo de ellos, el Ministerio de Sanidad y Consumo (MSC dará los criterios de coordinación de los diferentes modelos para llegar a un modelo integrado para todo el Sistema Nacional de Salud (SNS.The imminent introduction of electronic prescriptions, an essential element for improving quality in health care, as well as a key tool to control costs. It is necessary to identify the role they should have different health workers involved in its development. For this, we must know and possibly later to analyze the results of the pilot carried out in the different autonomous regions involved in the project, to provide answers to the questions that have application in different organizations involved, both doctors, nurses, pharmacists, professional associations and laboratories. A very important aspect is the computerization and supports it safely between them, ensuring all matters relating to the

  18. The role of paediatric nurses in medication safety prior to the implementation of electronic prescribing: a qualitative case study.

    Science.gov (United States)

    Farre, Albert; Heath, Gemma; Shaw, Karen; Jordan, Teresa; Cummins, Carole

    2017-04-01

    Objectives To explore paediatric nurses' experiences and perspectives of their role in the medication process and how this role is enacted in everyday practice. Methods A qualitative case study on a general surgical ward of a paediatric hospital in England, one year prior to the planned implementation of ePrescribing. Three focus groups and six individual semi-structured interviews were conducted, involving 24 nurses. Focus groups and interviews were audio-recorded, transcribed, anonymized and subjected to thematic analysis. Results Two overarching analytical themes were identified: the centrality of risk management in nurses' role in the medication process and the distributed nature of nurses' medication risk management practices. Nurses' contribution to medication safety was seen as an intrinsic feature of a role that extended beyond just preparing and administering medications as prescribed and placed nurses at the heart of a dynamic set of interactions, practices and situations through which medication risks were managed. These findings also illustrate the collective nature of patient safety. Conclusions Both the recognized and the unrecognized contributions of nurses to the management of medications needs to be considered in the design and implementation of ePrescribing systems.

  19. Controlled cooling of an electronic system based on projected conditions

    Science.gov (United States)

    David, Milnes P.; Iyengar, Madhusudan K.; Schmidt, Roger R.

    2015-08-18

    Energy efficient control of a cooling system cooling an electronic system is provided based, in part, on projected conditions. The control includes automatically determining an adjusted control setting(s) for an adjustable cooling component(s) of the cooling system. The automatically determining is based, at least in part, on projected power consumed by the electronic system at a future time and projected temperature at the future time of a heat sink to which heat extracted is rejected. The automatically determining operates to reduce power consumption of the cooling system and/or the electronic system while ensuring that at least one targeted temperature associated with the cooling system or the electronic system is within a desired range. The automatically determining may be based, at least in part, on an experimentally obtained model(s) relating the targeted temperature and power consumption of the adjustable cooling component(s) of the cooling system.

  20. LEP the large electron-positron project

    International Nuclear Information System (INIS)

    Schopper, H.

    1984-01-01

    LEP is an e + e - ring optimized for about 100 GeV per beam. The ring has a circumference of about 26.7 kilometers, and will be 80 to 125 meters deep underground. The existing accelerators, both the PS and the SPS, will be used as injectors. The cost of LEP is 910 million Swiss francs, at 1981 prices. This document describes the outline of the LEP project, especially, in relation to the present CERN site and experimental facilities. The present status of LEP, that is, machine ordering, installation or modification of the existing machines, is explained in the following areas: injection system, magnets, accelerating system, and experimental areas. As for the civil engineering works two international consortia are responsible for the excavation of the tunnel for the main ring. Some photographs are presented to show the status of the civil engineering works. For the transportation of both components and people, a monorail suspended from the ceiling of the tunnel is adopted. The first injection test into an octant is planned in the autumn of 1987, and the first beam all around the LEP will be at the end of 1988. (Aoki, K.)

  1. Complete electronics self-teaching guide with projects

    CERN Document Server

    Boysen, Earl

    2012-01-01

    An all-in-one resource on everything electronics-related! For almost 30 years, this book has been a classic text for electronics enthusiasts. Now completely updated for today's technology, this latest version combines concepts, self-tests, and hands-on projects to offer you a completely repackaged and revised resource. This unique self-teaching guide features easy-to-understand explanations that are presented in a user-friendly format to help you learn the essentials you need to work with electronic circuits. All you need is a general understanding of electronics concepts such as Oh

  2. Prescribing Antibiotics

    DEFF Research Database (Denmark)

    Pedersen, Inge Kryger; Jepsen, Kim Sune

    2018-01-01

    The medical professions will lose an indispensable tool in clinical practice if even simple infections cannot be cured because antibiotics have lost effectiveness. This article presents results from an exploratory enquiry into “good doctoring” in the case of antibiotic prescribing at a time when...... the knowledge base in the healthcare field is shifting. Drawing on in-depth interviews about diagnosing and prescribing, the article demonstrates how the problem of antimicrobial resistance is understood and engaged with by Danish general practitioners. When general practitioners speak of managing “non......-medical issues,” they refer to routines, clinical expertise, experiences with their patients, and decision-making based more on contextual circumstances than molecular conditions—and on the fact that such conditions can be hard to assess. This article’s contribution to knowledge about how new and global health...

  3. NON-PARTICIPATION BIAS IN HEALTH SERVICES RESEARCH USING DATA FROM AN INTEGRATED ELECTRONIC PRESCRIBING PROJECT: THE ROLE OF INFORMED CONSENT SESGO POR FALTA DE PARTICIPACIÓN EN LA INVESTIGACIÓN DE LOS SERVICIOS DE SALUD AL USAR DATOS DE UN PROYECTO INTEGRADO DE RESCRIPCIÓN ELECTRÓNICA: EL PAPEL DEL CONSENTIMIENTO INFORMADO SESGO PELA FALTA DE PARTICIPAÇÃO NA PESQUISA DOS SERVIÇOS DE SAÚDE AO USAR DADOS DE UM PROJETO INTEGRADO DE PRESCRIÇÃO ELETRÔNICA: O PAPEL DO CONSENTIMENTO INFORMADO

    Directory of Open Access Journals (Sweden)

    Gillian Bartlett

    2005-01-01

    Full Text Available Electronic prescribing potentially reduces adverse outcomes and provides critical information for drug safety research but studies may be distorted by non-participation bias. 52,507 patients and 28 physicians were evaluated to determine characteristics associated with consent status in an electronic prescribing project. Physicians with less technology proficiency, seeing more patients, and having patients with higher fragmentation of care were less likely to obtain consent. Older patients with complex health status, higher income, and more visits to the study physician were more likely to consent. These systematic differences could result in significant non-participation bias for research conducted only with consenting patientsLa prescripción electrónica reduce, potencialmente, los resultados adversos. y proporciona información crítica para una investigación segura en drogas, pero los estudios pueden ser distorsionados por un sesgo por falta de participación. Se evaluó a 52.505 pacientes y a 28 médicos para determinar características asociadas con el estatus del consentimiento en un proyecto de prescripción electrónica. Los médicos con menor eficiencia tecnológica, con más cantidad de pacientes que, además, mostraban mayor fragmentación en su atención, presentaban menor opción de obtener consentimiento. Los pacientes de más edad, con estatus de salud complejo, mayor ingreso y con más visitas al médico a cargo, manifestaban mayor disposición a consentir. Estas diferencias sistemáticas podrían desembocar en un sesgo significativo por falta de participación en la investigación llevada a cabo sólo con pacientes con consentimientoA prescrição eletrônica reduz potencialmente os resultados adversos e proporciona informação crítica para uma pesquisa segura em drogas, porém os estudos podem ser destorcidos por um sesgo por falta de participação. Avaliou-se 52.505 pacientes e a 28 médicos para determinar caracter

  4. Project ECHO: Electronic Communications from Halo Orbit

    Science.gov (United States)

    Borrelli, Jason; Cooley, Bryan; Debole, Marcy; Hrivnak, Lance; Nielsen, Kenneth; Sangmeister, Gary; Wolfe, Matthew

    1994-01-01

    The design of a communications relay to provide constant access between the Earth and the far side of the Moon is presented. Placement of the relay in a halo orbit about the L2 Earth-Moon Lagrange point allows the satellite to maintain constant simultaneous communication between Earth and scientific payloads on the far side of the Moon. The requirements of NASA's Discovery-class missions adopted and modified for this design are: total project cost should not exceed $150 million excluding launch costs, launch must be provided by Delta-class vehicle, and the satellite should maintain an operational lifetime of 10 to 15 years. The spacecraft will follow a transfer trajectory to the L2 point, after launch by a Delta II 7925 vehicle in 1999. Low-level thrust is used for injection into a stationkeeping-free halo orbit once the spacecraft reaches the L2 point. The shape of this halo orbit is highly elliptical with the maximum excursion from the L2 point being 35000 km. A spun section and despun section connected through a bearing and power transfer assembly (BAPTA) compose the structure of the spacecraft. Communications equipment is placed on the despun section to provide for a stationary dual parabolic offset-feed array antenna system. The dual system is necessary to provide communications coverage during portions of maximum excursion on the halo orbit. Transmissions to the NASA Deep Space Network 34 m antenna include six channels (color video, two voice, scientific data from lunar payloads, satellite housekeeping and telemetry and uplinked commands) using the S- and X-bands. Four radioisotope thermoelectric generators (RTG's) provide a total of 1360 W to power onboard systems and any two of the four Hughes 13 cm ion thrusters at once. Output of the ion thrusters is approximately 17.8 mN each with xenon as the propellant. Presence of torques generated by solar pressure on the antenna dish require the addition of a 'skirt' extending from the spun section of the satellite

  5. NASA-DoD Lead-Free Electronics Project

    Science.gov (United States)

    Kessel, Kurt

    2010-01-01

    This slide presentation reviews the current state of the lead-free electronics project. It characterizes the test articles, which were built with lead-free solder and lead-free component finishes. The tests performed and reported on are: thermal cycling, combine environments testing, mechanical shock testing, vibration testing and drop testing.

  6. Prescribing antibiotics in general practice:

    DEFF Research Database (Denmark)

    Sydenham, Rikke Vognbjerg; Pedersen, Line Bjørnskov; Plejdrup Hansen, Malene

    Objectives The majority of antibiotics are prescribed from general practice. The use of broad-spectrum antibiotics increases the risk of development of bacteria resistant to antibiotic treatment. In spite of guidelines aiming to minimize the use of broad-spectrum antibiotics we see an increase...... in the use of these agents. The overall aim of the project is to explore factors influencing the decision process and the prescribing behaviour of the GPs when prescribing antibiotics. We will study the impact of microbiological testing on the choice of antibiotic. Furthermore the project will explore how...... the GPs’ prescribing behaviour is influenced by selected factors. Method The study consists of a register-based study and a questionnaire study. The register-based study is based on data from the Register of Medicinal Product Statistics (prescribed antibiotics), Statistics Denmark (socio-demographic data...

  7. XUV free-electron laser-based projection lithography systems

    Energy Technology Data Exchange (ETDEWEB)

    Newnam, B.E.

    1990-01-01

    Free-electron laser sources, driven by rf-linear accelerators, have the potential to operate in the extreme ultraviolet (XUV) spectral range with more than sufficient average power for high-volume projection lithography. For XUV wavelengths from 100 nm to 4 nm, such sources will enable the resolution limit of optical projection lithography to be extended from 0.25 {mu}m to 0.05{mu}m and with an adequate total depth of focus (1 to 2 {mu}m). Recent developments of a photoinjector of very bright electron beams, high-precision magnetic undulators, and ring-resonator cavities raise our confidence that FEL operation below 100 nm is ready for prototype demonstration. We address the motivation for an XUV FEL source for commercial microcircuit production and its integration into a lithographic system, include reflecting reduction masks, reflecting XUV projection optics and alignment systems, and surface-imaging photoresists. 52 refs., 7 figs.

  8. DELSY project: status and development Dubna Electron Synchrotron

    CERN Document Server

    Balalykin, N; Bykovsky, V

    2003-01-01

    The DELSY (Dubna Electron Synchrotron) project is under development at the Joint Institute for Nuclear Research. It is based on an acceleration facility donated to the Joint Institute for Nuclear Research by the Institute for Nuclear and High Energy Physics (NIKHEF, Amsterdam). The NIKHEF accelerator facility consists of the linear electron accelerator MEA, which has an electron energy of 700 MeV, and the electron storage ring AmPS, with a maximum energy of 900 MeV and a beam current of 200 mA. There are three phases to the construction of the DELSY facility. Phase I will be accomplished with the construction of a complex of free-electron lasers covering continuously the spectrum from the far infrared down to the ultraviolet (approx 150 nm). Phase II will be accomplished with the commissioning of the storage ring DELSY. Complete commissioning of the DELSY project will take place after finishing Phase III, the construction of an X-ray free-electron laser. This phase is considered as the ultimate goal of the pr...

  9. In Data We Trust? Comparison of Electronic Versus Manual Abstraction of Antimicrobial Prescribing Quality Metrics for Hospitalized Veterans With Pneumonia.

    Science.gov (United States)

    Jones, Barbara E; Haroldsen, Candace; Madaras-Kelly, Karl; Goetz, Matthew B; Ying, Jian; Sauer, Brian; Jones, Makoto M; Leecaster, Molly; Greene, Tom; Fridkin, Scott K; Neuhauser, Melinda M; Samore, Matthew H

    2018-07-01

    Electronic health records provide the opportunity to assess system-wide quality measures. Veterans Affairs Pharmacy Benefits Management Center for Medication Safety uses medication use evaluation (MUE) through manual review of the electronic health records. To compare an electronic MUE approach versus human/manual review for extraction of antibiotic use (choice and duration) and severity metrics. Retrospective. Hospitalizations for uncomplicated pneumonia occurring during 2013 at 30 Veterans Affairs facilities. We compared summary statistics, individual hospitalization-level agreement, facility-level consistency, and patterns of variation between electronic and manual MUE for initial severity, antibiotic choice, daily clinical stability, and antibiotic duration. Among 2004 hospitalizations, electronic and manual abstraction methods showed high individual hospitalization-level agreement for initial severity measures (agreement=86%-98%, κ=0.5-0.82), antibiotic choice (agreement=89%-100%, κ=0.70-0.94), and facility-level consistency for empiric antibiotic choice (anti-MRSA r=0.97, P<0.001; antipseudomonal r=0.95, P<0.001) and therapy duration (r=0.77, P<0.001) but lower facility-level consistency for days to clinical stability (r=0.52, P=0.006) or excessive duration of therapy (r=0.55, P=0.005). Both methods identified widespread facility-level variation in antibiotic choice, but we found additional variation in manual estimation of excessive antibiotic duration and initial illness severity. Electronic and manual MUE agreed well for illness severity, antibiotic choice, and duration of therapy in pneumonia at both the individual and facility levels. Manual MUE showed additional reviewer-level variation in estimation of initial illness severity and excessive antibiotic use. Electronic MUE allows for reliable, scalable tracking of national patterns of antimicrobial use, enabling the examination of system-wide interventions to improve quality.

  10. Collaborative Computational Project for Electron cryo-Microscopy

    International Nuclear Information System (INIS)

    Wood, Chris; Burnley, Tom; Patwardhan, Ardan; Scheres, Sjors; Topf, Maya; Roseman, Alan; Winn, Martyn

    2015-01-01

    The Collaborative Computational Project for Electron cryo-Microscopy (CCP-EM) is a new initiative for the structural biology community, following the success of CCP4 for macromolecular crystallography. Progress in supporting the users and developers of cryoEM software is reported. The Collaborative Computational Project for Electron cryo-Microscopy (CCP-EM) has recently been established. The aims of the project are threefold: to build a coherent cryoEM community which will provide support for individual scientists and will act as a focal point for liaising with other communities, to support practising scientists in their use of cryoEM software and finally to support software developers in producing and disseminating robust and user-friendly programs. The project is closely modelled on CCP4 for macromolecular crystallography, and areas of common interest such as model fitting, underlying software libraries and tools for building program packages are being exploited. Nevertheless, cryoEM includes a number of techniques covering a large range of resolutions and a distinct project is required. In this article, progress so far is reported and future plans are discussed

  11. Collaborative Computational Project for Electron cryo-Microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Wood, Chris; Burnley, Tom [Science and Technology Facilities Council, Research Complex at Harwell, Didcot OX11 0FA (United Kingdom); Patwardhan, Ardan [European Molecular Biology Laboratory, Wellcome Trust Genome Campus, Hinxton, Cambridge CB10 1SD (United Kingdom); Scheres, Sjors [MRC Laboratory of Molecular Biology, Francis Crick Avenue, Cambridge Biomedical Campus, Cambridge CB2 0QH (United Kingdom); Topf, Maya [University of London, Malet Street, London WC1E 7HX (United Kingdom); Roseman, Alan [University of Manchester, Oxford Road, Manchester M13 9PT (United Kingdom); Winn, Martyn, E-mail: martyn.winn@stfc.ac.uk [Science and Technology Facilities Council, Daresbury Laboratory, Warrington WA4 4AD (United Kingdom); Science and Technology Facilities Council, Research Complex at Harwell, Didcot OX11 0FA (United Kingdom)

    2015-01-01

    The Collaborative Computational Project for Electron cryo-Microscopy (CCP-EM) is a new initiative for the structural biology community, following the success of CCP4 for macromolecular crystallography. Progress in supporting the users and developers of cryoEM software is reported. The Collaborative Computational Project for Electron cryo-Microscopy (CCP-EM) has recently been established. The aims of the project are threefold: to build a coherent cryoEM community which will provide support for individual scientists and will act as a focal point for liaising with other communities, to support practising scientists in their use of cryoEM software and finally to support software developers in producing and disseminating robust and user-friendly programs. The project is closely modelled on CCP4 for macromolecular crystallography, and areas of common interest such as model fitting, underlying software libraries and tools for building program packages are being exploited. Nevertheless, cryoEM includes a number of techniques covering a large range of resolutions and a distinct project is required. In this article, progress so far is reported and future plans are discussed.

  12. Electronic-projecting Moire method applying CBR-technology

    Science.gov (United States)

    Kuzyakov, O. N.; Lapteva, U. V.; Andreeva, M. A.

    2018-01-01

    Electronic-projecting method based on Moire effect for examining surface topology is suggested. Conditions of forming Moire fringes and their parameters’ dependence on reference parameters of object and virtual grids are analyzed. Control system structure and decision-making subsystem are elaborated. Subsystem execution includes CBR-technology, based on applying case base. The approach related to analysing and forming decision for each separate local area with consequent formation of common topology map is applied.

  13. Overview of the Livermore electron beam ion trap project

    International Nuclear Information System (INIS)

    Beiersdorfer, P.; Behar, E.; Boyce, K.R.; Brown, G.V.; Chen, H.; Gendreau, K.C.; Graf, A.; Gu, M.-F.; Harris, C.L.; Kahn, S.M.; Kelley, R.L.; Lepson, J.K.; May, M.J.; Neill, P.A.; Pinnington, E.H.; Porter, F.S.; Smith, A.J.; Stahle, C.K.; Szymkowiak, A.E.; Tillotson, A.; Thorn, D.B.; Traebert, E.; Wargelin, B.J.

    2003-01-01

    The Livermore electron beam ion trap facility has recently been moved to a new location within LLNL, and new instrumentation was added, including a 32-pixel microcalorimeter. The move was accompanied by a shift of focus toward in situ measurements of highly charged ions, which continue with increased vigor. Overviews of the facility, which includes EBIT-I and SuperEBIT, and the research projects are given, including results from optical spectroscopy, QED, and X-ray line excitation measurements

  14. Secondary use of data from hospital electronic prescribing and pharmacy systems to support the quality and safety of antimicrobial use: a systematic review.

    Science.gov (United States)

    Micallef, Christianne; Chaudhry, Navila T; Holmes, Alison H; Hopkins, Susan; Benn, Jonathan; Franklin, Bryony Dean

    2017-07-01

    Electronic prescribing (EP) and electronic hospital pharmacy (EHP) systems are increasingly common. A potential benefit is the extensive data in these systems that could be used to support antimicrobial stewardship, but there is little information on how such data are currently used to support the quality and safety of antimicrobial use. To summarize the literature on secondary use of data (SuD) from EP and EHP systems to support quality and safety of antimicrobial use, to describe any barriers to secondary use and to make recommendations for future work in this field. We conducted a systematic search within four databases; we included original research studies that were (1) based on SuD from hospital EP or EHP systems and (2) reported outcomes relating to quality and/or safety of antimicrobial use and/or qualitative findings relating to SuD in this context. Ninety-four full-text articles were obtained; 14 met our inclusion criteria. Only two described interventions based on SuD; seven described SuD to evaluate other antimicrobial stewardship interventions and five described descriptive or exploratory studies of potential applications of SuD. Types of data used were quantitative antibiotic usage data ( n  =   9 studies), dose administration data ( n  =   4) and user log data from an electronic dashboard ( n  = 1). Barriers included data access, data accuracy and completeness, and complexity when using data from multiple systems or hospital sites. The literature suggests that SuD from EP and EHP systems is potentially useful to support or evaluate antimicrobial stewardship activities; greater system functionality would help to realize these benefits. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Novel Front-end Electronics for Time Projection Chamber Detectors

    CERN Document Server

    García García, Eduardo José

    This work has been carried out in the European Organization for Nuclear Research (CERN) and it was supported by the European Union as part of the research and development towards the European detector the (EUDET) project, specifically for the International Linear Collider (ILC). In particle physics there are several different categories of particle detectors. The presented design is focused on a particular kind of tracking detector called Time Projection Chamber (TPC). The TPC provides a three dimensional image of electrically charged particles crossing a gaseous volume. The thesis includes a study of the requirements for future TPC detectors summarizing the parameters that the front-end readout electronics must fulfill. In addition, these requirements are compared with respect to the readouts used in existing TPC detectors. It is concluded that none of the existing front-end readout designs fulfill the stringent requirements. The main requirements for future TPC detectors are high integration, an increased n...

  16. THE PROFESSIONAL QUALIFICATION SOLIDARY EXTENSION PROJECT AT ELECTRONICS: TECHNICAL AUXILIAR

    Directory of Open Access Journals (Sweden)

    Glaucio Lopes Ramos

    2009-10-01

    Full Text Available This paper has the objective to present the extension course “professional qualification solidary extension project at electronics: technical auxiliar” in the Electrical Engineering course in the University Center of Belo Horizonte, as a professional qualification activity that make possible to young, adults and elderly people from poor communities the social inclusion and an opportunity to improve their access to the labor market. The course is part of extension program of Uni-BH, UniTrabalho e Renda, that is offered since 2006. The responsible for the course are professors and students of the Electrical Engineering course, and an electricity project is also offered. This paper presents the results of an evaluation that is made for the students at the beginning and at the end of the course and showed that the concepts had been assimilated by the students and the expectation of them related to the insertion at labor market is also improved.

  17. Classification of heterogeneous electron microscopic projections into homogeneous subsets

    International Nuclear Information System (INIS)

    Herman, G.T.; Kalinowski, M.

    2008-01-01

    The co-existence of different states of a macromolecular complex in samples used by three-dimensional electron microscopy (3D-EM) constitutes a serious challenge. The single particle method applied directly to such heterogeneous sets is unable to provide useful information about the encountered conformational diversity and produces reconstructions with severely reduced resolution. One approach to solving this problem is to partition heterogeneous projection set into homogeneous components and apply existing reconstruction techniques to each of them. Due to the nature of the projection images and the high noise level present in them, this classification task is difficult. A method is presented to achieve the desired classification by using a novel image similarity measure and solving the corresponding optimization problem. Unlike the majority of competing approaches, the presented method employs unsupervised classification (it does not require any prior knowledge about the objects being classified) and does not involve a 3D reconstruction procedure. We demonstrate a fast implementation of this method, capable of classifying projection sets that originate from 3D-EM. The method's performance is evaluated on synthetically generated data sets produced by projecting 3D objects that resemble biological structures

  18. Optimized design for the scattering with angular limitation in projection electron-beam lithography based electron projection system

    International Nuclear Information System (INIS)

    Xiu, K.; Gibson, J. M.

    2000-01-01

    We investigate the design for a scattering with angular limitation in projection electron-beam lithography (SCALPEL) based electron projection system with a demagnification of -4. By a ''field-flip'' process we can construct a doublet in which the magnetic field has a flat feature in most of the optic column but opposite sign at two sides connected by a sharp transition region. Such a theoretical model can give a near zero chromatic aberration of rotation and much smaller field curvature and astigmatism. Compared with the conventional doublet, the total image blur caused by aberrations at 1/√(2) mm off-axis distance and 1.5 mrad semiangle aperture at the mask side is about only 24 nm for a column length of 400 mm. A shorter column, less than the current 400 mm, is also favored for further reducing the total aberration. These guarantee that we can choose a much larger aperture angle (compared with present 0.5 mrad) and beam current density in such a SCALPEL projection system to achieve higher throughput while still maintaining current resolution. A practical issue for possible magnetic lens design is also discussed. (c) 2000 American Vacuum Society

  19. Safety risks associated with the lack of integration and interfacing of hospital health information technologies: a qualitative study of hospital electronic prescribing systems in England.

    Science.gov (United States)

    Cresswell, Kathrin M; Mozaffar, Hajar; Lee, Lisa; Williams, Robin; Sheikh, Aziz

    2017-07-01

    Substantial sums of money are being invested worldwide in health information technology. Realising benefits and mitigating safety risks is however highly dependent on effective integration of information within systems and/or interfacing to allow information exchange across systems. As part of an English programme of research, we explored the social and technical challenges relating to integration and interfacing experienced by early adopter hospitals of standalone and hospital-wide multimodular integrated electronic prescribing (ePrescribing) systems. We collected longitudinal qualitative data from six hospitals, which we conceptualised as case studies. We conducted 173 interviews with users, implementers and software suppliers (at up to three different times), 24 observations of system use and strategic meetings, 17 documents relating to implementation plans, and 2 whole-day expert round-table discussions. Data were thematically analysed initially within and then across cases, drawing on perspectives surrounding information infrastructures. We observed that integration and interfacing problems obstructed effective information transfer in both standalone and multimodular systems, resulting in threats to patient safety emerging from the lack of availability of timely information and duplicate data entry. Interfacing problems were immediately evident in some standalone systems where users had to cope with multiple log-ins, and this did not attenuate over time. Multimodular systems appeared at first sight to obviate such problems. However, with these systems, there was a perceived lack of data coherence across modules resulting in challenges in presenting a comprehensive overview of the patient record, this possibly resulting from the piecemeal implementation of modules with different functionalities. Although it was possible to access data from some primary care systems, we found poor two-way transfer of data between hospitals and primary care necessitating

  20. Problems and Projects Based Approach For Analog Electronic Circuits' Course

    Directory of Open Access Journals (Sweden)

    Vahé Nerguizian

    2009-04-01

    Full Text Available New educational methods and approaches are recently introduced and implemented at several North American and European universities using Problems and Projects Based Approach (PPBA. The PPBA employs a teaching technique based mostly on competences/skills rather than only on knowledge. This method has been implemented and proven by several pedagogical instructors and authors at several educational institutions. This approach is used at different disciplines such as medicine, biology, engineering and many others. It has the advantage to improve the student's skills and the knowledge retention rate, and reflects the 21st century industrial/company needs and demands. Before implementing this approach to a course, a good resources preparation and planning is needed upfront by the responsible or instructor of the course to achieve the course and students related objectives. This paper presents the preparation, the generated documentation and the implementation of a pilot project utilizing PPBA education for a second year undergraduate electronic course over a complete semester, and for two different class groups (morning and evening groups. The outcome of this project (achieved goals, observed difficulties and lessons learned is presented based on different tools such as students 'in class' communication and feedback, different course evaluation forms and the professor/instructor feedback. Resources, challenges, difficulties and recommendations are also assessed and presented. The impact, the effect and the results (during and at the end of the academic fall session of the PPBA on students and instructor are discussed, validated, managed and communicated to help other instructor in taking appropriate approach decisions with respect to this new educational approach compared to the classical one.

  1. Learning from prescribing errors

    OpenAIRE

    Dean, B

    2002-01-01

    

 The importance of learning from medical error has recently received increasing emphasis. This paper focuses on prescribing errors and argues that, while learning from prescribing errors is a laudable goal, there are currently barriers that can prevent this occurring. Learning from errors can take place on an individual level, at a team level, and across an organisation. Barriers to learning from prescribing errors include the non-discovery of many prescribing errors, lack of feedback to th...

  2. Front-end electronics for the Muon Portal project

    Energy Technology Data Exchange (ETDEWEB)

    Garozzo, S.; Marano, D.; Bonanno, G.; Grillo, A.; Romeo, G.; Timpanaro, M.C. [INAF, Osservatorio Astrofisico di Catania, Via S. Sofia 78, I-95123 Catania (Italy); Lo Presti, D.; Riggi, F.; Russo, V.; Bonanno, D.; La Rocca, P.; Longhitano, F.; Bongiovanni, D.G. [Università di Catania, Dipartimento di Fisica e Astronomia, and INFN, Sezione di Catania, Via S. Sofia 64, I-95123 Catania (Italy); Fallica, G.; Valvo, G. [ST-Microelectronics, Stradale V Primosole 50, Catania (Italy)

    2016-10-11

    The Muon Portal Project was born as a joint initiative between Italian research and industrial partners, aimed at the construction of a real-size working detector prototype to inspect the content of traveling containers by means of secondary cosmic-ray muon radiation and recognize potentially dangerous hidden materials. The tomographic image is obtained by reconstructing the incoming and outgoing muon trajectories when crossing the inspected volume, employing two tracker planes located above and below the container under inspection. In this paper, the design and development of the front-end electronics of the Muon Portal detector is presented, with particular emphasis being devoted to the photo-sensor devices detecting the scintillation light and to the read-out circuitry which is in charge of processing and digitizing the analog pulse signals. In addition, the remote control system, mechanical housing, and thermal cooling system of all structural blocks of the Muon Portal tracker are also discussed, demonstrating the effectiveness and functionality of the adopted design.

  3. Inappropriate prescribing in the elderly.

    LENUS (Irish Health Repository)

    Gallagher, P

    2012-02-03

    BACKGROUND AND OBJECTIVE: Drug therapy is necessary to treat acute illness, maintain current health and prevent further decline. However, optimizing drug therapy for older patients is challenging and sometimes, drug therapy can do more harm than good. Drug utilization review tools can highlight instances of potentially inappropriate prescribing to those involved in elderly pharmacotherapy, i.e. doctors, nurses and pharmacists. We aim to provide a review of the literature on potentially inappropriate prescribing in the elderly and also to review the explicit criteria that have been designed to detect potentially inappropriate prescribing in the elderly. METHODS: We performed an electronic search of the PUBMED database for articles published between 1991 and 2006 and a manual search through major journals for articles referenced in those located through PUBMED. Search terms were elderly, inappropriate prescribing, prescriptions, prevalence, Beers criteria, health outcomes and Europe. RESULTS AND DISCUSSION: Prescription of potentially inappropriate medications to older people is highly prevalent in the United States and Europe, ranging from 12% in community-dwelling elderly to 40% in nursing home residents. Inappropriate prescribing is associated with adverse drug events. Limited data exists on health outcomes from use of inappropriate medications. There are no prospective randomized controlled studies that test the tangible clinical benefit to patients of using drug utilization review tools. Existing drug utilization review tools have been designed on the basis of North American and Canadian drug formularies and may not be appropriate for use in European countries because of the differences in national drug formularies and prescribing attitudes. CONCLUSION: Given the high prevalence of inappropriate prescribing despite the widespread use of drug-utilization review tools, prospective randomized controlled trials are necessary to identify useful interventions. Drug

  4. Optimising the quality of antibiotic prescribing in out-of-hours primary care in Belgium: a study protocol for an action research project.

    Science.gov (United States)

    Colliers, Annelies; Coenen, Samuel; Philips, Hilde; Remmen, Roy; Anthierens, Sibyl

    2017-10-15

    Antimicrobial resistance is a major public health threat driven by inappropriate antibiotic use, mainly in general practice and for respiratory tract infections. In Belgium, the quality of general practitioners' (GPs) antibiotic prescribing is low. To improve antibiotic use, we need a better understanding of this quality problem and corresponding interventions. A general practitioners cooperative (GPC) for out-of-hours (OOH) care presents a unique opportunity to reach a large group of GPs and work on quality improvement. Participatory action research (PAR) is a bottom-up approach that focuses on implementing change into daily practice and has the potential to empower practitioners to produce their own solutions to optimise their antibiotic prescribing. This PAR study to improve antibiotic prescribing quality in OOH care uses a mixed methods approach. In a first exploratory phase, we will develop a partnership with a GPC and map the existing barriers and opportunities. In a second phase, we will focus on facilitating change and implementing interventions through PDSA (Plan-Do-Study-Act) cycles. In a third phase, antibiotic prescribing quality outside and antibiotic use during office hours will be evaluated. Equally important are the process evaluation and theory building on improving antibiotic prescribing. The study protocol was approved by the Ethics Committee of the Antwerp University Hospital/University of Antwerp. PAR unfolds in response to the needs and issues of the stakeholders, therefore new ethics approval will be obtained at each new stage of the research. Interventions to improve antibiotic prescribing are needed now more than ever and outcomes will be highly relevant for GPCs, GPs in daily practice, national policymakers and the international scientific community. NCT03082521; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless

  5. Drug Dosing in Patients with Renal Insufficiency in a Hospital Setting using Electronic Prescribing and Automated Reporting of Estimated Glomerular Filtration Rate

    DEFF Research Database (Denmark)

    Nielsen, Anita L.; Henriksen, Daniel Pilsgaard; Marinakis, Christianna

    2014-01-01

    In patients with impaired renal function, drug dose adjustment is often required. Non-adherence to clinical prescribing recommendations may result in severe adverse events. In previous studies, the prevalence rate of non-adherence to recommended dosing has been reported to be 19-67%. Using the cl...... decision support systems should be explored. This article is protected by copyright. All rights reserved....

  6. Project Guardian: Optimizing Electronic Warfare Systems for Ground Combat Vehicles

    National Research Council Canada - National Science Library

    Parks, Jack G; Jackson, William; Revello, James; Soltesz, James

    1995-01-01

    .... The study, Project Guardian, represents a new process for determining the optimum set of sensors and countermeasures for a specific vehicle class under the constraints of threat projection, combat...

  7. Project outline of high quality electron beam generation at Waseda University

    Energy Technology Data Exchange (ETDEWEB)

    Washio, M.; Hama, Y.; Kashiwagi, S.; Kuroda, R.; Kobuki, T. [Waseda Univ., Advanced Research Institute for Science and Engineering, Shinjuku, Tokyo (Japan); Hirose, T. [Tokyo Metropolitan Univ. (Japan). Dept. of Physics

    2000-03-01

    High quality electron beam generation project has been started at Waseda University under the grant of Ministry of Education, named High-Tech Research Center Project. In the project, we will install a laser photo-cathode RF Gun system with 1.6 accelerating structure cells of s-band and a stabilized RF power source. This RF Gun is expected to produce single electron bunch up to 1 or 2nC with around 10ps pulse duration. (author)

  8. Project outline of high quality electron beam generation at Waseda University

    International Nuclear Information System (INIS)

    Washio, M.; Hama, Y.; Kashiwagi, S.; Kuroda, R.; Kobuki, T.; Hirose, T.

    2000-01-01

    High quality electron beam generation project has been started at Waseda University under the grant of Ministry of Education, named High-Tech Research Center Project. In the project, we will install a laser photo-cathode RF Gun system with 1.6 accelerating structure cells of s-band and a stabilized RF power source. This RF Gun is expected to produce single electron bunch up to 1 or 2nC with around 10ps pulse duration. (author)

  9. Developing Web Services for Technology Education. The Graphic Communication Electronic Publishing Project.

    Science.gov (United States)

    Sanders, Mark

    1999-01-01

    Graphic Communication Electronic Publishing Project supports a Web site (http://TechEd.vt.edu/gcc/) for graphic communication teachers and students, providing links to Web materials, conversion of print materials to electronic formats, and electronic products and services including job listings, resume posting service, and a listserv. (SK)

  10. Project-Based Learning in Electronic Technology: A Case Study

    Science.gov (United States)

    Li, Li

    2015-01-01

    A case study of project-based learning (PBL) implemented in Tianjin University of Technology and Education is presented. This multidiscipline project is innovated to meet the novel requirements of industry while keeping its traditional effectiveness in driving students to apply knowledge to practice and problem-solving. The implementation of PBL…

  11. Project objectives and progress at the Research Laboratory of Electronics

    International Nuclear Information System (INIS)

    Allen, J.

    1983-01-01

    Molecule microscopy, semiconductor surface studies, atomic resonance and scattering, reaction dynamics at semiconductor surfaces, X-ray diffuse scattering, phase transitions in chemisorbed systems, optics and quantum electronics, photonics, optical spectroscopy of disordered materials and X-ray scattering from surfaces, infrared nonlinear optics, quantum optics and electronics, microwave and millimeter wave techniques, microwave and quantum magnetics, radio astronomy, electromagnetic wave theory and remote sensing, electronic properties of amorphous silicon dioxide, photon correlation spectroscopy and applications, submicron structures fabrication, plasma dynamics, optical propagation and communication, digital signal processing, speech communication, linguistics, cognitive information processing, custom integrated circuits, communications biophysics, and physiology, are discussed

  12. Cold Electronics for Giant Liquid Argon Time Projection Chambers

    International Nuclear Information System (INIS)

    Radeka, V.; De Geronimo, G.; Chen, H.; Deptuch, G.; Lanni, F.; Li, S.; Nambiar, N.; Rescia, S.; Thorn, C.; Yarema, R.; Yu, B.

    2011-01-01

    The choice between cold and warm electronics (inside or outside the cryostat) in very large LAr TPCs (>5-10 ktons) is not an electronics issue, but it is rather a major cryostat design issue. This is because the location of the signal processing electronics has a direct and far reaching effect on the cryostat design, an indirect effect on the TPC electrode design (sense wire spacing, wire length and drift distance), and a significant effect on the TPC performance. All these factors weigh so overwhelmingly in favor of the cold electronics that it remains an optimal solution for very large TPCs. In this paper signal and noise considerations are summarized, the concept of the readout chain is described, and the guidelines for design of CMOS circuits for operation in liquid argon (at ∼89 K) are discussed.

  13. Outline of FNCA project on application of electron accelerator

    International Nuclear Information System (INIS)

    Kume, Tamikazu

    2005-01-01

    FNCA (Forum for Nuclear Cooperation in Asia) activities in the field of electron accelerator applications are reported. The paper mainly reports on the achievement of the 3rd workshop to discuss status of utilization of electron accelerator for thin films/hydrogel in the FNCA participating countries, China, Indonesia, Japan, Korea, Malaysia, Philippines, Thailand, and Vietnam, held in August, 2003, at Kuala Lumpur. Cross-linking of thin film from sago starch polymer blend using the Cureton (200 keV, 20 mA) and cross-linking of hydrogel for wound dressing and CMC paste-like sheet using the medium energy (3.0 MeV, 30 mA) electron accelerator of MINT (from Malaysia) were successfully demonstrated. Efforts are being made by Vietnam, Thailand and Philippines having no electron accelerator to acquire the machine for R and D and commercial use in the near future. (S. Ohno)

  14. Data acquisition electronics for NESTOR experiment: project and tests

    International Nuclear Information System (INIS)

    Ameli, Fabrizio; Bonori, Maurizio; Bottai, Sergio; Capone, Antonio; Curti, Franco; Desiati, Paolo; De Marchis, Giancarlo; Massa, Fabrizio; Masullo, Rocco; Piccari, Luigi; Vannucci, Italo

    1999-01-01

    The NESTOR detector, at present under construction, is a telescope for high-energy neutrino astronomy. The apparatus, based on Cherenkov light detection, will be deployed in deep sea (about 4000 m) near the S.W. Greek coast. We briefly describe the NESTOR detector, then we describe with more details the electronics for NESTOR data acquisition and transmission. The detector signals are sampled at 200 MHz and all the resulting information are transmitted to the laboratory on 30 km long electro-optical cable. The estimated Mean Time Between Failure of the full electronics system is greater than 20 years. Tests performed on the first prototypes confirm the main characteristics of these electronics: the dynamic range allowed for the signals is bigger than 1000, the pulse shape is reconstructed with an 8 bit ADC accuracy and the resolution in the measurement of the signal 'threshold crossing time' is better than 200 ps

  15. NASA-DoD Lead-Free Electronics Project

    Science.gov (United States)

    Kessel, Kurt

    2011-01-01

    Original Equipment Manufacturers (OEMs). depots. and support contractors have to be prepared to deal with an electronics supply chain thaI increasingly provides parts with lead-free finishes. some labeled no differently and intenningled with their SnPb counterparts. Allowance oflead-free components presents one of the greatest risks to the reliability of military and aerospace electronics. The introduction of components with lead-free lenninations, tennination finishes, or circuit boards presents a host of concerns to customers. suppliers, and maintainers of aerospace and military electronic systems such as: 1. Electrical shorting due to tin whiskers; 2. Incompatibility oflead-free processes and parameters (including higher melting points of lead-free alloys) with other materials in the system; and 3. Unknown material properties and incompatibilities that could reduce solder joint re liability.

  16. The Dismantling Project for the Large Electron Positron (LEP) Collider

    CERN Document Server

    Poole, John

    2002-01-01

    The LEP accelerator was installed in a circular tunnel 27 km in length with nine access points distributed around the circumference in the countryside and villages which surround CERN's sites. The dismantling project involved the removal in less than 15 months of around 29000 tonnes of equipment from the accelerator itself and a further 10000 tonnes from the four experiments - all of which were located at an average depth of 100 m below ground level. There was no contamination risk in the project and less than 3% of the materials removed were classified as radioactive. However, the materials which were classified as radioactive have to be temporarily stored and they consume considerable resources. The major difficulties for the project were in the establishment of the theoretical radiological zoning, implementation of the traceability systems and making appropriate radiation measurements to confirm the zoning. The absence of detailed guidelines from the French authorities, having no threshold levels for relea...

  17. Electronic Learning in the German Science Project "NAWI-Interaktiv"

    Science.gov (United States)

    Wegner, Claas; Homann, Wiebke; Strehlke, Friederike

    2014-01-01

    The German science project "NAWI-Interaktiv" is an example of innovative use of E-Learning and new media education. Since 2009, the learning platform provides learners and teachers with high-quality learning tools, teaching material, useful information and E-learning programs for free. This is to raise the pupils' motivation to learn…

  18. Final report for the Department of Energy funded cooperative agreement ''Electronic Research Demonstration Project'' [University electronic research administration demonstration project

    Energy Technology Data Exchange (ETDEWEB)

    Rodman, John

    1998-07-31

    This is the final report for the Department of Energy (DOE) funded cooperative agreement ''Electronic Research Demonstration Project (DE-FC02-92ER35180)'' for the period August 1994-July 1998. The goal of the project, referred to as NewERA, was to demonstrate the use of open standards for electronic commerce to support research administration, otherwise referred to as Electronic Research Administration (ERA). The NewERA demonstration project provided a means to test interagency standards developed within the Federal Grant Electronic Commerce Committee, a group comprised of federal granting agencies. The NewERA program was initiated by DOE. NewERA was comprised of three separate, but related, ERA activities in preaward administration, postaward administration, and secure Internet commerce. The goal of New ERA was to demonstrate an open standard implementation of ERA using electronic data interchange, e-mail and Internet transaction security between grant applicants and DOE, along with t h e other participating agencies.

  19. Development of an electronic board for a neutrino telescope project

    International Nuclear Information System (INIS)

    Gabrielli, Alessandro; Gandolfi, Enzo; Ricci, Pier Paolo

    2006-01-01

    The NEMO (NEutrino Mediterranean Observatory) collaboration is involved in research and development for the construction of an underwater km 3 scale Cherenkov neutrino detector. The detector will consist of about four thousands of optical modules that interface with coaxial cables to electronics cards. The detector is connected to the shore by an electro-optical cable for data transmission and power supply. The board also provides signal synchronization, filtering, data compression and packing. We describe the details of this electronic control part, which has been developed using commercial components and the very high-speed, Hardware Description Language (VHDL). The design was implemented on a programmable device. A test-bench system was also designed using a PC-based acquisition board running on the National Instrument LabVIEW environment

  20. Opioid Prescribing PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second public service announcement is based on the July 2017 CDC Vital Signs report. Higher opioid prescribing puts patients at risk for addiction and overdose. Learn what can be done about this serious problem.

  1. Learning English through Automotive Electronics (Project LETAE), Final Evaluation Report, 1992-93. OREA Report.

    Science.gov (United States)

    New York City Board of Education, Brooklyn, NY. Office of Research, Evaluation, and Assessment.

    Learning Through Automotive Electronics (Project LETAE) was a federally funded program serving 77 limited-English-proficient (LEP) students and 5 English-proficient students in an automotive computer electronics course in 1992-93, its third year of operation. The program provided instruction in English-as-a-Second-Language (ESL), native language…

  2. Electronic Mentoring of LIS Research Utilizing BITNET: An ACRL Pilot Project.

    Science.gov (United States)

    Gregory, Vicki L.

    1992-01-01

    Describes an ACRL (American College and Research Libraries) project that utilized the electronic conferencing facility of BITNET to provide a system of mentoring for academic librarians conducting research. Results of an electronic mail survey of participants that examined experience levels, attitudes, problems, and communication patterns are…

  3. A Multidisciplinary PBL Robot Control Project in Automation and Electronic Engineering

    Science.gov (United States)

    Hassan, Houcine; Domínguez, Carlos; Martínez, Juan-Miguel; Perles, Angel; Capella, Juan-Vicente; Albaladejo, José

    2015-01-01

    This paper presents a multidisciplinary problem-based learning (PBL) project consisting of the development of a robot arm prototype and the implementation of its control system. The project is carried out as part of Industrial Informatics (II), a compulsory third-year course in the Automation and Electronic Engineering (AEE) degree program at the…

  4. CDIO Projects In DTU’s B.Eng. In Electronics Study Programme

    DEFF Research Database (Denmark)

    Kjærgaard, Claus; Brauer, Peter; Andersen, Jens Christian

    2011-01-01

    the paper is meant as an inspiration to others working on implementing cross disciplinary projects in their curriculum. In the B.Eng. in Electronics programme each of the first 4 semester contains a cross disciplinary project, two of these are CDIO Design Build courses which are placed in the 1st and 4th...

  5. ATLAS 10 GHz electron cyclotron resonance ion source upgrade project

    CERN Document Server

    Moehs, D P; Pardo, R C; Xie, D

    2000-01-01

    A major upgrade of the first ATLAS 10 GHz electron cyclotron resonance (ECR) ion source, which began operations in 1987, is in the planning and procurement phase. The new design will convert the old two-stage source into a single-stage source with an electron donor disk and high gradient magnetic field that preserves radial access for solid material feeds and pumping of the plasma chamber. The new magnetic-field profile allows for the possibility of a second ECR zone at a frequency of 14 GHz. An open hexapole configuration, using a high-energy-product Nd-Fe-B magnet material, having an inner diameter of 8.8 cm and pole gaps of 2.4 cm, has been adopted. Models indicate that the field strengths at the chamber wall, 4 cm in radius, will be 9.3 kG along the magnet poles and 5.6 kG along the pole gaps. The individual magnet bars will be housed in austenitic stainless steel, allowing the magnet housing within the aluminum plasma chamber to be used as a water channel for direct cooling of the magnets. Eight solenoid...

  6. ELECTRON BEAM ION SOURCE PREINJECTOR PROJECT (EBIS) CONCEPTUAL DESIGN REPORT.

    Energy Technology Data Exchange (ETDEWEB)

    ALESSI, J.; BARTON, D.; BEEBE, E.; GASSNER, D.; ET AL.

    2005-02-28

    This report describes a new heavy ion pre-injector for the Relativistic Heavy Ion Collider (RHIC) based on a high charge state Electron Beam Ion Source (EBIS), a Radio Frequency Quadrupole (RFQ) accelerator, and a short Linac. The highly successful development of an EBIS at BNL now makes it possible to replace the present pre-injector that is based on an electrostatic Tandem with a reliable, low maintenance Linac-based pre-injector. Linac-based pre-injectors are presently used at most accelerator and collider facilities with the exception of RHIC, where the required gold beam intensities could only be met with a Tandem until the recent EBIS development. EBIS produces high charge state ions directly, eliminating the need for the two stripping foils presently used with the Tandem. Unstable stripping efficiencies of these foils are a significant source of luminosity degradation in RHIC. The high reliability and flexibility of the new Linac-based pre-injector will lead to increased integrated luminosity at RHIC and is an essential component for the long-term success of the RHIC facility. This new pre-injector, based on an EBIS, also has the potential for significant future intensity increases and can produce heavy ion beams of all species including uranium beams and, as part of a future upgrade, might also be used to produce polarized {sup 3}He beams. These capabilities will be critical to the future luminosity upgrades and electron-ion collisions in RHIC. The new RFQ and Linac that are used to accelerate beams from the EBIS to an energy sufficient for injection into the Booster are both very similar to existing devices already in operation at other facilities. Injection into the Booster will occur at the same location as the existing injection from the Tandem.

  7. A search for supersymmetric electrons with the Mark II detector at PEP [Positron Electron Project

    International Nuclear Information System (INIS)

    LeClaire, B.W.

    1987-10-01

    An experimental search for selectrons, the supersymmetric partner of the electron, has been performed at the PEP storage ring at SLAC using the Mark II detector. The experimental search done was based upon hypothetical reaction in e + e - interactions at PEP center of mass energies of 29 GeV. In this reaction the selectrons, e, are assumed produced by the interaction of one of initial state electrons with a photon radiated from the other initial state electron. This latter electron is assumed to continue down the beam pipe undetected. The photon and electron then produce a selectron and a photino, γ, in the supersymmetric analog of Compton scattering. The photino is assumed to be the lightest supersymmetric particle, and as such, does not interact in the detector, thereby escaping detection very much like a neutrino. The selectron is assumed to immediately decay into an electron and photino. This electron is produced with large p perpendicular with respect to the beam pipe, since it must balance the transverse momentum carried off by the photinos. Thus, the experimental signature of the process is a single electron in the detector with a large unbalanced tranverse momentum. No events of this type were observed in the original search of 123 pb -1 of data, resulting in a cross section limit of less than 2.4 x 10 -2 pb (at the 95% CL) within the detector acceptance. This cross section upper limit applies to any process which produces anomalous single electron events with missing transverse momentum. When interpreted as a supersymmetry search it results in a lower selectron mass limit of 22.2 GeV/c 2 for the case of massless photinos. Limits for non-zero mass photinos have been calculated. 87 refs., 67 figs., 17 tabs

  8. A search for supersymmetric electrons with the Mark II detector at PEP (Positron Electron Project)

    Energy Technology Data Exchange (ETDEWEB)

    LeClaire, B.W.

    1987-10-01

    An experimental search for selectrons, the supersymmetric partner of the electron, has been performed at the PEP storage ring at SLAC using the Mark II detector. The experimental search done was based upon hypothetical reaction in e/sup +/e/sup -/ interactions at PEP center of mass energies of 29 GeV. In this reaction the selectrons, e-tilde, are assumed produced by the interaction of one of initial state electrons with a photon radiated from the other initial state electron. This latter electron is assumed to continue down the beam pipe undetected. The photon and electron then produce a selectron and a photino, ..gamma..-tilde, in the supersymmetric analog of Compton scattering. The photino is assumed to be the lightest supersymmetric particle, and as such, does not interact in the detector, thereby escaping detection very much like a neutrino. The selectron is assumed to immediately decay into an electron and photino. This electron is produced with large p perpendicular with respect to the beam pipe, since it must balance the transverse momentum carried off by the photinos. Thus, the experimental signature of the process is a single electron in the detector with a large unbalanced tranverse momentum. No events of this type were observed in the original search of 123 pb/sup -1/ of data, resulting in a cross section limit of less than 2.4 x 10/sup -2/ pb (at the 95% CL) within the detector acceptance. This cross section upper limit applies to any process which produces anomalous single electron events with missing transverse momentum. When interpreted as a supersymmetry search it results in a lower selectron mass limit of 22.2 GeV/c/sup 2/ for the case of massless photinos. Limits for non-zero mass photinos have been calculated. 87 refs., 67 figs., 17 tabs.

  9. National Skills Standards Development Program: Organization and Operation of Technical Committees To Develop National Skill Standards for Competency in the Electronics Industry. The Third Party Summative Evaluation of the Electronic Industries Foundation Project. Phase I & II. Final Report.

    Science.gov (United States)

    Losh, Charles

    The Electronics Industries Foundation was awarded a project to develop national entry-level standards and a certification system. Ten specialties were included: automotive electronics, avionics, biomedical electronics, business machines, consumer products electronics, general electronics, industrial electronics, instrumentation, microcomputer, and…

  10. ELECTRON BEAM ION SOURCE PREINJECTOR PROJECT (EBIS) CONCEPTUAL DESIGN REPORT.

    Energy Technology Data Exchange (ETDEWEB)

    ALESSI, J.; BARTON, D.; BEEBE, E.; GASSNER, D.; GRANDINETTI, R.; HSEUH, H.; JAVIDFAR, A.; KPONOU, A.; LAMBIASE, R.; LESSARD, E.; LOCKEY, R.; LODESTRO, V.; MAPES, M.; MIRABELLA, D.; NEHRING, T.; OERTER, B.; PENDZICK, A.; PIKIN, A.; RAPARIA, D.; RITTER, J.; ROSER, T.; RUSSO, T.; SNYDSTRUP, L.; WILINSKI, M.; ZALTSMAN, A.; ZHANG, S.

    2005-09-01

    This report describes a new heavy ion pre-injector for the Relativistic Heavy Ion Collider (RHIC) based on a high charge state Electron Beam Ion Source (EBIS), a Radio Frequency Quadrupole (RFQ) accelerator, and a short Linear accelerator (Linac). The highly successful development of an EBIS at Brookhaven National Laboratory (BNL) now makes it possible to replace the present pre-injector that is based on an electrostatic Tandem with a reliable, low maintenance Linac-based pre-injector. Linac-based preinjectors are presently used at most accelerator and collider facilities with the exception of RHIC, where the required gold beam intensities could only be met with a Tandem until the recent EBIS development. EBIS produces high charge state ions directly, eliminating the need for the two stripping foils presently used with the Tandem. Unstable stripping efficiencies of these foils are a significant source of luminosity degradation in RHIC. The high reliability and flexibility of the new Linac-based pre-injector will lead to increased integrated luminosity at RHIC and is an essential component for the long-term success of the RHIC facility. This new pre-injector, based on an EBIS, also has the potential for significant future intensity increases and can produce heavy ion beams of all species including uranium beams and, as part of a future upgrade, might also be used to produce polarized {sup 3}He beams. These capabilities will be critical to the future luminosity upgrades and electron-ion collisions in RHIC. The proposed pre-injector system would also provide for a major enhancement in capability for the NASA Space Radiation Laboratory (NSRL), which utilizes heavy-ion beams from the RHIC complex. EBIS would allow for the acceleration of all important ion species for the NASA radiobiology program, such as, helium, argon, and neon which are unavailable with the present Tandem injector. In addition, the new system would allow for very rapid switching of ion species for

  11. SATURNUS: the UCLA infrared free-electron laser project

    International Nuclear Information System (INIS)

    Dodd, J.W.; Hartman, S.C.; Park, S.; Pellegrini, C.; Rosenzweig, J.B.; Smolin, J.A.; Hairapetian, G.; Kolonko, J.; Barletta, W.A.; Cline, D.B.; Favis, J.G.; Joshi, C.J.; Luhmann, N.C. Jr.; Ivanchenkov, S.N.; Khlebnikov, A.S.; Lachin, Y.Y.; Varfolomeev, A.A.

    1991-01-01

    A compact 20 MeV linac with an RF laser-driven electron gun will be used to drive a high-gain (10cm gain length), 10.6 μm wavelength FEL amplifier, operating in the SASE mode. Saturnus will mainly study FEL physics in the high-gain regime, including start-up from noise, optical guiding, sidebands, saturation, and superradiance, with emphasis on the effects important for future short wavelength operation of FEL's. The hybrid undulator was designed and built at the Kurchatov Inst. of Atomic Energy in the USSR. The primary magnetic flux is provided by C-shaped iron yokes, where between the poles thin blocks of neodymium-iron-boron magnets are placed to provide additional magnetic flux along the undulator axis. The field strength is adjusted by moving the thin Nd-Fe-B blocks on a set screw mount. The initial assembly will have forty periods, each 1.5 cm long. The gap distance between the yoke pole-pieces is fixed at 5 mm. The undulator field has been measured, yielding on an axis peak value of 6.6kGauss, which closely matches computer simulations

  12. Opioid Prescribing PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2017-07-06

    This 60 second public service announcement is based on the July 2017 CDC Vital Signs report. Higher opioid prescribing puts patients at risk for addiction and overdose. Learn what can be done about this serious problem.  Created: 7/6/2017 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/6/2017.

  13. Matrix with Prescribed Eigenvectors

    Science.gov (United States)

    Ahmad, Faiz

    2011-01-01

    It is a routine matter for undergraduates to find eigenvalues and eigenvectors of a given matrix. But the converse problem of finding a matrix with prescribed eigenvalues and eigenvectors is rarely discussed in elementary texts on linear algebra. This problem is related to the "spectral" decomposition of a matrix and has important technical…

  14. Highly Integrated Mixed-Mode Electronics for the readout of Time Projection Chambers

    CERN Document Server

    França Santos, Hugo Miguel; Musa, Luciano

    Time Projection Chambers (TPCs) are one of the most prevalent particle trackers for high-energy physics experiments. Future planed TPCs for the International Linear Collider (ILC) and the Compact Linear Collider (CLIC) entail very high spatial resolution in large gas volumes, but impose low material budget for the end caps of the TPC cylinder. This constraint is not accomplished with the state-of-the-art front-end electronics because of its unsuited relatively large mass and of its associated water cooling system. To reach the required material budget, highly compact and power efficient dedicated TPC front-end electronics should be developed. This project aims at re-designing the different electronic elements with significant improvements in terms of performance, power efficiency and versatility, and developing an integrated circuit that merges all components of the front-end electronics. This chip ambitions a large volume production at low unitary cost and its employment in multiple detectors. The design of ...

  15. Identification of Low Momentum Electrons in The Time Projection Chamber of The ALICE Detector.

    CERN Document Server

    Mwewa, Chilufya

    2013-01-01

    This paper presents results obtained in the study to identify noisy low momentum electrons in the Time Projection Chamber (TPC) of the ALICE detector. To do this, the Circle Hough Transform is employed under the openCV library in python programming. This is tested on simulated tracks in the transverse view of the TPC. It is found that the noisy low momentum electrons can be identified and their exact positions in the transverse plane can be obtained.

  16. The near-infrared free-electron-laser project at Darmstadt

    International Nuclear Information System (INIS)

    Aab, V.; Alrutz-Ziemssen, K.; Genz, H.; Graef, H.D.; Richter, A.; Weise, H.

    1988-07-01

    The superconducting 130 MeV electron accelerator at Darmstadt will be modified for FEL experiments. The FEL project is planned with an electron beam in an energy range from 35 to 50 MeV corresponding to wavelengths from 4.9 to 2.4 μm. The planned FEL setup, a high current injection, the design of a hybrid undulator and the results of simulations of the FEL are presented. (orig.)

  17. First Detection of Low Energy Electron Neutrinos in Liquid Argon Time Projection Chambers

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Corey James [Yale U.

    2016-01-01

    Electron neutrino appearance is the signature channel to address the most pressing questions in neutrino oscillations physics, at both long and short baselines. This includes the search for CP violation in the neutrino sector, which the U.S. flagship neutrino experiment DUNE will address. In addition, the Short Baseline Neutrino Program at Fermilab (MicroBooNE, SBND, ICARUS-T600) searches for new physics, such as sterile neutrinos, through electron neutrino appearance. Liquid argon time projection chambers are the forefront of neutrino detection technology, and the detector of choice for both short and long baseline neutrino oscillation experiments. This work presents the first experimental observation and study of electron neutrinos in the 1-10 GeV range, the essential oscillation energy regime for the above experiments. The systematic uncertainties for an electron neutrino appearance search for the Fermilab Short Baseline Neutrino Program are carefully quantified, and the characterization of separation between electrons and high energy photons is examined.

  18. Changing doctor prescribing behaviour

    DEFF Research Database (Denmark)

    Gill, P.S.; Mäkelä, M.; Vermeulen, K.M.

    1999-01-01

    Collaboration on Effective Professional Practice. This register is kept up to date by searching the following databases for reports of relevant research: DHSS-DATA; EMBASE; MEDLINE; SIGLE; Resource Database in Continuing Medical Education (1975-1994), along with bibliographies of related topics, hand searching......The aim of this overview was to identify interventions that change doctor prescribing behaviour and to derive conclusions for practice and further research. Relevant studies (indicating prescribing as a behaviour change) were located from a database of studies maintained by the Cochrane...... of key journals and personal contact with content area experts. Randomised controlled trials and non-equivalent group designs with pre- and post-intervention measures were included. Outcome measures were those used by the study authors. For each study we determined whether these were positive, negative...

  19. Project on comparison of structural parameters and electron density maps of oxalic acid dihydrate

    NARCIS (Netherlands)

    Coppens, Philip; Dam, J.; Harkema, Sybolt; Feil, D.

    1984-01-01

    Results obtained from four X-ray and five neutron data sets collected under a project sponsored by the Commission on Charge, Spin and Momentum Densities are analyzed by comparison of thermal parameters, positional parameters and X - N electron density maps. Three sets of theoretical calculations are

  20. 77 FR 12312 - Electronic Submission of Nonclinical Study Data; Notice of Pilot Project

    Science.gov (United States)

    2012-02-29

    ...] Electronic Submission of Nonclinical Study Data; Notice of Pilot Project AGENCY: Food and Drug Administration... and Research (CBER) is announcing an invitation to participate in a pilot evaluation program to test.... Participation in the pilot program is open to all sponsors. The pilot program is intended to provide industry...

  1. Vertical and Horizontal Integration of Laboratory Curricula and Course Projects across the Electronic Engineering Technology Program

    Science.gov (United States)

    Zhan, Wei; Goulart, Ana; Morgan, Joseph A.; Porter, Jay R.

    2011-01-01

    This paper discusses the details of the curricular development effort with a focus on the vertical and horizontal integration of laboratory curricula and course projects within the Electronic Engineering Technology (EET) program at Texas A&M University. Both software and hardware aspects are addressed. A common set of software tools are…

  2. Convergence of photonics and electronics for Terahertz wireless communications – the ITN CELTA project

    DEFF Research Database (Denmark)

    Tafur Monroy, Idelfonso

    2016-01-01

    Terahertz wireless communications is expected to offer the required high capacity and low latency performance required from short-range wireless access and control applications. We present an overview of some the activities in this area in the newly started H2020 ITN project CELTA: convergence of...... of electronics and photonics technologies enabling Terahertz applications...

  3. Undergraduate Electronics Projects Based on the Design of an Optical Wireless Audio Transmission System

    Science.gov (United States)

    Oliveira, Luis Bica; Paulino, Nuno; Oliveira, João P.; Santos-Tavares, Rui; Pereira, Nuno; Goes, João

    2017-01-01

    The two projects presented in this paper can be used either as two separate assignments in two different semesters or as a final assignment for undergraduate students of electrical engineering. They have two main objectives: first, to teach basic electronic circuit design concepts and, second, to motivate the students to learn more about analog…

  4. [A high resolution projection electron spectrometers]: Final report 1978-1987

    International Nuclear Information System (INIS)

    1988-01-01

    The main emphasis of the work has been to study inner shell ionization processes. The signatures have been K x-rays or K Auger transitions. We have worked with semiconductor or Bragg x-ray spectrometers. Toward the end of the contract we concentrated on projectile electron spectroscopy. These topics and other atomic physics projects are described briefly in this progress report

  5. First observation of low energy electron neutrinos in a liquid argon time projection chamber

    Energy Technology Data Exchange (ETDEWEB)

    Acciarri, R.; Adams, C.; Asaadi, J.; Baller, B.; Bolton, T.; Bromberg, C.; Cavanna, F.; Church, E.; Edmunds, D.; Ereditato, A.; Farooq, S.; Fitzpatrick, R. S.; Fleming, B.; Hackenburg, A.; Horton-Smith, G.; James, C.; Lang, K.; Luo, X.; Mehdiyev, R.; Page, B.; Palamara, O.; Rebel, B.; Schukraft, A.; Scanavini, G.; Soderberg, M.; Spitz, J.; Szelc, A. M.; Weber, M.; Yang, T.; Zeller, G. P.

    2017-04-06

    Liquid argon time projection chambers (LArTPCs) produce remarkable fidelity in the observation of neutrino interactions. The superior capabilities of such detectors to reconstruct the spatial and calorimetric information of neutrino events have made them the detectors of choice in a number of experiments, specifically those looking to observe electron neutrino ($\

  6. Prescribed burning in the South: trends, purpose, and barriers

    Science.gov (United States)

    Terry K. Haines; Rodney L. Busby; David A. Cleaves

    2001-01-01

    The results of a survey of fire management officials concerning historical and projected prescribed burning activity in the South are reported. Prescribed burning programs on USDA Forest Service and private and State-owned lands are described in terms of area burned by ownership and State, intended resource benefits, barriers to expanded burning, and optimum burning...

  7. Validity of the Prescriber Information in the Danish National Prescription Registry

    DEFF Research Database (Denmark)

    Rasmussen, Lotte; Valentin, Julie; Gesser, Katarina Margareta

    2016-01-01

    The aim of this study was to measure the validity of the prescriber information recorded in the Danish National Prescription Registry (DNPR). The prescriber information recorded in the pharmacies' electronic dispensing system was considered to represent the prescriber information recorded...... in the DNPR. Further, the problem of validity of the prescriber information pertains only to non-electronic prescriptions, as these are manually entered into the dispensing system. The recorded prescriber information was thus validated against information from a total of 2,000 non-electronic prescriptions...... at five Danish community pharmacies. The validity of the recorded prescriber information was measured at the level of the individual prescriber and the prescriber type, respectively. The proportion of non-electronic prescriptions with incorrect registrations was 22.4% (95% Confidence Interval (CI): 20...

  8. Bug tracking and project management system application in an electronic design company

    Directory of Open Access Journals (Sweden)

    Sadık ARSLAN

    2016-05-01

    Full Text Available In this study, commercially available Bug Tracking and Management Information Systems has been investigated in a comprehensive manner. The systems that commonly used described in detail. Bug Tracking and Project Management Systems requirements analysis of medium-sized companies and Kentkart Ege Electronic which is an Information Technology company has been made. Obtained by the analysis requirements, the appropriate tools are selected for system application. JIRA that a product of Atlassian company was determined as a Bug Tracking and Project Management application tool. In this study, JIRA system adapted to the requirements, Bug Tracking and Project Management systems is designed in a structure which can be easily used by R&D employees. Cost-Benefit analysis is done and using this project was determined to be quite useful.

  9. VERTICAL PROJECTION EFFICIENCY OF PIVOT POINTS USING ELECTRONIC TACHEOMETER DURING CONSTRUCTION OF BUILDINGS AND STRUCTURES

    Directory of Open Access Journals (Sweden)

    M. S. Nesterenok

    2014-01-01

    Full Text Available The paper shows that functional limitation of zenith devices and introduction of modern high-accuracy electronic tacheometers should lead to substitution of the mentioned devices for tacheometers in geodesic works concerning vertical projection of pivot points of the constructed buildings and structures. However the electronic tacheometer has not been considered in the function of a zenith device in ТКП 45-1.03-26-2006.Special experiemnts and practical works executed by UE “Geokart” has proved that in accordance with its design the electronic tacheometer equipped with a compensator for small inclinations and zenith prism attachment for ocular can be applied as a vertical projection device while setting sighting line of a telescope in a fixed vertical position. Corresponding experiments have been carried out for multi-storied building of business centre located in the M. Tank Street in Minsk in order to obtain comparative characteristics of vertical projection accuracy with the help of tacheometer TOPCON GPT 7501 and zenith device PZL-100. An initial point of the staked grid has been situated at the elevation ±0,0 м, standard graph elevation has been equal to +49,5 м (concrete slab of the 14th floor, projection height referred to the device has been equal to Н = 47,8 м. Both devices have been set on the same stand using a purpose made adaptive device in order to exclude centering errors. Deviation in position of final projection points on the standard graph which were obtained with the help of two devices has been equal to 1.2 mm, that testifies practical equal accuracy of the zenith device and tacheometer for vertical projection function.Additional advantage of the electronic tacheometer in comparison with special vertical projection devi ces lies in the fact that in the case of a certain misalignment of geodesic openings in intermediate floors ta- cheometer deviating from the vertical makes it possible to carry out initial point

  10. Low-energy electron point projection microscopy of suspended graphene, the ultimate 'microscope slide'

    International Nuclear Information System (INIS)

    Mutus, J Y; Livadaru, L; Urban, R; Salomons, M H; Cloutier, M; Wolkow, R A; Robinson, J T

    2011-01-01

    Point projection microscopy (PPM) is used to image suspended graphene by using low-energy electrons (100-205 eV). Because of the low energies used, the graphene is neither damaged nor contaminated by the electron beam for doses of the order of 10 7 electrons per nm 2 . The transparency of graphene is measured to be 74%, equivalent to electron transmission through a sheet twice as thick as the covalent radius of sp 2 -bonded carbon. Also observed is rippling in the structure of the suspended graphene, with a wavelength of approximately 26 nm. The interference of the electron beam due to diffraction off the edge of a graphene knife edge is observed and is used to calculate a virtual source size of 4.7±0.6 A for the electron emitter. It is demonstrated that graphene can serve as both the anode and the substrate in PPM, thereby avoiding distortions due to strong field gradients around nanoscale objects. Graphene can be used to image objects suspended on the sheet using PPM and, in the future, electron holography.

  11. Teaching Power Electronics with a Design-Oriented, Project-Based Learning Method at the Technical University of Denmark

    Science.gov (United States)

    Zhang, Zhe; Hansen, Claus Thorp; Andersen, Michael A. E.

    2016-01-01

    Power electronics is a fast-developing technology within the electrical engineering field. This paper presents the results and experiences gained from applying design-oriented project-based learning to switch-mode power supply design in a power electronics course at the Technical University of Denmark (DTU). Project-based learning (PBL) is known…

  12. Characterization techniques for nano-electronics, with emphasis to electron microscopy. The role of the European Project ANNA

    Science.gov (United States)

    Armigliato, A.

    2008-07-01

    , however, European laboratories with high-level expertise in materials characterization still operate in a largely independent way; this adversely affects the competitivity of European science and industry at the international level. For this reason the European Commission has started an Integrated Infrastructure Initiative (I3) in the sixth Framework Programme (now continuing in FP7) and funded a project called ANNA (2006-2010). This acronym stands for European Integrated Activity of Excellence and Networking for Nano and Micro- Electronics Analysis. The consortium includes 12 partners from 7 European countries and is coordinated by the Fondazione B.Kessler (FBK) in Trento (Italy); CNR-IMM is one of the 12 partners. Aim of ANNA is the onset of strong, long-term collaboration among the partners, so to form an integrated multi-site analytical facility, able to offer to the European community a wide variety of top-level analytical expertise and services in the field of micro- and nano-electronics. They include X-ray diffraction and scattering, SIMS, electron microscopy, medium-energy ion scattering, optical and electrical techniques. The project will be focused on three main activities: Networking (standardization of samples and methodologies, establishment of accredited reference laboratories), Transnational Access to laboratories located in the partners' premises to perform specific analytical experiments (an example is given by the two STEM methodologies discussed above) and Joint Research activity, which is targeted at the improvement and extension of the methodologies through a continuous instrumental and technical development. It is planned that the European joint analytical laboratory will continue its activity beyond the end of the project in 2010.

  13. The TAPin electronic libraries project and the experience at the University of Birmingham

    Directory of Open Access Journals (Sweden)

    Tracy K. Mulvaney

    1997-01-01

    Full Text Available The TAPin Project and its implementation at the University of Birmingham is described. Local issues and key features of a hybrid approach to Networked Learner Support are addressed. The methods of NLS adopted included electronic mail and the Internet. The key role in NLS played by subject librarians is stressed. Transfer of skills to learners by means of targeted individual training and a web guide is discussed.

  14. Development of functional requirements for electronic health communication: preliminary results from the ELIN project.

    Science.gov (United States)

    Christensen, Tom; Grimsmo, Anders

    2005-01-01

    User participation is important for developing a functional requirements specification for electronic communication. General practitioners and practising specialists, however, often work in small practices without the resources to develop and present their requirements. It was necessary to find a method that could engage practising doctors in order to promote their needs related to electronic communication. Qualitative research methods were used, starting a process to develop and study documents and collect data from meetings in project groups. Triangulation was used, in that the participants were organised into a panel of experts, a user group, a supplier group and an editorial committee. The panel of experts created a list of functional requirements for electronic communication in health care, consisting of 197 requirements, in addition to 67 requirements selected from an existing Norwegian standard for electronic patient records (EPRs). Elimination of paper copies sent in parallel with electronic messages, optimal workflow, a common electronic 'envelope' with directory services for units and end-users, and defined requirements for content with the possibility of decision support were the most important requirements. The results indicate that we have found a method of developing functional requirements which provides valid results both for practising doctors and for suppliers of EPR systems.

  15. Social determinants of prescribed and non-prescribed medicine use

    Directory of Open Access Journals (Sweden)

    García-Altés Anna

    2010-05-01

    Full Text Available Abstract Background The aim of the present study was to describe the use of prescribed and non prescribed medicines in a non-institutionalised population older than 15 years of an urban area during the year 2000, in terms of age and gender, social class, employment status and type of Primary Health Care. Methods Cross-sectional study. Information came from the 2000 Barcelona Health Interview Survey. The indicators used were the prevalence of use of prescribed and non-prescribed medicines in the two weeks prior to the interview. Descriptive analyses, bivariate and multivariate logistic regression analyses were carried out. Results More women than men took medicines (75.8% vs. 60% respectively. The prevalence of use of prescribed medicines increased with age while the prevalence of non-prescribed use decreased. These age differences are smaller among those with poor perceived health. In terms of social class, a higher percentage of men with good health in the more advantaged classes took non-prescribed medicines compared with disadvantaged classes (38.7% vs 31.8%. In contrast, among the group with poor health, more people from the more advantaged classes took prescribed medicines, compared with disadvantaged classes (51.4% vs 33.3%. A higher proportion of people who were either retired, unemployed or students, with good health, used prescribed medicines. Conclusion This study shows that beside health needs, there are social determinants affecting medicine consumption in the city of Barcelona.

  16. e-Learning initiatives to support prescribing.

    Science.gov (United States)

    Maxwell, Simon; Mucklow, John

    2012-10-01

    Preparing medical students to prescribe is a major challenge of undergraduate education. They must develop an understanding of clinical pharmacology and acquire knowledge about drugs and therapeutics, as well as the skills to prescribe for individual patients in the face of multiple variables. The task of delivering the learning required to achieve these attributes relies upon limited numbers of teachers, who have increasingly busy clinical commitments. There is evidence that training is currently insufficient to meet the demands of the workplace. e-Learning provides an opportunity to improve the learning experience. The advantages for teachers are improved distribution of learning content, ease of update, standardization and tracking of learner activities. The advantages for learners are ease of access, greater interactivity and individual choice concerning the pace and mix of learning. Important disadvantages are the considerable resource required to develop e-Learning projects and difficulties in simulating some aspects of the real world prescribing experience. Pre-requisites for developing an e-Learning programme to support prescribing include academic expertise, institutional support, learning technology services and an effective virtual learning environment. e-Learning content might range from complex interactive learning sessions through to static web pages with links. It is now possible to simulate and provide feedback on prescribing decisions and this will improve with advances in virtual reality. Other content might include a student formulary, self-assessment exercises (e.g. calculations), a glossary and an on-line library. There is some evidence for the effectiveness of e-Learning but better research is required into its potential impact on prescribing. © 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

  17. e-Learning initiatives to support prescribing

    Science.gov (United States)

    Maxwell, Simon; Mucklow, John

    2012-01-01

    Preparing medical students to prescribe is a major challenge of undergraduate education. They must develop an understanding of clinical pharmacology and acquire knowledge about drugs and therapeutics, as well as the skills to prescribe for individual patients in the face of multiple variables. The task of delivering the learning required to achieve these attributes relies upon limited numbers of teachers, who have increasingly busy clinical commitments. There is evidence that training is currently insufficient to meet the demands of the workplace. e-Learning provides an opportunity to improve the learning experience. The advantages for teachers are improved distribution of learning content, ease of update, standardization and tracking of learner activities. The advantages for learners are ease of access, greater interactivity and individual choice concerning the pace and mix of learning. Important disadvantages are the considerable resource required to develop e-Learning projects and difficulties in simulating some aspects of the real world prescribing experience. Pre-requisites for developing an e-Learning programme to support prescribing include academic expertise, institutional support, learning technology services and an effective virtual learning environment. e-Learning content might range from complex interactive learning sessions through to static web pages with links. It is now possible to simulate and provide feedback on prescribing decisions and this will improve with advances in virtual reality. Other content might include a student formulary, self-assessment exercises (e.g. calculations), a glossary and an on-line library. There is some evidence for the effectiveness of e-Learning but better research is required into its potential impact on prescribing. PMID:22509885

  18. Radiation and temperature effects on electronic components investigated under the CSTI high capacity power project

    International Nuclear Information System (INIS)

    Schwarze, G.E.; Niedra, J.M.; Frasca, A.J.; Wieserman, W.R.

    1993-01-01

    The effects of nuclear radiation and high temperature environments must be fully known and understood for the electronic components and materials used in both the Power Conditioning and Control subsystem and the reactor Instrumentation and Control subsystem of future high capacity nuclear space power systems. This knowledge is required by the designer of these subsystems in order to develop highly reliable, long-life power systems for future NASA missions. A review and summary of the experimental results obtained for the electronic components and materials investigated under the power management element of the CSTI high capacity power project will be presented in this paper: (1) Neutron, gamma ray, and temperature effects on power semiconductor switches, (2) Temperature and frequency effects on soft magnetic materials; and (3) Temperature effects on rare-earth permanent magnets

  19. Radiation and temperature effects on electronic components investigated under the CSTI High Capacity Power Project

    International Nuclear Information System (INIS)

    Shwarze, G.E.; Wieserman, W.R.

    1994-01-01

    The effects of nuclear radiation and high temperature environments must be fully known and understood for the electronic components and materials used in both the Power Conditioning and Control subsystem and the reactor Instrumentation and Control subsystem of future high capacity nuclear space power systems. This knowledge is required by the designer of these subsystems in order to develop highly reliable, long-life power systems for future NASA missions. A review and summary of the experimental results obtained for the electronic components and materials investigated under the power management element of the CSTI high capacity power project will be presented in this paper: (1) Neutron, gamma ray, and temperature effects on power semiconductor switches, (2) Temperature and frequency effects on soft magnetic materials; and (3) Temperature effects on rare earth permanent magnets

  20. Modelling and Simulation of National Electronic Product Code Network Demonstrator Project

    Science.gov (United States)

    Mo, John P. T.

    The National Electronic Product Code (EPC) Network Demonstrator Project (NDP) was the first large scale consumer goods track and trace investigation in the world using full EPC protocol system for applying RFID technology in supply chains. The NDP demonstrated the methods of sharing information securely using EPC Network, providing authentication to interacting parties, and enhancing the ability to track and trace movement of goods within the entire supply chain involving transactions among multiple enterprise. Due to project constraints, the actual run of the NDP was 3 months only and was unable to consolidate with quantitative results. This paper discusses the modelling and simulation of activities in the NDP in a discrete event simulation environment and provides an estimation of the potential benefits that can be derived from the NDP if it was continued for one whole year.

  1. The European X-ray Free Electron Laser Project at DESY

    CERN Document Server

    Schwarz, Andreas

    2004-01-01

    On February 5, 2003, the German Federal Ministry of Education and Research decided that the X-ray free-electron laser XFEL, proposed by the International TESLA Collaboration, should be realized as a European project and located at DESY/Hamburg. The ministry also announced that in view of the locational advantage, Germany is prepared to cover half of the investment and personnel costs for the XFEL. In the course of the last year work has concentrated on the following areas: setting up of an organizational structure at DESY for the preparation of the project, discussions with potential European partners on several levels, selection of a new site for the XFEL facility and the preparation of the 'plan approval procedure'. The present status of the technical layout of the Linear Accelerator, the SASE Undulator and Photon Beamlines and the experiment stations will be presented.

  2. Development of a time projection chamber using gas electron multipliers (GEM-TPC)

    International Nuclear Information System (INIS)

    Oda, S.X.; Hamagaki, H.; Ozawa, K.; Inuzuka, M.; Sakaguchi, T.; Isobe, T.; Gunji, T.; Morino, Y.; Saito, S.; Yamaguchi, Y.L.; Sawada, S.; Yokkaichi, S.

    2006-01-01

    We developed a prototype time projection chamber using gas electron multipliers (GEM-TPC) for high energy heavy ion collision experiments. To investigate its performance, we conducted a beam test with three kinds of gases (Ar(90%)-CH 4 (10%), Ar(70%)-C 2 H 6 (30%) and CF 4 ). Detection efficiency of 99%, and spatial resolution of 79μm in the pad-row direction and 313μm in the drift direction were achieved. The test results show that the GEM-TPC meets the requirements for high energy heavy ion collision experiments. The configuration and performance of the GEM-TPC are described

  3. Data description and quality assessment of ionospheric electron density profiles for ARPA modeling project. Technical report

    International Nuclear Information System (INIS)

    Conkright, R.O.

    1977-03-01

    This report presents a description of the automated method used to produce electron density (N(h)) profiles from ionograms recorded on 35mm film and an assessment of the resulting data base. A large data base of about 30,000 profiles was required for an ionospheric modeling project. This motivated a search for an automated method of producing profiles. The automated method used is fully described, the resulting data are given a quality grade, and the noon and midnight profiles are presented. Selected portions of this data base are compared with profiles produced by the standard profiling method in use by the Environmental Data Service at Boulder, Colorado

  4. 5 MeV 300 kW electron accelerator project

    International Nuclear Information System (INIS)

    Auslender, V.L.; Cheskidov, V.G.; Gornakov, I.V.

    2004-01-01

    The paper presents a project of a high power linear accelerator for industrial applications. The accelerator has a modular structure and consists of the chain of accelerating cavities connected by the axis-located coupling cavities with coupling slots in the common walls. Main parameters of the accelerator are: operating frequency of 176 MHz, electron energy of up to 5 MeV, average beam power of 300 kW. The required RF pulse power can be supplied by the TH628 diacrode

  5. ePORT, NASA's Computer Database Program for System Safety Risk Management Oversight (Electronic Project Online Risk Tool)

    Science.gov (United States)

    Johnson, Paul W.

    2008-01-01

    ePORT (electronic Project Online Risk Tool) provides a systematic approach to using an electronic database program to manage a program/project risk management processes. This presentation will briefly cover the standard risk management procedures, then thoroughly cover NASA's Risk Management tool called ePORT. This electronic Project Online Risk Tool (ePORT) is a web-based risk management program that provides a common framework to capture and manage risks, independent of a programs/projects size and budget. It is used to thoroughly cover the risk management paradigm providing standardized evaluation criterion for common management reporting, ePORT improves Product Line, Center and Corporate Management insight, simplifies program/project manager reporting, and maintains an archive of data for historical reference.

  6. Femtosecond few- to single-electron point-projection microscopy for nanoscale dynamic imaging

    Directory of Open Access Journals (Sweden)

    A. R. Bainbridge

    2016-03-01

    Full Text Available Femtosecond electron microscopy produces real-space images of matter in a series of ultrafast snapshots. Pulses of electrons self-disperse under space-charge broadening, so without compression, the ideal operation mode is a single electron per pulse. Here, we demonstrate femtosecond single-electron point projection microscopy (fs-ePPM in a laser-pump fs-e-probe configuration. The electrons have an energy of only 150 eV and take tens of picoseconds to propagate to the object under study. Nonetheless, we achieve a temporal resolution with a standard deviation of 114 fs (equivalent to a full-width at half-maximum of 269 ± 40 fs combined with a spatial resolution of 100 nm, applied to a localized region of charge at the apex of a nanoscale metal tip induced by 30 fs 800 nm laser pulses at 50 kHz. These observations demonstrate real-space imaging of reversible processes, such as tracking charge distributions, is feasible whilst maintaining femtosecond resolution. Our findings could find application as a characterization method, which, depending on geometry, could resolve tens of femtoseconds and tens of nanometres. Dynamically imaging electric and magnetic fields and charge distributions on sub-micron length scales opens new avenues of ultrafast dynamics. Furthermore, through the use of active compression, such pulses are an ideal seed for few-femtosecond to attosecond imaging applications which will access sub-optical cycle processes in nanoplasmonics.

  7. Projection-reduction method applied to deriving non-linear optical conductivity for an electron-impurity system

    Directory of Open Access Journals (Sweden)

    Nam Lyong Kang

    2013-07-01

    Full Text Available The projection-reduction method introduced by the present authors is known to give a validated theory for optical transitions in the systems of electrons interacting with phonons. In this work, using this method, we derive the linear and first order nonlinear optical conductivites for an electron-impurity system and examine whether the expressions faithfully satisfy the quantum mechanical philosophy, in the same way as for the electron-phonon systems. The result shows that the Fermi distribution function for electrons, energy denominators, and electron-impurity coupling factors are contained properly in organized manners along with absorption of photons for each electron transition process in the final expressions. Furthermore, the result is shown to be represented properly by schematic diagrams, as in the formulation of electron-phonon interaction. Therefore, in conclusion, we claim that this method can be applied in modeling optical transitions of electrons interacting with both impurities and phonons.

  8. Project based education as motivation factor in undergraduate program in Electronics at Copenhagen University College of Engineering

    DEFF Research Database (Denmark)

    Friesel, Anna

    2012-01-01

    This paper summarizes the contents of our experience with project based courses and team work in the undergraduate program in Electronics. The main points of our program are described in this paper, where the leading idea is to combine theory with practical engineering projects. Our students work...

  9. Prescribing the behavior of early terminating GMRES and Arnoldi iterations

    Czech Academy of Sciences Publication Activity Database

    Duintjer Tebbens, Jurjen; Meurant, G.

    2014-01-01

    Roč. 65, č. 1 (2014), s. 69-90 ISSN 1017-1398 R&D Projects: GA AV ČR IAA100300802 Grant - others:GA AV ČR(CZ) M100301201 Institutional research plan: CEZ:AV0Z10300504 Keywords : Arnoldi process * early termination * GMRES method * prescribed GMRES convergence * Arnoldi method * prescribed Ritz values Subject RIV: BA - General Mathematics Impact factor: 1.417, year: 2014

  10. NASA-DoD Lead-Free Electronics Project. DRAFT Joint Test Report

    Science.gov (United States)

    Kessel, Kurt

    2011-01-01

    . The longer the transition period, the greater the likelihood of Pb-free parts inadvertently being mixed with Pb parts and ending up on what are supposed to be Pb systems. As a result, OEMs, depots, and support contractors need to take action now to either abate the influx of Pb-free parts, or accept it and deal with the likely interim consequences of reduced reliability due to a wide variety of matters, such as Pb contamination, high temperature incompatibility, and tin whiskering. Allowance of Pb-free components produces one of the greatest risks to the reliability of a weapon system. This is due to new and poorly understood failure mechanisms, as well as unknown long-term reliability. If the decision is made to consciously allow Pb-free solder and component finishes into SnPb electronics, additional effort (and cost) will be required to make the significant number of changes to drawings and task order procedures. This project is a follow-on effort to the Joint Council on Aging Aircraft/Joint Group on Pollution Prevention (JCAA/JG-PP) Pb-free Solder Project which was the first group to test the reliability of Pb-free solder joints against the requirements of the aerospace and military community.

  11. Prescribed burning: a topical issue

    Directory of Open Access Journals (Sweden)

    Bovio G

    2013-11-01

    Full Text Available Prescribed burning is a promising technique for the prevention of forest fires in Italy. The research deepened several ecological and operative aspects. However, legal issues need to be thoroughly investigated.

  12. Safe prescribing: a titanic challenge.

    Science.gov (United States)

    Routledge, Philip A

    2012-10-01

    The challenge to achieve safe prescribing merits the adjective 'titanic'. The organisational and human errors leading to poor prescribing (e.g. underprescribing, overprescribing, misprescribing or medication errors) have parallels in the organisational and human errors that led to the loss of the Titanic 100 years ago this year. Prescribing can be adversely affected by communication failures, critical conditions, complacency, corner cutting, callowness and a lack of courage of conviction, all of which were also factors leading to the Titanic tragedy. These issues need to be addressed by a commitment to excellence, the final component of the 'Seven C's'. Optimal prescribing is dependent upon close communication and collaborative working between highly trained health professionals, whose role is to ensure maximum clinical effectiveness, whilst also protecting their patients from avoidable harm. Since humans are prone to error, and the environments in which they work are imperfect, it is not surprising that medication errors are common, occurring more often during the prescribing stage than during dispensing or administration. A commitment to excellence in prescribing includes a continued focus on lifelong learning (including interprofessional learning) in pharmacology and therapeutics. This should be accompanied by improvements in the clinical working environment of prescribers, and the encouragement of a strong safety culture (including reporting of adverse incidents as well as suspected adverse drug reactions whenever appropriate). Finally, members of the clinical team must be prepared to challenge each other, when necessary, to ensure that prescribing combines the highest likelihood of benefit with the lowest potential for harm. © 2012 The Author. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

  13. Safe prescribing: a titanic challenge

    Science.gov (United States)

    Routledge, Philip A

    2012-01-01

    The challenge to achieve safe prescribing merits the adjective ‘titanic’. The organisational and human errors leading to poor prescribing (e.g. underprescribing, overprescribing, misprescribing or medication errors) have parallels in the organisational and human errors that led to the loss of the Titanic 100 years ago this year. Prescribing can be adversely affected by communication failures, critical conditions, complacency, corner cutting, callowness and a lack of courage of conviction, all of which were also factors leading to the Titanic tragedy. These issues need to be addressed by a commitment to excellence, the final component of the ‘Seven C's’. Optimal prescribing is dependent upon close communication and collaborative working between highly trained health professionals, whose role is to ensure maximum clinical effectiveness, whilst also protecting their patients from avoidable harm. Since humans are prone to error, and the environments in which they work are imperfect, it is not surprising that medication errors are common, occurring more often during the prescribing stage than during dispensing or administration. A commitment to excellence in prescribing includes a continued focus on lifelong learning (including interprofessional learning) in pharmacology and therapeutics. This should be accompanied by improvements in the clinical working environment of prescribers, and the encouragement of a strong safety culture (including reporting of adverse incidents as well as suspected adverse drug reactions whenever appropriate). Finally, members of the clinical team must be prepared to challenge each other, when necessary, to ensure that prescribing combines the highest likelihood of benefit with the lowest potential for harm. PMID:22738396

  14. An electron tomography algorithm for reconstructing 3D morphology using surface tangents of projected scattering interfaces

    Science.gov (United States)

    Petersen, T. C.; Ringer, S. P.

    2010-03-01

    Upon discerning the mere shape of an imaged object, as portrayed by projected perimeters, the full three-dimensional scattering density may not be of particular interest. In this situation considerable simplifications to the reconstruction problem are possible, allowing calculations based upon geometric principles. Here we describe and provide an algorithm which reconstructs the three-dimensional morphology of specimens from tilt series of images for application to electron tomography. Our algorithm uses a differential approach to infer the intersection of projected tangent lines with surfaces which define boundaries between regions of different scattering densities within and around the perimeters of specimens. Details of the algorithm implementation are given and explained using reconstruction calculations from simulations, which are built into the code. An experimental application of the algorithm to a nano-sized Aluminium tip is also presented to demonstrate practical analysis for a real specimen. Program summaryProgram title: STOMO version 1.0 Catalogue identifier: AEFS_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEFS_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.: 2988 No. of bytes in distributed program, including test data, etc.: 191 605 Distribution format: tar.gz Programming language: C/C++ Computer: PC Operating system: Windows XP RAM: Depends upon the size of experimental data as input, ranging from 200 Mb to 1.5 Gb Supplementary material: Sample output files, for the test run provided, are available. Classification: 7.4, 14 External routines: Dev-C++ ( http://www.bloodshed.net/devcpp.html) Nature of problem: Electron tomography of specimens for which conventional back projection may fail and/or data for which there is a limited angular

  15. Introduction to prescribed fires in Southern ecosystems

    Science.gov (United States)

    Thomas A. Waldrop; Scott L. Goodrick

    2012-01-01

    This publication is a guide for resource managers on planning and executing prescribed burns in Southern forests and grasslands. It includes explanations of reasons for prescribed burning, environmental effects, weather, and techniques as well as general information on prescribed burning.

  16. Positron--electron storage ring project: Stanford Linear Accelerator Center, Stanford, California. Final environmental statement

    International Nuclear Information System (INIS)

    1976-08-01

    A final environmental statement is given which was prepared in compliance with the National Environmental Policy Act to support the Energy Research and Development Administration project to design and construct the positron-electron colliding beam storage ring (PEP) facilities at the Stanford Linear Accelerator Center (SLAC). The PEP storage ring will be constructed underground adjacent to the existing two-mile long SLAC particle accelerator to utilize its beam. The ring will be about 700 meters in diameter, buried at depths of 20 to 100 feet, and located at the eastern extremity of the SLAC site. Positron and electron beams will collide in the storage ring to provide higher energies and hence higher particle velocities than have been heretofore achieved. Some of the energy from the collisions is transformed back into matter and produces a variety of particles of immense interest to physicists. The environmental impacts during the estimated two and one-half years construction period will consist of movement of an estimated 320,000 cubic yards of earth and the creation of some rubble, refuse, and dust and noise which will be kept to a practical minimum through planned construction procedures. The terrain will be restored to very nearly its original conditions. Normal operation of the storage ring facility will not produce significant adverse environmental effects different from operation of the existing facilities and the addition of one water cooling tower. No overall increase in SLAC staff is anticipated for operation of the facility. Alternatives to the proposed project that were considered include: termination, postponement, other locations and construction of a conventional high energy accelerator

  17. The pharmacist as prescriber: a discourse analysis of newspaper media in Canada.

    Science.gov (United States)

    Schindel, Theresa J; Given, Lisa M

    2013-01-01

    Legislation to expand the scope of practice for pharmacists to include authority to independently prescribe medications in Alberta, Canada was announced in 2006 and enacted in April 2007. To date, very little research has explored public views of pharmacist prescribing. This study analyzes newspaper media coverage of pharmacist prescribing 1 year before and 2 years after prescribing was implemented. News items related to pharmacist prescribing were retrieved from 2 national, Canadian newspapers and 5 local newspapers in Alberta over a 3-year period after the announcement of pharmacist prescribing. A purposive sample of 66 texts including news items, editorials, and letters were retrieved electronically from 2 databases, Newscan and Canadian Newsstand. This study uses social positioning theory as a lens for analyzing the discourse of pharmacist prescribing. The results demonstrate a binary positioning of the debate on pharmacist prescribing rights. Using social positioning theory as a lens for analysis, the results illustrate self- and other-positioning of pharmacists' expected roles as prescribers. Themes related to the discourse on pharmacist prescribing include qualifications, diagnosis, patient safety, physician support, and conflict of interest. Media representations of pharmacist prescribing point to polarized views that may serve to shape public, pharmacist, physician, and others' opinions of the issue. Multiple and contradictory views of pharmacist prescribing coexist. Pharmacists and pharmacy organizations are challenged to bring clarity and consistency about pharmacist prescribing to better serve the public interest in understanding options for health care services. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. REBL: design progress toward 16 nm half-pitch maskless projection electron beam lithography

    Science.gov (United States)

    McCord, Mark A.; Petric, Paul; Ummethala, Upendra; Carroll, Allen; Kojima, Shinichi; Grella, Luca; Shriyan, Sameet; Rettner, Charles T.; Bevis, Chris F.

    2012-03-01

    REBL (Reflective Electron Beam Lithography) is a novel concept for high speed maskless projection electron beam lithography. Originally targeting 45 nm HP (half pitch) under a DARPA funded contract, we are now working on optimizing the optics and architecture for the commercial silicon integrated circuit fabrication market at the equivalent of 16 nm HP. The shift to smaller features requires innovation in most major subsystems of the tool, including optics, stage, and metrology. We also require better simulation and understanding of the exposure process. In order to meet blur requirements for 16 nm lithography, we are both shrinking the pixel size and reducing the beam current. Throughput will be maintained by increasing the number of columns as well as other design optimizations. In consequence, the maximum stage speed required to meet wafer throughput targets at 16 nm will be much less than originally planned for at 45 nm. As a result, we are changing the stage architecture from a rotary design to a linear design that can still meet the throughput requirements but with more conventional technology that entails less technical risk. The linear concept also allows for simplifications in the datapath, primarily from being able to reuse pattern data across dies and columns. Finally, we are now able to demonstrate working dynamic pattern generator (DPG) chips, CMOS chips with microfabricated lenslets on top to prevent crosstalk between pixels.

  19. Quantum Monte Carlo algorithms for electronic structure at the petascale; the endstation project.

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J; Ceperley, D M; Purwanto, W; Walter, E J; Krakauer, H; Zhang, S W; Kent, P.R. C; Hennig, R G; Umrigar, C; Bajdich, M; Kolorenc, J; Mitas, L

    2008-10-01

    Over the past two decades, continuum quantum Monte Carlo (QMC) has proved to be an invaluable tool for predicting of the properties of matter from fundamental principles. By solving the Schrodinger equation through a stochastic projection, it achieves the greatest accuracy and reliability of methods available for physical systems containing more than a few quantum particles. QMC enjoys scaling favorable to quantum chemical methods, with a computational effort which grows with the second or third power of system size. This accuracy and scalability has enabled scientific discovery across a broad spectrum of disciplines. The current methods perform very efficiently at the terascale. The quantum Monte Carlo Endstation project is a collaborative effort among researchers in the field to develop a new generation of algorithms, and their efficient implementations, which will take advantage of the upcoming petaflop architectures. Some aspects of these developments are discussed here. These tools will expand the accuracy, efficiency and range of QMC applicability and enable us to tackle challenges which are currently out of reach. The methods will be applied to several important problems including electronic and structural properties of water, transition metal oxides, nanosystems and ultracold atoms.

  20. The State of Open Source Electronic Health Record Projects: A Software Anthropology Study.

    Science.gov (United States)

    Alsaffar, Mona; Yellowlees, Peter; Odor, Alberto; Hogarth, Michael

    2017-02-24

    Electronic health records (EHR) are a key tool in managing and storing patients' information. Currently, there are over 50 open source EHR systems available. Functionality and usability are important factors for determining the success of any system. These factors are often a direct reflection of the domain knowledge and developers' motivations. However, few published studies have focused on the characteristics of free and open source software (F/OSS) EHR systems and none to date have discussed the motivation, knowledge background, and demographic characteristics of the developers involved in open source EHR projects. This study analyzed the characteristics of prevailing F/OSS EHR systems and aimed to provide an understanding of the motivation, knowledge background, and characteristics of the developers. This study identified F/OSS EHR projects on SourceForge and other websites from May to July 2014. Projects were classified and characterized by license type, downloads, programming languages, spoken languages, project age, development status, supporting materials, top downloads by country, and whether they were "certified" EHRs. Health care F/OSS developers were also surveyed using an online survey. At the time of the assessment, we uncovered 54 open source EHR projects, but only four of them had been successfully certified under the Office of the National Coordinator for Health Information Technology (ONC Health IT) Certification Program. In the majority of cases, the open source EHR software was downloaded by users in the United States (64.07%, 148,666/232,034), underscoring that there is a significant interest in EHR open source applications in the United States. A survey of EHR open source developers was conducted and a total of 103 developers responded to the online questionnaire. The majority of EHR F/OSS developers (65.3%, 66/101) are participating in F/OSS projects as part of a paid activity and only 25.7% (26/101) of EHR F/OSS developers are, or have been

  1. A study of antibiotic prescribing

    DEFF Research Database (Denmark)

    Jaruseviciene, L.; Radzeviciene-Jurgute, R.; Jurgutis, A.

    2012-01-01

    Background. Globally, general practitioners (GPs) write more than 90% of all antibiotic prescriptions. This study examines the experiences of Lithuanian and Russian GPs in antibiotic prescription for upper respiratory tract infections, including their perceptions of when it is not indicated...... clinically or pharmacologically. Methods. 22 Lithuanian and 29 Russian GPs participated in five focus group discussions. Thematic analysis was used to analyse the data. Results. We identified four main thematic categories: patients' faith in antibiotics as medication for upper respiratory tract infections......; patient potential to influence a GP's decision to prescribe antibiotics for upper respiratory tract infections; impediments perceived by GPs in advocating clinically grounded antibiotic prescribing with their patients, and strategies applied in physician-patient negotiation about antibiotic prescribing...

  2. ELECTORAL PRESCRIBERS. WHO ARE THEY?

    Directory of Open Access Journals (Sweden)

    Constantin SASU

    2016-12-01

    Full Text Available The decision to vote and choosing among the candidates is an extremely important one with repercussions on everyday life by determining, in global mode, its quality for the whole society. Therefore the whole process by which the voter decides becomes a central concern. Prescribers, supposed to have a big influence on the electoral market, are a component of the microenvironment political organizations. These are people who occupy important positions that can influence the behavior of others. In the political environment, prescribers are known under the name of "opinion formers", "opinion leaders", "mediators" (Beciu, 2009 or "influencers" (Keller and Berry, 2003 Weimann, 1994. This paper aims to review the central opinions on what is the influence prescribers, opinion makers on voting behavior, voting and decisions on whether and how they act?

  3. To prescribe codeine or not to prescribe codeine?

    Science.gov (United States)

    Fleming, Marc L; Wanat, Matthew A

    2014-09-01

    A recently published study in Pediatrics by Kaiser et al. (2014; Epub April 21, DOI: 10.1542/peds.2013-3171) reported that on average, over the past decade, children aged 3 to 17 were prescribed approximately 700,000 prescriptions for codeine-containing products each year in association with emergency department (ED) visits. Although, guidelines from the American Academy of Pediatrics issued warnings in 1997 and reaffirmed their concerns regarding the safety and effectiveness of codeine in 2006, it is still often prescribed for pain and cough associated with upper respiratory infection. With the impending rescheduling of hydrocodone combination products to Schedule II, physicians and mid-level prescribers may be compelled to prescribe codeine-containing products (e.g., with acetaminophen) due to reduced administrative burden and limits on Schedule II prescriptive authority for nurse practitioners and physician assistants in some states. This commentary expounds on the safety and effectiveness concerns of codeine, with a primary focus on patients in the ED setting.

  4. Psychologists' right to prescribe – should prescribing privileges be ...

    African Journals Online (AJOL)

    Current changes in legislation regarding prescription rights increase the possibility of non-medical practitioners being authorised to presctibe medication. There has been ongoing debate about granting psychologists in South Africa a limited right to prescribe (RTP) psychotropic medication. The main reasons advanced for ...

  5. Development of magnets for infra-red-free electron laser project at RRCAT

    International Nuclear Information System (INIS)

    Ruwali, Kailash; Thakur, Vanshree; Das, S.; Biswas, Bhaskar; Singh, Kushraj; Amalraj, William; Sreeramulu, K.; Mishra, Anil Kumar; Shinde, R.S.

    2015-01-01

    This paper describes the design and development of the magnets for the beam transport line of Infra- red- Free Electron Laser (IR-FEL) project at RRCAT. All the magnets have been developed and fiducialized after magnetic characterization for installation in the tunnel. These magnets include three dipole magnets, twelve quadrupole magnets and twenty two steering magnets for bending, focussing and steering of 15 to 35 MeV electron beam through a dog-leg type beam line. The dipole magnet is designed as H type for a maximum magnetic field of 0.25 tesla with pole gap and bending angle of 42 mm and 22.5° respectively. The dipole magnet is quite thin (effective length ∼200 mm) therefore entry-exit ends were chamfered to achieve the integrated field uniformity of < 1 x 10 -3 within the good field zone. The quadrupole magnet is designed for maximum integrated strength of 2.5 T/m. The poles are wider than the coil to enhance the good field region and made detachable type. The pole profile is chosen as pure hyperbola with extension. Quadrupole magnets with two different sizes of apertures (aperture diameters of 60 mm and 40 mm) were developed. The steering magnet is designed for kick strength of 12 mrad at 25 MeV. Out of 22 steering magnets, 8 are vertical steering, 6 are horizontal steering and 8 combined function steering magnets. Magnetic measurements of dipole magnets were carried out in 3 axes Hall probe bench. Quadrupole and steering magnets were characterized in a rotating coil based harmonic measurement bench. The details of the design and magnetic measurements of these magnets with results will be discussed in this paper. (author)

  6. Fast three-material modeling with triple arch projection for electronic cleansing in CTC.

    Science.gov (United States)

    Lee, Hyunna; Lee, Jeongjin; Kim, Bohyoung; Kim, Se Hyung; Shin, Yeong-Gil

    2014-07-01

    In this paper, we propose a fast three-material modeling for electronic cleansing (EC) in computed tomographic colonography. Using a triple arch projection, our three-material modeling provides a very quick estimate of the three-material fractions to remove ridge-shaped artifacts at the T-junctions where air, soft-tissue (ST), and tagged residues (TRs) meet simultaneously. In our approach, colonic components including air, TR, the layer between air and TR, the layer between ST and TR (L(ST/TR)), and the T-junction are first segmented. Subsequently, the material fraction of ST for each voxel in L(ST/TR) and the T-junction is determined. Two-material fractions of the voxels in L(ST/TR) are derived based on a two-material transition model. On the other hand, three-material fractions of the voxels in the T-junction are estimated based on our fast three-material modeling with triple arch projection. Finally, the CT density value of each voxel is updated based on our fold-preserving reconstruction model. Experimental results using ten clinical datasets demonstrate that the proposed three-material modeling successfully removed the T-junction artifacts and clearly reconstructed the whole colon surface while preserving the submerged folds well. Furthermore, compared with the previous three-material transition model, the proposed three-material modeling resulted in about a five-fold increase in speed with the better preservation of submerged folds and the similar level of cleansing quality in T-junction regions.

  7. Prescribed burning for understory restoration

    Science.gov (United States)

    Kenneth W. Outcalt

    2006-01-01

    Because the longleaf ecosystem evolved with and is adapted to frequent fire, every 2 to 8 years, prescribed burning is often useful for restoring understory communities to a diverse ground layer of grasses, herbs, and small shrubs. This restoration provides habitat for a number of plant and animal species that are restricted to or found mostly in longleaf pine...

  8. c-Axis projected electron-positron momentum density in YBa2Cu3O7

    International Nuclear Information System (INIS)

    Bansil, A.; Smedskjaer, L.C.

    1990-11-01

    The authors present the theoretical c-axis projected electron-positron momentum density N 2γ (P x ,p y ) in YBa 2 Cu 3 O 7 based on the local density approximation (LDA) framework along various lines in momentum space. The calculations use the Korringa-Kohn-Rostoker (KKR) band structure formalism. The anisotropic distribution defined by taking cuts through the calculated spectra along different lines in the (p x ,p y ) plane possesses complex structures which arise from both Fermi surface effects and the anisotropy of the smoothly varying underlying background from filled bands; the maximum size of the anisotropy is about 10% of N 2γ (0,0). The theoretically predicted N 2γ (p x , y ) distribution is compared with the measured 2D-ACAR spectrum. The considerations suggest that in interpreting the 2D-ACAR data on YBa 2 Cu 3 O 7 in terms of a band theory LDA picture, a substantial, largely isotropic, background should be subtracted from both the 2D-ACAR's and the associated LCW-folded spectra

  9. Lessons learned from positron-electron project low level rf and longitudinal feedback

    Directory of Open Access Journals (Sweden)

    J. Fox

    2010-05-01

    Full Text Available The Positron-Electron Project II (PEP-II B Factory collider ended the final phase of operation at nearly twice the design current and 4X the design luminosity. In the ultimate operation state, eight 1.2 MW radio-frequency (rf klystrons and 12 accelerating cavities were added beyond the original implementation, and the two storage rings were operating with longitudinal instability growth rates roughly 5X in excess of the original design estimates. From initial commissioning there has been continual adaptation of the low level rf (LLRF control strategies, configuration tools, and some new hardware in response to unanticipated technical challenges. This paper offers a perspective on the original LLRF and longitudinal instability control design, and highlights via two examples the system evolution from the original design estimates through to the final machine with 1.2×10^{34} luminosity. The impact of unanticipated signals in the coupled-bunch longitudinal feedback and the significance of nonlinear processing elements in the LLRF systems are presented. We present valuable “lessons learned” which are of interest to designers of next generation feedback and impedance controlled LLRF systems.

  10. Variations in Metformin Prescribing for Type 2 Diabetes.

    Science.gov (United States)

    Goldberg, Tiffany; Kroehl, Miranda E; Suddarth, Kathleen Heist; Trinkley, Katy E

    2015-01-01

    Reasons for suboptimal metformin prescribing are unclear, but may be due to perceived risk of lactic acidosis. The purpose of this study is to describe provider attitudes regarding metformin prescribing in various patient situations. An anonymous, electronic survey was distributed electronically to 76 health care providers across the nation. The 14-item survey contained demographic questions and questions related to prescribing of metformin for T2DM in various patient situations, including suboptimal glycemic control, alcohol use, history of lactic acidosis, and varying degrees of severity for certain health conditions, including renal and hepatic dysfunction, chronic obstructive pulmonary disease, and heart failure. There were a total of 100 respondents. For suboptimal glycemic control, most providers (75%) would increase metformin from 1500 to 2000 mg daily; however, 25% would add an alternate agent, such as a sulfonylurea (18%) or dipeptidyl peptidase-4 inhibitor (7%). Although 51% of providers would stop metformin based on serum creatinine thresholds, the remainder would rely on glomerular filtration rate thresholds of <60 mL/min (15%), <30 mL/min (33%), or <15 mL/min (1%) to determine when to stop metformin. For heart failure, 45% of providers would continue metformin as currently prescribed regardless of severity. Most providers would adjust metformin for varying severity of hepatic dysfunction (74%) and alcohol abuse (40%). Despite evidence supporting the cardiovascular benefits of metformin, provider attitudes toward prescribing metformin are suboptimal in certain patient situations and vary greatly by provider. © Copyright 2015 by the American Board of Family Medicine.

  11. Can we influence prescribing patterns?

    Science.gov (United States)

    Sbarbaro, J A

    2001-09-15

    A variety of programming techniques and methods of training have been employed to change physician behavior. Didactic continuing medical education lectures and clinical guidelines have had minimal impact, although endorsement of national professional guidelines by local opinion leaders appears to have a positive influence on the impact of professional guidelines. Interactive, hands-on workshops, performance reporting, and peer/patient feedback are also effective. Changing prescribing habits has been equally difficult. Drug utilization letters involving both pharmacist and physician have more impact than do letters sent only to the physician. Academic detailing, when properly executed, has been consistently effective. When combined with these strategies, closed formularies become a powerful tool in changing prescribing behavior.

  12. Research project AUS-10370/CF: electron impact ionization and surface induced reactions of edge plasma constituents

    International Nuclear Information System (INIS)

    Maerk, T.D.

    1999-01-01

    In order to better understand elementary reactions which are taking place at the plasma edge of thermonuclear fusion devices, three areas of research were persuaded: I) Experimental studies about electron ionization of neutrals and ions and electron attachment to molecules, II) Theoretical studies about electron ionisation of neutrals and ions and III) Reactive interaction of molecular ions with surfaces

  13. Which prosthetic foot to prescribe?

    OpenAIRE

    De Asha, AR; Barnett, CT; Struchkov, V; Buckley, JG

    2017-01-01

    Introduction: \\ud Clinicians typically use findings from cohort studies to objectively inform judgements regarding the potential (dis)advantages of prescribing a new prosthetic device. However, before finalising prescription a clinician will typically ask a patient to 'try out' a change of prosthetic device while the patient is at the clinic. Observed differences in gait when using the new device should be the result of the device’s mechanical function, but could also conceivably be due to pa...

  14. Prescribing patterns in premenstrual syndrome

    Directory of Open Access Journals (Sweden)

    Jones Paul W

    2002-06-01

    Full Text Available Abstract Background Over 300 therapies have been proposed for premenstrual syndrome. To date there has been only one survey conducted in the UK of PMS treatments prescribed by GPs, a questionnaire-based study by the National Association of Premenstrual Syndrome in 1989. Since then, selective serotonin re-uptake inhibitors have been licensed for severe PMS/PMDD, and governmental recommendations to reduce the dosage of vitamin B6 (the first choice over-the-counter treatment for many women with PMS have been made. This study investigates the annual rates of diagnoses and prescribing patterns for premenstrual syndrome (1993–1998 within a computerised general practitioner database. Methods Retrospective survey of prescribing data for premenstrual syndrome between 1993–1998 using the General Practice Research Database for the West Midlands Region which contains information on 282,600 female patients Results Overall the proportion of women with a prescription-linked diagnosis of premenstrual syndrome has halved over the five years. Progestogens including progesterone were the most commonly recorded treatment for premenstrual syndrome during the whole study period accounting for over 40% of all prescriptions. Selective serotonin-reuptake inhibitors accounted for only 2% of the prescriptions in 1993 but rose to over 16% by 1998, becoming the second most commonly recorded treatment. Vitamin B6 accounted for 22% of the prescriptions in 1993 but dropped markedly between 1997 and 1998 to 11%. Conclusions This study shows a yearly decrease in the number of prescriptions linked to diagnoses for premenstrual syndrome. Progestogens including progesterone, is the most widely prescribed treatment for premenstrual syndrome despite the lack of evidence demonstrating their efficacy.

  15. Project of the electron linear accelerator on the biperiodical accelerating structure with deep energy retuning in a pulse mode

    International Nuclear Information System (INIS)

    Bogdanovich, B.Yu.; Zavadtsev, D.A.; Kaminskij, V.I.; Sobenin, N.P.; Fadin, A.I.; Zavadtsev, A.A.

    2001-01-01

    The schemes of the electron linear accelerator (ELA), realized on the basis of a biperiodical accelerating structure and ensuring the possibility of deep retuning of the beam energy in a pulse mode, are considered. Advantages and shortcomings of the proposed methods of pulse regulation of the electron energy are discussed. A project of a two-section ELA with two levels of energy (10 and 4 MeV) is presented as a base version. The beam dynamics is calculated for two versions of the ELA. Their main parameters are given [ru

  16. Medicare Provider Data - Part D Prescriber

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Part D Prescriber Public Use File (PUF) provides information on prescription drugs prescribed by individual physicians and other health care providers and paid...

  17. Dutch Travel Health Nurses: Prepared to Prescribe?

    NARCIS (Netherlands)

    Overbosch, Femke W.; Koeman, Susan C.; van den Hoek, Anneke; Sonder, Gerard J. B.

    2012-01-01

    Background. In travel medicine, as in other specialties, independent prescribing of medication has traditionally been the domain of practitioners like physicians, dentists, and midwives. However, a 2011 ruling in the Netherlands expands independent prescribing and introduces supplementary

  18. The quality of outpatient antimicrobial prescribing

    DEFF Research Database (Denmark)

    Malo, Sara; Bjerrum, Lars; Feja, Cristina

    2013-01-01

    The aim of the study was to analyse and compare the quality of outpatient antimicrobial prescribing in Denmark and Aragón (in northeastern Spain), with the objective of assessing inappropriate prescribing....

  19. Factors influencing the development of primary care data collection projects from electronic health records: a systematic review of the literature.

    Science.gov (United States)

    Gentil, Marie-Line; Cuggia, Marc; Fiquet, Laure; Hagenbourger, Camille; Le Berre, Thomas; Banâtre, Agnès; Renault, Eric; Bouzille, Guillaume; Chapron, Anthony

    2017-09-25

    Primary care data gathered from Electronic Health Records are of the utmost interest considering the essential role of general practitioners (GPs) as coordinators of patient care. These data represent the synthesis of the patient history and also give a comprehensive picture of the population health status. Nevertheless, discrepancies between countries exist concerning routine data collection projects. Therefore, we wanted to identify elements that influence the development and durability of such projects. A systematic review was conducted using the PubMed database to identify worldwide current primary care data collection projects. The gray literature was also searched via official project websites and their contact person was emailed to obtain information on the project managers. Data were retrieved from the included studies using a standardized form, screening four aspects: projects features, technological infrastructure, GPs' roles, data collection network organization. The literature search allowed identifying 36 routine data collection networks, mostly in English-speaking countries: CPRD and THIN in the United Kingdom, the Veterans Health Administration project in the United States, EMRALD and CPCSSN in Canada. These projects had in common the use of technical facilities that range from extraction tools to comprehensive computing platforms. Moreover, GPs initiated the extraction process and benefited from incentives for their participation. Finally, analysis of the literature data highlighted that governmental services, academic institutions, including departments of general practice, and software companies, are pivotal for the promotion and durability of primary care data collection projects. Solid technical facilities and strong academic and governmental support are required for promoting and supporting long-term and wide-range primary care data collection projects.

  20. Contraceptive Provision to Adolescent Females Prescribed Teratogenic Medications.

    Science.gov (United States)

    Stancil, Stephani L; Miller, Melissa; Briggs, Holley; Lynch, Daryl; Goggin, Kathy; Kearns, Gregory

    2016-01-01

    Rates of adult women receiving contraceptive provision when simultaneously prescribed a known teratogen are alarmingly low. The prevalence of this behavior among pediatric providers and their adolescent patients is unknown. The objective of this study was to describe pediatric provider behaviors for prescribing teratogens concurrently with counseling, referral, and/or prescribing of contraception (collectively called contraceptive provision) in the adolescent population. A retrospective review was conducted examining visits in 2008-2012 by adolescents aged 14 to 25 years in which a known teratogen (US Food and Drug Administration pregnancy risk category D or X) was prescribed. The electronic medical records were queried for demographic information, evidence of contraceptive provision, and menstrual and sexual histories. The data were analyzed using standard statistical methods. Within 4172 clinic visits, 1694 females received 4506 prescriptions for teratogenic medications. The most commonly prescribed teratogens were topiramate, methotrexate, diazepam, isotretinoin, and enalapril. The subspecialties prescribing teratogens most frequently were neurology, hematology-oncology, and dermatology. Overall, contraceptive provision was documented in 28.6% of the visits. Whites versus nonwhites and older versus younger girls were more likely to receive contraceptive provision. The presence of a federal risk mitigation system for the teratogen also increased the likelihood of contraceptive provision. Our data demonstrate female adolescents prescribed teratogens receive inadequate contraception provision, which could increase their risk for negative pregnancy outcomes. Although the presence of a federal risk mitigation system appears to improve contraceptive provision, these systems are costly and, in some instances, difficult to implement. Efforts to improve provider practices are needed. Copyright © 2016 by the American Academy of Pediatrics.

  1. Inappropriate prescribing: criteria, detection and prevention.

    LENUS (Irish Health Repository)

    O'Connor, Marie N

    2012-06-01

    Inappropriate prescribing is highly prevalent in older people and is a major healthcare concern because of its association with negative healthcare outcomes including adverse drug events, related morbidity and hospitalization. With changing population demographics resulting in increasing proportions of older people worldwide, improving the quality and safety of prescribing in older people poses a global challenge. To date a number of different strategies have been used to identify potentially inappropriate prescribing in older people. Over the last two decades, a number of criteria have been published to assist prescribers in detecting inappropriate prescribing, the majority of which have been explicit sets of criteria, though some are implicit. The majority of these prescribing indicators pertain to overprescribing and misprescribing, with only a minority focussing on the underprescribing of indicated medicines. Additional interventions to optimize prescribing in older people include comprehensive geriatric assessment, clinical pharmacist review, and education of prescribers as well as computerized prescribing with clinical decision support systems. In this review, we describe the inappropriate prescribing detection tools or criteria most frequently cited in the literature and examine their role in preventing inappropriate prescribing and other related healthcare outcomes. We also discuss other measures commonly used in the detection and prevention of inappropriate prescribing in older people and the evidence supporting their use and their application in everyday clinical practice.

  2. Sum rules and other properties involving resonance projection operators. [for optical potential description of electron scattering from atoms and ions

    Science.gov (United States)

    Berk, A.; Temkin, A.

    1985-01-01

    A sum rule is derived for the auxiliary eigenvalues of an equation whose eigenspectrum pertains to projection operators which describe electron scattering from multielectron atoms and ions. The sum rule's right-hand side depends on an integral involving the target system eigenfunctions. The sum rule is checked for several approximations of the two-electron target. It is shown that target functions which have a unit eigenvalue in their auxiliary eigenspectrum do not give rise to well-defined projection operators except through a limiting process. For Hylleraas target approximations, the auxiliary equations are shown to contain an infinite spectrum. However, using a Rayleigh-Ritz variational principle, it is shown that a comparatively simple aproximation can exhaust the sum rule to better than five significant figures. The auxiliary Hylleraas equation is greatly simplified by conversion to a square root equation containing the same eigenfunction spectrum and from which the required eigenvalues are trivially recovered by squaring.

  3. CeB6 electron gun for the soft X-ray FEL project at SPring-8

    International Nuclear Information System (INIS)

    Togawa, K.; Baba, H.; Onoe, K.; Inagaki, T.; Shintake, T.; Matsumoto, H.

    2004-01-01

    A pulsed high-voltage electron gun with a thermionic cathode is under development for the injector system of the soft X-ray FEL project at SPring-8 (SCSS project). A CeB 6 single crystal of 3 mm diameter was chosen as a thermionic cathode because of its excellent emission properties, i.e., high resistance against contamination, uniform emission density and smooth surface. The CeB 6 cathode can produce a 3 A beam with 2 μs FWHM. A gun voltage of -500 kV was chosen as a compromise between the need for controlling emittance growth and minimizing the risks of high-voltage arcing. We have constructed a 500 kV electron gun test stand and have begun performance tests. This paper describes the basic design and the current status of the hardware R and D on the CeB 6 gun

  4. Teaching Power Electronics with a Design-Oriented and Project-Based Learning Method at the Technical University of Denmark

    DEFF Research Database (Denmark)

    Zhang, Zhe; Hansen, Claus Thorp; Andersen, Michael A. E.

    2016-01-01

    Power electronics is a fast developing technology within the electrical engineering field. This paper presents the results and experiences gained from DesignOriented Project Based Learning of switch-mode power supply design within a power electronics course at the Technical University of Denmark...... (DTU). Project-based learning (PBL) is known to be a motivating and problem-centered teaching method that not only places students at the core of the teaching and learning activities but also gives students the ability to transfer their acquired scientific knowledge into industrial practices. Students...... are asked to choose a specification from different power converter applications such as a fuel cell power conditioning converter, a light-emitting diode (LED) driver or a battery charger. Based upon their choice, the students select topology, design magnetic components, calculate input/output filters...

  5. Factors influencing the development of primary care data collection projects from electronic health records: a systematic review of the literature

    OpenAIRE

    Gentil, Marie-Line; Cuggia, Marc; Fiquet, Laure; Hagenbourger, Camille; Le Berre, Thomas; Banâtre, Agnès; Renault, Eric; Bouzille, Guillaume; Chapron, Anthony

    2017-01-01

    Background Primary care data gathered from Electronic Health Records are of the utmost interest considering the essential role of general practitioners (GPs) as coordinators of patient care. These data represent the synthesis of the patient history and also give a comprehensive picture of the population health status. Nevertheless, discrepancies between countries exist concerning routine data collection projects. Therefore, we wanted to identify elements that influence the development and dur...

  6. Addressing Electronic Communications System Learning through a Radar-Based Active Learning Project

    Science.gov (United States)

    Hernandez-Jayo, Unai; López-Garde, Juan-Manuel; Rodríguez-Seco, J. Emilio

    2015-01-01

    In the Master's of Telecommunication Engineering program at the University of Deusto, Spain, courses in communication circuit design, electronic instrumentation, advanced systems for signal processing and radiocommunication systems allow students to acquire concepts crucial to the fields of electronics and communication. During the educational…

  7. Dynamical fragmentation and very high speed projection of micro-particulates with a pulsed electrons generator

    International Nuclear Information System (INIS)

    Cassany, B.; Courchinoux, R.; Bertron, I.; Malaise, F.; Hebert, D.

    2003-01-01

    This paper shows how to use a pulsed electrons beam to simulate the dynamical fragmentation of copper sheets and to eject diamond, tantalum and tungsten micro-particulates at very high speed (∼1000 m/s). These experiments were performed with the electrons generator CESAR of CEA/CESTA (France). (J.S.)

  8. Information Technology in project-organized electronic and computer technology engineering education

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Mølgaard; Nielsen, Jens Frederik Dalsgaard

    1999-01-01

    This paper describes the integration of IT in the education of electronic and computer technology engineers at Institute of Electronic Systems, Aalborg Uni-versity, Denmark. At the Institute Information Technology is an important tool in the aspects of the education as well as for communication...

  9. REXEBIS the Electron Beam Ion Source for the REX-ISOLDE project

    CERN Document Server

    Wenander, F; Liljeby, L; Nyman, G H

    1998-01-01

    The REXEBIS is an Electron Beam Ion Source (EBIS) developed especially to trap and further ionise the sometimes rare and short-lived isotopes that are produced in the ISOLDE separator for the Radioactive beam EXperiment at ISOLDE (REX-ISOLDE). By promoting the single-charged ions to a high charge-state the ions are more efficiently accelerated in the following linear accelerator. The EBIS uses an electron gun capable of producing a 0.5 A electron beam. The electron gun is immersed in a magnetic field of 0.2 T, and the electron beam is compressed to a current density of >200 A/cm2 inside a 2 T superconducting solenoid. The EBIS is situated on a high voltage (HV) platform with an initial electric potential of 60 kV allowing cooled and bunched 60 keV ions extracted from a Penning trap to be captured. After a period of confinement in the electron beam (<20 ms), the single-charged ions have been ionised to a charge-to-mass ratio of approximately ¼. During this confinement period, the platform potential is decr...

  10. Multi-scale transport in the DIII-D ITER baseline scenario with direct electron heating and projection to ITER

    Science.gov (United States)

    Grierson, B. A.; Staebler, G. M.; Solomon, W. M.; McKee, G. R.; Holland, C.; Austin, M.; Marinoni, A.; Schmitz, L.; Pinsker, R. I.; DIII-D Team

    2018-02-01

    Multi-scale fluctuations measured by turbulence diagnostics spanning long and short wavelength spatial scales impact energy confinement and the scale-lengths of plasma kinetic profiles in the DIII-D ITER baseline scenario with direct electron heating. Contrasting discharge phases with ECH + neutral beam injection (NBI) and NBI only at similar rotation reveal higher energy confinement and lower fluctuations when only NBI heating is used. Modeling of the core transport with TGYRO using the TGLF turbulent transport model and NEO neoclassical transport reproduces the experimental profile changes upon application of direct electron heating and indicates that multi-scale transport mechanisms are responsible for changes in the temperature and density profiles. Intermediate and high-k fluctuations appear responsible for the enhanced electron thermal flux, and intermediate-k electron modes produce an inward particle pinch that increases the inverse density scale length. Projection to ITER is performed with TGLF and indicates a density profile that has a finite scale length due to intermediate-k electron modes at low collisionality and increases the fusion gain. For a range of E × B shear, the dominant mechanism that increases fusion performance is suppression of outward low-k particle flux and increased density peaking.

  11. Inappropriate prescribing in geriatric patients.

    LENUS (Irish Health Repository)

    Barry, Patrick J

    2012-02-03

    Inappropriate prescribing in older people is a common condition associated with significant morbidity, mortality, and financial costs. Medication use increases with age, and this, in conjunction with an increasing disease burden, is associated with adverse drug reactions. This review outlines why older people are more likely to develop adverse drug reactions and how common the problem is. The use of different tools to identify and measure the problem is reviewed. Common syndromes seen in older adults (eg, falling, cognitive impairment, sleep disturbance) are considered, and recent evidence in relation to medication use for these conditions is reviewed. Finally, we present a brief summary of significant developments in the recent literature for those caring for older people.

  12. A Power Electronic and Drives Curriculum with Project-oriented and Problem-based Learning: A Dynamic Teaching Approach for the Future

    DEFF Research Database (Denmark)

    Blaabjerg, Frede

    2002-01-01

    extra study time. This paper present a teaching approach which makes it possible very fast for the student to get in-depth skills in this important area which is the problem-oriented and project-based learning. The trend and application of power electronics are illustrated. The necessary skills...... for power electronic engineers are outlined followed up by a discussion on how problem-oriented and project-based learning are implemented. A complete curriculum at Aalborg University is presented where different power electronics related projects at different study levels are carried out....

  13. Projectables

    DEFF Research Database (Denmark)

    Rasmussen, Troels A.; Merritt, Timothy R.

    2017-01-01

    CNC cutting machines have become essential tools for designers and architects enabling rapid prototyping, model-building and production of high quality components. Designers often cut from new materials, discarding the irregularly shaped remains. We introduce ProjecTables, a visual augmented...... reality system for interactive packing of model parts onto sheet materials. ProjecTables enables designers to (re)use scrap materials for CNC cutting that would have been previously thrown away, at the same time supporting aesthetic choices related to wood grain, avoiding surface blemishes, and other...... relevant material properties. We conducted evaluations of ProjecTables with design students from Aarhus School of Architecture, demonstrating that participants could quickly and easily place and orient model parts reducing material waste. Contextual interviews and ideation sessions led to a deeper...

  14. PubChemQC Project: A Large-Scale First-Principles Electronic Structure Database for Data-Driven Chemistry.

    Science.gov (United States)

    Nakata, Maho; Shimazaki, Tomomi

    2017-06-26

    Large-scale molecular databases play an essential role in the investigation of various subjects such as the development of organic materials, in silico drug design, and data-driven studies with machine learning. We have developed a large-scale quantum chemistry database based on first-principles methods. Our database currently contains the ground-state electronic structures of 3 million molecules based on density functional theory (DFT) at the B3LYP/6-31G* level, and we successively calculated 10 low-lying excited states of over 2 million molecules via time-dependent DFT with the B3LYP functional and the 6-31+G* basis set. To select the molecules calculated in our project, we referred to the PubChem Project, which was used as the source of the molecular structures in short strings using the InChI and SMILES representations. Accordingly, we have named our quantum chemistry database project "PubChemQC" ( http://pubchemqc.riken.jp/ ) and placed it in the public domain. In this paper, we show the fundamental features of the PubChemQC database and discuss the techniques used to construct the data set for large-scale quantum chemistry calculations. We also present a machine learning approach to predict the electronic structure of molecules as an example to demonstrate the suitability of the large-scale quantum chemistry database.

  15. Recycler Electron Cooling Project: Mechanical vibrations in the Pelletron and their effect on the beam

    International Nuclear Information System (INIS)

    Kazakevich, Grigory M.; Burov, A.; Boffo, C.; Joireman, P.; Saewert, G.; Schmidt, C.W.; Shemyakin, A.; Fermilab

    2005-01-01

    The Fermilab's Recycler ring will employ an electron cooler to cool stored 8.9 GeV antiprotons [1]. The cooler is based on an electrostatic accelerator, Pelletron [2], working in an energy-recovery regime. A full-scale prototype of the cooler has been assembled and commissioned in a separate building [3]. The main goal of the experiments with the prototype was to demonstrate stable operation with a 3.5 MeV, 0.5 A DC electron beam while preserving a high beam quality in the cooling section. The quality is characterized, first of all, by a spread of electron velocities in the cooling section, which may be significantly affected by mechanical vibration of the Pelletron elements. This paper describes the results of vibration measurements in the Pelletron terminal and correlates them with the beam motion in the cooling section

  16. Philips high tension generator (x-ray machine) testing for baby ebm (electron beam machine) project

    International Nuclear Information System (INIS)

    Norman Awalludin; Leo Kwee Wah; Abu Bakar Mhd Ghazali

    2005-01-01

    This paper describes the test of the HT system (from X-ray machine) for usage of the mini EBM (Electron Beam Machine). It consists the procedures of the installation, the safety procedures when deals with HT, modification of the system for testing purpose and the technique/method for testing the HT system. As a result, the voltage for the HT system and the electron gun (filament) current can be measured. Based on the results, suitability of the machine for baby EBM could be confirmed. (Author)

  17. Probing sea quarks and gluons: the electron-ion collider project

    International Nuclear Information System (INIS)

    Horn, T.

    2014-01-01

    A future Electron-Ion Collider (EIC) would be the world's first polarized electron-proton collider, and the world's first e-A collider, and would seek the QCD foundation of nucleons and nuclei in terms of the sea quarks and gluons, matching to these valence quark studies. The EIC will provide a versatile range of kinematics and beam polarization, as well as beam species, to allow for mapping the spin and spatial structure of the quark sea and gluons, to discover the collective effects of gluons in atomic nuclei, and to understand the emergence of hadronic matter from color charge. (authors)

  18. The SHARPn project on secondary use of Electronic Medical Record data: progress, plans, and possibilities.

    Science.gov (United States)

    Chute, Christopher G; Pathak, Jyotishman; Savova, Guergana K; Bailey, Kent R; Schor, Marshall I; Hart, Lacey A; Beebe, Calvin E; Huff, Stanley M

    2011-01-01

    SHARPn is a collaboration among 16 academic and industry partners committed to the production and distribution of high-quality software artifacts that support the secondary use of EMR data. Areas of emphasis are data normalization, natural language processing, high-throughput phenotyping, and data quality metrics. Our work avails the industrial scalability afforded by the Unstructured Information Management Architecture (UIMA) from IBM Watson Research labs, the same framework which underpins the Watson Jeopardy demonstration. This descriptive paper outlines our present work and achievements, and presages our trajectory for the remainder of the funding period. The project is one of the four Strategic Health IT Advanced Research Projects (SHARP) projects funded by the Office of the National Coordinator in 2010.

  19. Nurse prescribing in dermatology: doctors' and non-prescribing nurses' views.

    Science.gov (United States)

    Stenner, Karen; Carey, Nicola; Courtenay, Molly

    2009-04-01

    This paper is a report of a study conducted to explore doctor and non-prescribing nurse views about nurse prescribing in the light of their experience in dermatology. The cooperation of healthcare professionals and peers is of key importance in enabling and supporting nurse prescribing. Lack of understanding of and opposition to nurse prescribing are known barriers to its implementation. Given the important role they play, it is necessary to consider how the recent expansion of nurse prescribing rights in England impacts on the views of healthcare professionals. Interviews with 12 doctors and six non-prescribing nurses were conducted in 10 case study sites across England between 2006 and 2007. Participants all worked with nurses who prescribed for patients with dermatological conditions in secondary or primary care. Thematic analysis was conducted on the interview data. Participants were positive about their experiences of nurse prescribing having witnessed benefits from it, but had reservations about nurse prescribing in general. Acceptance was conditional upon the nurses' level of experience, awareness of their own limitations and the context in which they prescribed. Fears that nurses would prescribe beyond their level of competence were expected to reduce as understanding and experience of nurse prescribing increased. Indications are that nurse prescribing can be acceptable to doctors and nurses so long as it operates within recommended parameters. Greater promotion and assessment of standards and criteria are recommended to improve understanding and acceptance of nurse prescribing.

  20. CEBAF [Continuous Electron Beam Accelerator Facility] design overview and project status

    International Nuclear Information System (INIS)

    Leemann, C.

    1988-01-01

    This paper discusses the design and specifications of the Continuous Electron Beam Accelerator Facility. Beam performance objectives are discussed, as well as the recirculating linac concept, the injector, cavities, cryogenic system, beam transport and optics, rf system and construction progress. 19 refs., 10 figs

  1. The LXCat project: Electron scattering cross sections and swarm parameters for low temperature plasma modeling

    International Nuclear Information System (INIS)

    Pancheshnyi, S.; Biagi, S.; Bordage, M.C.; Hagelaar, G.J.M.; Morgan, W.L.; Phelps, A.V.; Pitchford, L.C.

    2012-01-01

    Graphical abstract: LXCat is an open-access website containing data needed for low temperature plasma modeling as well as on-line tools useful for their manipulation. Highlights: ► LXCat: an open-access website with data for low temperature plasma modeling. ► Contains compilations of electron scattering cross sections and transport data. ► Data from different contributors for many neutral, ground-state species. ► On-line tools for browsing, plotting, up/downloading data. ► On-line Boltzmann solver for calculating electron swarm parameters. - Abstract: LXCat is a dynamic, open-access, website for collecting, displaying, and downloading ELECtron SCATtering cross sections and swarm parameters (mobility, diffusion coefficient, reaction rates, etc.) required for modeling low temperature, non-equilibrium plasmas. Contributors set up individual databases, and the available databases, indicated by the contributor’s chosen title, include mainly complete sets of electron-neutral scattering cross sections, although the option for introducing partial sets of cross sections exists. A database for measured swarm parameters is also part of LXCat, and this is a growing activity. On-line tools include options for browsing, plotting, and downloading cross section data. The electron energy distribution functions (edfs) in low temperature plasmas are in general non-Maxwellian, and LXCat provides an option for execution of an on-line Boltzmann equation solver to calculate the edf in homogeneous electric fields. Thus, the user can obtain electron transport and rate coefficients (averages over the edfs) in pure gases or gas mixtures over a range of values of the reduced electric fields strength, E/N, the ratio of the electric field strength to the neutral density, using cross sections from the available databases. New contributors are welcome and anyone wishing to create a database and upload data can request a username and password. LXCat is part of a larger, community

  2. Attitudes of physicians and pharmacists towards International Non-proprietary Name prescribing in Belgium.

    Science.gov (United States)

    Van Bever, Elien; Elseviers, Monique; Plovie, Marijke; Vandeputte, Lieselot; Van Bortel, Luc; Vander Stichele, Robert

    2015-03-01

    International Non-proprietary Name (INN) prescribing is the use of the name of the active ingredient(s) instead of the brand name for prescribing. In Belgium, INN prescribing began in 2005 and a major policy change occurred in 2012. The aim was to explore the opinions of Dutch-speaking general practitioners (GPs) and pharmacists. An electronic questionnaire with 39 five-point Likert scale statements and one open question was administered in 2013. Multivariate analysis was performed with multiple linear regression on a sum score for benefit statements and for drawback statements. Answers to the open question were qualitatively analysed. We received 745 valid responses with a representable sample for both subgroups. Participants perceived the motives to introduce INN prescribing as purely economic (to reduce pharmaceutical expenditures for the government and the patient). Participants accepted the concept of INN prescribing, but 88% stressed the importance of guaranteed treatment continuity, especially in older, chronic patients, to prevent patient confusion, medication non-adherence and erroneous drug use. In conclusion, the current way in which INN prescribing is applied in Belgium leads to many concerns among primary health professionals about patient confusion and medication adherence. Slightly adapting the current concept of INN prescribing to these concerns can turn INN prescribing into one of the major policies in Belgium to reduce pharmaceutical expenditures and to stimulate rational drug prescribing. © 2014 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  3. Exposure to benzodiazepines (anxiolytics, hypnotics and related drugs) in seven European electronic healthcare databases: a cross-national descriptive study from the PROTECT-EU Project.

    Science.gov (United States)

    Huerta, Consuelo; Abbing-Karahagopian, Victoria; Requena, Gema; Oliva, Belén; Alvarez, Yolanda; Gardarsdottir, Helga; Miret, Montserrat; Schneider, Cornelia; Gil, Miguel; Souverein, Patrick C; De Bruin, Marie L; Slattery, Jim; De Groot, Mark C H; Hesse, Ulrik; Rottenkolber, Marietta; Schmiedl, Sven; Montero, Dolores; Bate, Andrew; Ruigomez, Ana; García-Rodríguez, Luis Alberto; Johansson, Saga; de Vries, Frank; Schlienger, Raymond G; Reynolds, Robert F; Klungel, Olaf H; de Abajo, Francisco José

    2016-03-01

    Studies on drug utilization usually do not allow direct cross-national comparisons because of differences in the respective applied methods. This study aimed to compare time trends in BZDs prescribing by applying a common protocol and analyses plan in seven European electronic healthcare databases. Crude and standardized prevalence rates of drug prescribing from 2001-2009 were calculated in databases from Spain, United Kingdon (UK), The Netherlands, Germany and Denmark. Prevalence was stratified by age, sex, BZD type [(using ATC codes), i.e. BZD-anxiolytics BZD-hypnotics, BZD-related drugs and clomethiazole], indication and number of prescription. Crude prevalence rates of BZDs prescribing ranged from 570 to 1700 per 10,000 person-years over the study period. Standardization by age and sex did not substantially change the differences. Standardized prevalence rates increased in the Spanish (+13%) and UK databases (+2% and +8%) over the study period, while they decreased in the Dutch databases (-4% and -22%), the German (-12%) and Danish (-26%) database. Prevalence of anxiolytics outweighed that of hypnotics in the Spanish, Dutch and Bavarian databases, but the reverse was shown in the UK and Danish databases. Prevalence rates consistently increased with age and were two-fold higher in women than in men in all databases. A median of 18% of users received 10 or more prescriptions in 2008. Although similar methods were applied, the prevalence of BZD prescribing varied considerably across different populations. Clinical factors related to BZDs and characteristics of the databases may explain these differences. Copyright © 2015 John Wiley & Sons, Ltd.

  4. The ELAStiC (Electronic Longitudinal Alcohol Study in Communities project

    Directory of Open Access Journals (Sweden)

    Ashley Akbari

    2017-04-01

    Our project will aim to provide evidence that informs the UK Government’s commitment to “radically reshape the approach to alcohol and reduce the number of people drinking to excess”, by working with existing longitudinal data collected in the UK to inform policy and practice.

  5. The desktop muon detector: A simple, physics-motivated machine- and electronics-shop project for university students

    Science.gov (United States)

    Axani, S. N.; Conrad, J. M.; Kirby, C.

    2017-12-01

    This paper describes the construction of a desktop muon detector, an undergraduate-level physics project that develops machine-shop and electronics-shop technical skills. The desktop muon detector is a self-contained apparatus that employs a plastic scintillator as the detection medium and a silicon photomultiplier for light collection. This detector can be battery powered and is used in conjunction with the provided software. The total cost per detector is approximately 100. We describe physics experiments we have performed, and then suggest several other interesting measurements that are possible, with one or more desktop muon detectors.

  6. Emittance study of a 28 GHz electron cyclotron resonance ion source for the Rare Isotope Science Project superconducting linear accelerator.

    Science.gov (United States)

    Park, Bum-Sik; Hong, In-Seok; Jang, Ji-Ho; Jin, Hyunchang; Choi, Sukjin; Kim, Yonghwan

    2016-02-01

    A 28 GHz electron cyclotron resonance (ECR) ion source is being developed for use as an injector for the superconducting linear accelerator of the Rare Isotope Science Project. Beam extraction from the ECR ion source has been simulated using the KOBRA3-INP software. The simulation software can calculate charged particle trajectories in three dimensional complex magnetic field structures, which in this case are formed by the arrangement of five superconducting magnets. In this study, the beam emittance is simulated to understand the effects of plasma potential, mass-to-charge ratio, and spatial distribution. The results of these simulations and their comparison to experimental results are presented in this paper.

  7. Electronics

    Science.gov (United States)

    2001-01-01

    International Acer Incorporated, Hsin Chu, Taiwan Aerospace Industrial Development Corporation, Taichung, Taiwan American Institute of Taiwan, Taipei, Taiwan...Singapore and Malaysia .5 - 4 - The largest market for semiconductor products is the high technology consumer electronics industry that consumes up...Singapore, and Malaysia . A new semiconductor facility costs around $3 billion to build and takes about two years to become operational

  8. Prescribing Safety in Ambulatory Care: Physician Perspectives

    National Research Council Canada - National Science Library

    Rundall, Thomas G; Hsu, John; Lafata, Jennifer E; Fung, Vicki; Paez, Kathryn A; Simpkins, Jan; Simon, Steven R; Robinson, Scott B; Uratsu, Connie; Gunter, Margaret J; Soumerai, Stephen B; Selby, Joseph V

    2005-01-01

    .... We asked about current safety practices, perceptions of ambulatory prescribing safety. Using a content analysis approach, three investigators independently coded responses into thematic categories...

  9. A Novel Design for Drug-Drug Interaction Alerts Improves Prescribing Efficiency.

    Science.gov (United States)

    Russ, Alissa L; Chen, Siying; Melton, Brittany L; Johnson, Elizabette G; Spina, Jeffrey R; Weiner, Michael; Zillich, Alan J

    2015-09-01

    Drug-drug interactions (DDIs) are common in clinical care and pose serious risks for patients. Electronic health records display DDI alerts that can influence prescribers, but the interface design of DDI alerts has largely been unstudied. In this study, the objective was to apply human factors engineering principles to alert design. It was hypothesized that redesigned DDI alerts would significantly improve prescribers' efficiency and reduce prescribing errors. In a counterbalanced, crossover study with prescribers, two DDI alert designs were evaluated. Department of Veterans Affairs (VA) prescribers were video recorded as they completed fictitious patient scenarios, which included DDI alerts of varying severity. Efficiency was measured from time-stamped recordings. Prescribing errors were evaluated against predefined criteria. Efficiency and prescribing errors were analyzed with the Wilcoxon signed-rank test. Other usability data were collected on the adequacy of alert content, prescribers' use of the DDI monograph, and alert navigation. Twenty prescribers completed patient scenarios for both designs. Prescribers resolved redesigned alerts in about half the time (redesign: 52 seconds versus original design: 97 seconds; p<.001). Prescribing errors were not significantly different between the two designs. Usability results indicate that DDI alerts might be enhanced by facilitating easier access to laboratory data and dosing information and by allowing prescribers to cancel either interacting medication directly from the alert. Results also suggest that neither design provided adequate information for decision making via the primary interface. Applying human factors principles to DDI alerts improved overall efficiency. Aspects of DDI alert design that could be further enhanced prior to implementation were also identified.

  10. Electron cooling system in the booster synchrotron of the HIAF project

    Energy Technology Data Exchange (ETDEWEB)

    Mao, L.J., E-mail: maolijun@impcas.ac.cn [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); Yang, J.C.; Xia, J.W.; Yang, X.D.; Yuan, Y.J.; Li, J.; Ma, X.M.; Yan, T.L.; Yin, D.Y.; Chai, W.P.; Sheng, L.N. [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); Shen, G.D.; Zhao, H.; Tang, M.T. [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); Graduate University of Chinese Academy of Sciences, Beijing 100049 (China)

    2015-06-21

    The High Intensity heavy ion Accelerator Facility (HIAF) is a new accelerator complex under design at the Institute of Modern Physics (IMP). The facility is aiming at the production of high intensity heavy ion beams for a wide range of experiments in high energy density physics, nuclear physics, atomic physics and other applications. It consists of a superconducting electron-cyclotron-resonance ion source and an intense proton ion source, a linear accelerator, a 34 Tm booster synchrotron ring, a 43 Tm multifunction compression synchrotron ring, a 13 Tm high precision spectrometer ring and several experimental terminals. A magnetized electron cooling device is supposed to be used in the booster ring for decreasing the transverse emittance of injected beams. The conceptual design and main parameters of this cooler are presented in this paper.

  11. Awareness, Trial, and Current Use of Electronic Cigarettes in 10 Countries: Findings from the ITC Project

    OpenAIRE

    Gravely, Shannon; Fong, Geoffrey T.; Cummings, K. Michael; Yan, Mi; Quah, Anne C. K.; Borland, Ron; Yong, Hua-Hie; Hitchman, Sara C.; McNeill, Ann; Hammond, David; Thrasher, James F.; Willemsen, Marc C.; Seo, Hong Gwan; Jiang, Yuan; Cavalcante, Tania

    2014-01-01

    Background: In recent years, electronic cigarettes (e-cigarettes) have generated considerable interest and debate on the implications for tobacco control and public health. Although the rapid growth of e-cigarettes is global, at present, little is known about awareness and use. This paper presents self-reported awareness, trial and current use of e-cigarettes in 10 countries surveyed between 2009 and 2013; for six of these countries, we present the first data on e-cigarettes from probabilit...

  12. Spin-orbit maps and electron spin dynamics for the luminosity upgrade project at HERA

    International Nuclear Information System (INIS)

    Berglund, G.Z.M.

    2001-09-01

    HERA is the high energy electron(positron)-proton collider at deutsches elektronen-synchrotron (DESY) in Hamburg. Following eight years of successful running, five of which were with a longitudinally spin polarized electron(positron) beam for the HERMES experiment, the rings have now been modified to increase the luminosity by a factor of about five and spin rotators have been installed for the H1 and ZEUS experiments. The modifications involve nonstandard configurations of overlapping magnetic fields and other aspects which have profound implications for the polarization. This thesis addresses the problem of calculating the polarization in the upgraded machine and the measures needed to maintain the polarization. A central topic is the construction of realistic spin-orbit transport maps for the regions of overlapping fields and their implementation in existing software. This is the first time that calculations with such fields have been possible. Using the upgraded software, calculations are presented for the polarization that can be expected in the upgraded machine and an analysis is made of the contributions to depolarization from the various parts of the machine. It is concluded that about 50% polarization should be possible. The key issues for tuning the machine are discussed. The last chapter deals with a separate topic, namely how to exploit a simple unitary model of spin motion to describe electron depolarization and thereby expose a misconception appearing in the literature. (orig.)

  13. Impact of pharmacists assisting with prescribing and undertaking medication review on oxycodone prescribing and supply for patients discharged from surgical wards.

    Science.gov (United States)

    Tran, T; Taylor, S E; Hardidge, A; Findakly, D; Aminian, P; Elliott, R A

    2017-10-01

    Overprescribing of oxycodone is a contributor to the epidemic of prescription opioid misuse and deaths. Practice models to optimize oxycodone prescribing and supply need to be evaluated. We explored the impact of pharmacist-assisted discharge prescribing and medication review on oxycodone prescribing and supply for patients discharged from surgical wards. A retrospective audit was conducted on two surgical inpatient wards following a 16-week prospective pre- and post-intervention study. During the pre-intervention period, discharge prescriptions were prepared by hospital doctors and then reviewed by a ward pharmacist (WP) before being dispensed. Post-intervention, prescriptions were prepared by a project pharmacist in consultation with hospital doctors and then reviewed by a WP and dispensed. Proportion of patients who were prescribed, and proportion supplied, oxycodone on discharge; Median amount (milligrams) of oxycodone prescribed and supplied, for patients who were prescribed and supplied at least one oxycodone-containing preparation, respectively. A total of 320 and 341 patients were evaluated pre- and post-intervention, respectively. Pre-intervention, 75.6% of patients were prescribed oxycodone; after WP review, 60.3% were supplied oxycodone (Psupplied was 100 milligrams/patient. Post-intervention, 68.6% of patients were prescribed oxycodone; after WP review, 57.8% were supplied oxycodone (Psupplied was 50 milligrams/patient (difference in amount prescribed and supplied: 50 milligrams, Psupplied oxycodone but not the amount supplied/patient. Having a pharmacist assist with prescribing reduced the amount of oxycodone supplied. © 2017 John Wiley & Sons Ltd.

  14. Project and construction of energy degrading and scattering plates for electron beam radiotherapy for skin diseases

    International Nuclear Information System (INIS)

    Fonseca, Gabriel Paiva

    2010-01-01

    There are many radiosensitive epidermotropics diseases such as mycosis fungo-ids and the syndrome of Sezary, coetaneous neoplasics originated from type T lymphocytes. Several studies indicate the eradication of the disease when treated with linear accelerators emitting electron beams with energies between 4 to 10 MeV. However, this treatment technique presents innumerable technical challenges since the disease in general reaches all patient's body, becoming necessary not only a very large field size radiation beam, but also deliver superficial doses limited to the skin depth. To reach the uniformity in the dose distribution, many techniques had already been developed. Based on these previous studies and guided by the report no. 23 of the American Association of Physicists in Medi-cine (AAPM), the present study developed an energy scattering and degrading plates and made dosimetry (computational and experimental), supplying subsidies for a future installation of Total Skin Electron Therapy (TSET) at the Servico de Radioterapia do Hospital das Clinicas de Sao Paulo. As part of the plates design, first of all, the energy spectrum of the 6 MeV electron beam of the VARIAN 2100C accelerator was reconstructed through Monte Carlo simulations using the MCNP4C code and based on experimental data. Once the spectrum is built, several materials were analyzed for the plates design based on radial and axial dose distribution, production of rays-x and dose attenuation. The simulation results were validated by experimental measurements in order to obtain a large field of radiation with 200 cm x 80 cm that meets the specifications of the AAPM protocol. (author)

  15. Improving immunization delivery using an electronic health record: the ImmProve project.

    Science.gov (United States)

    Bundy, David G; Persing, Nichole M; Solomon, Barry S; King, Tracy M; Murakami, Peter N; Thompson, Richard E; Engineer, Lilly D; Lehmann, Christoph U; Miller, Marlene R

    2013-01-01

    Though an essential pediatric preventive service, immunizations are challenging to deliver reliably. Our objective was to measure the impact on pediatric immunization rates of providing clinicians with electronic health record-derived immunization prompting. Operating in a large, urban, hospital-based pediatric primary care clinic, we evaluated 2 interventions to improve immunization delivery to children ages 2, 6, and 13 years: point-of-care, patient-specific electronic clinical decision support (CDS) when children overdue for immunizations presented for care, and provider-specific bulletins listing children overdue for immunizations. Overall, the proportion of children up to date for a composite of recommended immunizations at ages 2, 6, and 13 years was not different in the intervention (CDS active) and historical control (CDS not active) periods; historical immunization rates were high. The proportion of children receiving 2 doses of hepatitis A immunization before their second birthday was significantly improved during the intervention period. Human papillomavirus (HPV) immunization delivery was low during both control and intervention periods and was unchanged for 13-year-olds. For 14-year-olds, however, 4 of the 5 highest quarterly rates of complete HPV immunization occurred in the final year of the intervention. Provider-specific bulletins listing children overdue for immunizations increased the likelihood of identified children receiving catch-up hepatitis A immunizations (hazard ratio 1.32; 95% confidence interval 1.12-1.56); results for HPV and the composite of recommended immunizations were of a similar magnitude but not statistically significant. In our patient population, with high baseline uptake of recommended immunizations, electronic health record-derived immunization prompting had a limited effect on immunization delivery. Benefit was more clearly demonstrated for newer immunizations with lower baseline uptake. Copyright © 2013 Academic

  16. Retrieval of the projected potential by inversion from the scattering matrix in electron-crystal scattering

    International Nuclear Information System (INIS)

    Allen, L.J.; Spargo, A.E.C.; Leeb, H.

    1998-01-01

    The retrieval of a unique crystal potential from the scattering matrix S in high energy transmission electron diffraction is discussed. It is shown that, in general, data taken at a single orientation are not sufficient to determine all the elements of S. Additional measurements with tilted incident beam are required for the determination of the whole S-matrix. An algorithm for the extraction of the crystal potential from the S-matrix measured at a single energy and thickness is presented. The limiting case of thin crystals is discussed. Several examples with simulated data are considered

  17. Prevalence and Predictors of Inappropriate Medications Prescribing ...

    African Journals Online (AJOL)

    Data analysis involved use of World Health Organization (WHO) prescribing indicators, Updated 2002 Beer's criteria and DRUG-REAX® system software package of MICROMEDEX (R) Healthcare Series to assess the prescribing pattern, identify potentially inappropriate medications and potential drug-drug interactions, ...

  18. Medication errors: prescribing faults and prescription errors.

    Science.gov (United States)

    Velo, Giampaolo P; Minuz, Pietro

    2009-06-01

    1. Medication errors are common in general practice and in hospitals. Both errors in the act of writing (prescription errors) and prescribing faults due to erroneous medical decisions can result in harm to patients. 2. Any step in the prescribing process can generate errors. Slips, lapses, or mistakes are sources of errors, as in unintended omissions in the transcription of drugs. Faults in dose selection, omitted transcription, and poor handwriting are common. 3. Inadequate knowledge or competence and incomplete information about clinical characteristics and previous treatment of individual patients can result in prescribing faults, including the use of potentially inappropriate medications. 4. An unsafe working environment, complex or undefined procedures, and inadequate communication among health-care personnel, particularly between doctors and nurses, have been identified as important underlying factors that contribute to prescription errors and prescribing faults. 5. Active interventions aimed at reducing prescription errors and prescribing faults are strongly recommended. These should be focused on the education and training of prescribers and the use of on-line aids. The complexity of the prescribing procedure should be reduced by introducing automated systems or uniform prescribing charts, in order to avoid transcription and omission errors. Feedback control systems and immediate review of prescriptions, which can be performed with the assistance of a hospital pharmacist, are also helpful. Audits should be performed periodically.

  19. Psychiatric Prescribers' Experiences With Doctor Shoppers.

    Science.gov (United States)

    Worley, Julie; Johnson, Mary; Karnik, Niranjan

    2015-01-01

    Doctor shopping is a primary method of prescription medication diversion. After opioids, benzodiazepines and stimulants are the next most common prescription medications used nonmedically. Studies have shown that patients who engage in doctor shopping find it fun, exciting, and easy to do. There is a lack of research on the prescriber's perspective on the phenomenon of doctor shopping. This study investigates the experiences of prescribers in psychiatry with patients who engage in doctor shopping. Fifteen prescribers including psychiatrists and psychiatric nurse practitioners working in outpatient psychiatry were interviewed to elicit detailed information about their experiences with patients who engage in doctor shopping. Themes found throughout the interview were that psychiatric prescribers' experience with patients who engage in doctor shopping includes (a) detecting red flags, (b) negative emotional responding, (c) addressing the patient and the problem, and (d) inconsistently implementing precautions. When red flags were detected when prescribing controlled drugs, prescribers in psychiatry experienced both their own negative emotional responses such as disappointment and resentment as well as the negative emotions of the patients such as anger and other extreme emotional responses. Psychiatric prescribers responded to patient's doctor shopping in a variety of ways such as changing their practice, discharging the patients or taking steps to not accept certain patients identified as being at risk for doctor shopping, as well as by talking to the patient and trying to offer them help. Despite experiencing doctor shopping, the prescribers inconsistently implemented precautionary measures such as checking prescription drug monitoring programs. © The Author(s) 2015.

  20. Using electronic health records for clinical research: the case of the EHR4CR project.

    Science.gov (United States)

    De Moor, Georges; Sundgren, Mats; Kalra, Dipak; Schmidt, Andreas; Dugas, Martin; Claerhout, Brecht; Karakoyun, Töresin; Ohmann, Christian; Lastic, Pierre-Yves; Ammour, Nadir; Kush, Rebecca; Dupont, Danielle; Cuggia, Marc; Daniel, Christel; Thienpont, Geert; Coorevits, Pascal

    2015-02-01

    To describe the IMI EHR4CR project which is designing and developing, and aims to demonstrate, a scalable, widely acceptable and efficient approach to interoperability between EHR systems and clinical research systems. The IMI EHR4CR project is combining and extending several previously isolated state-of-the-art technical components through a new approach to develop a platform for reusing EHR data to support medical research. This will be achieved through multiple but unified initiatives across different major disease areas (e.g. cardiovascular, cancer) and clinical research use cases (protocol feasibility, patient identification and recruitment, clinical trial execution and serious adverse event reporting), with various local and national stakeholders across several countries and therefore under various legal frameworks. An initial instance of the platform has been built, providing communication, security and terminology services to the eleven participating hospitals and ten pharmaceutical companies located in seven European countries. Proof-of-concept demonstrators have been built and evaluated for the protocol feasibility and patient recruitment scenarios. The specifications of the clinical trial execution and the adverse event reporting scenarios have been documented and reviewed. Through a combination of a consortium that brings collectively many years of experience from previous relevant EU projects and of the global conduct of clinical trials, of an approach to ethics that engages many important stakeholders across Europe to ensure acceptability, of a robust iterative design methodology for the platform services that is anchored on requirements of an underlying Service Oriented Architecture that has been designed to be scalable and adaptable, EHR4CR could be well placed to deliver a sound, useful and well accepted pan-European solution for the reuse of hospital EHR data to support clinical research studies. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Influences on the prescribing of new drugs.

    Science.gov (United States)

    Tobin, Luke; de Almedia Neto, Abelio C; Wutzke, Sonia; Patterson, Craig; Mackson, Judith; Weekes, Lynn; Williamson, Margaret

    2008-01-01

    The aim of this study was to identify the factors that influence prescribing of new drugs among general practitioners, endocrinologists and psychiatrists. Four focus groups were conducted with GPs, endocrinologists and psychiatrists on sources of awareness and influences on prescribing of new drugs. Pharmaceutical companies were the most important source for becoming aware of new drugs. There were many influences on the decision to prescribe a new drug, the most important being efficacy, safety, cost and advantage over existing therapies. Endocrinologists placed greater emphasis on evidence from clinical trials and scientific conferences, and psychiatrists and GPs placed more weight on pharmaceutical representatives, colleagues and specialists. New drug prescribing occurs in a complex environment with many influences. Effective interventions to promote rational, safe and effective prescribing of new drugs will need to be cognisant of these factors.

  2. Project-Based Learning and Agile Methodologies in Electronic Courses: Effect of Student Population and Open Issues

    Directory of Open Access Journals (Sweden)

    Marina Zapater

    2013-12-01

    Full Text Available Project-Based Learning (PBL and Agile methodologies have proven to be very interesting instructional strategies in Electronics and Engineering education, because they provide practical learning skills that help students understand the basis of electronics. In this paper we analyze two courses, one belonging to a Master in Electronic Engineering and one to a Bachelor in Telecommunication Engineering that apply Agile-PBL methodologies, and compare the results obtained in both courses with a traditional laboratory course. Our results support previous work stating that Agile-PBL methodologies increase student satisfaction. However, we also highlight some open issues that negatively affect the implementation of these methodologies,such as planning overhead or accidental complexity. Moreover,we show how differences in the student population, mostly related to the time spent on-campus, their commitment to the course or part-time dedication, have an impact on the benefits of Agile-PBL methods. In these cases, Agile-PBL methodologies by themselves are not enough and need to be combined with other techniques to increase student motivation.

  3. Antipsychotic prescribing in older people.

    Science.gov (United States)

    Neil, Wendy; Curran, Stephen; Wattis, John

    2003-09-01

    older people. There is a need to redress this balance to ensure that the prescribing of antipsychotics in older people is evidence based.

  4. Antecedent and progress of the project on the treatment of chimney gases with electrons in Mexico

    International Nuclear Information System (INIS)

    Pina V, G.

    1991-10-01

    After the realization of the chimney gases treatment seminar with electrons, organized jointly among the National Institute of Nuclear Research (ININ) and the International Atomic Energy Agency (IAEA), in August of 1990 and following one of the received recommendations, it was elaborated an economic technical feasibility study of this process in Mexico, using technical data of a thermoelectric power station of Federal Commission of Electricity, where is being consumed fuel oil. This study is good to know some technical parameters of a plant of this process, proposed to settle in Mexico, so as some economic estimates of installation and operation costs of this plant; also, it is traced about the construction of a demonstration plant of the process, with capacity of 20,000 m 3 N/h, using the same data of the thermoelectric power station considered previously, as the first step in the scaling of this process toward industrial level. (Author)

  5. The Continuous Electron Beam Accelerator Facility: Project status and physics outlook

    International Nuclear Information System (INIS)

    Grunder, H.A.

    1989-01-01

    Nuclear physics research program planning, accelerator tunnel construction, and accelerator component development, assembly, and testing are under way at the Continuous Electron Beam Accelerator Facility, Newport News, Virginia. CEBAF's 4-GeV, 200-μA superconducting recirculating accelerator will provide cw beam to simultaneous experiments in three end stations for studies of the nuclear many-body system, its quark substructure, and the strong and electroweak interactions governing this form of matter. An experimental program is being defined in collaboration with the user community. The experimental halls have been designed, and preliminary experimental equipment conceptual designs have been prepared. Planned for Hall A are two 4-GeV/c high-resolution (δp/p ≤ 10 -4 ) spectrometers (HRS) with moderate acceptance (∼8 msr) for a program of completely exclusive experiments in which the nuclear final state has to be fully specified. A CEBAF large acceptance spectrometer (CLAS) is planned for the program of Hall B, which will include bias-free investigation of hadronic final states in inelastic electron scattering and detection of multiple-particle final states. The CLAS will be a multi-gap device based on a toroidal magnet with six superconducting coils arranged around the beamline to produce an essentially circular magnetic field. Hall C is envisioned as serving a diversity of interests, including form factor measurements, parity violation investigations, form factors of nucleon resonances, and a high-Q 2 baryon resonance program. A moderate-resolution, high-momentum, 6-GeV/c spectrometer (HMS) together with several specialized second arms -- in particular, a symmetric toroidal array spectrometer -- are being planned to carry out Hall C experimentation. 14 figs., 8 tabs

  6. Optical techniques for electron-beam characterizations on the APS SASE FEL project

    International Nuclear Information System (INIS)

    Lumpkin, A.H.; Yang, B.X.; Berg, W.J.; White, M.; Lewellen, J.W.; Milton, S.V.

    1998-01-01

    At the Advanced Photon Source (APS) the injector linac's DC thermionic gun is being supplemented by a low-emittance rf thermionic gun that will support the SASE FEL project. To address the anticipated smaller beam sizes, the standard Chromox beam-profiling screens are being complemented by optical transition radiation (OTR) and Ce-doped YAG single-crystal converters. Direct comparisons of the effective conversion efficiency, spatial resolution, and time response of the three converter screen types have been performed using the DC thermionic gun's beam accelerated to 400 to 650 MeV. An apparent blurring of observed beam size with increasing incident charge areal density in the YAG crystal was observed for the first time. Only the OTR was prompt enough for the few-ps domain micropulse bunch length measurements performed with a stream camera. Initial beam images of the rf-thermionic gun beam have also been obtained

  7. Development of free electron laser and accelerator technology in Poland (CARE and EuCARD projects)

    CERN Document Server

    Romaniuk, Ryszard

    2009-01-01

    The development of accelerator technology in Poland is strictly combined with the cooperation with specialist accelerator centers of global character, where the relevant knowledge is generated, allowing to build big and modern machines. These are relatively costly undertakings of interdisciplinary character. Most of them are financed from the local resources. Only the biggest machines are financed commonly by many nations like: LHC in CERN, ILC in Fermi Lab, E-XFEL in DESY. A similar financing solution has to be implemented in Poland, where a scientific and political campaign is underway on behalf of building two big machines, a Polish Synchrotron in Kraków and a Polish FEL in Świerk. Around these two projects, there are realized a dozen or so smaller ones.

  8. Development of consensus guidance to facilitate service redesign around pharmacist prescribing in UK hospital practice.

    Science.gov (United States)

    Tonna, Antonella; McCaig, Dorothy; Diack, Lesley; West, Bernice; Stewart, Derek

    2014-10-01

    The last decade has seen a drive towards non-medical prescribing in the United Kingdom (UK). However, there is a dearth of any published literature on applying the principles of service redesign to support pharmacist prescribing in any sphere of practice. To develop consensus guidance to facilitate service redesign around pharmacist prescribing. UK hospital practice. The Delphi technique was used to measure consensus of a panel of expert opinion holders in Scotland. Individuals with key strategic and operational roles in implementing initiatives of pharmacy practice and medicines management were recruited as experts. An electronic questionnaire consisting of 30 statements related to pharmacist prescribing service redesign was developed. These were presented as five-point Likert scales with illustrative quotes. Consensus, defined as 70 % of panel members agreeing (ranked strongly agree/agree) with each statement. Responses were obtained from 35/40 (87.5 %) experts in round one and 29 (72.5 %) in round two. Consensus in round one was achieved for 27/30 of statements relating to aspects of generic 'service development' (e.g. succession planning, multidisciplinary working, quality evaluation, practice development and outcome measures) and 'pharmacist prescribing role development' (e.g. education and future orientation of service). Issues of disagreement were around targeting of pharmacist prescribing to clinical specialities and financial remuneration for prescribing in the hospital setting. Consensus guidance has been developed to facilitate service redesign around hospital pharmacist prescribing.

  9. Neuropharmacology and mental health nurse prescribers.

    Science.gov (United States)

    Skingsley, David; Bradley, Eleanor J; Nolan, Peter

    2006-08-01

    To outline the development and content of a 'top-up' neuropharmacology module for mental health nurse prescribers and consider how much pharmacology training is required to ensure effective mental health prescribing practice. Debate about the content of prescribing training courses has persisted within the United Kingdom since the mid-1980s. In early 2003 supplementary prescribing was introduced and gave mental health nurses the opportunity to become prescribers. The challenge of the nurse prescribing curriculum for universities is that they have only a short time to provide nurses from a range of backgrounds with enough knowledge to ensure that they meet agreed levels of competency for safe prescribing. There is growing concern within mental health care that the prescribing of medication in mental health services falls short of what would be deemed good practice. Over the past two decades, nurse training has increasingly adopted a psychosocial approach to nursing care raising concerns that, although nurses attending prescribing training may be able to communicate effectively with service users, they may lack the basic knowledge of biology and pharmacology to make effective decisions about medication. Following the completion of a general nurse prescribing course, mental health nurses who attended were asked to identify their specific needs during the evaluation phase. Although they had covered basic pharmacological principles in their training, they stated that they needed more specific information about drugs used in mental health; particularly how to select appropriate drug treatments for mental health conditions. This paper describes how the nurses were involved in the design of a specific module which would enable them to transfer their theoretical leaning to practice and in so doing increase their confidence in their new roles. The findings of this study suggest that the understanding and confidence of mental health nurse prescribers about the drugs they

  10. Antibiotic prescribing in dental practice in Belgium.

    Science.gov (United States)

    Mainjot, A; D'Hoore, W; Vanheusden, A; Van Nieuwenhuysen, J-P

    2009-12-01

    To assess the types and frequency of antibiotic prescriptions by Belgian dentists, the indications for antibiotic prescription, and dentists' knowledge about recommended practice in antibiotic use. In this cross-sectional survey, dental practitioners were asked to record information about all antibiotics prescribed to their patients during a 2-week period. The dental practitioners were also asked to complete a self-administered questionnaire regarding demographic data, prescribing practices, and knowledge about antibiotic use. A random sample of 268 Belgian dentists participated in the survey. During the 2-week period, 24 421 patient encounters were recorded; 1033 patients were prescribed an antibiotic (4.2%). The median number of prescriptions per dentist for the 2 weeks was 3. Broad spectrum antibiotics were most commonly prescribed: 82% of all prescriptions were for amoxycillin, amoxycillin-clavulanic acid and clindamycin. Antibiotics were often prescribed in the absence of fever (92.2%) and without any local treatment (54.2%). The most frequent diagnosis for which antibiotics were prescribed was periapical abscess (51.9%). Antibiotics were prescribed to 63.3% of patients with periapical abscess and 4.3% of patients with pulpitis. Patterns of prescriptions were confirmed by the data from the self-reported practice. Discrepancies between observed and recommended practice support the need for educational initiatives to promote rational use of antibiotics in dentistry in Belgium.

  11. Sets with Prescribed Arithmetic Densities

    Czech Academy of Sciences Publication Activity Database

    Luca, F.; Pomerance, C.; Porubský, Štefan

    2008-01-01

    Roč. 3, č. 2 (2008), s. 67-80 ISSN 1336-913X R&D Projects: GA ČR GA201/07/0191 Institutional research plan: CEZ:AV0Z10300504 Keywords : generalized arithmetic density * generalized asymptotic density * generalized logarithmic density * arithmetical semigroup * weighted arithmetic mean * ratio set * R-dense set * Axiom A * delta-regularly varying function Subject RIV: BA - General Mathematics

  12. Nurse practitioner prescribing: an international perspective

    Directory of Open Access Journals (Sweden)

    Fong J

    2015-10-01

    Full Text Available Jacqueline Fong,1,2 Thomas Buckley,2 Andrew Cashin3 1St George Hospital, Kogarah, 2Sydney Nursing School, University of Sydney, Camperdown, NSW, Australia; 3School of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia Background: Internationally, the delivery of care provided by nurses and midwives has undergone a significant change due to a variety of interrelated factors, including economic circumstances, a diminishing number of medical providers, the unavailability of adequate health care services in underserved and rural areas, and growing specialization among the professions. One solution to the challenges of care delivery has been the introduction of nurse practitioners (NPs and the authorization of NPs to prescribe medicines. Aim: The aim of this paper was to review the current international literature related to NP prescribing and compare the findings to the Australian context. The review focuses on literature from the United States, Canada, Europe, Australia, and New Zealand. Methods: Databases were searched from January 2000 to January 2015. The following keywords: “nurse practitioner”, “advanced nurse”, “advanced practice nurse”, “prescri*”, “Australia”, “United States America”, “UK”, “New Zealand”, “Canada”, “Europe”, “drug prescri*”, “prescri* authority”, and “prescri* legislation” were used. Findings: NPs tend to prescribe in differing contexts of practice to provide care in underserved populations and require good systems literacy to practice across complex systems. The key themes identified internationally related to NP prescribing relate to barriers to prescribing, confidence in prescribing, and the unique role of NPs in prescribing medicines, eg, the high prevalence of prescribing pain medicines in several countries, including Australia. Conclusion: Across all countries reviewed, there appears a need for further research into the organizational and

  13. General formalism of Hamiltonians for realizing a prescribed evolution of a qubit

    International Nuclear Information System (INIS)

    Tong, D.M.; Chen, J.-L.; Lai, C.H.; Oh, C.H.; Kwek, L.C.

    2003-01-01

    We investigate the inverse problem concerning the evolution of a qubit system, specifically we consider how one can establish the Hamiltonians that account for the evolution of a qubit along a prescribed path in the projected Hilbert space. For a given path, there are infinite Hamiltonians which can realize the same evolution. A general form of the Hamiltonians is constructed in which one may select the desired one for implementing a prescribed evolution. This scheme can be generalized to higher dimensional systems

  14. Electronic Health Record Tools to Care for At-Risk Older Drivers: A Quality Improvement Project.

    Science.gov (United States)

    Casey, Colleen M; Salinas, Katherine; Eckstrom, Elizabeth

    2015-06-01

    Evaluating driving safety of older adults is an important health topic, but primary care providers (PCP) face multiple barriers in addressing this issue. The study's objectives were to develop an electronic health record (EHR)-based Driving Clinical Support Tool, train PCPs to perform driving assessments utilizing the tool, and systematize documentation of assessment and management of driving safety issues via the tool. The intervention included development of an evidence-based Driving Clinical Support Tool within the EHR, followed by training of internal medicine providers in the tool's content and use. Pre- and postintervention provider surveys and chart review of driving-related patient visits were conducted. Surveys included self-report of preparedness and knowledge to evaluate at-risk older drivers and were analyzed using paired t-test. A chart review of driving-related office visits compared documentation pre- and postintervention including: completeness of appropriate focused history and exam, identification of deficits, patient education, and reporting to appropriate authorities when indicated. Data from 86 providers were analyzed. Pre- and postintervention surveys showed significantly increased self-assessed preparedness (p < .001) and increased driving-related knowledge (p < .001). Postintervention charts showed improved documentation of correct cognitive testing, more referrals/consults, increased patient education about community resources, and appropriate regulatory reporting when deficits were identified. Focused training and an EHR-based clinical support tool improved provider self-reported preparedness and knowledge of how to evaluate at-risk older drivers. The tool improved documentation of driving-related issues and led to improved access to interdisciplinary care coordination. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

  15. Seasonality and physician-related factors associated with antibiotic prescribing: A cross-sectional study in Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Leila Safaeian

    2015-01-01

    Conclusions: These findings showed the widespread use of antibiotics by general practitioners that was associated with the physicians′ gender, time since graduation and practice location and also season of prescribing. More researches are needed on other factors related to the overprescribing of antibiotics and they could be used to project educational programs for improvement of antibiotic prescribing quality in our country.

  16. Burn and they will come! The western regional birds and burns study examines bird responses to prescribed fire

    Science.gov (United States)

    Jonathan Thompson; John Lehmkuhl

    2008-01-01

    Although prescribed fire is increasingly being used in ponderosa pine forests as a management tool to reduce the risk of future high-severity wildfire, its effects on wildlife habitat have rarely been examined. The Birds and Burns Network was created to assist managers in planning prescribed fire projects that will reduce fuels and enhance bird habitat. Researchers...

  17. Determination of the Projected Atomic Potential by Deconvolution of the Auto-Correlation Function of TEM Electron Nano-Diffraction Patterns

    Directory of Open Access Journals (Sweden)

    Liberato De Caro

    2016-11-01

    Full Text Available We present a novel method to determine the projected atomic potential of a specimen directly from transmission electron microscopy coherent electron nano-diffraction patterns, overcoming common limitations encountered so far due to the dynamical nature of electron-matter interaction. The projected potential is obtained by deconvolution of the inverse Fourier transform of experimental diffraction patterns rescaled in intensity by using theoretical values of the kinematical atomic scattering factors. This novelty enables the compensation of dynamical effects typical of transmission electron microscopy (TEM experiments on standard specimens with thicknesses up to a few tens of nm. The projected atomic potentials so obtained are averaged on sample regions illuminated by nano-sized electron probes and are in good quantitative agreement with theoretical expectations. Contrary to lens-based microscopy, here the spatial resolution in the retrieved projected atomic potential profiles is related to the finer lattice spacing measured in the electron diffraction pattern. The method has been successfully applied to experimental nano-diffraction data of crystalline centrosymmetric and non-centrosymmetric specimens achieving a resolution of 65 pm.

  18. Electron-cloud simulation studies for the CERN-PS in the framework of the LHC Injectors Upgrade project

    CERN Document Server

    Rioja Fuentelsaz, Sergio

    The present study aims to provide a consistent picture of the electron cloud effect in the CERN Proton Synchrotron (PS) and to investigate possible future limitations due to the requirements foreseen by the LHC Injectors Upgrade (LIU) project. It consists of a complete simulation survey of the electron cloud build-up in the different beam pipe sections of the ring depending on several controllable beam parameters and vacuum chamber surface properties, covering present and future operation parameters. As the combined function magnets of the accelerator constitute almost the $80\\%$ in length of the ring, the implementation of a new feature for the simulation of any external magnetic field on the PyECLOUD code, made it possible to perform this study. All the results of the simulations are given as a function of the vacuum chamber surface properties in order to deduce them, both locally and globally, when compared with experimental data. In a first step, we characterize locally the maximum possible number of ...

  19. Awareness, Trial, and Current Use of Electronic Cigarettes in 10 Countries: Findings from the ITC Project

    Directory of Open Access Journals (Sweden)

    Shannon Gravely

    2014-11-01

    Full Text Available Background: In recent years, electronic cigarettes (e-cigarettes have generated considerable interest and debate on the implications for tobacco control and public health. Although the rapid growth of e-cigarettes is global, at present, little is known about awareness and use. This paper presents self-reported awareness, trial and current use of e-cigarettes in 10 countries surveyed between 2009 and 2013; for six of these countries, we present the first data on e-cigarettes from probability samples of adult smokers. Methods: A cross-sectional analysis of probability samples of adult (≥ 18 years current and former smokers participating in the International Tobacco Control (ITC surveys from 10 countries. Surveys were administered either via phone, face-to-face interviews, or the web. Survey questions included sociodemographic and smoking-related variables, and questions about e-cigarette awareness, trial and current use. Results: There was considerable cross-country variation by year of data collection and for awareness of e-cigarettes (Netherlands (2013: 88%, Republic of Korea (2010: 79%, United States (2010: 73%, Australia (2013: 66%, Malaysia (2011: 62%, United Kingdom (2010: 54%, Canada (2010: 40%, Brazil (2013: 35%, Mexico (2012: 34%, and China (2009: 31%, in self-reports of ever having tried e-cigarettes (Australia, (20%, Malaysia (19%, Netherlands (18%, United States (15%, Republic of Korea (11%, United Kingdom (10%, Mexico (4%, Canada (4%, Brazil (3%, and China (2%, and in current use (Malaysia (14%, Republic of Korea (7%, Australia (7%, United States (6%, United Kingdom (4%, Netherlands (3%, Canada (1%, and China (0.05%. Conclusions: The cross-country variability in awareness, trial, and current use of e-cigarettes is likely due to a confluence of country-specific market factors, tobacco control policies and regulations (e.g., the legal status of e-cigarettes and nicotine, and the survey timing along the trajectory of e

  20. Awareness, trial, and current use of electronic cigarettes in 10 countries: Findings from the ITC project.

    Science.gov (United States)

    Gravely, Shannon; Fong, Geoffrey T; Cummings, K Michael; Yan, Mi; Quah, Anne C K; Borland, Ron; Yong, Hua-Hie; Hitchman, Sara C; McNeill, Ann; Hammond, David; Thrasher, James F; Willemsen, Marc C; Seo, Hong Gwan; Jiang, Yuan; Cavalcante, Tania; Perez, Cristina; Omar, Maizurah; Hummel, Karin

    2014-11-13

    In recent years, electronic cigarettes (e-cigarettes) have generated considerable interest and debate on the implications for tobacco control and public health. Although the rapid growth of e-cigarettes is global, at present, little is known about awareness and use. This paper presents self-reported awareness, trial and current use of e-cigarettes in 10 countries surveyed between 2009 and 2013; for six of these countries, we present the first data on e-cigarettes from probability samples of adult smokers. A cross-sectional analysis of probability samples of adult (≥ 18 years) current and former smokers participating in the International Tobacco Control (ITC) surveys from 10 countries. Surveys were administered either via phone, face-to-face interviews, or the web. Survey questions included sociodemographic and smoking-related variables, and questions about e-cigarette awareness, trial and current use. There was considerable cross-country variation by year of data collection and for awareness of e-cigarettes (Netherlands (2013: 88%), Republic of Korea (2010: 79%), United States (2010: 73%), Australia (2013: 66%), Malaysia (2011: 62%), United Kingdom (2010: 54%), Canada (2010: 40%), Brazil (2013: 37%), Mexico (2012: 34%), and China (2009: 31%)), in self-reports of ever having tried e-cigarettes (Australia, (20%), Malaysia (19%), Netherlands (18%), United States (15%), Republic of Korea (11%), United Kingdom (10%), Brazil (8%), Mexico (4%), Canada (4%), and China (2%)), and in current use (Malaysia (14%), Republic of Korea (7%), Australia (7%), United States (6%), United Kingdom (4%), Netherlands (3%), Canada (1%), and China (0.05%)) [corrected]. The cross-country variability in awareness, trial, and current use of e-cigarettes is likely due to a confluence of country-specific market factors, tobacco control policies and regulations (e.g., the legal status of e-cigarettes and nicotine), and the survey timing along the trajectory of e-cigarette awareness and trial

  1. Understanding the determinants of antimicrobial prescribing within hospitals: the role of "prescribing etiquette".

    Science.gov (United States)

    Charani, E; Castro-Sanchez, E; Sevdalis, N; Kyratsis, Y; Drumright, L; Shah, N; Holmes, A

    2013-07-01

    There is limited knowledge of the key determinants of antimicrobial prescribing behavior (APB) in hospitals. An understanding of these determinants is required for the successful design, adoption, and implementation of quality improvement interventions in antimicrobial stewardship programs. Qualitative semistructured interviews were conducted with doctors (n = 10), pharmacists (n = 10), and nurses and midwives (n = 19) in 4 hospitals in London. Interviews were conducted until thematic saturation was reached. Thematic analysis was applied to the data to identify the key determinants of antimicrobial prescribing behaviors. The APB of healthcare professionals is governed by a set of cultural rules. Antimicrobial prescribing is performed in an environment where the behavior of clinical leaders or seniors influences practice of junior doctors. Senior doctors consider themselves exempt from following policy and practice within a culture of perceived autonomous decision making that relies more on personal knowledge and experience than formal policy. Prescribers identify with the clinical groups in which they work and adjust their APB according to the prevailing practice within these groups. A culture of "noninterference" in the antimicrobial prescribing practice of peers prevents intervention into prescribing of colleagues. These sets of cultural rules demonstrate the existence of a "prescribing etiquette," which dominates the APB of healthcare professionals. Prescribing etiquette creates an environment in which professional hierarchy and clinical groups act as key determinants of APB. To influence the antimicrobial prescribing of individual healthcare professionals, interventions need to address prescribing etiquette and use clinical leadership within existing clinical groups to influence practice.

  2. Prescribing Practices and Polypharmacy in Kitovu Hospital

    African Journals Online (AJOL)

    admin

    1Division of Medicine and Therapeutics, Centre for Medical Education, The Queen's ... This audit of prescribing practices explores recent trends at Kitovu Hospital, Uganda ..... This creates a cycle of poor ... interventions to remedy these is vital.

  3. Customization in prescribing for bipolar disorder.

    Science.gov (United States)

    Hodgkin, Dominic; Volpe-Vartanian, Joanna; Merrick, Elizabeth L; Horgan, Constance M; Nierenberg, Andrew A; Frank, Richard G; Lee, Sue

    2012-06-01

    For many disorders, patient heterogeneity requires physicians to customize their treatment to each patient's needs. We test for the existence of customization in physicians' prescribing for bipolar disorder, using data from a naturalistic clinical effectiveness trial of bipolar disorder treatment (STEP-BD), which did not constrain physician prescribing. Multinomial logit is used to model the physician's choice among five combinations of drug classes. We find that our observed measure of the patient's clinical status played only a limited role in the choice among drug class combinations, even for conditions such as mania that are expected to affect class choice. However, treatment of a patient with given characteristics differed widely depending on which physician was seen. The explanatory power of the model was low. There was variation within each physician's prescribing, but the results do not suggest a high degree of customization in physicians' prescribing, based on our measure of clinical status. Copyright © 2011 John Wiley & Sons, Ltd.

  4. Nurse prescribing ethics and medical marketing.

    Science.gov (United States)

    Adams, J

    This article suggests that nurse prescribers require an awareness of key concepts in ethics, such as deontology and utilitarianism to reflect on current debates and contribute to them. The principles of biomedical ethics have also been influential in the development of professional codes of conduct. Attention is drawn to the importance of the Association of the British Pharmaceutical Industry's code of practice for the pharmaceutical industry in regulating marketing aimed at prescribers.

  5. Prevalence of inappropriate prescribing in primary care

    DEFF Research Database (Denmark)

    Bregnhøj, Lisbeth; Thirstrup, Steffen; Kristensen, Mogens Brandt

    2007-01-01

    to the patients. Topical, dermatological medications and medications not used regularly were excluded. RESULTS: 212 patients were prescribed 1621 medications by their GPs at baseline. In all, 640 (39.5%) of the medications had one or more inappropriate ratings in the 10 criteria making up the MAI. The main part...... is good. However, the majority of patients used one or more medications with inappropriate ratings. The inappropriate prescribing relates to specific therapeutic groups and criteria, which should be targeted in future interventions....

  6. `Twisted' electrons

    Science.gov (United States)

    Larocque, Hugo; Kaminer, Ido; Grillo, Vincenzo; Leuchs, Gerd; Padgett, Miles J.; Boyd, Robert W.; Segev, Mordechai; Karimi, Ebrahim

    2018-04-01

    Electrons have played a significant role in the development of many fields of physics during the last century. The interest surrounding them mostly involved their wave-like features prescribed by the quantum theory. In particular, these features correctly predict the behaviour of electrons in various physical systems including atoms, molecules, solid-state materials, and even in free space. Ten years ago, new breakthroughs were made, arising from the new ability to bestow orbital angular momentum (OAM) to the wave function of electrons. This quantity, in conjunction with the electron's charge, results in an additional magnetic property. Owing to these features, OAM-carrying, or twisted, electrons can effectively interact with magnetic fields in unprecedented ways and have motivated materials scientists to find new methods for generating twisted electrons and measuring their OAM content. Here, we provide an overview of such techniques along with an introduction to the exciting dynamics of twisted electrons.

  7. Reducing antibiotic prescribing in Australian general practice: time for a national strategy.

    Science.gov (United States)

    Del Mar, Christopher B; Scott, Anna Mae; Glasziou, Paul P; Hoffmann, Tammy; van Driel, Mieke L; Beller, Elaine; Phillips, Susan M; Dartnell, Jonathan

    2017-11-06

    In Australia, the antibiotic resistance crisis may be partly alleviated by reducing antibiotic use in general practice, which has relatively high prescribing rates - antibiotics are mostly prescribed for acute respiratory infections, for which they provide only minor benefits. Current surveillance is inadequate for monitoring community antibiotic resistance rates, prescribing rates by indication, and serious complications of acute respiratory infections (which antibiotic use earlier in the infection may have averted), making target setting difficult. Categories of interventions that may support general practitioners to reduce prescribing antibiotics are: regulatory (eg, changing the default to "no repeats" in electronic prescribing, changing the packaging of antibiotics to facilitate tailored amounts of antibiotics for the right indication and restricting access to prescribing selected antibiotics to conserve them), externally administered (eg, academic detailing and audit and feedback on total antibiotic use for individual GPs), interventions that GPs can individually implement (eg, delayed prescribing, shared decision making, public declarations in the practice about conserving antibiotics, and self-administered audit), supporting GPs' access to near-patient diagnostic testing, and public awareness campaigns. Many unanswered clinical research questions remain, including research into optimal implementation methods. Reducing antibiotic use in Australian general practice will require a range of approaches (with various intervention categories), a sustained effort over many years and a commitment of appropriate resources and support.

  8. Air Pollution Episodes Associated with Prescribed Burns

    Science.gov (United States)

    Hart, M.; Di Virgilio, G.; Jiang, N.

    2017-12-01

    Air pollution events associated with wildfires have been associated with extreme health impacts. Prescribed burns are an important tool to reduce the severity of wildfires. However, if undertaken during unfavourable meteorological conditions, they too have the capacity to trigger extreme air pollution events. The Australian state of New South Wales has increased the annual average area treated by prescribed burn activities by 45%, in order to limit wildfire activity. Prescribed burns need to be undertaken during meteorological conditions that allow the fuel load to burn, while still allowing the burn to remain under control. These conditions are similar to those that inhibit atmospheric dispersion, resulting in a fine balance between managing fire risk and managing ambient air pollution. During prescribed burns, the Sydney air shed can experience elevated particulate matter concentrations, especially fine particulates (PM2.5) that occasionally exceed national air quality standards. Using pollutant and meteorological data from sixteen monitoring stations in Sydney we used generalized additive model and CART analyses to profile the meteorological conditions influencing air quality during planned burns. The insights gained from this study will help improve prescribed burn scheduling in order to reduce the pollution risk to the community, while allowing fire agencies to conduct this important work.

  9. Control of invasive weeds with prescribed burning

    Science.gov (United States)

    DiTomaso, Joseph M.; Brooks, Matthew L.; Allen, Edith B.; Minnich, Ralph; Rice, Peter M.; Kyser, Guy B.

    2006-01-01

    Prescribed burning has primarily been used as a tool for the control of invasive late-season annual broadleaf and grass species, particularly yellow starthistle, medusahead, barb goatgrass, and several bromes. However, timely burning of a few invasive biennial broadleaves (e.g., sweetclover and garlic mustard), perennial grasses (e.g., bluegrasses and smooth brome), and woody species (e.g., brooms and Chinese tallow tree) also has been successful. In many cases, the effectiveness of prescribed burning can be enhanced when incorporated into an integrated vegetation management program. Although there are some excellent examples of successful use of prescribed burning for the control of invasive species, a limited number of species have been evaluated. In addition, few studies have measured the impact of prescribed burning on the long-term changes in plant communities, impacts to endangered plant species, effects on wildlife and insect populations, and alterations in soil biology, including nutrition, mycorrhizae, and hydrology. In this review, we evaluate the current state of knowledge on prescribed burning as a tool for invasive weed management.

  10. The use of prescribed and non-prescribed medication by Dutch children.

    NARCIS (Netherlands)

    Dijk, L. van; Lindert, H. van

    2002-01-01

    Background: Most research on the use of medication focuses on adults. Children, however, use medication too, most of which is prescribed by GP's. Children also use non-prescribed medication (f.e. bought in the drugstore), but the extent to which is not known. Moreover, it is not known to what extent

  11. Auditing GPs' prescribing habits : Cardiovascular prescribing frequently continues medication initiated by specialists

    NARCIS (Netherlands)

    de Vries, C.S; van Diepen, N.M; de Jong-van den Berg, L T W

    Objective: To determine to what extent general practitioners' (GPs) prescribing behaviour is a result of repeat prescribing of medication which has been initiated by specialists. Method: During a 4-week period, pharmacists identified GPs' prescriptions for a large group of cardiovascular drugs.

  12. Modeling and Simulation of Longitudinal Dynamics for Low Energy Ring-High Energy Ring at the Positron-Electron Project

    International Nuclear Information System (INIS)

    Rivetta, Claudio; Mastorides, T.; Fox, J.D.; Teytelman, D.; Van Winkle, D.

    2007-01-01

    A time domain dynamic modeling and simulation tool for beam-cavity interactions in the Low Energy Ring (LER) and High Energy Ring (HER) at the Positron-Electron Project (PEP-II) is presented. Dynamic simulation results for PEP-II are compared to measurements of the actual machine. The motivation for this tool is to explore the stability margins and performance limits of PEP-II radio-frequency (RF) systems at future higher currents and upgraded RF configurations. It also serves as a test bed for new control algorithms and can define the ultimate limits of the low-level RF (LLRF) architecture. The time domain program captures the dynamic behavior of the beam-cavity-LLRF interaction based on a reduced model. The ring current is represented by macrobunches. Multiple RF stations in the ring are represented via one or two macrocavities. Each macrocavity captures the overall behavior of all the 2 or 4 cavity RF stations. Station models include nonlinear elements in the klystron and signal processing. This enables modeling the principal longitudinal impedance control loops interacting via the longitudinal beam model. The dynamics of the simulation model are validated by comparing the measured growth rates for the LER with simulation results. The simulated behavior of the LER at increased operation currents is presented via low-mode instability growth rates. Different control strategies are compared and the effects of both the imperfections in the LLRF signal processing and the nonlinear drivers and klystrons are explored

  13. Pharmaceutical marketing research and the prescribing physician.

    Science.gov (United States)

    Greene, Jeremy A

    2007-05-15

    Surveillance of physicians' prescribing patterns and the accumulation and sale of these data for pharmaceutical marketing are currently the subjects of legislation in several states and action by state and national medical associations. Contrary to common perception, the growth of the health care information organization industry has not been limited to the past decade but has been building slowly over the past 50 years, beginning in the 1940s when growth in the prescription drug market fueled industry interest in understanding and influencing prescribing patterns. The development of this surveillance system was not simply imposed on the medical profession by the pharmaceutical industry but was developed through the interactions of pharmaceutical salesmen, pharmaceutical marketers, academic researchers, individual physicians, and physician organizations. Examination of the role of physicians and physician organizations in the development of prescriber profiling is directly relevant to the contemporary policy debate surrounding this issue.

  14. The Quality of Prescribing for Psychiatric Patients

    DEFF Research Database (Denmark)

    Soerensen, A L; Nielsen, L P; Poulsen, B K

    2014-01-01

    The Quality of Prescribing for Psychiatric PatientsSoerensen AL1,2, Nielsen LP3,4, Poulsen BK3, Lisby M3,5, Mainz J6,7 1Danish Center for Healthcare Improvements, Faculty of Social Sciences and Faculty of Health Sciences, Aalborg University, Denmark; 2University College of Northern Denmark; 3......, Aalborg; Denmark OBJECTIVES: Prescribing for adult psychiatric patients is often highly complex due to the nature of psychiatric conditions, but also due to somatic comorbidity. Therefore, the aim of this study was to identify prevalence and types of potential inappropriate prescribing (PIP), asses...... the severity of potential clinical consequences and identify possible predictive factors of PIP.METHODS: The study was designed as a prospective study of PIP using medication reviews. Patients who were admitted during a 4 month period (August 2013 - November 2013) to a psychiatric university hospital were...

  15. The Quality of Prescribing for Psychiatric Patients

    DEFF Research Database (Denmark)

    Sørensen, Ann Lykkegaard; Nielsen, Lars Peter; Poulsen, Birgitte Klindt

    2014-01-01

    The Quality of Prescribing for Psychiatric Patients Soerensen AL1,2, Nielsen LP3,4, Poulsen BK3, Lisby M3,5, Mainz J6,7 1Danish Center for Healthcare Improvements, Faculty of Social Sciences and Faculty of Health Sciences, Aalborg University, Denmark; 2University College of Northern Denmark; 3......, Aalborg; Denmark OBJECTIVES: Prescribing for adult psychiatric patients is often highly complex due to the nature of psychiatric conditions, but also due to somatic comorbidity. Therefore, the aim of this study was to identify prevalence and types of potential inappropriate prescribing (PIP), asses...... the severity of potential clinical consequences and identify possible predictive factors of PIP. METHODS: The study was designed as a prospective study of PIP using medication reviews. Patients who were admitted during a 4 month period (August 2013 - November 2013) to a psychiatric university hospital were...

  16. [Computer-aided prescribing: from utopia to reality].

    Science.gov (United States)

    Suárez-Varela Ubeda, J; Beltrán Calvo, C; Molina López, T; Navarro Marín, P

    2005-05-31

    To determine whether the introduction of computer-aided prescribing helped reduce the administrative burden at primary care centers. Descriptive, cross-sectional design. Torreblanca Health Center in the province of Seville, southern Spain. From 29 October 2003 to the present a pilot project involving nine pharmacies in the basic health zone served by this health center has been running to evaluate computer-aided prescribing (the Receta XXI project) with real patients. All patients on the center's list of patients who came to the center for an administrative consultation to renew prescriptions for medications or supplies for long-term treatment. Total number of administrative visits per patient for patients who came to the center to renew prescriptions for long-term treatment, as recorded by the Diraya system (Historia Clinica Digital del Ciudadano, or Citizen's Digital Medical Record) during the period from February to July 2004. Total number of the same type of administrative visits recorded by the previous system (TASS) during the period from February to July 2003. The mean number of administrative visits per month during the period from February to July 2003 was 160, compared to a mean number of 64 visits during the period from February to July 2004. The reduction in the number of visits for prescription renewal was 60%. Introducing a system for computer-aided prescribing significantly reduced the number of administrative visits for prescription renewal for long-term treatment. This could help reduce the administrative burden considerably in primary care if the system were used in all centers.

  17. The project of the technological line of the electronic-beam drains disinfection in the infected hospitals' divisions and tubercular centres

    International Nuclear Information System (INIS)

    Shlapatska, V.V.; Volkonsky, V.G.; Sakhno, V.I.; Tomchaj, S.P.

    1999-01-01

    The purpose of the project was to create the electrophysical facility for the environmental protection from contamination by drains of the infected hospitals' divisions and tubercular centres and prevention of open water reservoirs. Development of the economically approved methods of the radiative disinfection of contaminated drains; development of the inexpensive compact facility for the electron-beam disinfection of small volume drains

  18. Evoking prescribed spike times in stochastic neurons

    Science.gov (United States)

    Doose, Jens; Lindner, Benjamin

    2017-09-01

    Single cell stimulation in vivo is a powerful tool to investigate the properties of single neurons and their functionality in neural networks. We present a method to determine a cell-specific stimulus that reliably evokes a prescribed spike train with high temporal precision of action potentials. We test the performance of this stimulus in simulations for two different stochastic neuron models. For a broad range of parameters and a neuron firing with intermediate firing rates (20-40 Hz) the reliability in evoking the prescribed spike train is close to its theoretical maximum that is mainly determined by the level of intrinsic noise.

  19. Blueprint for prescriber continuing education program.

    Science.gov (United States)

    2012-06-01

    On October 25, 2011, the Center for Drug Evaluation and Research (CDER) of the Food and Drug Administration (FDA) posted online this Blueprint for Prescriber Continuing Education, labeled "final," relating to extended-release and long-acting opioids. The pending FDA Risk Evaluation Management Strategy (REMS) requires prescriber education. This document provides guidance to sponsors of these dosage forms in developing the prescvriber education component of their REMS. This report was posted online by the federal agency on October 25, 2011 at: http://www.fda.gov/downloads/drugs/drugsafety/informationbydrugclass/ucm277916.pdf. It is in the public domain.

  20. 69-74 A Retrospective Analysis of Prescribing Prac

    African Journals Online (AJOL)

    user

    A Retrospective Analysis of Prescribing Practice Based on WHO Prescribing Indicators at Four. Selected Hospitals of West ... Key words: World Health Organization, prescribing indicators, rational drug use. INTRODUCTION. Indicators of ... factors, the risk of irrational prescribing could raise several folds. Irrational use of ...

  1. Antimalarial prescribing patterns in state hospitals and selected ...

    African Journals Online (AJOL)

    slowdown of progression to resistance could be achieved by improving prescribing practice, drug quality, and patient compliance. Objective: To determine the antimalarial prescribing pattern and to assess rational prescribing of chloroquine by prescribers in government hospitals and parastatals in Lagos State. Methods: ...

  2. Barriers and facilitators to implementing electronic prescription: a systematic review of user groups' perceptions.

    Science.gov (United States)

    Gagnon, Marie-Pierre; Nsangou, Édith-Romy; Payne-Gagnon, Julie; Grenier, Sonya; Sicotte, Claude

    2014-01-01

    We conducted a systematic review identifying users groups' perceptions of barriers and facilitators to implementing electronic prescription (e-prescribing) in primary care. We included studies following these criteria: presence of an empirical design, focus on the users' experience of e-prescribing implementation, conducted in primary care, and providing data on barriers and facilitators to e-prescribing implementation. We used the Donabedian logical model of healthcare quality (adapted by Barber et al) to analyze our findings. We found 34 publications (related to 28 individual studies) eligible to be included in this review. These studies identified a total of 594 elements as barriers or facilitators to e-prescribing implementation. Most user groups perceived that e-prescribing was facilitated by design and technical concerns, interoperability, content appropriate for the users, attitude towards e-prescribing, productivity, and available resources. This review highlights the importance of technical and organizational support for the successful implementation of e-prescribing systems. It also shows that the same factor can be seen as a barrier or a facilitator depending on the project's own circumstances. Moreover, a factor can change in nature, from a barrier to a facilitator and vice versa, in the process of e-prescribing implementation. This review summarizes current knowledge on factors related to e-prescribing implementation in primary care that could support decision makers in their design of effective implementation strategies. Finally, future studies should emphasize on the perceptions of other user groups, such as pharmacists, managers, vendors, and patients, who remain neglected in the literature.

  3. Impact of Prior Therapeutic Opioid Use by Emergency Department Providers on Opioid Prescribing Decisions

    Directory of Open Access Journals (Sweden)

    Adam C Pomerleau

    2016-11-01

    Full Text Available INTRODUCTION: Our study sought to examine the opioid analgesic (OA prescribing decisions of emergency department (ED providers who have themselves used OA therapeutically and those who have not. A second objective was to determine if OA prescribing decisions would differ based on the patient's relationship to the provider. METHODS: We distributed an electronic survey to a random sample of ED providers at participating centers in a nationwide research consortium. Question topics included provider attitudes about OA prescribing, prior personal therapeutic use of OAs (indications, dosing, and disposal of leftover medication, and hypothetical analgesic-prescribing decisions for their patients, family members, and themselves for different painful conditions. RESULTS: The total survey population was 957 individuals; 515 responded to the survey, a 54% response rate. Prior personal therapeutic OA use was reported in 63% (95% CI = [58-68]. A majority of these providers (82%; 95% CI = [77-87] took fewer than half the number of pills prescribed. Regarding provider attitudes towards OA prescribing, 66% (95% CI = [61-71] agreed that OA could lead to addiction even with short-term use. When providers were asked if they would prescribe OA to a patient with 10/10 pain from an ankle sprain, 21% (95% CI = [17-25] would for an adult patient, 13% (95% CI = [10-16] would for an adult family member, and 6% (95% CI = [4-8] indicated they themselves would take an opioid for the same pain. When the scenario involved an ankle fracture, 86% (95% CI = [83-89] would prescribe OA for an adult patient, 75% (95% CI = [71-79] for an adult family member, and 52% (95% CI = [47-57] would themselves take OA. Providers who have personally used OA to treat their pain were found to make similar prescribing decisions compared to those who had not. CONCLUSION: No consistent differences in prescribing decisions were found between ED providers based on their prior therapeutic use of OA

  4. Final Report for completed IPP-0110 and 0110A Projects: 'High Energy Ion Technology of Interfacial Thin Film Coatings for Electronic, Optical and Industrial Applications'

    International Nuclear Information System (INIS)

    Brown, Ian

    2009-01-01

    The DOE-supported IPP (Initiatives for Proliferation Prevention) Project, IPP-0110, and its accompanying 'add-on project' IPP-0110A, entitled 'High Energy Ion Technology of Interfacial Thin Film Coatings for Electronic, Optical and Industrial Applications' was a collaborative project involving the Lawrence Berkeley National Laboratory (LBNL) as the U.S. DOE lab; the US surface modification company, Phygen, Inc., as the US private company involved; and the High Current Electronics Institute (HCEI) of the Russian Academy of Sciences, Tomsk, Siberia, Russia, as the NIS Institute involved. Regular scientific research progress meetings were held to which personnel came from all participating partners. The meetings were held mostly at the Phygen facilities in Minneapolis, Minnesota (with Phygen as host) with meetings also held at Tomsk, Russia (HCEI as host), and at Berkeley, California (LBNL as host) In this way, good exposure of all researchers to the various different laboratories involved was attained. This report contains the Final Reports (final deliverables) from the Russian Institute, HCEI. The first part is that for IPP-0110A (the 'main part' of the overall project) and the second part is that for the add-on project IPP-0110A. These reports are detailed, and contain all aspects of all the research carried out. The project was successful in that all deliverables as specified in the proposals were successfully developed, tested, and delivered to Phygen. All of the plasma hardware was designed, made and tested at HCEI, and the performance was excellent. Some of the machine and performance parameters were certainly of 'world class'. The goals and requirements of the IPP Project were well satisfied. I would like to express my gratitude to the DOE IPP program for support of this project throughout its entire duration, and for the unparalleled opportunity thereby provided for all of the diverse participants in the project to join in this collaborative research. The

  5. Learning from escaped prescribed fire reviews

    Science.gov (United States)

    Anne E. Black; Dave Thomas; James Saveland; Jennifer D. Ziegler

    2011-01-01

    The U.S. wildland fire community has developed a number of innovative methods for conducting a review following escape of a prescribed fire (expanding on the typical regional or local reviews, to include more of a learning focus - expanded After Action Reviews, reviews that incorporate High Reliability Organizing, Facilitated Learning Analyses, etc). The stated purpose...

  6. Prescribing Behavior of General Practitioners : Competition Matters!

    NARCIS (Netherlands)

    Schaumans, C.B.C.

    2014-01-01

    Background: General Practitioners have limited means to compete. As quality is hard to observe by patients, GPs have incentives to signal quality by using instruments patients perceive as quality. Objectives: We investigate whether GPs exhibit different prescribing behavior (volume and value of

  7. Prescribing behavior of general practitioners : Competition matters!

    NARCIS (Netherlands)

    Schaumans, C.B.C.

    Background General Practitioners (GP) have limited means to compete. As quality is hard to observe by patients, GPs have incentives to signal quality by using instruments patients perceive as quality. Objectives I investigate whether GPs prescribe more units when confronted with more competition. As

  8. Antimalarial Drugs for Pediatrics - Prescribing and Dispensing ...

    African Journals Online (AJOL)

    Purpose: To assess dispensing and prescribing practices with regard to antimalarial drugs for pediatrics in private pharmacies and public hospitals in Dar es Salaam, Tanzania. Methods: This was a cross-sectional, descriptive study that assessed the knowledge and practice of 200 drug dispensers in the private community ...

  9. Cost Evaluation of Commonly Prescribed Antihypertensive Drugs ...

    African Journals Online (AJOL)

    It was also concluded that generic prescription should be encouraged among prescribers to lessen the financial burden of patients because drugs marketed under generic names are usually cheaper than those with brand names. Key words: Brand, Generic,Prescription, Antihypertensives,Cost. [Nig. Jnl Health & Biomedical ...

  10. PRESCRIBING PATTERN OF NON-STEROIDAL ANTI ...

    African Journals Online (AJOL)

    2015-03-01

    Mar 1, 2015 ... Design: A total of 3800 prescriptions containing. NSAIDs were analyzed for information on drug name, the number of NSAIDs per prescription, the presence of ACE inhibitors and diuretics alongside. NSAIDs and NSAIDs prescribed in generic or brand names. Results: The results showed that Aspirin was ...

  11. Prescribing Patterns of Methylphenidate and Atomoxetine for ...

    African Journals Online (AJOL)

    Purpose: To determine the prescribing pattern of methylphenidate and atomoxetine to patients with. Attention-Deficit/Hyperactivity Disorder (ADHD) in South Africa. Methods: A retrospective, cross-sectional pharmacoepidemiological study was conducted based on the data from a medical aid administrator in South Africa for ...

  12. Prescribing Patterns of Methylphenidate and Atomoxetine for ...

    African Journals Online (AJOL)

    Purpose: To determine the prescribing pattern of methylphenidate and atomoxetine to patients with Attention-Deficit/Hyperactivity Disorder (ADHD) in South Africa. Methods: A retrospective, cross-sectional pharmacoepidemiological study was conducted based on the data from a medical aid administrator in South Africa for ...

  13. An atmospheric dispersion index for prescribed burning

    Science.gov (United States)

    Leonidas G. Lavdas

    1986-01-01

    A numerical index that estimates the atmosphere's capacity to disperse smoke from prescribed burning is described. The physical assumptions and mathematical development of the index are given in detail. A preliminary interpretation of dispersion index values is offered. A FORTRAN subroutine package for computing the index is included.

  14. [Prescribing, the perspectives of health professionals].

    Science.gov (United States)

    Debout, Christophe; Lescot, Thomas; Loyer, Frédérique; Ambrosino, Florence

    2016-10-01

    While, in France, various health professionals are authorised to prescribe, they approach this activity in a different way, depending on the professional category to which they belong. The areas and products concerned are specific to each profession, and inevitably evolve. This article presents the different perspectives of a doctor, a midwife and a nurse. Copyright © 2016. Published by Elsevier Masson SAS.

  15. Emerging and encouraging trends in e-prescribing adoption among providers and pharmacies.

    Science.gov (United States)

    Gabriel, Meghan E; Furukawa, Michael F; Vaidya, Varun

    2013-09-01

    The objective of this study is to describe the growth in provider (physician, nurse practitioner, and physician assistant) adoption of e-prescribing and the growth in pharmacies actively accepting e-prescriptions using nationally representative data from December 2008 to December 2012. Additionally, this study explored e-prescribing adoption variation by urban and rural counties. Descriptive analysis of nationally representative, transactional e-prescribing data. Data for this analysis were from Surescripts. Surescripts is a leading e-prescription network utilized by a majority of all chain, franchise, or independently owned pharmacies in the United States routing prescriptions for more than 240 million patients through their network. The total number of prescribers, including physicians, nurse practitioners, and physician assistants e-prescribing via an electronic health record (EHR) on the Surescripts network has increased from 7% to 54%. Additionally, the number of pharmacies actively accepting e-prescriptions is 94%. These increases in pharmacies actively accepting e-prescriptions and the provider's eprescribing mirror the increase in the volume of e-prescriptions sent on the Surescripts network. This analysis shows that the vast majority of pharmacies in the United States are able to accept e-prescriptions and over half of providers are e-prescribing via an EHR.

  16. Understanding the gender gap in antibiotic prescribing : a cross-sectional analysis of English primary care

    NARCIS (Netherlands)

    Smith, David R M; Dolk, F Christiaan K; Smieszek, Timo; Robotham, Julie V; Pouwels, Koen B

    2018-01-01

    OBJECTIVES: To explore the causes of the gender gap in antibiotic prescribing, and to determine whether women are more likely than men to receive an antibiotic prescription per consultation. DESIGN: Cross-sectional analysis of routinely collected electronic medical records from The Health

  17. Inappropriate prescribing and prescribing omissions among drug-related problems using STOPP-START criteria

    NARCIS (Netherlands)

    Verdoorn, M.A.; Kwint, H.-F.; Faber, A.; L. Bouvy, M.

    2013-01-01

    Background and objectives: Medication review has been suggested as a way to prevent drug related problems (DRPs). Screening tools have been formulated to identify potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs) respectively called Screening Tool of Older

  18. Benzodiazepine Use Among Low Back Pain Patients Concurrently Prescribed Opioids in the Military Health System

    Science.gov (United States)

    2017-08-27

    TYPE 08/27/2017 Poster 4. TITLE AND SUBTITLE Benzodiazepine Lise Among Lo\\v Back Pain Patients Concurrently Prescribed Opioids in the tvfilitary...PRO’-:iRAM ELEMENT NUMBER 5d. PROJECT NUMBER Se. TASK NUMBER Sf. WORK UNIT NUMBER 8. PERFORMING ORGANIZATION REPORT NUMBER 17356 10. SPONSOR

  19. Asthma management in five European countries : doctors' knowledge, attitudes and prescribing behaviour

    NARCIS (Netherlands)

    Lagerlov, P; Veninga, CCM; Muskova, M; Hummers-Pradier, E; Lundborg, CS; Andrew, M; Haaijer-Ruskamp, FM; DEP-group, [No Value

    The aim of the study was to examine the relationship between guideline recommendations on asthma management, and the performance of doctors in five different European health care contexts, Knowledge, attitudes and prescribing behaviour of doctors recruited to an educational project was investigated.

  20. Antiepileptic drug prescribing before, during and after pregnancy: a study in seven European regions.

    Science.gov (United States)

    Charlton, Rachel; Garne, Ester; Wang, Hao; Klungsøyr, Kari; Jordan, Sue; Neville, Amanda; Pierini, Anna; Hansen, Anne; Engeland, Anders; Gini, Rosa; Thayer, Daniel; Bos, Jens; Puccini, Aurora; Nybo Andersen, Anne-Marie; Dolk, Helen; de Jong-van den Berg, Lolkje

    2015-11-01

    The aim of this study was to explore antiepileptic drug (AED) prescribing before, during and after pregnancy as recorded in seven population-based electronic healthcare databases. Databases in Denmark, Norway, the Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the Clinical Practice Research Datalink, representing the rest of the UK, were accessed for the study. Women with a pregnancy starting and ending between 2004 and 2010, which ended in a delivery, were identified. AED prescriptions issued (UK) or dispensed (non-UK) at any time during pregnancy and the 6 months before and after pregnancy were identified in each of the databases. AED prescribing patterns were analysed, and the choice of AEDs and co-prescribing of folic acid were evaluated. In total, 978 957 women with 1 248 713 deliveries were identified. In all regions, AED prescribing declined during pregnancy and was lowest during the third trimester, before returning to pre-pregnancy levels by 6 months following delivery. For all deliveries, the prevalence of AED prescribing during pregnancy was 51 per 10 000 pregnancies (CI95 49-52%) and was lowest in the Netherlands (43/10 000; CI95 33-54%) and highest in Wales (60/10 000; CI95 54-66%). In Denmark, Norway and the two UK databases lamotrigine was the most commonly prescribed AED; whereas in the Italian and Dutch databases, carbamazepine, valproate and phenobarbital were most frequently prescribed. Few women prescribed with AEDs in the 3 months before pregnancy were co-prescribed with high-dose folic acid: ranging from 1.0% (CI95 0.3-1.8%) in Emilia Romagna to 33.5% (CI95 28.7-38.4%) in Wales. The country's differences in prescribing patterns may suggest different use, knowledge or interpretation of the scientific evidence base. The low co-prescribing of folic acid indicates that more needs to be done to better inform clinicians and women of childbearing age taking AEDs about the need to offer and receive complete preconception care

  1. Changes in antimicrobial prescribing behavior after the introduction of the antimicrobial stewardship program: A pre- and post-intervention survey

    Directory of Open Access Journals (Sweden)

    Ruchir Chavada

    2017-10-01

    Full Text Available The introduction of an antimicrobial stewardship (AMS program is associated with a change in antimicrobial prescribing behavior. A proposed mechanism for this change is by impacting the prescribing etiquette described in qualitative studies. This study sought to detect a change in prescribing attitudes 12 months after the introduction of AMS and gauge utility of various AMS interventions. Surveys were distributed to doctors in two regional Australian hospitals on a convenience basis 6 months before, and 12 months after, the introduction of AMS. Agreement with 20 statements describing attitudes (cultural, behavioral and knowledge towards antimicrobial prescribing was assessed on a 4-point Likert scale. Mean response scores were compared using the Wilcoxon Rank sum test. 155 responses were collected before the introduction of AMS, and 144 afterwards. After the introduction of AMS, an increase was observed in knowledge about available resources such as electronic decision support systems (EDSS and therapeutic guidelines, with raised awareness about the support available through AMS rounds and the process to be followed when prescribing restricted antimicrobials. Additionally, doctors were less likely to rely on pharmacy to ascertain when an antimicrobial was restricted, depend on infectious diseases consultant advice and use past experience to guide antimicrobial prescribing. Responses to this survey indicate that positive changes to the antimicrobial prescribing etiquette may be achieved with the introduction of an AMS program. Use of EDSS and other resources such as evidence-based guidelines are perceived to be important to drive rational antimicrobial prescribing within AMS programs.

  2. 75 deaths in asthmatics prescribed home nebulisers.

    Science.gov (United States)

    Sears, M R; Rea, H H; Fenwick, J; Gillies, A J; Holst, P E; O'Donnell, T V; Rothwell, R P

    1987-02-21

    The circumstances surrounding the deaths of 75 asthmatic patients who had been prescribed a domiciliary nebuliser driven by an air compressor pump for administration of high dose beta sympathomimetic drugs were investigated as part of the New Zealand national asthma mortality study. Death was judged unavoidable in 19 patients who seemed to have precipitous attacks despite apparently good long term management. Delays in seeking medical help because of overreliance on beta agonist delivered by nebuliser were evident in 12 cases and possible in a further 11, but these represented only 8% of the 271 verified deaths from asthma in New Zealanders aged under 70 during the period. Evidence for direct toxicity of high dose beta agonist was not found. Nevertheless, the absence of serum potassium and theophylline concentrations and of electrocardiographic monitoring in the period immediately preceding death precluded firm conclusions whether arrhythmias might have occurred due to these factors rather than to hypoxia alone. In most patients prescribed domiciliary nebulisers death was associated with deficiencies in long term and short term care similar to those seen in patients without nebulisers. Discretion in prescribing home nebulisers, greater use of other appropriate drugs, including adequate corticosteroids, and careful supervision and instruction of patients taking beta agonist by nebuliser should help to reduce the mortality from asthma.

  3. Best available control measures for prescribed burning

    International Nuclear Information System (INIS)

    Smith, A.M.; Stoneman, C.S.

    1992-01-01

    Section 190 of the Clean Air Act (CAA) as amended in 1990 requires the US Environmental Protection Agency (EPA) to issue guidance on Best Available Control Measures (BACM) of PM 10 (particulate matter with a nominal aerodynamic diameter less than or equal to 10 micrometers) from urban fugitive dust, residential wood combustion, and prescribed silvicultural and agricultural burning (prescribed burning). The purpose of this guidance is to assist states (especially, but not exclusively, those with PM 10 nonattainment areas which have been classified as serious) in developing a control measure for these three source categories. This guidance is to be issued no later than May 15, 1992 as required under the CAA. The guidance will be issued in the form of a policy guidance generic to all three BACM and in the form of Technical Information Documents (TIDs) for each of the three source categories. The policy guidance will provide the analytical approach for determining BACM and the TID will provide the technical information. The purpose of this paper is to present some insight from the forthcoming TID on what BACM might entail for prescribed burning in a serious PM 10 nonattainment area

  4. Electronic Reverse Auctions: Integrating an E-Sourcing Tool into a Sales and Purchasing Cross-Course Negotiation Project

    Science.gov (United States)

    Williams, Jacqueline A.; Dobie, Kathryn

    2011-01-01

    Electronic reverse auctions are increasingly being used by firms to improve firm financial and operational performance. The described teaching innovation serves as a model for introducing electronic reverse auctions as a central element in a comprehensive negotiation exercise involving sales management and purchasing management students. Results…

  5. FY 1995 annual report on the project for promoting development of superhigh electronic techniques; 1995 nendo chosentan denshi gijutsu kaihatsu sokushin jigyo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-05-01

    Described herein are the FY 1995 results of the R and D project for developing superfine machining process techniques, measurement/analysis/controlling techniques for extreme conditions, and techniques for electronic materials of new functions, in order to establish the superhigh electronic techniques of two generations beyond. The project is implemented, mainly for the following targets: direct image drawing systems with electron beams by R and D of the techniques for electro-optical systems and superhigh-accuracy controlling techniques therefor; patterning systems with supershort-wavelength electro-magnetic waves by R and D of techniques for X-ray optical systems, superhigh-accuracy controlling techniques therefor and photosensitive process techniques; superfine photosensitive techniques with ultrashort-wavelength laser beams; techniques for superhigh-accuracy light-shielding systems; superhigh techniques for measurement/analysis/controlling of plasma reactions as the bases for plasma-aided superthin film making and superfine etching; basic techniques for superhigh cleaning; techniques for superhigh-sensitivity media; techniques for elements of new functions and making thin films thereof; and techniques for electronic materials of new functions. (NEDO)

  6. Table-top laser-driven ultrashort electron and X-ray source: the CIBER-X source project

    Science.gov (United States)

    Girardeau-Montaut, Jean-Pierre; Kiraly, Bélà; Girardeau-Montaut, Claire; Leboutet, Hubert

    2000-09-01

    We report on the development of a new laser-driven table-top ultrashort electron and X-ray source, also called the CIBER-X source . X-ray pulses are produced by a three-step process which consists of the photoelectron emission from a thin metallic photocathode illuminated by 16 ps duration laser pulses at 213 nm. The e-gun is a standard Pierce diode electrode type, in which electrons are accelerated by a cw electric field of ˜11 MV/m up to a hole made in the anode. The photoinjector produces a train of 70-80 keV electron pulses of ˜0.5 nC and 20 A peak current at a repetition rate of 10 Hz. The electrons are then transported outside the diode along a path of 20 cm length, and are focused onto a target of thullium by magnetic fields produced by two electromagnetic coils. X-rays are then produced by the impact of electrons on the target. Simulations of geometrical, electromagnetic fields and energetic characteristics of the complete source were performed previously with the assistance of the code PIXEL1 also developed at the laboratory. Finally, experimental electron and X-ray performances of the CIBER-X source as well as its application to very low dose imagery are presented and discussed. source Compacte d' Impulsions Brèves d' Electrons et de Rayons X

  7. Electron Cloud induced instabilities in the Fermilab Main Injector(MI) for the High Intensity Neutrino Source (HINS) project

    International Nuclear Information System (INIS)

    Sonnad, Kiran G.; Furman, Miguel A.; Vay, Jean-Luc; Venturini, Marco; Celata, Christine; Grote, David

    2006-01-01

    The electrostatic particle-in-cell codeWARP is currently being expanded in order to study electron cloud effects on the dynamics of the beam in storage rings. Results for the Fermilab main injector (MI) show the existence of a threshold in the electron density beyond which there is rapid emittance growth. The Fermilab MI is being considered for an upgrade as part of the high intensity neutrino source (HINS) effort, which will result in a significant increasing of the bunch intensity relative to its present value, placing it in a regime where electron-cloud effects are expected to become important. Various results from the simulations using WARP are discussed here

  8. Using Big Data to Assess Prescribing Patterns in Greece: The Case of Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Souliotis, Kyriakos; Kani, Chara; Papageorgiou, Manto; Lionis, Dimitrios; Gourgoulianis, Konstantinos

    2016-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is one of the top leading causes of death and disability, and its management is focused on reducing risk factors, relieving symptoms, and preventing exacerbations. The study aim was to describe COPD prescribing patterns in Greece by using existing health administrative data for outpatients. This is a retrospective cross-sectional study based on prescriptions collected by the largest social insurance fund, during the first and last trimester of 2012. Selection criteria were the prescription of specific active substances and a COPD diagnosis. Extracted information included active substance, strength, pharmaceutical form and number of packages prescribed, diagnosis, time of dispensing, as well as insurees' age, gender, percentage of co-payment and social security unique number. Statistical analysis included descriptive statistics and logistic regression. 174,357 patients received medicines for COPD during the study period. Patients were almost equally distributed between male and female, and age above 55 years was strongly correlated with COPD. Most patients received a long-acting beta agonist plus inhaled corticosteroid combination (LABA +ICS), followed by long-acting muscarinic agonist (LAMA). 63% patients belonging in the 35-54 age received LABA+ICS. LAMA was prescribed more frequently among males and was strongly correlated with COPD. The study provides big data analysis of Greek COPD prescribing patterns. It highlights the need for appropriate COPD classification in primary care illustrating the role of electronic prescribing in ensuring appropriate prescribing. Moreover, it indicates possible gender differences in treatment response or disease severity, and the impact of statutory co-payments on prescribing.

  9. Brand Name Statin Prescribing in a Resident Ambulatory Practice: Implications for Teaching Cost-Conscious Medicine.

    Science.gov (United States)

    Ryskina, Kira L; Pesko, Michael F; Gossey, J Travis; Caesar, Erica Phillips; Bishop, Tara F

    2014-09-01

    Several national initiatives aim to teach high-value care to residents. While there is a growing body of literature on cost impact of physicians' therapeutic decisions, few studies have assessed factors that influence residents' prescribing practices. We studied factors associated with intensive health care utilization among internal medicine residents, using brand name statin prescribing as a proxy for higher-cost care. We conducted a retrospective, cross-sectional analysis of statin prescriptions by residents at an urban academic internal medicine program, using electronic health record data between July 1, 2010, and June 30, 2011. For 319 encounters by 90 residents, patients were given a brand name statin in 50% of cases. When categorized into quintiles, the bottom quintile of residents prescribed brand name statins in 2% of encounters, while the top quintile prescribed brand name statins in 98% of encounters. After adjusting for potential confounders, including patient characteristics and supervising attending, being in the primary care track was associated with lower odds (odds ratio [OR], 0.38; P  =  .02; 95% confidence interval [CI], 0.16-0.86), and graduating from a medical school with an above-average hospital care intensity index was associated with higher odds of prescribing brand name statins (OR, 1.70; P  =  .049; 95% CI, 1.003-2.88). We found considerable variation in brand name statin prescribing by residents. Medical school attended and residency program type were associated with resident prescribing behavior. Future interventions should raise awareness of these patterns in an effort to teach high-value, cost-conscious care to all residents.

  10. Using Big Data to Assess Prescribing Patterns in Greece: The Case of Chronic Obstructive Pulmonary Disease.

    Directory of Open Access Journals (Sweden)

    Kyriakos Souliotis

    Full Text Available Chronic Obstructive Pulmonary Disease (COPD is one of the top leading causes of death and disability, and its management is focused on reducing risk factors, relieving symptoms, and preventing exacerbations. The study aim was to describe COPD prescribing patterns in Greece by using existing health administrative data for outpatients.This is a retrospective cross-sectional study based on prescriptions collected by the largest social insurance fund, during the first and last trimester of 2012. Selection criteria were the prescription of specific active substances and a COPD diagnosis. Extracted information included active substance, strength, pharmaceutical form and number of packages prescribed, diagnosis, time of dispensing, as well as insurees' age, gender, percentage of co-payment and social security unique number. Statistical analysis included descriptive statistics and logistic regression.174,357 patients received medicines for COPD during the study period. Patients were almost equally distributed between male and female, and age above 55 years was strongly correlated with COPD. Most patients received a long-acting beta agonist plus inhaled corticosteroid combination (LABA +ICS, followed by long-acting muscarinic agonist (LAMA. 63% patients belonging in the 35-54 age received LABA+ICS. LAMA was prescribed more frequently among males and was strongly correlated with COPD.The study provides big data analysis of Greek COPD prescribing patterns. It highlights the need for appropriate COPD classification in primary care illustrating the role of electronic prescribing in ensuring appropriate prescribing. Moreover, it indicates possible gender differences in treatment response or disease severity, and the impact of statutory co-payments on prescribing.

  11. Information from pharmaceutical companies and the quality, quantity, and cost of physicians' prescribing: a systematic review.

    Directory of Open Access Journals (Sweden)

    Geoffrey K Spurling

    2010-10-01

    Full Text Available BACKGROUND: Pharmaceutical companies spent $57.5 billion on pharmaceutical promotion in the United States in 2004. The industry claims that promotion provides scientific and educational information to physicians. While some evidence indicates that promotion may adversely influence prescribing, physicians hold a wide range of views about pharmaceutical promotion. The objective of this review is to examine the relationship between exposure to information from pharmaceutical companies and the quality, quantity, and cost of physicians' prescribing. METHODS AND FINDINGS: We searched for studies of physicians with prescribing rights who were exposed to information from pharmaceutical companies (promotional or otherwise. Exposures included pharmaceutical sales representative visits, journal advertisements, attendance at pharmaceutical sponsored meetings, mailed information, prescribing software, and participation in sponsored clinical trials. The outcomes measured were quality, quantity, and cost of physicians' prescribing. We searched Medline (1966 to February 2008, International Pharmaceutical Abstracts (1970 to February 2008, Embase (1997 to February 2008, Current Contents (2001 to 2008, and Central (The Cochrane Library Issue 3, 2007 using the search terms developed with an expert librarian. Additionally, we reviewed reference lists and contacted experts and pharmaceutical companies for information. Randomized and observational studies evaluating information from pharmaceutical companies and measures of physicians' prescribing were independently appraised for methodological quality by two authors. Studies were excluded where insufficient study information precluded appraisal. The full text of 255 articles was retrieved from electronic databases (7,185 studies and other sources (138 studies. Articles were then excluded because they did not fulfil inclusion criteria (179 or quality appraisal criteria (18, leaving 58 included studies with 87 distinct

  12. Does non-medical prescribing make a difference to patients?

    Science.gov (United States)

    Carey, Nicola; Stenner, Karen

    This article examines the literature on non-medical prescribing to establish its impact on UK healthcare. It discusses how better access to medication through non-medical prescribing can improve patient safety and patient-centred care, and how nurse prescribing can help ensure quality of care in the NHS during the current financial crisis.

  13. Antibiotic Utilization and Prescribing Patterns in a Nigerian ...

    African Journals Online (AJOL)

    The study of prescribing pattern seeks to monitor, evaluate and suggest a modification in prescriber's prescribing habits so as to make medical care rational and cost effective. Information about antibiotic use pattern is necessary for a constructive approach to problems that arise from multiple antibiotics available. To identify ...

  14. Out-Patient Prescribing Practices at Mbagathi District Hospital ...

    African Journals Online (AJOL)

    On average, each patient was prescribed 3.85 types of drugs. A total of 835 drugs were prescribed by generic name, accounting for 25.6% of total number of drugs prescribed (1,506). Out of 391 sampled prescriptions, 266 had antibiotics accounting for (68.0%). A relatively small proportion of the prescriptions, 9.5% had an ...

  15. Using relative humidity to predict spotfire probability on prescribed burns

    Science.gov (United States)

    John R. Weir

    2007-01-01

    Spotfires have and always will be a problem that burn bosses and fire crews will have to contend with on prescribed burns. Weather factors (temperature, wind speed and relative humidity) are the main variables burn bosses can use to predict and monitor prescribed fire behavior. At the Oklahoma State University Research Range, prescribed burns are conducted during...

  16. FinalReport for completed IPP-0110 and 0110A Projects:"High Energy Ion Technology of Interfacial Thin Film Coatings for Electronic, Optical and Industrial Applications"

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Ian

    2009-09-01

    The DOE-supported IPP (Initiatives for Proliferation Prevention) Project, IPP-0110, and its accompanying 'add-on project' IPP-0110A, entitled 'High Energy Ion Technology of Interfacial Thin Film Coatings for Electronic, Optical and Industrial Applications' was a collaborative project involving the Lawrence Berkeley National Laboratory (LBNL) as the U.S. DOE lab; the US surface modification company, Phygen, Inc., as the US private company involved; and the High Current Electronics Institute (HCEI) of the Russian Academy of Sciences, Tomsk, Siberia, Russia, as the NIS Institute involved. Regular scientific research progress meetings were held to which personnel came from all participating partners. The meetings were held mostly at the Phygen facilities in Minneapolis, Minnesota (with Phygen as host) with meetings also held at Tomsk, Russia (HCEI as host), and at Berkeley, California (LBNL as host) In this way, good exposure of all researchers to the various different laboratories involved was attained. This report contains the Final Reports (final deliverables) from the Russian Institute, HCEI. The first part is that for IPP-0110A (the 'main part' of the overall project) and the second part is that for the add-on project IPP-0110A. These reports are detailed, and contain all aspects of all the research carried out. The project was successful in that all deliverables as specified in the proposals were successfully developed, tested, and delivered to Phygen. All of the plasma hardware was designed, made and tested at HCEI, and the performance was excellent. Some of the machine and performance parameters were certainly of 'world class'. The goals and requirements of the IPP Project were well satisfied. I would like to express my gratitude to the DOE IPP program for support of this project throughout its entire duration, and for the unparalleled opportunity thereby provided for all of the diverse participants in the project to join

  17. Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study.

    Science.gov (United States)

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

    2011-11-03

    To describe, explore, and compare organisational routines for repeat prescribing in general practice to identify contributors and barriers to safety and quality. Ethnographic case study. Four urban UK general practices with diverse organisational characteristics using electronic patient records that supported semi-automation of repeat prescribing. 395 hours of ethnographic observation of staff (25 doctors, 16 nurses, 4 healthcare assistants, 6 managers, and 56 reception or administrative staff), and 28 documents and other artefacts relating to repeat prescribing locally and nationally. Potential threats to patient safety and characteristics of good practice. Observation of how doctors, receptionists, and other administrative staff contributed to, and collaborated on, the repeat prescribing routine. Analysis included mapping prescribing routines, building a rich description of organisational practices, and drawing these together through narrative synthesis. This was informed by a sociological model of how organisational routines shape and are shaped by information and communications technologies. Results Repeat prescribing was a complex, technology-supported social practice requiring collaboration between clinical and administrative staff, with important implications for patient safety. More than half of requests for repeat prescriptions were classed as "exceptions" by receptionists (most commonly because the drug, dose, or timing differed from what was on the electronic repeat list). They managed these exceptions by making situated judgments that enabled them (sometimes but not always) to bridge the gap between the idealised assumptions about tasks, roles, and interactions that were built into the electronic patient record and formal protocols, and the actual repeat prescribing routine as it played out in practice. This work was creative and demanded both explicit and tacit knowledge. Clinicians were often unaware of this input and it did not feature in policy

  18. Table-top laser-driven ultrashort electron and X-ray source: the CIBER-X source project

    Energy Technology Data Exchange (ETDEWEB)

    Girardeau-Montaut, J.-P. E-mail: jean-pierre.girardeau@univ-lyonl.fr; Kiraly, Bela; Girardeau-Montaut, Claire; Leboutet, Hubert

    2000-09-21

    We report on the development of a new laser-driven table-top ultrashort electron and X-ray source, also called the CIBER-X source . X-ray pulses are produced by a three-step process which consists of the photoelectron emission from a thin metallic photocathode illuminated by 16 ps duration laser pulses at 213 nm. The e-gun is a standard Pierce diode electrode type, in which electrons are accelerated by a cw electric field of {approx}11 MV/m up to a hole made in the anode. The photoinjector produces a train of 70-80 keV electron pulses of {approx}0.5 nC and 20 A peak current at a repetition rate of 10 Hz. The electrons are then transported outside the diode along a path of 20 cm length, and are focused onto a target of thulium by magnetic fields produced by two electromagnetic coils. X-rays are then produced by the impact of electrons on the target. Simulations of geometrical, electromagnetic fields and energetic characteristics of the complete source were performed previously with the assistance of the code PIXEL1 also developed at the laboratory. Finally, experimental electron and X-ray performances of the CIBER-X source as well as its application to very low dose imagery are presented and discussed.

  19. Chronology of prescribing error during the hospital stay and prediction of pharmacist's alerts overriding: a prospective analysis

    Directory of Open Access Journals (Sweden)

    Bruni Vanida

    2010-01-01

    Full Text Available Abstract Background Drug prescribing errors are frequent in the hospital setting and pharmacists play an important role in detection of these errors. The objectives of this study are (1 to describe the drug prescribing errors rate during the patient's stay, (2 to find which characteristics for a prescribing error are the most predictive of their reproduction the next day despite pharmacist's alert (i.e. override the alert. Methods We prospectively collected all medication order lines and prescribing errors during 18 days in 7 medical wards' using computerized physician order entry. We described and modelled the errors rate according to the chronology of hospital stay. We performed a classification and regression tree analysis to find which characteristics of alerts were predictive of their overriding (i.e. prescribing error repeated. Results 12 533 order lines were reviewed, 117 errors (errors rate 0.9% were observed and 51% of these errors occurred on the first day of the hospital stay. The risk of a prescribing error decreased over time. 52% of the alerts were overridden (i.e error uncorrected by prescribers on the following day. Drug omissions were the most frequently taken into account by prescribers. The classification and regression tree analysis showed that overriding pharmacist's alerts is first related to the ward of the prescriber and then to either Anatomical Therapeutic Chemical class of the drug or the type of error. Conclusions Since 51% of prescribing errors occurred on the first day of stay, pharmacist should concentrate his analysis of drug prescriptions on this day. The difference of overriding behavior between wards and according drug Anatomical Therapeutic Chemical class or type of error could also guide the validation tasks and programming of electronic alerts.

  20. Soil heating and impact of prescribed burning

    Science.gov (United States)

    Stoof, Cathelijne

    2016-04-01

    Prescribed burning is highly uncommon in the Netherlands, where wildfire awareness is increasing but its risk management does not yet include fuel management strategies. A major exception is on two military bases, that need to burn their fields in winter and spring to prevent wildfires during summer shooting practice. Research on these very frequent burns has so far been limited to effects on biodiversity, yet site managers and policy makers have questions regarding the soil temperatures reached during these burns because of potential impact on soil properties and soil dwelling fauna. In March 2015, I therefore measured soil and litter temperatures under heath and grass vegetation during a prescribed burn on military terrain in the Netherlands. Soil and litter moisture were sampled pre- and post-fire, ash was collected, and fireline intensity was estimated from flame length. While standing vegetation was dry (0.13 g water/g biomass for grass and 0.6 g/g for heather), soil and litter were moist (0.21 cm3/cm3 and 1.6 g/g, respectively). Soil heating was therefore very limited, with maximum soil temperature at the soil-litter interface remaining being as low as 6.5 to 11.5°C, and litter temperatures reaching a maximum of 77.5°C at the top of the litter layer. As a result, any changes in physical properties like soil organic matter content and bulk density were not significant. These results are a first step towards a database of soil heating in relation to fuel load and fire intensity in this temperate country, which is not only valuable to increase understanding of the relationships between fire intensity and severity, but also instrumental in the policy debate regarding the sustainability of prescribed burns.

  1. [Prescribed drugs - a new crime field?].

    Science.gov (United States)

    Schwarzenbrunner, Thomas

    2014-12-01

    The first chapter of the following article discusses measures in terms of substitution treatment of a program of the Austrian Minister of the Interior. The relevance of psychosocial measures and aims of substitution treatment for opioid-dependent patients is illuminated. The abstinence as the only goal definition is modified and by the results of the study PREMOS a target differentiation at addiction work is illustrated. The second chapter addresses the misuse of prescribed drugs. Thereby police report data will be analyzed and the market situation of opioids will be outlined.

  2. How to prescribe physical exercise in rheumatology

    Directory of Open Access Journals (Sweden)

    S. Maddali Bongi

    2011-06-01

    Full Text Available Physical exercise, aiming to improve range of movement, muscle strength and physical well being, lately substituted the immobilization previously prescribed in rheumatic diseases. International guidelines, recommendations of Scientific Societies, and structured reviews regard physical exercise as of pivotal importance in treating rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, fibromyalgia syndrome, osteoporosis, and to be considered in connective tissue diseases. Therapeutic exercise should: aim to improve firstly local symptoms and then general health; respect the pain threshold; be a part of a treatment including pharmacological therapies and other rehabilitation techniques, be administered by skilled physiotherapist under the guide of a rheumatologist, be different according to different diseases, disease phases and patient expectations.

  3. Prescribing tests must have curriculum support

    Directory of Open Access Journals (Sweden)

    Lemon TI

    2013-05-01

    Full Text Available Rupali D Shah, Thomas I LemonSchool of Medicine, Cardiff University, University Hospital of Wales, Cardiff, WalesGordon, Catchpole and Baker1 have discussed and investigated a very interesting, currently relevant, subject in medical education; particularly with the introduction of the prescribing test for undergraduates trialled in the UK this year and set to become a fully-fledged part of the curriculum and assessment criteria for 2014 graduates.2 It would of course be of great interest to compare the themes discussed in this paper and see they how would compare to recent graduates in late 2014.View original paper by Gordon and colleagues.

  4. Assessing the Impact of Fires on Air Quality in the Southeastern U.S. with a Unified Prescribed Burning Database

    Science.gov (United States)

    Garcia Menendez, F.; Afrin, S.

    2017-12-01

    Prescribed fires are used extensively across the Southeastern United States and are a major source of air pollutant emissions in the region. These land management projects can adversely impact local and regional air quality. However, the emissions and air pollution impacts of prescribed fires remain largely uncertain. Satellite data, commonly used to estimate fire emissions, is often unable to detect the low-intensity, short-lived prescribed fires characteristic of the region. Additionally, existing ground-based prescribed burn records are incomplete, inconsistent and scattered. Here we present a new unified database of prescribed fire occurrence and characteristics developed from systemized digital burn permit records collected from public and private land management organizations in the Southeast. This bottom-up fire database is used to analyze the correlation between high PM2.5 concentrations measured by monitoring networks in southern states and prescribed fire occurrence at varying spatial and temporal scales. We show significant associations between ground-based records of prescribed fire activity and the observational air quality record at numerous sites by applying regression analysis and controlling confounding effects of meteorology. Furthermore, we demonstrate that the response of measured PM2.5 concentrations to prescribed fire estimates based on burning permits is significantly stronger than their response to satellite fire observations from MODIS (moderate-resolution imaging spectroradiometer) and geostationary satellites or prescribed fire emissions data in the National Emissions Inventory. These results show the importance of bottom-up smoke emissions estimates and reflect the need for improved ground-based fire data to advance air quality impacts assessments focused on prescribed burning.

  5. Electronic medical file exchange between on-duty care providers and the attending paediatrician: a Belgian paediatric pilot project.

    Science.gov (United States)

    Deneyer, M; Hachimi-Idrissi, S; Michel, L; Nyssen, M; De Moor, G; Vandenplas, Y

    2012-01-01

    The authors propose the introduction of a pilot project: "paediatric core file exchange in emergencies" (PCF-EXEM) which enables the exchange of medical data between the attending paediatrician (AP), holder of the medical record, and on-duty medical units (i.e. general practitioners, paediatricians, surgeons, emergency physicians,...). This project is based on two pillars: a protected server (PCF-server) containing paediatric core files (PCF), with important clinical data that should be available for the physician in order to quickly get a clear insight into the relevant clinical medical history of the child, and secondly, the possibility to provide feedback to the attending physician about the findings recorded during the on-call duty. The permanent availability of health data on the PCF-server and the possibility to provide feedback represent together the PCF-EXEM-project. This project meets the demand of the care providers to have relevant medical information permanently available in order to guarantee high quality care in emergency situations. The frail balance between the right to informative privacy and professional confidentiality on the one hand and the right to quality health care on the other hand has been taken into account. The technical and practical feasibility of this project is described. The objectives and vision of the PCF-EXEM project are conform to Belgian legislation concerning the processing of medical data and are in line with the still under consideration European projects which are focusing on interoperability and the development of a common access control to databanks containing health data for care providers. PCF-EXEM could therefore be a model for other EU countries as well.

  6. By Default: The Effect of Prepopulated Prescription Quantities on Opioid Prescribing in the Emergency Department.

    Science.gov (United States)

    Santistevan, Jamie R; Sharp, Brian R; Hamedani, Azita G; Fruhan, Scott; Lee, Andrew W; Patterson, Brian W

    2018-03-01

    Opioid prescribing patterns have come under increasing scrutiny with the recent rise in opioid prescriptions, opioid misuse and abuse, and opioid-related adverse events. To date, there have been limited studies on the effect of default tablet quantities as part of emergency department (ED) electronic order entry. Our goal was to evaluate opioid prescribing patterns before and after the removal of a default quantity of 20 tablets from ED electronic order entry. We performed a retrospective observational study at a single academic, urban ED with 58,000 annual visits. We identified all adult patients (18 years or older) seen in the ED and discharged home with prescriptions for tablet forms of hydrocodone and oxycodone (including mixed formulations with acetaminophen). We compared the quantity of tablets prescribed per opioid prescription 12 months before and 10 months after the electronic order-entry prescription default quantity of 20 tablets was removed and replaced with no default quantity. No specific messaging was given to providers, to avoid influencing prescribing patterns. We used two-sample Wilcoxon rank-sum test, two-sample test of proportions, and Pearson's chi-squared tests where appropriate for statistical analysis. A total of 4,104 adult patients received discharge prescriptions for opioids in the pre-intervention period (151.6 prescriptions per 1,000 discharged adult patients), and 2,464 post-intervention (106.69 prescriptions per 1,000 discharged adult patients). The median quantity of opioid tablets prescribed decreased from 20 (interquartile ration [IQR] 10-20) to 15 (IQR 10-20) (pdefault quantity. While the most frequent quantity of tablets received in both groups was 20 tablets, the proportion of patients who received prescriptions on discharge that contained 20 tablets decreased from 0.5 (95% confidence interval [CI] [0.48-0.52]) to 0.23 (95% CI [0.21-0.24]) (pdefault quantity removal. Although the median number of tablets differed significantly

  7. Prescribing Patterns of Intravenous Golimumab for Rheumatoid Arthritis.

    Science.gov (United States)

    Brady, Brenna L; Tkacz, Joseph P; Lofland, Jennifer; Meyer, Roxanne; Bolge, Susan C

    2015-09-01

    The use of intravenous golimumab (GLM-IV), in combination with methotrexate, was approved by the US Food and Drug Administration in July 2013 for the treatment of moderate to severe, active rheumatoid arthritis (RA). GLM-IV is available in 50-mg vials, and the prescribing information specifies a dosing regimen of 2 mg/kg at 0 and 4 weeks and then every 8 weeks thereafter. The purpose of this study was to examine the patterns of prescribing and administration of GLM-IV, including the demographic, clinical, and utilization characteristics of patients with RA newly treated with GLM-IV. Rheumatology practices across the continental United States were solicited for a chart-review study. Inclusion criteria were: (1) diagnosis of RA; (2) current treatment with GLM-IV; (3) age ≥18 years; and (4) lack of pregnancy (in female patients). Physicians were offered a monetary incentive for each eligible chart provided. An electronic case-report form was developed to aid in the chart data extraction and included fields for demographic characteristics, available comorbid diagnoses, prior RA treatments, and doses and dates of GLM-IV administration. A total of 117 eligible patient charts from 15 rheumatologist practices were reviewed. The patient sample was predominantly female (81.2%), with a mean (SD) age of 55.4 (14.5) years. A total of 55.6% of patients had evidence of biologic treatment before receiving GLM-IV, and 53% had at least 1 comorbid condition. In total, 300 individual GLM-IV infusions from this sample were reviewed. Due to the relatively recent approval of GLM-IV use by the US Food and Drug Administration, the majority of patients in this sample (69.2%) had received only between 2 and 4 infusions at the time of the review. For infusion records with valid dose data, the mean number of administered vials was 3.6 (0.8) (total dose, 180 mg); the majority of patients received a dose consistent with the prescribed dose of 2 mg/kg. Combination therapy with methotrexate was

  8. Status Report: Mathematics Curriculum-Development Projects Today

    Science.gov (United States)

    Arithmetic Teacher, 1972

    1972-01-01

    Brief reports on the Cambridge Conference on School Mathematics, Comprehensive School Mathematics Program, Computer-Assisted Instruction Projects at Stanford, Individually Prescribed Instruction Project, The Madison Project, Mathematics/Science Learning System, MINNEMAST, and School Mathematics Study Group. (MM)

  9. “Comprehensive emission measurements from prescribed ...

    Science.gov (United States)

    Simultaneous aerial- and ground-based emission sampling was conducted during prescribed burns at Eglin Air Force Base in November 2012 on a short grass/shrub field and a pine forest. Cumulative emission samples for volatile organic comounds, elemental carbon, organic carbon, chlorinated dioxins and furans, and PM2.5 and continuous samples for black carbon, particle size, and CO2 were taken. Aerial instruments were lofted using a 5 m diameter, helium-filled aerostat that was maneuvered with two remotely-controlled tethers mounted on all-terrain vehicles. A parallel set of instruments on the ground made simultaneous measurements, allowing for a comparison of ground level versus elevated measurements. Ground instruments were supplemented by additional measurements of polycyclic aromatic hydrocarbons and particle aerosol absorption and light scattering. Raw biomass was also gathered on site and tested in a laboratory combustion facility using the same array of instruments. This work compares emissions derived from aerial and ground sampling as well as field and laboratory results. This abstract will likely be the first ever prescribed burn study to compare laboratory and field emission results with results from aerial and and ground sampling. As such it will inform sampling methods for future events and determine the ability of laboratory simulations to mimic events inthe field.

  10. Personal and professional challenges of nurse prescribing in Ireland.

    Science.gov (United States)

    McBrien, Barry

    This article presents the challenges regarding the development of a collaborative practice agreement in order to undertake nurse prescribing in an emergency department in a large teaching hospital. Nurse prescribing has been introduced quite recently in Ireland. Although there is a plethora of knowledge regarding the topic, there are many personal and professional challenges in relation to this emerging role. The nurse prescribing initiative in Ireland is continually developing and many nurses now have the authority to prescribe from almost the same range of medicines as doctors. Prescribing has the potential to improve job satisfaction, autonomy and ultimately improves patient outcomes. However, nurses need to be cognisant of the impact it can have on the dynamics of the healthcare team. An analysis of some complexities of nurse prescribing is given, in conjunction with reflective thoughts on a clinical incident in the area of morphine prescribing.

  11. Implementing nurse prescribing: a case study in diabetes.

    Science.gov (United States)

    Stenner, Karen; Carey, Nicola; Courtenay, Molly

    2010-03-01

    This paper is a report of a study exploring the views of nurses and team members on the implementation of nurse prescribing in diabetes services. Nurse prescribing is adopted as a means of improving service efficiency, particularly where demand outstretches resources. Although factors that support nurse prescribing have been identified, it is not known how these function within specific contexts. This is important as its uptake and use varies according to mode of prescribing and area of practice. A case study was undertaken in nine practice settings across England where nurses prescribed medicines for patients with diabetes. Thematic analysis was conducted on qualitative data from 31 semi-structured interviews undertaken between 2007 and 2008. Participants were qualified nurse prescribers, administrative staff, physicians and non-nurse prescribers. Nurses prescribed more often following the expansion of nurse independent prescribing rights in 2006. Initial implementation problems had been resolved and few current problems were reported. As nurses' roles were well-established, no major alterations to service provision were required to implement nurse prescribing. Access to formal and informal resources for support and training were available. Participants were accepting and supportive of this initiative to improve the efficiency of diabetes services. The main factors that promoted implementation of nurse prescribing in this setting were the ability to prescribe independently, acceptance of the prescribing role, good working relationships between doctors and nurses, and sound organizational and interpersonal support. The history of established nursing roles in diabetes care, and increasing service demand, meant that these diabetes services were primed to assimilate nurse prescribing.

  12. Growth of nurse prescribing competence: facilitators and barriers during education.

    Science.gov (United States)

    Hopia, Hanna; Karhunen, Anne; Heikkilä, Johanna

    2017-10-01

    To describe facilitators and barriers in relation to the growth of nurse prescribing competence from the perspective of the nurses studying in a prescribing programme. The number of nurses enrolled in a nurse prescribing programme is rapidly increasing in Finland. However, few studies on nurse prescribing education are available and therefore research is needed, particularly from the point of view of nurses studying in the programme. The descriptive, qualitative study used the text of student online learning diaries as data during a 14-month prescribing programme. The sample consisted of 31 nurses, public health nurses or midwives enrolled in a prescribing programme at a university of applied sciences. The data were analysed using the inductive analysis method. The growth of nurses' prescribing competence was facilitated by learning clinical examination of the patient, networking with peers, receiving support from the workplace and supervisors, doctors' positive attitude towards nurse prescribing and being able to apply competencies directly to nursing practice. The barriers to the growth of nurses' prescribing competence were unclear job description, incomplete care plans and concerns about how consultation with doctors will be organised and realised. The results show that, for the purpose of developing the new role and position of nurse prescribers, educators and nursing managers must invest more in staff awareness of nurse prescribing education and also offer more support to nurse prescribers in their workplaces. The results of this study can be used especially in countries where nurse prescribing education is only in the process of being planned or has just been started. Heads of nursing and educators in prescribing education will benefit from the results when creating expanded job descriptions for nurses and supporting networking between students during the period of training. © 2016 John Wiley & Sons Ltd.

  13. Web Accessibility Issues for Higher & Further Education. EDNER (Formative Evaluation of the Distributed National Electronic Resource) Project. Issues Paper.

    Science.gov (United States)

    Manchester Metropolitan Univ. (England).

    This issues paper, sixth in a series of eight, is intended to distill formative evaluation questions on topics that are central to the development of the higher and further education information environment in the United Kingdom. In undertaking formative evaluation studies, the Formative Evaluation of the Distributed National Electronic Resource…

  14. Radiation Test Results on COTS and non-COTS Electronic Devices for NASA-JSC Space Flight Projects

    Science.gov (United States)

    Allums, Kimberly K.; O'Neill, P. M.; Reddell, B. D.; Nguyen, K. V.; Bailey, C. R.

    2012-01-01

    This presentation reports the results of recent proton and heavy ion Single Event Effect (SEE) testing on a variety of COTS and non-COTs electronic devices and assemblies tested for the Space Shuttle, International Space Station (ISS) and Multi-Purpose Crew Vehicle (MPCV).

  15. Physicians' attitudes towards ePrescribing – evaluation of a Swedish full-scale implementation

    Directory of Open Access Journals (Sweden)

    Montelius Emelie

    2009-08-01

    Full Text Available Abstract Background The penetration rate of Electronic Health Record (EHR systems in health care is increasing. However, many different EHR-systems are used with varying ePrescription designs and functionalities. The aim of the present study was to evaluate experienced ePrescribers' attitudes towards ePrescribing for suggesting improvements. Methods Physicians (n = 431 from seven out of the 21 Swedish health care regions, using one of the six most widely implemented EHR-systems with integrated electronic prescribing modules, were recruited from primary care centers and hospital clinics of internal medicine, orthopaedics and surgery. The physicians received a web survey that comprised eight questions on background data and 19 items covering attitudes towards ePrescribing. Forty-two percent (n = 199 of the physicians answered the questionnaire; 90% (n = 180 of the respondents met the inclusion criteria and were included in the final analysis. Results A majority of the respondents regarded their EHR-system easy to use in general (81%, and for the prescribing of drugs (88%. Most respondents believed they were able to provide the patients better service by ePrescribing (92%, and regarded ePrescriptions to be time saving (91% and to be safer (83%, compared to handwritten prescriptions. Some of the most frequently reported weaknesses were: not clearly displayed price of drugs (43%, complicated drug choice (21%, and the perception that it was possible to handle more than one patient at a time when ePrescribing (13%. Moreover, 62% reported a lack of receipt from the pharmacy after successful transmission of an ePrescription. Although a majority (73% of the physicians reported that they were always or often checking the ePrescription a last time before transmitting, 25% declared that they were seldom or never doing a last check. The respondents suggested a number of improvements, among others, to simplify the drug choice and the cancellation of e

  16. Drug use evaluation of antibiotics prescribed in a Jordanian hospital outpatient and emergency clinics using WHO prescribing indicators

    International Nuclear Information System (INIS)

    Al-Niemat, Sahar I.; Bloukh, Diana T.; Al-Harasis, Manal D.; Al-Fanek, Alen F.; Salah, Rehab K.

    2008-01-01

    Objective was to evaluate the use of antibiotics prescribed in hospital outpatient and emergency clinics in King Hussein Medical Centre (KHMC) using WHO prescribing indicators in an attempt to rationalize the use of antibiotics in the Royal Medical Services. We retrospectively surveyed a sample of 187,822 antibiotic prescriptions obtained from 5 outpatient pharmacies in KHMC written over the period of 3 consecutive months May 2007 to July 2007. The percentage of encounters of an antibiotic prescribed was calculated using the methodology recommended by the WHO. An additional indicator, the percentage share of different antibiotics was also included to identify the frequency prescribed from those antibiotics. The average percentage of prescriptions involving antibiotics was 35.6% out of 187,822 prescriptions surveyed. From these, 65,500 antibiotic prescriptions were observed. Penicillins most frequently amoxcillins and Quinolones most frequently ciprofloxacinllin and norfloxacillin were the most commonly prescribed antibiotics with an average percentage of 31.8% and 27.5%. The average prescribing rate for the other antibiotic categories was as follows: macrolides 5.2%, cephalosporins 16% and amoxcillins/clavulanate 5.4%. The high percentage of prescriptions involving antibiotics observed in KHMC pharmacies requires rational use of antibiotics and judicious prescribing by Military prescribers. An insight into factors influencing antibiotic prescribing patterns and adherence to antibiotic prescribing guidelines by the Military prescribers is warranted. (author)

  17. Heavy-ion injector based on an electron cyclotron ion source for the superconducting linear accelerator of the Rare Isotope Science Project.

    Science.gov (United States)

    Hong, In-Seok; Kim, Yong-Hwan; Choi, Bong-Hyuk; Choi, Suk-Jin; Park, Bum-Sik; Jin, Hyun-Chang; Kim, Hye-Jin; Heo, Jeong-Il; Kim, Deok-Min; Jang, Ji-Ho

    2016-02-01

    The injector for the main driver linear accelerator of the Rare Isotope Science Project in Korea, has been developed to allow heavy ions up to uranium to be delivered to the inflight fragmentation system. The critical components of the injector are the superconducting electron cyclotron resonance (ECR) ion sources, the radio frequency quadrupole (RFQ), and matching systems for low and medium energy beams. We have built superconducting magnets for the ECR ion source, and a prototype with one segment of the RFQ structure, with the aim of developing a design that can satisfy our specifications, demonstrate stable operation, and prove results to compare the design simulation.

  18. [Prescribing medication in 2013: legal aspects].

    Science.gov (United States)

    Berland-Benhaïm, C; Bartoli, C; Karsenty, G; Piercecchi-Marti, M-D

    2013-11-01

    To describe the legal framework of medicine prescription in France in 2013. With the assistance of lawyer and forensic pathologist, consultation (legifrance.gouv.fr), analysis, summary of French laws and rules surrounding drugs prescriptions to humans for medical purpose. Free medicine prescription is an essential feature of a doctor's action. To prescribe involve his responsibility at 3 levels: deontological, civilian and penal. Aim of the rules of medicine prescription is to preserve patient's safety and health. Doctors are encouraged to refer to recommendations and peer-reviewed publication every time the prescriptions go out of the case planned by law. Knowledge and respect of medicine prescription legal rules is essential for a good quality practice. Medical societies have a major role to improve medicine use among practitioners. Copyright © 2013. Published by Elsevier Masson SAS.

  19. Designing magnets with prescribed magnetic fields

    International Nuclear Information System (INIS)

    Liu Liping

    2011-01-01

    We present a novel design method capable of finding the magnetization densities that generate prescribed magnetic fields. The method is based on the solution to a simple variational inequality and the resulting designs have simple piecewise-constant magnetization densities. By this method, we obtain new designs of magnets that generate commonly used magnetic fields: uniform magnetic fields, self-shielding fields, quadrupole fields and sextupole fields. Further, it is worth noting that this method is not limited to the presented examples, and in particular, three-dimensional designs can be constructed in a similar manner. In conclusion, this novel design method is anticipated to have broad applications where specific magnetic fields are important for the performance of the devices.

  20. Ibuprofen in paediatrics: pharmacology, prescribing and controversies.

    Science.gov (United States)

    Moriarty, Camilla; Carroll, Will

    2016-12-01

    Ibuprofen, a propionic acid derivative, is a non-steroidal anti-inflammatory drug. The oral formulation is widely used in paediatric practice and after paracetamol it is one of the most common drugs prescribed for children in hospital. The treatment of fever with antipyretics such as ibuprofen is controversial as fever is the normal response of the body to infection and unless the child becomes distressed or symptomatic, fever alone should not be routinely treated. Combined treatment with paracetamol and ibuprofen is commonly undertaken but almost certainly is not helpful. This article aims to describe the indications and mode of action of the drug, outline its pharmacokinetics and highlight the important key messages regarding its use in clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Generic medicine and prescribing: A quick assessment

    Directory of Open Access Journals (Sweden)

    Mainul Haque

    2017-01-01

    Full Text Available Generic drugs are copies of brand-name drugs that have exactly the same dosage, intended use, effects, side effects, route of administration, risks, safety, and strength as the original drug. In other words, their pharmacological effects are exactly the same as those of their brand-name counterparts. The Food and Drug Administration (FDA describes that generic drugs are essential possibilities that allow better access to healthcare for all Americans. They are replicas of brand-name drugs and are the identical as those of brand-name drugs in dosage form, safety, strength, route of administration, quality, performance features, and anticipated to use. Healthcare authorities and users can be guaranteed that FDA-approved generic drug products have met the same stiff principles as the innovator drug. The company that made Bayer aspirin fought in court enthusiastically to keep generic versions off the shelves, in the 1920s. The company lost in court, and consumers suddenly had an array of choices in generic aspirin. The Supreme Court of India uttering ‘the Supreme Court's ruling will prevent companies from further seeking unwarranted patents on HIV and other essential medicines.’ Generic medicine cannot be sold at a price higher than the branded medicine, so it is regularly a low-priced option. Thereafter, both the end user and the government who pay for part of the price of the medicine under the Pharmaceutical Benefits Scheme in Australia are benefitted. The treatment of diseases using essential drugs, prescribed by their generic names, has been emphasised by the WHO and many national health policies. Although there are some improvements in generic medicine prescribing, it has been advised by the WHO that ‘countries should intensify efforts to measure and regularly monitor medicine prices and availability, and adopt policy measures to address the issues identified.’

  2. Using Think Aloud Protocols to Assess E-Prescribing in Community Pharmacies

    Directory of Open Access Journals (Sweden)

    Olufunmilola K. Odukoya, BPharm, MS

    2012-01-01

    Full Text Available Introduction: Think aloud protocol has rarely been used as a method of data collection in community pharmacies.Purpose: The aim of the report is to describe how think aloud protocols were used to identify issues that arise when using e-prescribing technology in pharmacies. In this paper, we report on the benefits and challenges of using think aloud protocols in pharmacies to examine the use of e-prescribing systems.Methods: Sixteen pharmacists and pharmacy technicians were recruited from seven community pharmacies in Wisconsin. Data were collected using direct observation alongside think aloud protocol. Direct observations and think aloud protocols took place between January-February, 2011. Participants were asked to verbalize their thoughts as they process electronic prescriptions.Results: Participants identified weaknesses in e-prescribing that they had previously not conceived. This created heightened awareness for vigilance when processing e-prescriptions. The main challenge with using think aloud protocols was due to interruptions in the pharmacies. Also, a few participants found it challenging to remember to continue verbalizing their thought process during think aloud sessions.Conclusion: The use of think aloud protocols as method of data collection is a new way for understanding the issues related to technology use in community pharmacy practice. Think aloud protocol was beneficial in providing objective information on e-prescribing use not solely based on pharmacist’s or technician’s opinion of the technology. This method provided detailed information on a wide variety of real time challenges with e-prescribing technology use in community pharmacies. Using this data collection method can help identify potential patient safety issues when using e-prescribing and suggestions for redesign.

  3. The causes of prescribing errors in English general practices: a qualitative study.

    Science.gov (United States)

    Slight, Sarah P; Howard, Rachel; Ghaleb, Maisoon; Barber, Nick; Franklin, Bryony Dean; Avery, Anthony J

    2013-10-01

    Few detailed studies exist of the underlying causes of prescribing errors in the UK. To examine the causes of prescribing and monitoring errors in general practice and provide recommendations for how they may be overcome. Qualitative interview and focus group study with purposive sampling of English general practices. General practice staff from 15 general practices across three PCTs in England participated in a combination of semi-structured interviews (n = 34) and six focus groups (n = 46). Thematic analysis informed by Reason's Accident Causation Model was used. Seven categories of high-level error-producing conditions were identified: the prescriber, the patient, the team, the working environment, the task, the computer system, and the primary-secondary care interface. These were broken down to reveal various error-producing conditions: the prescriber's therapeutic training, drug knowledge and experience, knowledge of the patient, perception of risk, and their physical and emotional health; the patient's characteristics and the complexity of the individual clinical case; the importance of feeling comfortable within the practice team was highlighted, as well as the safety implications of GPs signing prescriptions generated by nurses when they had not seen the patient for themselves; the working environment with its extensive workload, time pressures, and interruptions; and computer-related issues associated with mis-selecting drugs from electronic pick-lists and overriding alerts were all highlighted as possible causes of prescribing errors and were often interconnected. Complex underlying causes of prescribing and monitoring errors in general practices were highlighted, several of which are amenable to intervention.

  4. The electronic Space Weather upper atmosphere (eSWua project at INGV: advancements and state of the art

    Directory of Open Access Journals (Sweden)

    V. Romano

    2008-02-01

    Full Text Available The eSWua project is based on measurements performed by all the instruments installed by the upper atmosphere physics group of the Istituto Nazionale di Geofisica e Vulcanologia, Italy and on all the related studies. The aim is the realization of a hardware-software system to standardize historical and real-time observations for different instruments.

    An interactive Web site, supported by a well organized database, can be a powerful tool for the scientific and technological community in the field of telecommunications and space weather. The most common and useful database type for our purposes is the relational one, in which data are organized in tables for petabytes data archiving and the complete flexibility in data retrieving.

    The project started in June 2005 and will last till August 2007. In the first phase the major effort has been focused on the design of hardware and database architecture. The first two databases related to the DPS4 digisonde and GISTM measurements are complete concerning populating, tests and output procedures. Details on the structure and Web tools concerning these two databases are presented, as well as the general description of the project and technical features.

  5. The electronic Space Weather upper atmosphere (eSWua project at INGV: advancements and state of the art

    Directory of Open Access Journals (Sweden)

    V. Romano

    2008-02-01

    Full Text Available The eSWua project is based on measurements performed by all the instruments installed by the upper atmosphere physics group of the Istituto Nazionale di Geofisica e Vulcanologia, Italy and on all the related studies. The aim is the realization of a hardware-software system to standardize historical and real-time observations for different instruments. An interactive Web site, supported by a well organized database, can be a powerful tool for the scientific and technological community in the field of telecommunications and space weather. The most common and useful database type for our purposes is the relational one, in which data are organized in tables for petabytes data archiving and the complete flexibility in data retrieving. The project started in June 2005 and will last till August 2007. In the first phase the major effort has been focused on the design of hardware and database architecture. The first two databases related to the DPS4 digisonde and GISTM measurements are complete concerning populating, tests and output procedures. Details on the structure and Web tools concerning these two databases are presented, as well as the general description of the project and technical features.

  6. A Technological Innovation to Reduce Prescribing Errors Based on Implementation Intentions: The Acceptability and Feasibility of MyPrescribe.

    Science.gov (United States)

    Keyworth, Chris; Hart, Jo; Thoong, Hong; Ferguson, Jane; Tully, Mary

    2017-08-01

    Although prescribing of medication in hospitals is rarely an error-free process, prescribers receive little feedback on their mistakes and ways to change future practices. Audit and feedback interventions may be an effective approach to modifying the clinical practice of health professionals, but these may pose logistical challenges when used in hospitals. Moreover, such interventions are often labor intensive. Consequently, there is a need to develop effective and innovative interventions to overcome these challenges and to improve the delivery of feedback on prescribing. Implementation intentions, which have been shown to be effective in changing behavior, link critical situations with an appropriate response; however, these have rarely been used in the context of improving prescribing practices. Semistructured qualitative interviews were conducted to evaluate the acceptability and feasibility of providing feedback on prescribing errors via MyPrescribe, a mobile-compatible website informed by implementation intentions. Data relating to 200 prescribing errors made by 52 junior doctors were collected by 11 hospital pharmacists. These errors were populated into MyPrescribe, where prescribers were able to construct their own personalized action plans. Qualitative interviews with a subsample of 15 junior doctors were used to explore issues regarding feasibility and acceptability of MyPrescribe and their experiences of using implementation intentions to construct prescribing action plans. Framework analysis was used to identify prominent themes, with findings mapped to the behavioral components of the COM-B model (capability, opportunity, motivation, and behavior) to inform the development of future interventions. MyPrescribe was perceived to be effective in providing opportunities for critical reflection on prescribing errors and to complement existing training (such as junior doctors' e-portfolio). The participants were able to provide examples of how they would use

  7. First Penning-trap mass measurement of the electron capture nuclide {sup 163}Ho and its daughter {sup 163}Dy for the ECHO project

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Fabian [Institut fuer Kernchemie und Institut fuer Physik, Johannes Gutenberg-Universitaet Mainz (Germany); Collaboration: TRIGA-SPEC Collaboration; ECHo-Collaboration

    2015-07-01

    The ECHo (Electron Capture of {sup 163}Ho) project aims to determine the mass of the electron neutrino by measuring the calorimetric spectrum of {sup 163}Ho. To be able to extract the neutrino mass from the spectrum near the endpoint a precise knowledge of the decay Q-value is necessary. The ideal way to measure this in a model independent way is by high-precision Penning-trap mass spectrometry. The ECHo collaboration has {sup 163}Ho samples available, which were produced by reactor neutron irradiation. Such samples are typically highly contaminated with radioactive and stable species. These were efficiently removed by chemical purification. Ionization by laser ablation allows high-precision Penning-trap mass measurements with sample sizes of 10{sup 16} atoms. From the measured cyclotron frequency ratio of {sup 163}Ho{sup 16}O{sup +} to {sup 163}Dy{sup 16}O{sup +} we determined the Q-value to be 2.5(7) keV. In addition absolute mass measurements using carbon cluster ions as reference were performed with an uncertainty two times lower than literature values. Future measurements at SHIPTRAP (GSI, Darmstadt) and PENTATRAP (MPIK, Heidelberg) are planned with the aim to drastically improve the uncertainty of the Q-value down to a few eV and thus providing the required input for the ECHo project.

  8. Antiepileptic drug prescribing before, during and after pregnancy

    DEFF Research Database (Denmark)

    Charlton, Rachel; Garne, Ester; Wang, Hao

    2015-01-01

    and after pregnancy were identified in each of the databases. AED prescribing patterns were analysed, and the choice of AEDs and co-prescribing of folic acid were evaluated. Results In total, 978 957 women with 1 248 713 deliveries were identified. In all regions, AED prescribing declined during pregnancy...... co-prescribed with high-dose folic acid: ranging from 1.0% (CI950.3–1.8%) in Emilia Romagna to 33.5% (CI9528.7–38.4%) in Wales. Conclusion The country's differences in prescribing patterns may suggest different use, knowledge or interpretation of the scientific evidence base. The low co......-prescribing of folic acid indicates that more needs to be done to better inform clinicians and women of childbearing age taking AEDs about the need to offer and receive complete preconception care....

  9. Prescribing practices amid the OxyContin crisis: examining the effect of print media coverage on opioid prescribing among physicians.

    Science.gov (United States)

    Borwein, Alexandra; Kephart, George; Whelan, Emma; Asbridge, Mark

    2013-12-01

    The pain medication OxyContin (hereafter referred to as oxycodone extended release) has been the subject of sustained, and largely negative, media attention in recent years. We sought to determine whether media coverage of oxycodone extended release in North American newspapers has led to changes in prescribing of the drug in Nova Scotia, Canada. An interrupted time-series design examined the effect of media attention on physicians' monthly prescribing of opioids. The outcome measures were, for each physician, the monthly proportions of all opioids prescribed and the proportion of strong opioids prescribed that were for oxycodone extended release. The exposure of interest was media attention defined as the number of articles published each month in 27 North American newspapers. Variations in media effects by provider characteristics (specialty, prescribing volume, and region) were assessed. Within-provider changes in the prescribing of oxycodone extended release in Nova Scotia were observed, and they followed changes in media coverage. Oxycodone extended release prescribing rose steadily prior to receiving media attention. Following peak media attention in the United States, the prescribing of oxycodone extended release slowed. Likewise, following peak coverage in Canadian newspapers, the prescribing of oxycodone extended release declined. These patterns were observed across prescriber specialties and by prescriber volume, though the magnitude of change in prescribing varied. This study demonstrates that print media reporting of oxycodone extended release in North American newspapers, and its continued portrayal as a social problem, coincided with reductions in the prescribing of oxycodone extended release by physicians in Nova Scotia. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.

  10. OMEGA project

    International Nuclear Information System (INIS)

    Shibuya, E.H.

    1989-01-01

    The OMEGA - Observation of Multiple particle production, Exotic Interactions and Gamma-ray Air Shower-project is presented. The project try to associate photosensitive detectors from experiences of hadronic interactions with electronic detectors used by experiences that investigate extensive atmospheric showers. (M.C.K.)

  11. A General Construction of Linear Differential Equations with Solutions of Prescribed Properties

    Czech Academy of Sciences Publication Activity Database

    Neuman, František

    2004-01-01

    Roč. 17, č. 1 (2004), s. 71-76 ISSN 0893-9659 R&D Projects: GA AV ČR IAA1019902; GA ČR GA201/99/0295 Institutional research plan: CEZ:AV0Z1019905 Keywords : construction of linear differential equations * prescribed qualitative properties of solutions Subject RIV: BA - General Mathematics Impact factor: 0.414, year: 2004

  12. Bill project authorizing the convention related to the building and exploitation of a European X-ray free electron laser

    International Nuclear Information System (INIS)

    2011-01-01

    This document briefly recalls the objectives of the convention and the planned installations in the region of Hamburg of a free electron laser. It discusses the estimated consequences of the convention implementation: scientific consequences, international context (two existing installations in the United States and in Japan), economic consequences, financial consequences (French contribution), social consequences, legal consequences (none for the French law), and administrative consequences (association of the CEA and CNRS to the XFEL company). It recalls the negotiation history from 2003, and indicates the signature and ratification status in the different involved countries (Germany, France, Denmark, Russia, Sweden, Poland, Switzerland, Hungary, Greece, and Slovakia)

  13. Prescribers and pharmaceutical representatives: why are we still meeting?

    Science.gov (United States)

    Fischer, Melissa A; Keough, Mary Ellen; Baril, Joann L; Saccoccio, Laura; Mazor, Kathleen M; Ladd, Elissa; Von Worley, Ann; Gurwitz, Jerry H

    2009-07-01

    Research suggests that pharmaceutical marketing influences prescribing and may cause cognitive dissonance for prescribers. This work has primarily been with physicians and physician-trainees. Questions remain regarding why prescribers continue to meet with pharmaceutical representatives (PRs). To describe the reasons that prescribers from various health professions continue to interact with PRs despite growing evidence of the influence of these interactions. Multi-disciplinary focus groups with 61 participants held in practice settings and at society meetings. Most prescribers participating in our focus groups believe that overall PR interactions are beneficial to patient care and practice health. They either trust the information from PRs or feel that they are equipped to evaluate it independently. Despite acknowledgement of study findings to the contrary, prescribers state that they are able to effectively manage PR interactions such that their own prescribing is not adversely impacted. Prescribers describe few specific strategies or policies for these interactions, and report that policies are not consistently implemented with all members of a clinic or institution. Some prescribers perceive an inherent contradiction between academic centers and national societies receiving money from pharmaceutical companies, and then recommending restriction at the level of the individual prescriber. Prescribers with different training backgrounds present a few novel reasons for these meetings. Despite evidence that PR detailing influences prescribing, providers from several health professions continue to believe that PR interactions improve patient care, and that they can adequately evaluate and filter information presented to them by PRs. Focus group comments suggest that cultural change is necessary to break the norms that exist in many settings. Applying policies consistently, considering non-physician members of the healthcare team, working with trainees, restructuring

  14. Factor analysis improves the selection of prescribing indicators

    DEFF Research Database (Denmark)

    Rasmussen, Hanne Marie Skyggedal; Søndergaard, Jens; Sokolowski, Ineta

    2006-01-01

    OBJECTIVE: To test a method for improving the selection of indicators of general practitioners' prescribing. METHODS: We conducted a prescription database study including all 180 general practices in the County of Funen, Denmark, approximately 472,000 inhabitants. Principal factor analysis was us...... appropriate and inappropriate prescribing, as revealed by the correlation of the indicators in the first factor. CONCLUSION: Correlation and factor analysis is a feasible method that assists the selection of indicators and gives better insight into prescribing patterns....

  15. A RCT evaluating the effectiveness and cost-effectiveness of academic detailing versus postal prescribing feedback in changing GP antibiotic prescribing.

    LENUS (Irish Health Repository)

    Naughton, Corina

    2009-10-01

    The aim of this study is to evaluate the effectiveness of academic detailing (AD) plus postal prescribing feedback versus postal prescribing feedback alone in reducing: (i) the overall rate of antibiotic; and (ii) proportion of second-line antibiotic prescribing. In addition, the cost-effectiveness of an outreach prescriber adviser service versus a postal prescribing feedback service was evaluated.

  16. Electron beam bunch length characterizations using incoherent and coherent transition radiation on the APS SASE FEL project

    CERN Document Server

    Lumpkin, Alex H; Berg, W J; Lewellen, J W; Sereno, N S; Happek, U

    2000-01-01

    The Advanced Photon Source (APS) injector linac has been reconfigured with a low-emittance RF thermionic gun and a photocathode (PC) RF gun to support self-amplified spontaneous emission (SASE) free-electron laser (FEL) experiments. One of the most critical parameters for optimizing SASE performance (gain length) is the electron beam peak current, which requires a charge measurement and a bunch length measurement capability. We report here initial measurements of the latter using both incoherent optical transition radiation (OTR) and coherent transition radiation (CTR). A visible light Hamamatsu C5680 synchroscan streak camera was used to measure the thermionic RF gun beam's bunch length (sigma approx 2-3 ps) via OTR generated by the beam at 220 MeV and 200 mA macropulse average current. In addition, a CTR monitor (Michelson Interferometer) based on a Golay cell as the far-infrared (FIR) detector has been installed at the 40-MeV station in the beamline. Initial observations of CTR signal strength variation wi...

  17. Feasibility of electronic peer mentoring for transition-age youth and young adults with intellectual and developmental disabilities: Project Teens making Environment and Activity Modifications.

    Science.gov (United States)

    Kramer, Jessica M; Ryan, Cathryn T; Moore, Rachel; Schwartz, Ariel

    2018-01-01

    There is a need for mentoring interventions in which transition-age youth and young adults with intellectual and/or developmental disabilities (I/DD) participate as both mentors and mentees. Project TEAM (Teens making Environment and Activity Modifications) is a problem-solving intervention that includes an electronic peer-mentoring component. Forty-two mentees and nine mentors with I/DD participated. The present authors analysed recorded peer-mentoring calls and field notes for mentee engagement, mentor achievement of objectives and supports needed to implement peer mentoring. Overall, mentees attended 87% of scheduled calls and actively engaged during 94% of call objectives. Across all mentoring dyads, mentors achieved 87% of objectives and there was a significant relationship between the use of supports (mentoring script, direct supervision) and fidelity. Transition-age mentees with I/DD can engage in electronic peer mentoring to further practice problem-solving skills. Mentors with I/DD can implement electronic peer mentoring when trained personnel provide supports and individualized job accommodations. © 2017 John Wiley & Sons Ltd.

  18. Advanced Electronics

    Science.gov (United States)

    2017-07-21

    AFRL-RV-PS- AFRL-RV-PS- TR-2017-0114 TR-2017-0114 ADVANCED ELECTRONICS Ashwani Sharma 21 Jul 2017 Interim Report APPROVED FOR PUBLIC RELEASE...NUMBER Advanced Electronics 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 62601F 6. AUTHOR(S) 5d. PROJECT NUMBER 4846 Ashwani Sharma 5e. TASK NUMBER...Approved for public release; distribution is unlimited. (RDMX-17-14919 dtd 20 Mar 2018) 13. SUPPLEMENTARY NOTES 14. ABSTRACT The Space Electronics

  19. Asthma medication prescribing before, during and after pregnancy: a study in seven European regions.

    Science.gov (United States)

    Charlton, Rachel A; Pierini, Anna; Klungsøyr, Kari; Neville, Amanda J; Jordan, Susan; de Jong-van den Berg, Lolkje T W; Thayer, Daniel; Bos, H Jens; Puccini, Aurora; Hansen, Anne V; Gini, Rosa; Engeland, Anders; Nybo Andersen, Anne-Marie; Dolk, Helen; Garne, Ester

    2016-01-19

    To explore utilisation patterns of asthma medication before, during and after pregnancy as recorded in seven European population-based databases. A descriptive drug utilisation study. 7 electronic healthcare databases in Denmark, Norway, the Netherlands, Italy (Emilia Romagna and Tuscany), Wales, and the Clinical Practice Research Datalink representing the rest of the UK. All women with a pregnancy ending in a delivery that started and ended between 2004 and 2010, who had been present in the database for the year before, throughout and the year following pregnancy. The percentage of deliveries where the woman received an asthma medicine prescription, based on prescriptions issued (UK) or dispensed (non-UK), during the year before, throughout or during the year following pregnancy. Asthma medicine prescribing patterns were described for 3-month time periods and the choice of asthma medicine and changes in prescribing over the study period were evaluated in each database. In total, 1,165,435 deliveries were identified. The prevalence of asthma medication prescribing during pregnancy was highest in the UK and Wales databases (9.4% (CI95 9.3% to 9.6%) and 9.4% (CI95 9.1% to 9.6%), respectively) and lowest in the Norwegian database (3.7% (CI95 3.7% to 3.8%)). In the year before pregnancy, the prevalence of asthma medication prescribing remained constant in all regions. Prescribing levels peaked during the second trimester of pregnancy and were at their lowest during the 3-month period following delivery. A decline was observed, in all regions except the UK, in the prescribing of long-acting β-2-agonists during pregnancy. During the 7-year study period, there were only small changes in prescribing patterns. Differences were found in the prevalence of prescribing of asthma medications during and surrounding pregnancy in Europe. Inhaled β-2 agonists and inhaled corticosteroids were, however, the most popular therapeutic regimens in all databases. Published by the BMJ

  20. The Exploration, Discovery, Recovery, and Preservation of Endangered Electronic Scientific Records, the Lunar Orbiter Image Recovery Project

    Science.gov (United States)

    Wingo, D. R.; Harper, M.

    2017-12-01

    In 1966 and 1967 NASA sent five photo reconnaissance satellites to the Moon to scout out sites for the first Apollo landings. This was the first mission in human history to extensively map the Moon to one meter resolution. The Lunar Orbiter spacecraft obtained photographs via 70 millimeter film in high resolution (one meter), and medium resolution (7-8) meter. Each mission took approximately 200 medium and high resolution photographs. These were processed in an on board film laboratory and then scanned via a 6.5 micron light beam.. These images were then transmitted to the Earth as analog waveforms double modulated as a vestigial sideband (VSB) and Frequency Modulation With Feedback (FMFB). The spacecraft transmissions were received at NASA's Deep Space Network at Goldstone (DSS-12), Madrid (DSS-61) and Woomera (DSS-41). The signals received were shifted to a 10 MHz intermediate frequency spectrum which was then written to 2"analog instrumentation tape drives (Ampex-FR-900's). In parallel the signals were demodulated and displayed on a kinescope, which then was photographed using a 35mm camera, and the 35mm film was then rephotographed, processed, and printed for initial analysis by the landing site selection team. The magnetic tape based analog sigals preserved the higher dynamic range of the spacecraft 70mm film, and this was then digitized utilizing digitizer and fed to a Univac 1170 computer for analysis of rock height, slope angles, and geologic context. After the Apollo missions these tapes were largely forgotten. In 2007, retired NASA archivist Nancy Evans, who had saved the last surviving Ampex FR-900's donated the drives to the Lunar Orbiter Image Recovery Project. The project obtained the 1474 hours of original tapes from NASA JPL, and at NASA Ames refurbished the drives. Additionally, the demodulator system was recreated from archived documentation using modern techniques. The project digitized the 1474 tapes, processed the 20 terabyes of raw data. The

  1. Electronic data base for the project of cogeneration power plants; Planilha eletronica para projeto de centrais de cogeracao

    Energy Technology Data Exchange (ETDEWEB)

    Lopes, Paulo Renato Galveias; Balestieri, Jose Antonio Perrella [UNESP, Guaratingueta, SP (Brazil)

    1997-12-31

    In the cogeneration system design some basic characteristics of the proposed scheme must be technical and economically evaluated in comparison with other possible schemes that equally fits the thermal and electrical energy demands. The presented model for helping the cogeneration systems design process is based on electronic data base and is characterized by its easy of using and including technical and economic new variables, the availability in personal computers and the possibility of being connected to graphical software s that allow visualizing the schemes proposed turning it very useful both to the beginners as well as the professional accustomed to this procedure. In this paper it is present the results obtained in the development of the model highlighting specially its technical characteristics. (author) 9 refs., 7 figs.; e-mail: perrella at feg.unesp.br

  2. EBFA project

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    An engineering project office was established during the fall of 1976 to manage and coordinate all of the activities of the Electron Beam Fusion Project. The goal of the project is to develop the Electron Beam Fusion Accelerator (EBFA) and its supporting systems, and integrate these systems into the new Electron Beam Fusion Facility (EBFF). Supporting systems for EBFA include a control/monitor system, a data acquistion/automatic data processing system, the liquid transfer systems, the insulating gas transfer systems, etc. Engineers and technicians were assigned to the project office to carry out the engineering design, initiate procurement, monitor the fabrication, perform the assembly and to assist the pulsed power research group in the activation of the EBFA

  3. The Pocketable Electronic Devices in Radiation Oncology (PEDRO) Project: How the Use of Tools in Medical Decision Making is Changing?

    Science.gov (United States)

    De Bari, Berardino; Franco, Pierfrancesco; Niyazi, Maximilian; Cornetto, Andrea Peruzzo; Qvortrup, Camilla; Martin, Arturo Navarro; Cacicedo, Jon; Fernandez, Gonçalo; Louro, Luís Vasco; Lestrade, Laëtitia; Ciammella, Patrizia; Greto, Daniela; Checkrine, Tarik; Youssef, Elkholti; Filippi, Andrea Riccardo; Poulsen, Laurids Østergaard; Alongi, Filippo

    2016-04-01

    To analyze the impact of mobile electronic devices (MEDs) and apps in the daily clinical activity of young radiation or clinical oncologists in 5 Western European countries (Italy, Germany, Spain, Portugal, and Denmark). A web-based questionnaire was sent to 462 young (≤40 years) members of the national radiation or clinical oncology associations of the countries involved in the study. The 15 items investigated diffusion of MEDs (smartphones and/or tablets), their impact on daily clinical activity, and the differences perceived by participants along time. A total of 386 (83.5%) of the 462 correctly filled questionnaires were statistically evaluated. Up to 65% of respondents declared to use an electronic device during their clinical activity. Conversely, 72% considered low to moderate impact of smartphones/tables on their daily practice. The daily use significantly increased from 2009 to 2012: users reporting a use ≥6 times/d raised from 5% to 39.9%. Professional needs fulfillment was declared by less than 68% of respondents and compliance to apps indications by 66%. Significant differences were seen among the countries, in particular concerning the feeling of usefulness of MEDs in the daily clinical life. The perception of the need of a comprehensive Web site containing a variety of applications (apps) for clinical use significantly differed among countries in 2009, while it was comparable in 2012. This survey showed a large diffusion of MEDs in young professionals working in radiation oncology. Looking at these data, it is important to verify the consistency of information found within apps, in order to avoid potential errors eventually detrimental for patients. "Quality assurance" criteria should be specifically developed for medical apps and a comprehensive Web site gathering all reliable applications and tools might be useful for daily clinical practice. © The Author(s) 2015.

  4. Remotely controlled biking is associated with improved adherence to prescribed cycling speed.

    Science.gov (United States)

    Jeong, In Cheol; Finkelstein, Joseph

    2015-01-01

    Individuals with mobility impairment may benefit from passive exercise mode which can be subsequently enhanced by an active exercise program. However, it is unclear which exercise mode promotes higher adherence to prescribed exercise intensity. The goal of this project was to compare adherence to prescribed speed during passive and active cycling exercise. We used cross-over study design in which subjects followed the same cycling intensity prescription for passive and active exercise modes in a random sequence. Coefficient of variation (CV) and speed differences were used to estimate extent of deviation from the prescribed trajectory. CV varied from 5.2% to 20.4% for the active mode and from 2.8% to 4.5% for the passive mode respectively. Though the CV differences did not reach statistical significance, analysis of cycling speed adherence of 120-second periods showed significantly higher cycling adherence during passive mode for each target cycling speed. Our results indicated that the passive mode may promote exercise safety and efficacy by helping patients who have safety concerns such as the frail elderly, patients with cardiovascular conditions or people with other contraindications for excessive exertion during exercise, in following the optimal intensity trajectory prescribed by their provider.

  5. Electronic correlation without double counting via a combination of spin projected Hartree-Fock and density functional theories

    Energy Technology Data Exchange (ETDEWEB)

    Garza, Alejandro J.; Jiménez-Hoyos, Carlos A. [Department of Chemistry, Rice University, Houston, Texas 77251-1892 (United States); Scuseria, Gustavo E. [Department of Chemistry and Department of Physics and Astronomy, Rice University, Houston, Texas 77251-1892, USA and Chemistry Department, Faculty of Science, King Abdulaziz University, Jeddah 21589 (Saudi Arabia)

    2014-06-28

    Several schemes to avoid the double counting of correlations in methods that merge multireference wavefunctions with density functional theory (DFT) are studied and here adapted to a combination of spin-projected Hartree-Fock (SUHF) and DFT. The advantages and limitations of the new method, denoted SUHF+f{sub c}DFT, are explored through calculations on benchmark sets in which the accounting of correlations is challenging for pure SUHF or DFT. It is shown that SUHF+f{sub c}DFT can greatly improve the description of certain molecular properties (e.g., singlet-triplet energy gaps) which are not improved by simple addition of DFT dynamical correlation to SUHF. However, SUHF+f{sub c}DFT is also shown to have difficulties dissociating certain types of bonds and describing highly charged ions with static correlation. Possible improvements to the current SUHF+f{sub c}DFT scheme are discussed in light of these results.

  6. Study of device mass production capability of the character projection based electron beam direct writing process technology toward 14 nm node and beyond

    Science.gov (United States)

    Kojima, Yoshinori; Takahashi, Yasushi; Takakuwa, Masaki; Ohshio, Shuzo; Sugatani, Shinji; Tujimura, Ryo; Takita, Hiroshi; Ogino, Kozo; Hoshino, Hiromi; Ito, Yoshio; Miyajima, Masaaki; Kon, Jun-ichi

    2012-03-01

    Techniques to appropriately control the key factors for a character projection (CP) based electron beam direct writing (EBDW) technology for mass production are shown and discussed. In order to achieve accurate CD control, the CP technique using the master CP is adopted. Another CP technique, the Packed CP, is used to obtain suitable shot count. For the alignment on the some critical layers which have the normally an even surface, the alignment methodology differ from photolithography is required. The process that etches the SiO2 material in the shallow trench isolation is added and then the alignment marks can be detected using electron beam even at the gate layer, which is normally on an even surface. The proximity effect correction using the simplified electron energy flux model and the hybrid exposure are used to obtain enough process margins. As a result, the sufficient CD accuracy, overlay accuracy, and yield are obtained on the 65 nm node device. The condition in our system is checked using self-diagnosis on a regular basis, and scheduled maintenances have been properly performed. Due to the proper system control, more than 10,000 production wafers have been successfully exposed so far without any major system downtime. It is shown that those techniques can be adapted to the 32 nm node production with slight modifications. For the 14 nm node and beyond, however, the drastic increment of the shot count becomes more of a concern. The Multi column cell (MCC) exposure method, the key concept of which is the parallelization of the electron beam columns with a CP, can overcome this concern. It is expected that by using the MCC exposure system, those techniques will be applicable to the rapid establishment for the 14 nm node technology.

  7. Prescribed Travel Schedules for Fatigue Management

    Science.gov (United States)

    Whitmire, Alexandra; Johnston, Smith; Lockley, Steven

    2011-01-01

    The NASA Fatigue Management Team is developing recommendations for managing fatigue during travel and for shift work operations, as Clinical Practice Guidelines for the Management of Circadian Desynchrony in ISS Operations. The Guidelines provide the International Space Station (ISS ) flight surgeons and other operational clinicians with evidence-based recommendations for mitigating fatigue and other factors related to sleep loss and circadian desynchronization. As much international travel is involved both before and after flight, the guidelines provide recommendations for: pre-flight training, in-flight operations, and post-flight rehabilitation. The objective of is to standardize the process by which care is provided to crewmembers, ground controllers, and other support personnel such as trainers, when overseas travel or schedule shifting is required. Proper scheduling of countermeasures - light, darkness, melatonin, diet, exercise, and medications - is the cornerstone for facilitating circadian adaptation, improving sleep, enhancing alertness, and optimizing performance. The Guidelines provide, among other things, prescribed travel schedules that outline the specific implementation of these mitigation strategies. Each travel schedule offers evidence based protocols for properly using the NASA identified countermeasures for fatigue. This presentation will describe the travel implementation schedules and how these can be used to alleviate the effects of jet lag and/or schedule shifts.

  8. Clinical Trial Electronic Portals for Expedited Safety Reporting: Recommendations from the Clinical Trials Transformation Initiative Investigational New Drug Safety Advancement Project.

    Science.gov (United States)

    Perez, Raymond P; Finnigan, Shanda; Patel, Krupa; Whitney, Shanell; Forrest, Annemarie

    2016-12-15

    Use of electronic clinical trial portals has increased in recent years to assist with sponsor-investigator communication, safety reporting, and clinical trial management. Electronic portals can help reduce time and costs associated with processing paperwork and add security measures; however, there is a lack of information on clinical trial investigative staff's perceived challenges and benefits of using portals. The Clinical Trials Transformation Initiative (CTTI) sought to (1) identify challenges to investigator receipt and management of investigational new drug (IND) safety reports at oncologic investigative sites and coordinating centers and (2) facilitate adoption of best practices for communicating and managing IND safety reports using electronic portals. CTTI, a public-private partnership to improve the conduct of clinical trials, distributed surveys and conducted interviews in an opinion-gathering effort to record investigator and research staff views on electronic portals in the context of the new safety reporting requirements described in the US Food and Drug Administration's final rule (Code of Federal Regulations Title 21 Section 312). The project focused on receipt, management, and review of safety reports as opposed to the reporting of adverse events. The top challenge investigators and staff identified in using individual sponsor portals was remembering several complex individual passwords to access each site. Also, certain tasks are time-consuming (eg, downloading reports) due to slow sites or difficulties associated with particular operating systems or software. To improve user experiences, respondents suggested that portals function independently of browsers and operating systems, have intuitive interfaces with easy navigation, and incorporate additional features that would allow users to filter, search, and batch safety reports. Results indicate that an ideal system for sharing expedited IND safety information is through a central portal used by

  9. Evaluation of a multifaceted intervention to limit excessive antipsychotic co-prescribing in schizophrenia out-patients

    DEFF Research Database (Denmark)

    Baandrup, Lone; Allerup, Peter; Lublin, H

    2010-01-01

    polypharmacy, socioeconomic status and functional level of patients. The intervention was aimed at psychiatric healthcare providers and consisted of 1 day of didactic lectures, six 3-h educational outreach visits and an electronic reminder during drug prescribing. RESULTS: Between-group use of antipsychotic...

  10. Operational use of prescribed fire in southern California chaparral

    Science.gov (United States)

    Ron Dougherty; Philip J. Riggan

    1982-01-01

    The use of prescribed fire in the chaparral could reduce the incidence and impacts of severe wildfires and enhance watershed re-sources. This paper describes the operational planning needed for a successful prescribed fire and discusses the recent experience with this technique on the Cleveland National Forest.

  11. Proton pump inhibitors: potential cost reductions by applying prescribing guidelines.

    LENUS (Irish Health Repository)

    Cahir, Caitriona

    2012-01-01

    There are concerns that proton pump inhibitors (PPI) are being over prescribed in both primary and secondary care. This study aims to establish potential cost savings in a community drug scheme for a one year period according to published clinical and cost-effective guidelines for PPI prescribing.

  12. Estimating fuel consumption during prescribed fires in Arkansas

    Science.gov (United States)

    Virginia L. McDaniel; James M. Guldin; Roger W. Perry

    2012-01-01

    While prescribed fire is essential to maintaining numerous plant communities, fine particles produced in smoke can impair human health and reduce visibility in scenic areas. The Arkansas Smoke Management Program was established to mitigate the impacts of smoke from prescribed fires. This program uses fuel loading and consumption estimates from standard fire-behavior...

  13. Prescribing style and variation in antibiotic prescriptions for sore throat

    DEFF Research Database (Denmark)

    Cordoba Currea, Gloria Cristina; Siersma, Volkert Dirk; Lopez-Valcarcel, Beatriz Gonzalez

    2015-01-01

    never did. After adjusting for patient and GP characteristics, prescribing style in the group of GPs from Russia was about three times more heterogeneous than the prescribing style in the group of GPs from Denmark – Median Odds Ratio ( 6.8, 95%CI 3.1;8.8 ) and ( 2.6, 95%CI 2.2;4.4 ) respectively...

  14. Benefits of nurse prescribing for patients in pain: nurses' views.

    Science.gov (United States)

    Stenner, Karen; Courtenay, Molly

    2008-07-01

    This paper is a report of a study to explore nurses' views on the benefits of adopting the role of prescribing for patients with acute and chronic pain. It was envisioned that the advent of nurse prescribing would be beneficial to the efficiency and effectiveness of the United Kingdom National Health Service. Research to date does indeed indicate that nurse prescribing can be beneficial to patients, nurses and the health service in general. Despite the expansion of nurse prescribing, there is little evidence of its impact according to nurses working in specialist areas, such as with patients in acute and chronic pain. Interviews were conducted during 2006 and 2007 with 26 nurses qualified to prescribe medicines for patients in acute and chronic pain. This was a qualitative study and a thematic analysis was conducted. Nurses reported a number of benefits, including faster access to treatment, improved quality of care, more appropriate prescribing of medication, improved safety, improved relations and communication with patients, greater efficiency and cost effectiveness. Nurses benefited from increased job satisfaction, credibility with patients and healthcare professionals and also gained knowledge through prescribing. There is potential for the benefits of nurse prescribing to be expanded beyond the United Kingdom in settings where nurses hold similar roles in the treatment of pain, although further research using a wider range of research methods is recommended to substantiate these findings.

  15. Impacts of prescribed fire on Pinus rigida Mill

    Science.gov (United States)

    Nicholas J. Carlo; Heidi J. Renninger; Kenneth L. Clark; Karina V.R. Schäfer

    2016-01-01

    A comparative analysis of the impacts of prescribed fire on three upland forest stands in the Northeastern Atlantic Plain, NJ, USA, was conducted. Effects of prescribed fire on water use and gas exchange of overstory pines were estimated via sap-flux rates and photosynthetic measurements on Pinus rigida Mill. Each study site had two sap-flux plots...

  16. Forum: Psychotropic prescribing in HIV | Reid | Southern African ...

    African Journals Online (AJOL)

    We provide a brief guide to the diagnosis and treatment of common mental disorders in people living with HIV/AIDS, including: prescribing psychotropics in HIV; neuropsychiatric side-effects of ARVs and other medications commonly prescribed in HIV; and the diagnosis and treatment of depression, anxiety, psychosis, ...

  17. Seed bank response to prescribed fire in the central Appalachians.

    Science.gov (United States)

    Thomas M. Schuler; Melissa Thomas Van-Gundy; Mary B. Adams; W. Mark. Ford

    2010-01-01

    Pre- and post-treatment seed-bank characteristics of woody species were compared after two prescribed fires in a mesic mixed-oak forest in the central Appalachians. Nineteen woody species were identified from soil samples. Mean species richness declined but evenness did not after prescribed burning. The...

  18. Computational opioid prescribing: a novel application of clinical pharmacokinetics.

    Science.gov (United States)

    Linares, Oscar A; Linares, Annemarie L

    2011-01-01

    We implemented a pharmacokinetics-based mathematical modeling technique using algebra to assist prescribers with point-of-care opioid dosing. We call this technique computational opioid prescribing (COP). Because population pharmacokinetic parameter values are needed to estimate drug dosing regimen designs for individual patients using COP, and those values are not readily available to prescribers because they exist scattered in the vast pharmacology literature, we estimated the population pharmacokinetic parameter values for 12 commonly prescribed opioids from various sources using the bootstrap resampling technique. Our results show that opioid dosing regimen design, evaluation, and modification is feasible using COP. We conclude that COP is a new technique for the quantitative assessment of opioid dosing regimen design evaluation and adjustment, which may help prescribers to manage acute and chronic pain at the point-of-care. Potential benefits include opioid dose optimization and minimization of adverse opioid drug events, leading to potential improvement in patient treatment outcomes and safety.

  19. Medication discussion between nurse prescribers and people with diabetes

    DEFF Research Database (Denmark)

    Sibley, Andrew; Latter, Sue; Richard, Claude

    2011-01-01

    Aim. This paper is a report of a study to identify the content of, and participation in, medicine discussion between nurse prescribers and people with diabetes in England. Background. Diabetes affects 246 million people worldwide and effective management of medicines is an essential component...... of successful disease control. There are now over 20,000 nurse independent prescribers in the UK, many of whom frequently prescribe for people with diabetes. With this responsibility comes a challenge to effectively communicate with patients about medicines. National guidelines on medicines communication have...... recently been issued, but the extent to which nurse prescribers are facilitating effective medicine-taking in diabetes remains unknown. Methods. A purposive sample of 20 nurse prescribers working with diabetes patients audio-recorded 59 of their routine consultations and a descriptive analysis...

  20. Occupational PAH Exposures during Prescribed Pile Burns

    Science.gov (United States)

    Robinson, M. S.; Anthony, T. R.; Littau, S. R.; Herckes, P.; Nelson, X.; Poplin, G. S.; Burgess, J. L.

    2008-01-01

    Wildland firefighters are exposed to particulate matter and gases containing polycyclic aromatic hydrocarbons (PAHs), many of which are known carcinogens. Our objective was to evaluate the extent of firefighter exposure to particulate and PAHs during prescribed pile burns of mainly ponderosa pine slash and determine whether these exposures were correlated with changes in urinary 1-hydroxypyrene (1-HP), a PAH metabolite. Personal and area sampling for particulate and PAH exposures were conducted on the White Mountain Apache Tribe reservation, working with 21 Bureau of Indian Affairs/Fort Apache Agency wildland firefighters during the fall of 2006. Urine samples were collected pre- and post-exposure and pulmonary function was measured. Personal PAH exposures were detectable for only 3 of 16 PAHs analyzed: naphthalene, phenanthrene, and fluorene, all of which were identified only in vapor-phase samples. Condensed-phase PAHs were detected in PM2.5 area samples (20 of 21 PAHs analyzed were detected, all but naphthalene) at concentrations below 1 μg m−3. The total PAH/PM2.5 mass fractions were roughly a factor of two higher during smoldering (1.06 ± 0.15) than ignition (0.55 ± 0.04 μg mg−1). There were no significant changes in urinary 1-HP or pulmonary function following exposure to pile burning. In summary, PAH exposures were low in pile burns, and urinary testing for a PAH metabolite failed to show a significant difference between baseline and post-exposure measurements. PMID:18515848

  1. DIII-D electron cyclotron heating 2 MW upgrade project. Final report for the period FY89 through FY97

    International Nuclear Information System (INIS)

    Callis, R.W.

    1997-08-01

    The 2 MW, 110 GHz ECH system was based on the General Atomics Proposal to the Department of Energy: DIII-D Fusion Research Program Vol. I Technical, and Vol. II Cost (GACP-72-166, July 1987 and revised). This proposal was reviewed in August 1987 by a senior technical review committee, who recommended to vigorously pursue increasing the ECH power to 6 MW. The realization of the higher frequency and power ECH on DIII-D was recognized by the committee to be important, not only for the DIII-D program, but also for future devices and the whole ECH area. Subsequently, an engineering cost and schedule review was conducted by DOE-OAK which confirmed the GA costs and schedules and recommended proceeding directly to 10 MW. However, because of budgetary constraints, in the April 1988 Field Task Proposal submission, GA proposed a phased ECH approach, Phase I being 2 MW and Phase II increasing the power to 10 MW. After review, DOE instructed GA to initiate the prototype 2 MW, 110 GHz program. The contract to procure four 500 kW, 110 GHz, 10 s gyrotrons from Varian Associates was initiated in April 1989 with final delivery by November 1990. Because of difficulties in spreading the energy of the electron beam over the collector area, the testing of the first gyrotron delayed its delivery until February 1991. The second gyrotron was able to operate for 1 s at 500 kW and 2 s at 300 kW, but failed when the cavity suffered thermal damage

  2. Antidepressant prescribing in five European countries

    DEFF Research Database (Denmark)

    Abbing-Karahagopian, V; Huerta, C; Souverein, P C

    2014-01-01

    , calculated in a uniform manner, in seven European electronic healthcare databases. METHODS: Annual prevalence per 10,000 person-years (PYs) was calculated for 2001-2009 in databases from Spain, Germany, Denmark, the United Kingdom (UK), and the Netherlands. Prevalence data were stratified according to age...

  3. Evaluation of prescriber responses to pharmacogenomics clinical decision support for thiopurine S-methyltransferase testing.

    Science.gov (United States)

    Ubanyionwu, Samuel; Formea, Christine M; Anderson, Benjamin; Wix, Kelly; Dierkhising, Ross; Caraballo, Pedro J

    2018-02-15

    Results of a study of prescribers' responses to a pharmacogenomics-based clinical decision support (CDS) alert designed to prompt thiopurine S -methyltransferase (TPMT) status testing are reported. A single-center, retrospective, chart review-based study was conducted to evaluate prescriber compliance with a pretest CDS alert that warned of potential thiopurine drug toxicity resulting from deficient TPMT activity due to TPMT gene polymorphism. The CDS alert was triggered when prescribers ordered thiopurine drugs for patients whose records did not indicate TPMT status or when historical thiopurine use was documented in the electronic health record. The alert pop-up also provided a link to online educational resources to guide thiopurine dosing calculations. During the 9-month study period, 500 CDS alerts were generated: in 101 cases (20%), TPMT phenotyping or TPMT genotyping was ordered; in 399 cases (80%), testing was not ordered. Multivariable regression analysis indicated that documentation of historical thiopurine use was the only independent predictor of test ordering. Among the 99 patients tested subsequent to CDS alerts, 70 (71%) had normal TPMT activity, 29 (29%) had intermediate activity, and none had deficient activity. The online resources provided thiopurine dosing recommendations applicable to 24 patients, but only 3 were prescribed guideline-supported doses after CDS alerts. The pretest CDS rule resulted in a large proportion of neglected alerts due to poor alerting accuracy and consequent alert fatigue. Prescriber usage of online thiopurine dosing resources was low. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  4. Deciding Where to Burn: Stakeholder Priorities for Prescribed Burning of a Fire-Dependent Ecosystem

    Directory of Open Access Journals (Sweden)

    Jennifer K. Costanza

    2011-03-01

    Full Text Available Multiagency partnerships increasingly work cooperatively to plan and implement fire management. The stakeholders that comprise such partnerships differ in their perceptions of the benefits and risks of fire use or nonuse. These differences inform how different stakeholders prioritize sites for burning, constrain prescribed burning, and how they rationalize these priorities and constraints. Using a survey of individuals involved in the planning and implementation of prescribed fire in the Onslow Bight region of North Carolina, we examined how the constraints and priorities for burning in the longleaf pine (Pinus palustris ecosystem differed among three stakeholder groups: prescribed burn practitioners from agencies, practitioners from private companies, and nonpractitioners. Stakeholder groups did not differ in their perceptions of constraints to burning, and development near potentially burned sites was the most important constraint identified. The top criteria used by stakeholders to decide where to burn were the time since a site was last burned, and a site's ecosystem health, with preference given to recently burned sites in good health. Differences among stakeholder groups almost always pertained to perceptions of the nonecological impacts of burning. Prescribed burning priorities of the two groups of practitioners, and particularly practitioners from private companies, tended to be most influenced by nonecological impacts, especially through deprioritization of sites that have not been burned recently or are in the wildland-urban interface (WUI. Our results highlight the difficulty of burning these sites, despite widespread laws in the southeast U.S. that limit liability of prescribed burn practitioners. To avoid ecosystem degradation on sites that are challenging to burn, particularly those in the WUI, conservation partnerships can facilitate demonstration projects involving public and private burn practitioners on those sites. In summary

  5. Design of a lighting system with high-power LEDs, large area electronics, and light management structure in the LUMENTILE European project

    Science.gov (United States)

    Carraro, L.; Simonetta, M.; Benetti, G.; Tramonte, A.; Capelli, G.; Benedetti, M.; Randone, E. M.; Ylisaukko-oja, A.; Keränen, K.; Facchinetti, T.; Giuliani, G.

    2017-02-01

    LUMENTILE (LUMinous ElectroNic TILE) is a project funded by the European Commission with the goal of developing a luminous tile with novel functionalities, capable of changing its color and interact with the user. Applications include interior/exterior tile for walls and floors covering, high-efficiency luminaries, and advertising under the form of giant video screens. High overall electrical efficiency of the tile is mandatory, as several millions of square meters are foreseen to be installed each year. Demand is for high uniformity of the illumination of the top tile surface, and for high optical extraction efficiency. These features are achieved by smart light management, using a new approach based on light guiding slab and spatially selective light extraction obtained using both diffusion and/or reflection from the top and bottom interfaces of the optical layer. Planar and edge configurations for the RGB LEDs are considered and compared. A square shape with side length from 20cm to 60cm is considered for the tiles. The electronic circuit layout must optimize the electrical efficiency, and be compatible with low-cost roll-to-roll production on flexible substrates. LED heat management is tackled by using dedicated solutions that allow operation in thermally harsh environment. An approach based on OLEDs has also been considered, still needing improvement on emitted power and ruggedness.

  6. The electronics, trigger and data acquisition system for the liquid argon time projection chamber of the DarkSide-50 search for dark matter

    Energy Technology Data Exchange (ETDEWEB)

    Agnes, P.; Albuquerque, I. F. M.; Alexander, T.; Alton, A. K.; Arisaka, K.; Asner, D. M.; Ave, M.; Back, H. O.; Baldin, B.; Biery, K.; Bocci, V.; Bonfini, G.; Bonivento, W.; Bossa, M.; Bottino, B.; Brigatti, A.; Brodsky, J.; Budano, F.; Bussino, S.; Cadeddu, M.; Cadoni, M.; Calaprice, F.; Canci, N.; Candela, A.; Cao, H.; Caravati, M.; Cariello, M.; Carlini, M.; Catalanotti, S.; Cataudella, V.; Cavalcante, P.; Chepurnov, A.; Cicaló, C.; Cocco, A. G.; Covone, G.; Crippa, L.; D' Angelo, D.; D' Incecco, M.; Davini, S.; de Candia, A.; Cecco, S. De; Deo, M. De; Filippis, G. De; Rosa, G. De; Vincenzi, M. De; Derbin, A.; Devoto, A.; Eusanio, F. Di; Dionisi, C.; Pietro, G. Di; Edkins, E.; Empl, A.; Fan, A.; Fiorillo, G.; Fomenko, K.; Forster, G.; Franco, D.; Gabriele, F.; Galbiati, C.; Giagu, S.; Giganti, C.; Giovanetti, G. K.; Goretti, A. M.; Granato, F.; Grandi, L.; Gromov, M.; Guan, M.; Guardincerri, Y.; Hackett, B. R.; Herner, K. R.; Hughes, D.; Humble, P.; Hungerford, E. V.; Ianni, A.; Ianni, A.; James, I.; Johnson, T. N.; Keeter, K.; Kendziora, C. L.; Kobychev, V.; Koh, G.; Korablev, D.; Korga, G.; Kubankin, A.; Li, X.; Lissia, M.; Loer, B.; Lombardi, P.; Longo, G.; Luitz, S.; Ma, Y.; Machado, A.; Machulin, I. N.; Mandarano, A.; Mari, S. M.; Maricic, J.; Marini, L.; Martoff, C. J.; Meyers, P. D.; Miletic, T.; Milincic, R.; Montanari, D.; Monte, A.; Montuschi, M.; Monzani, M. E.; Mosteiro, P.; Mount, B. J.; Muratova, V. N.; Musico, P.; Agasson, A. Navrer; Nelson, A.; Odrowski, S.; Oleinik, A.; Orsini, M.; Ortica, F.; Pagani, L.; Pallavicini, M.; Pantic, E.; Parmeggiano, S.; Pelczar, K.; Pelliccia, N.; Pocar, A.; Pordes, S.; Pugachev, D. A.; Qian, H.; Randle, K.; Ranucci, G.; Razeti, M.; Razeto, A.; Reinhold, B.; Renshaw, A. L.; Rescigno, M.; Riffard, Q.; Romani, A.; Rossi, B.; Rossi, N.; Rountree, S. D.; Sablone, D.; Saggese, P.; Saldanha, R.; Sands, W.; Sangiorgio, S.; Savarese, C.; Schlitzer, B.; Segreto, E.; Semenov, D. A.; Shields, E.; Singh, P. N.; Skorokhvatov, M. D.; Smirnov, O.; Sotnikov, A.; Stanford, C.; Suvorov, Y.; Tartaglia, R.; Tatarowicz, J.; Testera, G.; Tonazzo, A.; Trinchese, P.; Unzhakov, E. V.; Verducci, M.; Vishneva, A.; Vogelaar, R. B.; Wada, M.; Walker, S.; Wang, H.; Wang, Y.; Watson, A. W.; Westerdale, S.; Wojcik, M. M.; Xiang, X.; Xiao, X.; Xu, J.; Yang, C.; Yoo, J.; Zavatarelli, S.; Zec, A.; Zhong, W.; Zhu, C.; Zuzel, G.

    2017-12-01

    The DarkSide-50 experiment at the Laboratori Nazionali del Gran Sasso is a search for dark matter using a dual phase time projection chamber with 50 kg of low radioactivity argon as target. Light signals from interactions in the argon are detected by a system of 38 photo-multiplier tubes (PMTs), 19 above and 19 below the TPC volume inside the argon cryostat. We describe the electronics which processes the signals from the photo-multipliers, the trigger system which identifies events of interest, and the data-acquisition system which records the data for further analysis. The electronics include resistive voltage dividers on the PMTs, custom pre-amplifiers mounted directly on the PMT voltage dividers in the liquid argon, and custom amplifier/discriminators (at room temperature). After amplification, the PMT signals are digitized in CAEN waveform digitizers, and CAEN logic modules are used to construct the trigger, the data acquisition system for the TPC is based on the Fermilab "artdaq" software. The system has been in operation since early 2014.

  7. Antibiotic prescribing for acute lower respiratory tract infections (LRTI) - guideline adherence in the German primary care setting: An analysis of routine data.

    Science.gov (United States)

    Kraus, Eva Maria; Pelzl, Steffen; Szecsenyi, Joachim; Laux, Gunter

    2017-01-01

    Antibiotic overprescribing in primary care has major impacts on the development of antibiotic resistance. The objective of this study is to provide insight in antibiotics prescriptions for patients suffering from cough, acute bronchitis or community acquired pneumonia in primary care. Data from 2009 to 2013 of electronic health records of 12,880 patients in Germany were obtained from a research database. The prescription of antibiotics for acute lower respiratory tract infections was compared to the national S3 guideline cough from the German Society of General Practitioners and Family Medicine. Antibiotics were prescribed in 41% of consultations. General practitioners' decision of whether or not to prescribe an antibiotic was congruent with the guideline in 52% of consultations and the antibiotic choice congruence was 51% of antibiotic prescriptions. Hence, a congruent prescribing decision and a prescription of recommendation was found in only 25% of antibiotic prescriptions. Split by diagnosis we found that around three quarters of antibiotics prescribed for cough (73%) and acute bronchitis (78%) were not congruent to the guidelines. In contrast to that around one quarter of antibiotics prescribed for community acquired pneumonia (28%) were not congruent to the guidelines. Our results show that there is a big gap between guideline recommendation and actual prescribing, in the decision to prescribe and the choice of antibiotic agent. This gap could be closed by periodic quality circles on antibiotic prescribing for GPs.

  8. Networking Hospital ePrescribing: A Systemic View of Digitalization of Medicines' Use in England.

    Science.gov (United States)

    Lichtner, Valentina; Hibberd, Ralph; Cornford, Tony

    2016-01-01

    Medicine management is at the core of hospital care and digitalization of prescribing and administration of medicines is often the focus of attention of health IT programs. This may be conveyed to the public in terms of the elimination of paper-based drug charts and increased readability of doctors' prescriptions. Based on analysis of documents about hospital medicines supply and use (including systems' implementation) in the UK, in this conceptual paper electronic prescribing and administration are repositioned as only one aspect of an important wider transformation in medicine management in hospital settings, involving, for example, procurement, dispensing, auditing, waste management, research and safety vigilance. Approaching digitalization from a systemic perspective has the potential to uncover the wider implications of this transformation for patients, the organization and the wider health care system.

  9. Classification of projection images of proteins with structural polymorphism by manifold: A simulation study for x-ray free-electron laser diffraction imaging

    Science.gov (United States)

    Yoshidome, Takashi; Oroguchi, Tomotaka; Nakasako, Masayoshi; Ikeguchi, Mitsunori

    2015-09-01

    Coherent x-ray diffraction imaging (CXDI) enables us to visualize noncrystalline sample particles with micrometer to submicrometer dimensions. Using x-ray free-electron laser (XFEL) sources, two-dimensional diffraction patterns are collected from fresh samples supplied to the irradiation area in the "diffraction-before-destruction" scheme. A recent significant increase in the intensity of the XFEL pulse is promising and will allow us to visualize the three-dimensional structures of proteins using XFEL-CXDI in the future. For the protocol proposed for molecular structure determination using future XFEL-CXDI [T. Oroguchi and M. Nakasako, Phys. Rev. E 87, 022712 (2013), 10.1103/PhysRevE.87.022712], we require an algorithm that can classify the data in accordance with the structural polymorphism of proteins arising from their conformational dynamics. However, most of the algorithms proposed primarily require the numbers of conformational classes, and then the results are biased by the numbers. To improve this point, here we examine whether a method based on the manifold concept can classify simulated XFEL-CXDI data with respect to the structural polymorphism of a protein that predominantly adopts two states. After random sampling of the conformations of the two states and in-between states from the trajectories of molecular dynamics simulations, a diffraction pattern is calculated from each conformation. Classification was performed by using our custom-made program suite named enma, in which the diffusion map (DM) method developed based on the manifold concept was implemented. We successfully classify most of the projection electron density maps phase retrieved from diffraction patterns into each of the two states and in-between conformations without the knowledge of the number of conformational classes. We also examined the classification of the projection electron density maps of each of the three states with respect to the Euler angle. The present results suggest

  10. Prescribing smoked cannabis for chronic noncancer pain

    Science.gov (United States)

    Kahan, Meldon; Srivastava, Anita; Spithoff, Sheryl; Bromley, Lisa

    2014-01-01

    Objective To offer preliminary guidance on prescribing smoked cannabis for chronic pain before the release of formal guidelines. Quality of evidence We reviewed the literature on the analgesic effectiveness of smoked cannabis and the harms of medical and recreational cannabis use. We developed recommendations on indications, contraindications, precautions, and dosing of smoked cannabis, and categorized the recommendations based on levels of evidence. Evidence is mostly level II (well conducted observational studies) and III (expert opinion). Main message Smoked cannabis might be indicated for patients with severe neuropathic pain conditions who have not responded to adequate trials of pharmaceutical cannabinoids and standard analgesics (level II evidence). Smoked cannabis is contraindicated in patients who are 25 years of age or younger (level II evidence); who have a current, past, or strong family history of psychosis (level II evidence); who have a current or past cannabis use disorder (level III evidence); who have a current substance use disorder (level III evidence); who have cardiovascular or respiratory disease (level III evidence); or who are pregnant or planning to become pregnant (level II evidence). It should be used with caution in patients who smoke tobacco (level II evidence), who are at increased risk of cardiovascular disease (level III evidence), who have anxiety or mood disorders (level II evidence), or who are taking higher doses of opioids or benzodiazepines (level III evidence). Cannabis users should be advised not to drive for at least 3 to 4 hours after smoking, for at least 6 hours after oral ingestion, and for at least 8 hours if they experience a subjective “high” (level II evidence). The maximum recommended dose is 1 inhalation 4 times per day (approximately 400 mg per day) of dried cannabis containing 9% delta-9-tetrahydrocannabinol (level III evidence). Physicians should avoid referring patients to “cannabinoid” clinics (level

  11. Prokinetics prescribing in paediatrics: evidence on cisapride, domperidone, and metoclopramide.

    Science.gov (United States)

    Mt-Isa, Shahrul; Tomlin, Stephen; Sutcliffe, Alastair; Underwood, Martin; Williamson, Paula; Croft, Nicholas M; Ashby, Deborah

    2015-04-01

    Domperidone and metoclopramide are prokinetics commonly prescribed off-label to infants and younger children in an attempt to treat gastro-oesophageal reflux symptoms. Another prokinetic drug, cisapride, was used but withdrawn in 2000 in the United Kingdom because of serious arrhythmic adverse events. Medicines and Healthcare Products Regulatory Agency issued safety warnings for domperidone in May 2012 and restricted its indications. We report here national primary care prescribing trends and safety signals of these drugs in children. We used data from the General Practice Research Database between 1990 and 2006 for children <18 years. Descriptive statistics and Poisson regressions were performed to characterise prescribing trends. We examined safety signals in nested case-control studies. The proportion of children <2 years old being prescribed one of the medications doubled during the study period. Prescriptions of domperidone increased 10-fold, mainly following the withdrawal of cisapride in 2000. Prescriptions of metoclopramide did not change significantly. Despite the increase in prescriptions of domperidone, no new safety signals were identified. These data showed dramatic changes in prescribing of cisapride and domperidone despite the lack of good-quality supporting evidence. It is possible that these prescribing trends were influenced by published guidelines. Even if produced without robust efficacy and safety evidence, published guidelines can influence clinicians and consequently affect prescribing. Therefore, improving the evidence base on prokinetics to inform future guidelines is vital. The lack of new safety signals during this period would support the development of suitable powered clinical studies.

  12. Antimicrobial prescribing behaviour in dogs and cats by Belgian veterinarians.

    Science.gov (United States)

    Van Cleven, Alexia; Sarrazin, Steven; de Rooster, Hilde; Paepe, Dominique; Van der Meeren, Sofie; Dewulf, Jeroen

    2018-03-17

    The objective of this study is to survey general prescribing behaviour by Belgian companion animal veterinarians and to assess agreement of these practices with current treatment guidelines. Therefore an online survey was administered with five realistic and frequently occurring first-line cases to primary-care veterinary practitioners. For each case a predefined pattern of questions were asked about whether or not they would prescribe antimicrobials, if they would prescribe a non-antimicrobial treatment and if they would perform additional diagnostic steps. The responses were compared with recommendations in national guidelines and recent literature. The overall most prescribed antimicrobials were potentiated amoxicillin (43.0 per cent), fluoroquinolones (14.7 per cent), third-generation and fourth-generation cephalosporins (10.9 per cent) and tetracyclines (10.9 per cent). Only 48.3 per cent of the veterinarians complied with the guidelines in nearly all of the clinical scenarios (ie, prescribing antimicrobials when indicated, not prescribing antimicrobials when it is not indicated). Moreover, when prescribing highest priority critically important antimicrobials, susceptibility testing on bacterial cultures was performed in only 12.4 per cent of the prescriptions. The results showed that the prescribing behaviour of antimicrobial compounds by primary-care veterinary practitioners in dogs and cats is often not in agreement with national guidelines. Focus in improvement of this prescribing behaviour should be on performing the appropriate diagnostic steps and decreasing the use of highest priority critically important antimicrobials. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. The Supply of Prescription Opioids: Contributions of Episodic-Care Prescribers and High-Quantity Prescribers.

    Science.gov (United States)

    Schneberk, Todd; Raffetto, Brian; Kim, David; Schriger, David L

    2018-06-01

    We determine episodic and high-quantity prescribers' contribution to opioid prescriptions and total morphine milligram equivalents in California, especially among individuals prescribed large amounts of opioids. This was a cross-sectional descriptive analysis of opioid prescribing patterns during an 8-year period using the de-identified Controlled Substance Utilization Review and Evaluation System (CURES) database, the California subsection of the prescription drug monitoring program. We took a 10% random sample of all patients and stratified them by the amount of prescription opioids obtained during their maximal 90-day period. We identified "episodic prescribers" as those whose prescribing pattern included short-acting opioids on greater than 95% of all prescriptions, fewer than or equal to 31 pills on 95% of all prescriptions, only 1 prescription in the database for greater than 90% of all patients to whom they gave opioids, fewer than 6 prescriptions in the database to greater than 99% of patients given opioids, and fewer than 540 prescriptions per year. We identified top 5% prescribers by their morphine milligram equivalents per day in the database. We examined the relationship between patient opioid prescriptions and provider type, with the primary analysis performed on the patient cohort who received only short-acting opioids in an attempt to avoid guideline-concordant palliative, oncologic, and addiction care, and a secondary analysis performed on all patients. Among patients with short-acting opioid only, episodic prescribers (14.6% of 173,000 prescribers) wrote at least one prescription to 25% of 2.7 million individuals but were responsible for less than 9% of the 10.5 million opioid prescriptions and less than 3% of the 3.9 billion morphine milligram equivalents in our sample. Among individuals with high morphine milligram equivalents use, episodic prescribers were responsible for 2.8% of prescriptions and 0.6% of total morphine milligram equivalents

  14. Prescribing in prison: minimizing psychotropic drug diversion in correctional practice.

    Science.gov (United States)

    Pilkinton, Patricia D; Pilkinton, James C

    2014-04-01

    Correctional facilities are a major provider of mental health care throughout the United States. In spite of the numerous benefits of providing care in this setting, clinicians are sometimes concerned about entering into correctional care because of uncertainty in prescribing practices. This article provides an introduction to prescription drug use, abuse, and diversion in the correctional setting, including systems issues in prescribing, commonly abused prescription medications, motivation for and detection of prescription drug abuse, and the use of laboratory monitoring. By understanding the personal and systemic factors that affect prescribing habits, the clinician can develop a more rewarding correctional practice and improve care for inmates with mental illness.

  15. Fiscal 1998 research cooperation project on development of the easy-to-operate electronic design/production support system; 1998 nendo kan'i sosagata denshi sekkei seisan shien system no kaihatsu ni kansuru kenkyu kyoryoku jigyo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    This report summarizes 'Research cooperation on the easy-to- operate electronic design/production support system' which was promoted together with Asian countries as a part of the international research projects. This project is promoted by joint research with research organizations in China, Indonesia, Malaysia, Singapore and Thailand. The project promotes the interexchange and cooperation of researchers along the memoranda on MATIC (Manufacturing Technology International Cooperation) concluded between NEDO and research organizations every country. The project is implemented by CICC (Center of the International Cooperation for Computerization) through the contract with NEDO. CICC is promoting this project with the production system future integrated information system committee, MATIC committee, and automobile, home appliance, fiber and apparel working groups. The project has been promoted by the survey in fiscal 1994, the basic planning in fiscal 1995-1996, and development of the prototype information system in fiscal 1996-1998. The final demonstration test is scheduled in fiscal 1998. (NEDO)

  16. Fiscal 1998 research cooperation project on development of the easy-to-operate electronic design/production support system; 1998 nendo kan'i sosagata denshi sekkei seisan shien system no kaihatsu ni kansuru kenkyu kyoryoku jigyo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    This report summarizes 'Research cooperation on the easy-to- operate electronic design/production support system' which was promoted together with Asian countries as a part of the international research projects. This project is promoted by joint research with research organizations in China, Indonesia, Malaysia, Singapore and Thailand. The project promotes the interexchange and cooperation of researchers along the memoranda on MATIC (Manufacturing Technology International Cooperation) concluded between NEDO and research organizations every country. The project is implemented by CICC (Center of the International Cooperation for Computerization) through the contract with NEDO. CICC is promoting this project with the production system future integrated information system committee, MATIC committee, and automobile, home appliance, fiber and apparel working groups. The project has been promoted by the survey in fiscal 1994, the basic planning in fiscal 1995-1996, and development of the prototype information system in fiscal 1996-1998. The final demonstration test is scheduled in fiscal 1998. (NEDO)

  17. Improving Pain Care with Project ECHO in Community Health Centers.

    Science.gov (United States)

    Anderson, Daren; Zlateva, Ianita; Davis, Bennet; Bifulco, Lauren; Giannotti, Tierney; Coman, Emil; Spegman, Douglas

    2017-10-01

    Pain is an extremely common complaint in primary care, and patient outcomes are often suboptimal. This project evaluated the impact of Project ECHO Pain videoconference case-based learning sessions on knowledge and quality of pain care in two Federally Qualified Health Centers. Quasi-experimental, pre-post intervention, with comparison group. Two large, multisite federally qualified health centers in Connecticut and Arizona. Intervention (N = 10) and comparison (N = 10) primary care providers. Primary care providers attended 48 weekly Project ECHO Pain sessions between January and December 2013, led by a multidisciplinary pain specialty team. Surveys and focus groups assessed providers' pain-related knowledge and self-efficacy. Electronic health record data were analyzed to evaluate opioid prescribing and specialty referrals. Compared with control, primary care providers in the intervention had a significantly greater increase in pain-related knowledge and self-efficacy. Providers who attended ECHO were more likely to use formal assessment tools and opioid agreements and refer to behavioral health and physical therapy compared with control providers. Opioid prescribing decreased significantly more among providers in the intervention compared with those in the control group. Pain is an extremely common and challenging problem, particularly among vulnerable patients such as those cared for at the more than 1,200 Federally Qualified Health Centers in the United States. In this study, attendance at weekly Project ECHO Pain sessions not only improved knowledge and self-efficacy, but also altered prescribing and referral patterns, suggesting that knowledge acquired during ECHO sessions translated into practice changes. © 2017 American Academy of Pain Medicine.

  18. Barriers to accepting e-prescribing in the U.S.A.

    Science.gov (United States)

    Smith, Alan D

    2006-01-01

    With the number of prescriptions rising nationally each year, it is surprising that Web-based technology is not fully embraced in the pharmacy industry as an aid to quality-assuring prescribing processes. Traditional prescription handling is done in a manual fashion with physicians hand-writing prescriptions for the patients during an office visit, giving the patient the responsibility of taking the prescription to a pharmacy or mailing the prescription to a mail order company for fulfillment. Electronic prescribing (e-prescribing) has the ability not only to streamline the prescription writing process, but also to reduce the number of errors that may be incurred with hand-written prescriptions. The purpose of this paper is to investigate these phenomena in the U.S.A. A number of hypotheses were tested using principal-components analysis (PCA) and factor analyses. As a result, a total of 55 fully employed, professional and semi-professional service management and internet users, representing a college-educated and knowledge-based sample derived from the metropolitan section of Pittsburgh, was selected. The six major constructs generated from the factor loadings in descending order of importance were: profit and risk factors, shipping and handling, saving, customer relationship management (CRM) and ethics, age, and awareness. The dependent variable chosen to be regressed against these major independent factor-based constructs was willingness to purchase prescriptions online. The overall relationship was found to be statistically significant (F = 2.971, p = 0.015) in predicting willingness to use e-prescribing options based on the various independent constructs. However, when testing the various standardized beta coefficients in the linear model, only the factor score-based construct CRM and ethics was found to significantly contribute to predicting the willingness to purchase prescriptions online (t = -3.074, p = 0.003). Although this study appears to represent the

  19. Electronics for dummies

    CERN Document Server

    Shamieh

    2015-01-01

    Explore the basic concepts of electronics, build your electronics workbench, and begin creating fun electronics projects right away! Electronics For Dummies, 3rd Edition is your guide to the world of electronics. Spanning circuitry, wiring, robotics, transmitters, amplifiers, and more, this book demystifies electricity basics and beyond. The third edition offers new content revised to reflect the latest advancements in the electronics field, and it offers full color project examples to spark your creativity and inspire you to put your new skills to use! Packed with projects that can be comple

  20. Cost-benefit assessment of using electronic health records data for clinical research versus current practices: Contribution of the Electronic Health Records for Clinical Research (EHR4CR) European Project.

    Science.gov (United States)

    Beresniak, Ariel; Schmidt, Andreas; Proeve, Johann; Bolanos, Elena; Patel, Neelam; Ammour, Nadir; Sundgren, Mats; Ericson, Mats; Karakoyun, Töresin; Coorevits, Pascal; Kalra, Dipak; De Moor, Georges; Dupont, Danielle

    2016-01-01

    The widespread adoption of electronic health records (EHR) provides a new opportunity to improve the efficiency of clinical research. The European EHR4CR (Electronic Health Records for Clinical Research) 4-year project has developed an innovative technological platform to enable the re-use of EHR data for clinical research. The objective of this cost-benefit assessment (CBA) is to assess the value of EHR4CR solutions compared to current practices, from the perspective of sponsors of clinical trials. A CBA model was developed using an advanced modeling approach. The costs of performing three clinical research scenarios (S) applied to a hypothetical Phase II or III oncology clinical trial workflow (reference case) were estimated under current and EHR4CR conditions, namely protocol feasibility assessment (S1), patient identification for recruitment (S2), and clinical study execution (S3). The potential benefits were calculated considering that the estimated reduction in actual person-time and costs for performing EHR4CR S1, S2, and S3 would accelerate time to market (TTM). Probabilistic sensitivity analyses using Monte Carlo simulations were conducted to manage uncertainty. Should the estimated efficiency gains achieved with the EHR4CR platform translate into faster TTM, the expected benefits for the global pharmaceutical oncology sector were estimated at €161.5m (S1), €45.7m (S2), €204.5m (S1+S2), €1906m (S3), and up to €2121.8m (S1+S2+S3) when the scenarios were used sequentially. The results suggest that optimizing clinical trial design and execution with the EHR4CR platform would generate substantial added value for pharmaceutical industry, as main sponsors of clinical trials in Europe, and beyond. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Data feedback and behavioural change intervention to improve primary care prescribing safety (EFIPPS): multicentre, three arm, cluster randomised controlled trial.

    Science.gov (United States)

    Guthrie, Bruce; Kavanagh, Kimberley; Robertson, Chris; Barnett, Karen; Treweek, Shaun; Petrie, Dennis; Ritchie, Lewis; Bennie, Marion

    2016-08-18

    was effective at reducing high risk prescribing. The intervention would be feasible to implement at scale in contexts where electronic health records are in general use.Trial registration Clinical trials NCT01602705. 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.

  2. What do Australian consumers, pharmacists and prescribers think about documenting indications on prescriptions and dispensed medicines labels?: A qualitative study.

    Science.gov (United States)

    Garada, Mona; McLachlan, Andrew J; Schiff, Gordon D; Lehnbom, Elin C

    2017-11-15

    Documenting the indication on prescriptions and dispensed medicines labels is not standard practice in Australia. However, previous studies that have focused on the content and design of dispensed medicines labels, have suggested including the indication as a safety measure. The aim of this study was to investigate the perspectives of Australian consumers, pharmacists and prescribers on documenting the indication on prescriptions and dispensed medicines labels. Semi-structured interviews were conducted and mock-up of dispensed medicines labels were designed for participants. Consumers (n = 19) and pharmacists (n = 7) were recruited by convenience sample at community pharmacies in Sydney (Australia) and prescribers (n = 8), including two medical students, were recruited through snowballing. Thirty-four participants were interviewed. Most participants agreed that documenting the indication would be beneficial especially for patients who are forgetful or take multiple medications. Participants also believed it would improve consumers' medication understanding and adherence. Prescribers and pharmacists believed it could help reduce prescribing and dispensing errors by matching the drug/dosage to the correct indication. Prescribers refrained from documenting the indication to protect patients' privacy; however, most patients did not consider documenting the indication as a breach of privacy. Prescribers raised concerns about the extra time to include indications on prescriptions and best language to document indications, using plain language as opposed to medical terminology. All interviewed stakeholders identified numerous benefits of documenting the indication on prescriptions and dispensed medicines labels. Whether these potential benefits can be realized remains unknown and addressing prescribers' concern regarding the time involved in documenting the indication on prescriptions remains a challenge for vendors of electronic medication management systems.

  3. A drug utilisation study investigating prescribed daily doses of ...

    African Journals Online (AJOL)

    and drug groups. Design. Retrospective drug utilisation study using data .... drugs that were prescribed 20 or fewer times during the period under ... occurs in women and men at different ages and with different severity. group. On average, men ...

  4. Prescribing psychotropic drugs to adults with an intellectual disability

    Science.gov (United States)

    Trollor, Julian N; Salomon, Carmela; Franklin, Catherine

    2016-01-01

    SUMMARY Mental illness is common in people with intellectual disability. They may also have physical health problems which can affect their mental state. Difficulties in communication can contribute to mental health problems being overlooked. These may present with changes in behaviour. Psychological management is usually preferable to prescribing psychotropic drugs. Behavioural approaches are the most appropriate way to manage challenging behaviour. If a drug is considered, prescribers should complete a thorough diagnostic assessment, exclude physical and environmental contributions to symptoms, and consider medical comorbidities before prescribing. Where possible avoid psychotropics with the highest cardiometabolic burden. Prescribe the minimum effective dose and treatment length, and regularly monitor drug efficacy and adverse effects. There is insufficient evidence to support the use of psychotropics for challenging behaviour. They should be avoided unless the behaviour is severe and non-responsive to other treatments. PMID:27756975

  5. Retrospective evaluation of antimicrobial prescribing pattern in a ...

    African Journals Online (AJOL)

    Retrospective evaluation of antimicrobial prescribing pattern in a tertiary hospital in Nigeria. ... Annals of Biomedical Sciences ... prescription in University of Benin Teaching Hospital, Benin City, Nigeria over a period of seven years. Materials ...

  6. On a class of graphs with prescribed mean curvature

    International Nuclear Information System (INIS)

    Duong Minh Duc; Costa Salavessa, I.M. de

    1989-11-01

    We study a class of quasilinear elliptic equations on the unit ball of R n and apply these results to get the existence of graphs with prescribed mean curvature on n-hyperbolic spaces. (author). 18 refs

  7. Potentially inappropriate prescribing in older patients admitted to psychiatric hospital

    NARCIS (Netherlands)

    Rongen, S.; Kramers, C.; O'Mahony, D.; Feuth, T.; Olde Rikkert, M.G.M.; Ahmed, A.I.A.

    2016-01-01

    OBJECTIVES: The objectives of this study are to determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs) and to assess related risk factors in older people with major psychiatric illness.

  8. Medicare Part D Prescriber Look-up Tool

    Data.gov (United States)

    U.S. Department of Health & Human Services — This look-up tool is a searchable database that allows you to look up a Medicare Part D prescriber by National Provider Identifier (NPI), or by name and location....

  9. Research Article Antimalarial Drugs for Pediatrics - Prescribing and ...

    African Journals Online (AJOL)

    Erah

    2011-03-23

    Mar 23, 2011 ... is a need to institute measures to ensure rational prescribing, dispensing and use of antimalarial drugs in pediatrics. ... facilities, strategies to control behaviour in the private sector are ..... changes were implemented in 2006 in.

  10. Antibiotic prescribing practice and adherence to guidelines in ...

    African Journals Online (AJOL)

    clinical outcomes, including death, and consume more healthcare resources.[2] Globally 700 ... Individual prescribing decisions affect the population level of resistance. .... professionals (doctors, nurses, dentists and primary care drug therapist ...

  11. Trends in Antibiotic Prescribing in Adults in Dutch General Practice

    NARCIS (Netherlands)

    M.B. Haeseker (Michiel); N.H.T.M. Dukers-Muijrers (Nicole); C.J.P.A. Hoebe (Christian); C.A. Bruggeman (Cathrien); J.W.L. Cals (Jochen); A. Verbon (Annelies)

    2012-01-01

    textabstractBackground: Antibiotic consumption is associated with adverse drug events (ADE) and increasing antibiotic resistance. Detailed information of antibiotic prescribing in different age categories is scarce, but necessary to develop strategies for prudent antibiotic use. The aim of this

  12. Polypharmacy patterns: unravelling systematic associations between prescribed medications.

    Directory of Open Access Journals (Sweden)

    Amaia Calderón-Larrañaga

    Full Text Available OBJECTIVES: The aim of this study was to demonstrate the existence of systematic associations in drug prescription that lead to the establishment of patterns of polypharmacy, and the clinical interpretation of the associations found in each pattern. METHODS: A cross-sectional study was conducted based on information obtained from electronic medical records and the primary care pharmacy database in 2008. An exploratory factor analysis of drug dispensing information regarding 79,089 adult patients was performed to identify the patterns of polypharmacy. The analysis was stratified by age and sex. RESULTS: Seven patterns of polypharmacy were identified, which may be classified depending on the type of disease they are intended to treat: cardiovascular, depression-anxiety, acute respiratory infection (ARI, chronic obstructive pulmonary disease (COPD, rhinitis-asthma, pain, and menopause. Some of these patterns revealed a clear clinical consistency and included drugs that are prescribed together for the same clinical indication (i.e., ARI and COPD patterns. Other patterns were more complex but also clinically consistent: in the cardiovascular pattern, drugs for the treatment of known risk factors-such as hypertension or dyslipidemia-were combined with other medications for the treatment of diabetes or established cardiovascular pathology (e.g., antiplatelet agents. Almost all of the patterns included drugs for preventing or treating potential side effects of other drugs in the same pattern. CONCLUSIONS: The present study demonstrated the existence of non-random associations in drug prescription, resulting in patterns of polypharmacy that are sound from the pharmacological and clinical viewpoints and that exist in a significant proportion of the population. This finding necessitates future longitudinal studies to confirm some of the proposed causal associations. The information discovered would further the development and/or adaptation of clinical

  13. Existence of conformal metrics on spheres with prescribed Paneitz curvature

    International Nuclear Information System (INIS)

    Ben Ayed, Mohamed; El Mehdi, Khalil

    2003-07-01

    In this paper we study the problem of prescribing a fourth order conformal invariant (the Paneitz curvature) on the n-spheres, with n ≥ 5. Using tools from the theory of critical points at infinity, we provide some topological conditions on the level sets of a given function defined on the sphere, under which we prove the existence of conformal metric with prescribed Paneitz curvature. (author)

  14. Nurse prescriber-patient consultations: a case study in dermatology.

    Science.gov (United States)

    Courtenay, Molly; Carey, Nicola; Stenner, Karen

    2009-06-01

    This paper is a report of a study exploring the content and processes in consultations between nurse prescribers and patients with dermatological conditions. Communication skills, consultation time, information and follow-up are central to the treatment and management of patients with dermatological conditions. The contribution nurses make to the care of these patients has great potential. A multiple case study was conducted with 10 practice settings across England in which nurses prescribed medicines for patients with dermatological conditions. Data were collected between June 2006 and September 2007 using semi-structured interviews (n = 40), patient questionnaires (n = 165/200) and videotaped observations of nurse consultations (n = 40). Data analysis included thematic analysis, descriptive statistics, chi-square and non-parametric tests. Nurses believed that their holistic approach to assessment, combined with their prescribing knowledge, improved prescribing decisions. Listening and explanation of treatments were aspects of nurse communication that were rated highly by patients. Listening and dealing sensitively with emotions were also aspects of the videotaped consultations that were rated highly by assessors. Nurses were less consistent in providing information about medicines. Triangulated data from this study suggest that nurse prescribing enhances the care of patients with dermatological conditions through improved prescribing decisions. If patients are to be more involved in this decision-making, nurses must give them more information about their medicines. The benefits of prescribing were most evident in the practices of dermatology specialist nurses. Further evidence is required to identify whether prescribing by specialist nurses offers similar benefits in other therapeutic areas.

  15. Existence of conformal metrics on spheres with prescribed Paneitz curvature

    CERN Document Server

    Ben-Ayed, M

    2003-01-01

    In this paper we study the problem of prescribing a fourth order conformal invariant (the Paneitz curvature) on the n-spheres, with n >= 5. Using tools from the theory of critical points at infinity, we provide some topological conditions on the level sets of a given function defined on the sphere, under which we prove the existence of conformal metric with prescribed Paneitz curvature.

  16. Sorafenib prescribed by gastroenterologists and hepatologists for hepatocellular carcinoma

    Science.gov (United States)

    Kaplan, David E.; Mehta, Rajni; D’Addeo, Kathryn; Valderrama, Adriana; Taddei, Tamar H.

    2018-01-01

    Abstract Sorafenib is the only Food and Drug Administration (FDA)-approved first-line therapy shown to have survival benefit for patients with advanced hepatocellular carcinoma (HCC). Patients with advanced HCC are often but not exclusively transferred from non-oncologists to oncologists to initiate systemic therapy. The objective of this study was to assess whether sorafenib prescribing by non-oncologists has any impact on utilization, adverse effects, cost or outcome. This was a retrospective cohort study utilizing data from patients prescribed sorafenib for HCC within Veterans Health Administration hospitals with 100% chart abstraction to confirm HCC diagnosis, identify prescribing provider specialty (oncology versus gastroenterology/hepatology), and obtain data required for cancer staging by the Barcelona Clinic Liver Cancer (BCLC) system. The primary outcome was overall survival from the time of sorafenib prescription. A total of 4903 patients who prescribed sorafenib for HCC were identified, for whom 340 patients (6.9%) were prescribed drug by a non-oncologist (Onc). BCLC Stage, age, Child–Turcotte–Pugh score, and comorbidity indices were similar between patients prescribed sorafenib by oncologists and non-oncologists. Oncologists more often discontinued sorafenib due to progression, whereas non-oncologists were more likely to continue sorafenib until death resulting in greater pill utilization and cost. Overall survival in both unadjusted and multivariable models showed no significant impact of prescriber type on survival (222 vs 217 days, P = .96), confirmed with propensity-matched subcohorts. Similar survival outcomes were observed for patients with HCC prescribed sorafenib by non-oncologists and oncologists, suggesting that non-oncologists with expertise in the management of HCC can safely and effectively administer sorafenib. PMID:29369224

  17. Assessment of antibiotic prescribing in Latvian general practitioners

    Directory of Open Access Journals (Sweden)

    Dumpis Uga

    2013-01-01

    Full Text Available Abstract Background Though general antibiotic consumption data is available, information on the actual patterns of prescribing antibiotics locally is difficult to obtain. An easy to use methodology was designed to assess ambulatory management of infections by Latvian general practitioners (GPs. Methods GPs were asked to record data in a patient data collection form for every patient that received antibiotics. Study period – (7 days one week in November, 2008. Data recorded included the following details: an antibiotic, the prescribed dose, dosing interval, route of administration combined with the demographic factors of the patient and clinical diagnosis based on a pre-defined list. Results Two hundred forty eight forms out of the 600 (41% were returned by post. Antibiotics were prescribed in 6.4% (1711/26803 of outpatient consultations. In total, 1763 antibiotics were prescribed during the study period. Ninety seven percent of the patients received monotherapy and only 47 (2.7% patients were prescribed two antibiotics. The most commonly prescribed antibiotics were amoxicillin (33.9% of prescribed, amoxicillin/clavulanate (18,7% and clarithromycin (7.6%. The most commonly treated indications were pharyngitis (29.8%, acute bronchitis (25.3% and rhinosinusitis (10.2%. Pneumonia was mostly treated with amoxicillin/clavulanate (25,7%, amoxicillin (15.7% and clarithromycin (19.3%. Conclusions Methodology employed provided useful additional information on ambulatory practice of prescribing antibiotics and could be used in further assessment studies. Educational interventions should be focused on treatment of acute pharyngitis and bronchitis in children and unnecessary use of quinolones in adults for uncomplicated urinary tract infection.

  18. [Antibiotic prescribing in acute respiratory tract infections in general practice].

    Science.gov (United States)

    Malo, S; Bjerrum, L; Feja, C; Lallana, M J; Poncel, A; Rabanaque, M J

    2015-06-01

    Antimicrobial resistance is a worldwide threat to public health. Acute respiratory tract infections are the main reason for antibiotic prescribing in the Spanish paediatric population. The aim of the study was to describe the frequency of antibiotic prescription and their pattern of use in acute respiratory tract infections diagnosed in children in Primary Care in Aragón (Spain). A study was conducted over a 1-year period on children between 0 and 14 years-old, recording all episodes of acute otitis, acute pharyngotonsillitis, non-specific upper respiratory infection, and acute bronchitis. The proportion of episodes within each diagnosis receiving an antibiotic prescription was calculated, and the prescribing pattern was determined. Half (50%) of the children in Aragón were diagnosed with a respiratory tract infection during the study period. Non-specific upper respiratory infection was the most frequent diagnosis. An antibiotic was prescribed in 75% of pharyngotonsillitis episodes, 72% of otitis, 27% of bronchitis, and 16% of non-specific upper respiratory infections. Broad spectrum antibiotics, mainly amoxicillin and amoxicillin-clavulanic, were predominantly prescribed. Antibiotic prescribing in respiratory tract infections in children was generally high, and the choice of antibiotics was probably inappropriate in a high percentage of cases. Therefore an improvement in antibiotic prescribing in children appears to be needed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  19. A survey of the criteria for prescribing in cases of borderline refractive errors

    Directory of Open Access Journals (Sweden)

    Einat Shneor

    2016-01-01

    Conclusions: The prescribing criteria found in this study are broadly comparable with those in previous studies and with published prescribing guidelines. Subtle indications suggest that optometrists may become more conservative in their prescribing criteria with experience.

  20. Drug prescribing pattern in three levels of health care facilities in the ...

    African Journals Online (AJOL)

    tabulation and goodness of fit. Results showed that there is significant statistical differences in the number of drugs prescribed per patient encounter, percentage of encounter with an injection prescribed, in adherence to WHO prescribing ...

  1. Pharmacy and primary care perspectives on e-prescribing in a rural community: A focused ethnography.

    Science.gov (United States)

    Kooienga, Sarah; Singh, Reshmi L

    Electronic prescribing (ERx) is the ability for prescriber to send a digital prescription directly to a pharmacist through a dedicated secure network. A number of federally funded incentives such as the health information technology for economic and clinical health (HITECH) and Meaningful Use standards have led to ERx implementation. ERx is an integral part of primary care practice and today most community pharmacies are enabled to accept e-prescriptions. Little is known about the experience of rural pharmacists, primary care providers and patients regarding e-prescribing. This paper reports on the results of ERx from their perspectives. The findings are a portion of a larger qualitative descriptive study focused on the meaning of Meaningful Use in remote rural communities. One remote rural community in the Pacific Northwest was used for this research endeavor. Explore understandings of e-prescribing from both pharmacist and primary care provider perspective. Explore patients' understandings and experiences of e-prescribing. The conceptual model for this research was the Ecological Transactional Model. This model informed the research design, interview questions and analysis. A qualitative descriptive methodology - focused ethnography was used for this study. Six key informant interviews, 14 patient interviews and 15 hours of participant observation provided the data. Data analysis occurred collectively between a social pharmacy researcher, a primary care nurse practitioner-researcher and pharmacy graduate students. The research qualitatively identified contextual understandings and dimensions of ERx in this setting. Based on a focused ethnographic methodology, contextual understandings of rurality and role identity, both pharmacist and primary care provider, were explored. Perspectives on ERx of patients, clinic manager and RN staff were also elicited. Three dimensions of ERx were identified - technological, structural and communication. The structural

  2. Prescribing Optimization Method for Improving Prescribing in Elderly Patients Receiving Polypharmacy Results of Application to Case Histories by General Practitioners

    NARCIS (Netherlands)

    Drenth-van Maanen, A. Clara; van Marum, Rob J.; Knol, Wilma; van der Linden, Carolien M. J.; Jansen, Paul A. F.

    2009-01-01

    Background: Optimizing polypharmacy is often difficult, and critical appraisal of medication use often leads to one or more changes. We developed the Prescribing Optimization Method (POM) to assist physicians, especially general practitioners (GPs), in their attempts to optimize polypharmacy in

  3. Effect of a drug allergy educational program and antibiotic prescribing guideline on inpatient clinical providers' antibiotic prescribing knowledge.

    Science.gov (United States)

    Blumenthal, Kimberly G; Shenoy, Erica S; Hurwitz, Shelley; Varughese, Christy A; Hooper, David C; Banerji, Aleena

    2014-01-01

    Inpatient providers have varying levels of knowledge in managing patients with drug and/or penicillin (PCN) allergy. Our objectives were (1) to survey inpatient providers to ascertain their baseline drug allergy knowledge and preparedness in caring for patients with PCN allergy, and (2) to assess the impact of an educational program paired with the implementation of a hospital-based clinical guideline. We electronically surveyed 521 inpatient providers at a tertiary care medical center at baseline and again 6 weeks after an educational initiative paired with clinical guideline implementation. The guideline informed providers on drug allergy history taking and antibiotic prescribing for inpatients with PCN or cephalosporin allergy. Of 323 unique responders, 42% (95% CI, 37-48%) reported no prior education in drug allergy. When considering those who responded to both surveys (n = 213), we observed a significant increase in knowledge about PCN skin testing (35% vs 54%; P allergy over time (54% vs 80%; P allergy was severe significantly improved (77% vs 92%; P = .03). Other areas, including understanding absolute contraindications to receiving a drug again and PCN cross-reactivity with other antimicrobials, did not improve significantly. Inpatient providers have drug allergy knowledge deficits but are interested in tools to help them care for inpatients with drug allergies. Our educational initiative and hospital guideline implementation were associated with increased PCN allergy knowledge in several crucial areas. To improve care of inpatients with drug allergy, more research is needed to evaluate hospital policies and sustainable educational tools. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  4. [Access to medicines prescribed for acute health conditions in adults in South and Northeast Brazil].

    Science.gov (United States)

    Paniz, Vera Maria Vieira; Cechin, Isabel Carolina Coelho Flores; Fassa, Anaclaudia Gastal; Piccini, Roberto Xavier; Tomasi, Elaine; Thumé, Elaine; Silveira, Denise Silva da; Facchini, Luiz Augusto

    2016-01-01

    This was a cross-sectional study within Brazil's Project for the Expansion and Consolidation of Family Health, 2005, with the objective of universal and free access to the medication prescribed in the last medical appointment for acute health problems and to estimate the degree to which access may have improved with inclusion of the medicines in prevailing policies and programs. The sample included 4,060 adults living in the area of primary health care units in 41 municipalities in South and Northeast Brazil. Access was greater in the South (83.2%) than in the Northeast (71%), and free access was similar (37%), with a greater share by the Family Health Program (FHP) when compared to the traditional model, especially in the Northeast. Some 60% of prescribed medicines and 50% of those on the National List of Essential Medicines (RENAME) were paid for. No variation was observed in the proportion of medicines present on the prevailing RENAME list and access. However, 40% of the medicines that were paid for can currently be obtained through the Popular Pharmacy Program. The latter program appears to emerge as a new way to guarantee access to medicines prescribed in the health system.

  5. Optical simulations for the S3 project - Super separator spectrometer - gamma-electron coincidence spectroscopy of a transfermium nucleus: the 251Md101

    International Nuclear Information System (INIS)

    Dechery, Fabien

    2012-01-01

    In analogy with the atomic closed shells giving rise to the stability and high ionisation energies of noble gases, nuclear physics also has its magic numbers of protons and neutrons which enhance nuclear structure stability. Knowledge of the structure of doubly-magic nuclei, both proton and neutron numbers, is crucial to parameterize theoretical models. The discovery of the next and ultimate magic numbers will provide a strong constraint on the many predictions. These two numbers are like the centre coordinates of an area of enhanced stability of the nuclear chart, well known as 'island of stability'. These superheavy nuclei only exist due to pure quantum shell effects. My thesis work deals with two distinct, but complementary, aspects of fundamental physics with the common goal of studying these extreme mass nuclei structure. The first part corresponds to the development of a next generation instrument for nuclear physics to allow synthesis and spectroscopy studies of superheavy nuclei: the Super Separator Spectrometer S 3 . This project will be installed at SPIRAL2 (GANIL) and has been approved by the French Research National Agency (ANR) within the EQUIPEX framework. It has been designed to take advantage of the high intensity heavy ion beam from the LINAC, giving access to a wide range of physical programs. The second part corresponds to the preparation, realisation and analysis of an experiment on 251-Mendelevium in which the very first prompt gamma-electron coincidence spectroscopy was performed for a transfermium nuclei. (author) [fr

  6. Atomic data from the IRON Project. XXXII. On the accuracy of the effective collision strength for the electron impact excitation of the quadrupole transition in AR III

    Science.gov (United States)

    Galavís, M. E.; Mendoza, C.; Zeippen, C. J.

    1998-12-01

    Since te[Burgess et al. (1997)]{bur97} have recently questioned the accuracy of the effective collision strength calculated in the IRON Project for the electron impact excitation of the 3ssp23p sp4 \\ sp1 D -sp1 S quadrupole transition in Ar iii, an extended R-matrix calculation has been performed for this transition. The original 24-state target model was maintained, but the energy regime was increased to 100 Ryd. It is shown that in order to ensure convergence of the partial wave expansion at such energies, it is necessary to take into account partial collision strengths up to L=30 and to ``top-up'' with a geometric series procedure. By comparing effective collision strengths, it is found that the differences from the original calculation are not greater than 25% around the upper end of the common temperature range and that they are much smaller than 20% over most of it. This is consistent with the accuracy rating (20%) previously assigned to transitions in this low ionisation system. Also the present high-temperature limit agrees fairly well (15%) with the Coulomb-Born limit estimated by Burgess et al., thus confirming our previous accuracy rating. It appears that Burgess et al., in their data assessment, have overextended the low-energy behaviour of our reduced effective collision strength to obtain an extrapolated high-temperature limit that appeared to be in error by a factor of 2.

  7. "What they see is what you get": Prescribing antibiotics for respiratory tract infections in primary care: Do high prescribers diagnose differently? An analysis of German routine data.

    Science.gov (United States)

    Hueber, Susann; Kuehlein, Thomas; Gerlach, Roman; Tauscher, Martin; Schedlbauer, Angela

    2017-01-01

    Characteristics of high and low prescribers of antibiotics in German primary care were analysed using population data. We aimed to evaluate differences in prescribing rates and factors being associated with high prescribing, and whether high prescribers made the diagnosis of perceived bacterial infections more often. Routine data were provided by the Bavarian Association of Statutory Health Insurance Physicians. Routine data are delivered by primary care practices on a quarterly basis. We analysed data from 2011 and 2012. Patients older than 15 years with respiratory tract infections consulting a primary care physician were selected (6.647 primary care practices). Patient and physician characteristics associated with high prescribing were identified using stepwise logistic regression. Mean prescribing rate of antibiotics was 24.9%. Prescribing rate for high prescribers was 43.5% compared to 8.5% for low prescribers. High prescribers made the diagnosis of perceived bacterial infections more often (Mhigh = 64.5%, Mlow = 45.2%). In the adjusted regression model, perceived bacterial infections were strongly associated with high prescribing (OR = 13.9, 95% CI [10.2, 18.8]). Treating patients with comorbidities was associated with lower prescribing of antibiotics (OR = 0.6, 95% CI [0.4, 0.8]). High prescribers had a higher practice volume, a higher degree of prescribing dominance, and were situated more often in deprived areas and in rural settings. Compared to findings of studies in other European countries, prescribing rates were low. There was a considerable difference between prescribing rates of high and low prescribers. Diagnostic labelling was the best predictor for high prescribing. Current guidelines recommend considering antibiotic treatment for patients with co-morbidities. In our study, treating a large number of high-risk patients was not associated with high prescribing.

  8. Change in antihypertensive drug prescribing after guideline implementation: a controlled before and after study

    Directory of Open Access Journals (Sweden)

    Helin-Salmivaara Arja

    2011-08-01

    Full Text Available Abstract Background Antihypertensive drug choices and treatment levels are not in accordance with the existing guidelines. We aimed to assess the impact of a guideline implementation intervention on antihypertensive drug prescribing. Methods In this controlled before and after study, the effects of a multifaceted (education, audit and feedback, local care pathway quality programme was evaluated. The intervention was carried out in a health centre between 2002 and 2003. From each health care unit (n = 31, a doctor-nurse pair was trained to act as peer facilitators in the intervention. All antihypertensive drugs prescribed by 25 facilitator general practitioners (intervention GPs and 53 control GPs were retrieved from the nationwide Prescription Register for three-month periods in 2001 and 2003. The proportions of patients receiving specific antihypertensive drugs and multiple antihypertensive drugs were measured before and after the intervention for three subgroups of hypertension patients: hypertension only, with coronary heart disease, and with diabetes. Results In all subgroups, the use of multiple concurrent medications increased. For intervention patients with hypertension only, the odds ratio (OR was 1.12 (95% CI 0.99, 1.25; p = 0.06 and for controls 1.13 (1.05, 1.21; p = 0.002. We observed no statistically significant differences in the change in the prescribing of specific antihypertensive agents between the intervention and control groups. The use of agents acting on the renin-angiotensin-aldosterone system increased in all subgroups (hypertension only intervention patients OR 1.19 (1.06, 1.34; p = 0.004 and controls OR 1.24 (1.15, 1.34; p Conclusions A multifaceted guideline implementation intervention does not necessarily lead to significant changes in prescribing performance. Rigorous planning of the interventions and quality projects and their evaluation are essential.

  9. A Validation Study of Homeopathic Prescribing and Patient Care Indicators

    Directory of Open Access Journals (Sweden)

    Munmun Koley

    2014-10-01

    Full Text Available A preliminary version of the homeopathic prescribing and patient care indicators was available. The instrument was modified further in this study with an intention to address formally its validity and reliability, audit prescriptions, identify areas of sub-optimal prescribing, and highlight target areas for improving the quality of practices. A cross-sectional study with record analysis was conducted on systematically sampled 377 patients of Mahesh Bhattacharyya Homeopathic Medical College and Hospital (MBHMC and H, Howrah, West Bengal, India. The outcome measures were homeopathic prescribing indicators (6 items and patient care indicators (5 items. Individualized homeopathic prescriptions predominated in the encounters. Areas demanding immediate attention were extremely poor labeling of drugs dispensed from the hospital pharmacy, improper record of case history and disease diagnosis, ongoing therapies, and investigational findings in the prescriptions. Internal consistency of the overall instrument was estimated to be good (Cronbach's alpha: Prescribing indicators 0.752 and patient care indicators 0.791. The prescribing indicators, except items 1 and 3, reflected acceptable item-corrected total correlations – Pearson's r from 0.58 (95% CI: 0.52-0.65 to 0.74 (95% CI: 0.69-0.78. The patient care indicators, except item 2, showed acceptable correlations – Pearson's r from 0.40 (95% CI: 0.31-0.48 to 0.82 (95% CI: 0.78-0.85. The instrument also showed high discriminant validity (prescribing indicators P<0.0001 and patient care indicators P<0.0001. Improper prescribing practice was quite rampant and corrective measures are warranted. The developed indicators appeared to be validated and reliable; however, they are amendable for further development.

  10. A Validation Study of Homeopathic Prescribing and Patient Care Indicators

    Science.gov (United States)

    Koley, Munmun; Saha, Subhranil; Ghosh, Shubhamoy; Nag, Goutam; Kundu, Monojit; Mondal, Ramkumar; Purkait, Rajib; Patra, Supratim

    2014-01-01

    A preliminary version of the homeopathic prescribing and patient care indicators was available. The instrument was modified further in this study with an intention to address formally its validity and reliability, audit prescriptions, identify areas of sub-optimal prescribing, and highlight target areas for improving the quality of practices. A cross-sectional study with record analysis was conducted on systematically sampled 377 patients of Mahesh Bhattacharyya Homeopathic Medical College and Hospital (MBHMC and H), Howrah, West Bengal, India. The outcome measures were homeopathic prescribing indicators (6 items) and patient care indicators (5 items). Individualized homeopathic prescriptions predominated in the encounters. Areas demanding immediate attention were extremely poor labeling of drugs dispensed from the hospital pharmacy, improper record of case history and disease diagnosis, ongoing therapies, and investigational findings in the prescriptions. Internal consistency of the overall instrument was estimated to be good (Cronbach's alpha: Prescribing indicators 0.752 and patient care indicators 0.791). The prescribing indicators, except items 1 and 3, reflected acceptable item-corrected total correlations – Pearson's r from 0.58 (95% CI: 0.52-0.65) to 0.74 (95% CI: 0.69-0.78). The patient care indicators, except item 2, showed acceptable correlations – Pearson's r from 0.40 (95% CI: 0.31-0.48) to 0.82 (95% CI: 0.78-0.85). The instrument also showed high discriminant validity (prescribing indicators P < 0.0001 and patient care indicators P < 0.0001). Improper prescribing practice was quite rampant and corrective measures are warranted. The developed indicators appeared to be validated and reliable; however, they are amendable for further development. PMID:25379474

  11. Does fire severity influence shrub resprouting after spring prescribed burning?

    Science.gov (United States)

    Fernández, Cristina; Vega, José A.; Fonturbel, Teresa

    2013-04-01

    Prescribed burning is commonly used to reduce the risk of severe wildfire. However, further information about the associated environmental effects is required to help forest managers select the most appropriate treatment. To address this question, we evaluated if fire severity during spring prescribed burning significantly affects the resprouting ability of two common shrub species in shrubland under a Mediterranean climate in NW Spain. Fire behaviour and temperatures were recorded in tagged individuals of Erica australis and Pterospartum tridentatum during prescribed burning. The number and length of resprouted shoots were measured three times (6, 12 and 18 months) after the prescribed burning. The influence of a series of fire severity indicators on some plant resprouting vigour parameters was tested by canonical correlation analysis. Six months and one year after prescribed burning, soil burn severity (measured by the absolute reduction in depth of the organic soil layer, maximum temperatures in the organic soil layer and the mineral soil surface during burning and the post-fire depth of the organic soil layer) reduced the resprouting vigour of E. australis and P. tridentatum. In contrast, direct measurements of fire effects on plants (minimum branch diameter, duration of temperatures above 300 °C in the shrub crown and fireline intensity) did not affect the post-fire plant vigour. Soil burn severity during spring prescribed burning significantly affected the short-term resprouting vigour in a mixed heathland in Galicia. The lack of effects eighteen months after prescribed burning indicates the high resilience of these species and illustrates the need to conciliate fire prevention and conservation goals.

  12. Prescribed burning supports grassland biodiversity - A multi-species study

    Science.gov (United States)

    Valkó, Orsolya; Deák, Balázs; Magura, Tibor; Török, Péter; Kelemen, András; Tóth, Katalin; Horváth, Roland; Nagy, Dávid; Debnár, Zsuzsanna; Zsigrai, György; Kapocsi, István; Tóthmérész, Béla

    2017-04-01

    During ancient times, fire was an important factor shaping European landscapes. Nowadays, prescribed burning can be one of the most effective conservation tools for the management of open landscapes, controlling dominant species, reducing accumulated litter or decreasing wildfire risk. In a prescribed burning experiment, we studied the effects of fire on dry alkaline grasslands. We tested whether autumn prescribed burning can be an alternative conservation measure in these grasslands. We selected six sites in Hungary: in three sites, prescribed burning was applied in November 2011, while three sites remained unburnt. We studied the effects of fire on soil characteristics, plant biomass and on the vegetation and arthropod assemblages (isopods, spiders, ground beetles and rove beetles). Soluble salt content increased significantly in the burnt sites, but soil pH, organic matter, potassium and phosphorous did not change. We found that prescribed fire had several positive effects from the nature conservation viewpoint. Diversity and the number of flowering shoots were higher, and the cover of the dominant grass was lower in the burnt sites. Graminoid biomass was lower, while total, green and forb biomass were higher in the burnt plots compared to the control ones. Our findings suggest that prescribed burning fire did not harm arthropods; species-level analyses showed that out of the most abundant invertebrate species, the abundance of ten was not affected, one decreased and one increased after burning. Our findings highlight that mosaic prescribed fire is a viable management tool in open landscapes, because it supports plant diversity and does not threaten arthropods.

  13. A model of methods for influencing prescribing: Part I. A review of prescribing models, persuasion theories, and administrative and educational methods.

    Science.gov (United States)

    Raisch, D W

    1990-04-01

    The purpose of this literature review is to develop a model of methods to be used to influence prescribing. Four bodies of literature were identified as being important for developing the model: (1) Theoretical prescribing models furnish information concerning factors that affect prescribing and how prescribing decisions are made. (2) Theories of persuasion provide insight into important components of educational communications. (3) Research articles of programs to improve prescribing identify types of programs that have been found to be successful. (4) Theories of human inference describe how judgments are formulated and identify errors in judgment that can play a role in prescribing. This review is presented in two parts. This article reviews prescribing models, theories of persuasion, studies of administrative programs to control prescribing, and sub-optimally designed studies of educational efforts to influence drug prescribing.

  14. Investigating soil moisture-climate interactions with prescribed soil moisture experiments: an assessment with the Community Earth System Model (version 1.2)

    Science.gov (United States)

    Hauser, Mathias; Orth, René; Seneviratne, Sonia I.

    2017-04-01

    Land surface hydrology is an important control of surface weather and climate. A valuable technique to investigate this link is the prescription of soil moisture in land surface models, which leads to a decoupling of the atmosphere and land processes. Diverse approaches to prescribe soil moisture, as well as different prescribed soil moisture conditions have been used in previous studies. Here, we compare and assess four methodologies to prescribe soil moisture and investigate the impact of two different estimates of the climatological seasonal cycle used to prescribe soil moisture. Our analysis shows that, though in appearance similar, the different approaches require substantially different long-term moisture inputs and lead to different temperature signals. The smallest influence on temperature and the water balance is found when prescribing the median seasonal cycle of deep soil liquid water, whereas the strongest signal is found when prescribing soil liquid and soil ice using the mean seasonal cycle. These results indicate that induced net water-balance perturbations in experiments investigating soil moisture-climate coupling are important contributors to the climate response, in addition to the intended impact of the decoupling. These results help to guide the set-up of future experiments prescribing soil moisture, as for instance planned within the Land Surface, Snow and Soil Moisture Model Intercomparison Project (LS3MIP).

  15. Electron tube

    Science.gov (United States)

    Suyama, Motohiro [Hamamatsu, JP; Fukasawa, Atsuhito [Hamamatsu, JP; Arisaka, Katsushi [Los Angeles, CA; Wang, Hanguo [North Hills, CA

    2011-12-20

    An electron tube of the present invention includes: a vacuum vessel including a face plate portion made of synthetic silica and having a surface on which a photoelectric surface is provided, a stem portion arranged facing the photoelectric surface and made of synthetic silica, and a side tube portion having one end connected to the face plate portion and the other end connected to the stem portion and made of synthetic silica; a projection portion arranged in the vacuum vessel, extending from the stem portion toward the photoelectric surface, and made of synthetic silica; and an electron detector arranged on the projection portion, for detecting electrons from the photoelectric surface, and made of silicon.

  16. Protocol: mixed-methods study to evaluate implementation, enforcement, and outcomes of U.S. state laws intended to curb high-risk opioid prescribing.

    Science.gov (United States)

    McGinty, Emma E; Stuart, Elizabeth A; Caleb Alexander, G; Barry, Colleen L; Bicket, Mark C; Rutkow, Lainie

    2018-02-26

    The U.S. opioid epidemic has been driven by the high volume of opioids prescribed by healthcare providers. U.S. states have recently enacted four types of laws designed to curb high-risk prescribing practices, such as high-dose and long-term opioid prescribing, associated with opioid-related mortality: (1) mandatory Prescription Drug Monitoring Program (PDMP) enrollment laws, which require prescribers to enroll in their state's PDMP, an electronic database of patients' controlled substance prescriptions, (2) mandatory PDMP query laws, which require prescribers to query the PDMP prior to prescribing an opioid, (3) opioid prescribing cap laws, which limit the dose and/or duration of opioid prescriptions, and (4) pill mill laws, which strictly regulate pain clinics to prevent nonmedical opioid prescribing. Some pain experts have expressed concern that these laws could negatively affect pain management among patients with chronic non-cancer pain. This paper describes the protocol for a mixed-methods study analyzing the independent effects of these four types of laws on opioid prescribing patterns and chronic non-cancer pain treatment, accounting for variation in implementation and enforcement of laws across states. Many states have enacted multiple opioid prescribing laws at or around the same time. To overcome this issue, our study focuses on 18 treatment states that each enacted a single law of interest, and no other potentially confounding laws, over a 4-year period (2 years pre-/post-law). Qualitative interviews with key leaders in each of the 18 treatment states will characterize the timing, scope, and strength of each state law's implementation and enforcement. This information will inform the design and interpretation of synthetic control models analyzing the effects of each of the two types of laws on two sets of outcomes: measures of (1) high-risk opioid prescribing and (2) non-opioid treatments for chronic non-cancer pain. Study of mandatory PDMP enrollment

  17. Prescribing medical cannabis in Canada: Are we being too cautious?

    Science.gov (United States)

    Lake, Stephanie; Kerr, Thomas; Montaner, Julio

    2015-04-30

    There has been much recent discussion and debate surrounding cannabis in Canada, including the prescribing of medical cannabis for therapeutic purposes. Certain commentators - including the Canadian Medical Association (CMA) - have denounced the prescribing of cannabis for medical purposes due to a perceived lack of evidence related to the drug's efficacy, harms, and mechanism of action. In this commentary, we present arguments in favour of prescribing medical cannabis in Canada. We believe the anti-cannabis position taken by CMA and other commentators is not entirely evidence-based. Using the example of neuropathic pain, we present and summarize the clinical evidence surrounding smoked or vapourized cannabis, including recent evidence pertaining to the effectiveness of cannabis in comparison to existing standard pharmacotherapies for neuropathy. Further, we outline how the concerns expressed regarding cannabis' mechanism of action are inconsistent with current decision-making processes related to the prescribing of many common pharmaceuticals. Finally, we discuss potential secondary public health benefits of prescribing cannabis for pain-related disorders in Canada and North America.

  18. Prescribed and self-reported seasonal training of distance runners.

    Science.gov (United States)

    Hewson, D J; Hopkins, W G

    1995-12-01

    A survey of 123 distance-running coaches and their best runners was undertaken to describe prescribed seasonal training and its relationship to the performance and self-reported training of the runners. The runners were 43 females and 80 males, aged 24 +/- 8 years (mean +/- S.D.), training for events from 800 m to the marathon, with seasonal best paces of 86 +/- 6% of sex- and age-group world records. The coaches and runners completed a questionnaire on typical weekly volumes of interval and strength training, and typical weekly volumes and paces of moderate and hard continuous running, for build-up, pre-competition, competition and post-competition phases of a season. Prescribed training decreased in volume and increased in intensity from the build-up through to the competition phase, and had similarities with 'long slow distance' training. Coaches of the faster runners prescribed longer build-ups, greater volumes of moderate continuous running and slower relative paces of continuous running (r = 0.19-0.36, P training close to competition pace. The mean training volumes and paces prescribed by the coaches were similar to those reported by the runners, but the correlations between prescribed and reported training were poor (r = 0.2-0.6). Coaches may therefore need to monitor their runners' training more closely.

  19. Characteristics of prescribers whose patients shop for opioids: results from a cohort study.

    Science.gov (United States)

    Cepeda, M Soledad; Fife, Daniel; Berlin, Jesse A; Mastrogiovanni, Gregory; Yuan, Yingli

    2012-01-01

    Little is known about the prevalence of opioid shoppers in clinical practices and the relation between prescriber characteristics and the risk of having opioid shoppers. Describe the prevalence of opioid shoppers in prescribers' practices. Assess the relation between prescribers' characteristics and patient opioid shopping behavior. Retrospective cohort study using a large US retail prescription database. Patients with ≥1 opioid dispensing were followed 18 months. These patients' prescribers are the focus of the study. A patient was a "shopper" if he or she had opioid prescriptions written by ≥1 prescriber with ≥1 day of overlap filled at ≥3 pharmacies and a "heavy shopper" if he or she had ≥5 shopping episodes. The proportions of shoppers by prescriber and the proportion of prescribers with ≥1 shopper or heavy shopper were calculated. Among 858,290 opioid prescribers, most (87 percent) had no shoppers and 98 percent had no heavy shoppers. Prescribers who were aged 70-79 years, male, or who prescribed schedule II opioids had an increased likelihood of having shoppers. As the number of patients for whom a prescriber prescribed opioids increased, the proportion of shoppers also increased. Prescribers with 66 or more patients receiving opioids, who represented 25 percent of prescribers, prescribed for 82 percent of all shoppers. The great majority of opioid prescribers appear to have no shoppers in their practice. Any educational program will be more cost effective if targeted to prescribers of schedule II opioids with a large volume of patients requiring opioids.

  20. Use of electron paramagnetic resonance dosimetry with tooth enamel for retrospective dose assessment. Report of a co-ordinated research project

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-12-01

    Electron paramagnetic resonance (EPR) dosimetry is a physical method for the assessment of absorbed dose from ionising radiation. It is based on the measurement of stable radiation induced radicals in human calcified tissues (primarily in tooth enamel). EPR dosimetry with teeth is now firmly established in retrospective dosimetry. It is a powerful method for providing information on exposure to ionising radiation many years after the event, since the 'signal' is 'stored' in the tooth or the bone. This technique is of particular relevance to relatively low dose exposures or when the results of conventional dosimetry are not available (e.g. in accidental circumstances). The use of EPR dosimetry, as an essential tool for retrospective assessment of radiation exposure is an important part of radioepidemiological studies and also provides data to select appropriate countermeasures based on retrospective evaluation of individual doses. Despite well established regulations and protocols for maintaining radiation protection dose limits, the assurance that these limits will not be exceeded cannot be guaranteed, thus providing new challenges for development of accurate methods of individual dose assessment. To meet some of these challenges, in 1998 the IAEA initiated a co-ordinated research project (CRP) with the objective to review the available methods, current research and development in EPR biodosimetry technology, which may be of practical use. The major goal of this CRP was to investigate the use of EPR biodosimetry for reconstruction of absorbed dose in tooth enamel with the aim of providing Member States with up-to-date, and generally agreed upon advice regarding the most suitable procedures and the best focus for their research. The co-ordinated research project was conducted over four years and this publication presents the results and findings by a group of investigators from different countries. The available cytogenetic methods for radiation dose assessment were

  1. Use of electron paramagnetic resonance dosimetry with tooth enamel for retrospective dose assessment. Report of a co-ordinated research project

    International Nuclear Information System (INIS)

    2002-12-01

    Electron paramagnetic resonance (EPR) dosimetry is a physical method for the assessment of absorbed dose from ionising radiation. It is based on the measurement of stable radiation induced radicals in human calcified tissues (primarily in tooth enamel). EPR dosimetry with teeth is now firmly established in retrospective dosimetry. It is a powerful method for providing information on exposure to ionising radiation many years after the event, since the 'signal' is 'stored' in the tooth or the bone. This technique is of particular relevance to relatively low dose exposures or when the results of conventional dosimetry are not available (e.g. in accidental circumstances). The use of EPR dosimetry, as an essential tool for retrospective assessment of radiation exposure is an important part of radioepidemiological studies and also provides data to select appropriate countermeasures based on retrospective evaluation of individual doses. Despite well established regulations and protocols for maintaining radiation protection dose limits, the assurance that these limits will not be exceeded cannot be guaranteed, thus providing new challenges for development of accurate methods of individual dose assessment. To meet some of these challenges, in 1998 the IAEA initiated a co-ordinated research project (CRP) with the objective to review the available methods, current research and development in EPR biodosimetry technology, which may be of practical use. The major goal of this CRP was to investigate the use of EPR biodosimetry for reconstruction of absorbed dose in tooth enamel with the aim of providing Member States with up-to-date, and generally agreed upon advice regarding the most suitable procedures and the best focus for their research. The co-ordinated research project was conducted over four years and this publication presents the results and findings by a group of investigators from different countries. The available cytogenetic methods for radiation dose assessment were

  2. What do Australian consumers, pharmacists and prescribers think about documenting indications on prescriptions and dispensed medicines labels?: A qualitative study

    Directory of Open Access Journals (Sweden)

    Mona Garada

    2017-11-01

    Full Text Available Abstract Background Documenting the indication on prescriptions and dispensed medicines labels is not standard practice in Australia. However, previous studies that have focused on the content and design of dispensed medicines labels, have suggested including the indication as a safety measure. The aim of this study was to investigate the perspectives of Australian consumers, pharmacists and prescribers on documenting the indication on prescriptions and dispensed medicines labels. Methods Semi-structured interviews were conducted and mock-up of dispensed medicines labels were designed for participants. Consumers (n = 19 and pharmacists (n = 7 were recruited by convenience sample at community pharmacies in Sydney (Australia and prescribers (n = 8, including two medical students, were recruited through snowballing. Results Thirty-four participants were interviewed. Most participants agreed that documenting the indication would be beneficial especially for patients who are forgetful or take multiple medications. Participants also believed it would improve consumers’ medication understanding and adherence. Prescribers and pharmacists believed it could help reduce prescribing and dispensing errors by matching the drug/dosage to the correct indication. Prescribers refrained from documenting the indication to protect patients’ privacy; however, most patients did not consider documenting the indication as a breach of privacy. Prescribers raised concerns about the extra time to include indications on prescriptions and best language to document indications, using plain language as opposed to medical terminology. Conclusions All interviewed stakeholders identified numerous benefits of documenting the indication on prescriptions and dispensed medicines labels. Whether these potential benefits can be realized remains unknown and addressing prescribers’ concern regarding the time involved in documenting the indication on prescriptions

  3. The effect of pharmacist-led interventions in optimising prescribing in older adults in primary care: A systematic review

    Directory of Open Access Journals (Sweden)

    David O Riordan

    2016-06-01

    Full Text Available Objective: To evaluate studies of pharmacist-led interventions on potentially inappropriate prescribing among community-dwelling older adults receiving primary care to identify the components of a successful intervention. Data sources: An electronic search of the literature was conducted using the following databases from inception to December 2015: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, MEDLINE (through Ovid, Trip, Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews, ISI Web of Science, ScienceDirect, ClinicalTrials.gov, metaRegister of Controlled Trials, ProQuest Dissertations & Theses Database (Theses in Great Britain, Ireland and North America. Review methods: Studies were included if they were randomised controlled trials or quasi-randomised studies involving a pharmacist-led intervention compared to usual/routine care which aimed to reduce potentially inappropriate prescribing in older adults in primary care. Methodological quality of the included studies was independently assessed. Results: A comprehensive literature search was conducted which identified 2193 studies following removal of duplicates. Five studies met the inclusion criteria. Four studies involved a pharmacist conducting a medication review and providing feedback to patients or their family physician. One randomised controlled trial evaluated the effect of a computerised tool that alerted pharmacists when elderly patients were newly prescribed potentially inappropriate medications. Four studies were associated with an improvement in prescribing appropriateness. Conclusion: Overall, this review demonstrates that pharmacist-led interventions may improve prescribing appropriateness in community-dwelling older adults. However, the quality of evidence is low. The role of a pharmacist working as part of a multidisciplinary primary care team requires further investigation to optimise prescribing in this group of

  4. Prescribing Oxygen for Cluster Headache: A Guide for the Provider.

    Science.gov (United States)

    Tepper, Stewart J; Duplin, Jessica; Nye, Barbara; Tepper, Deborah E

    2017-10-01

    Oxygen is the standard of care for acute treatment of cluster headache. CMS, the US Centers for Medicaid and Medicare Services, has made the indefensible decision to not cover oxygen for cluster headache for patients with Medicaid and Medicare insurance, despite the evidence and professional guidelines. Commercial insurance generally covers oxygen for cluster headache. This is a "how-to" guide for successfully prescribing oxygen in the US. Prescription information is provided that can be incorporated as dot phrases, smart sets, or other standard templates for prescribing oxygen for cluster patients. In many states, oxygen is affordable and can be prescribed for Medicaid and Medicare patients who wish to pay cash. Welding or nonmedical grade industrial oxygen is almost the same cost as medical oxygen. However, it is less pure, lacks the same inspection of tanks, and is delivered without regulators to provide appropriate flow rates. Patients who pay cash should be strongly encouraged to buy medical oxygen. © 2017 American Headache Society.

  5. An audit of generic prescribing in a general surgical department.

    LENUS (Irish Health Repository)

    Gleeson, M

    2013-01-17

    BACKGROUND: The Health Service Executive introduced a generic prescription policy to reduce costs. Despite this, generic prescription rates remain low. AIM: To audit in-patient prescription practice in a single surgical department and identify potential savings which could be realised by adherence to the generic prescribing policy. METHODS: Surgical in-patient charts were obtained at the point of discharge and their drug prescription information was recorded. RESULTS: 51 % of prescriptions involved a trade-name prescription where an appropriate generic equivalent existed. The cost implications for hospital and community patients were found to be greatly affected by substitution policies that exist at hospital pharmacy level. CONCLUSION: There is a need to promote greater adherence to generic prescribing amongst hospital doctors in line with international best practice. It can have a positive impact in terms of safe prescribing and can have cost implications at both hospital and community level.

  6. [Prescribing antibiotics for sore throat: a persistent habit].

    Science.gov (United States)

    Damoiseaux, Roger A M J; Venekamp, Roderick P

    2015-01-01

    Recently the revision of the guideline of the Dutch College of General Practitioners on sore throat has been published. Again, one of the key messages is restricting the use of antibiotics. In the Netherlands general practitioners prescribe antibiotics in 50% of cases of tonsillitis. Although there has been a decrease in the number of antibiotic prescriptions for tonsillitis in the last 30 years, they are still being prescribed twice as often as is recommended by the guideline. The beliefs of both patient and doctor play an important role in prescribing and better communication might help to improve the situation. Public campaigns can also help by providing the best knowledge on the effectiveness of antibiotics to the public.

  7. Prescribing Privileges for Psychologists: A Public Service or Hazard?

    Directory of Open Access Journals (Sweden)

    Shaheen E. Lakhan

    2007-07-01

    Full Text Available The privilege to prescribe pharmacotherapeutics has been granted in limited areas to psychologists. The psychologist's role in society may be approaching a great evolution that can dramatically impact the state of mental healthcare and the discipline of psychiatry. Opponents argue drug company funding and cheaper non-PhD psychological professionals fuel the movement for prescription rights for PhD level psychologists. However, proponents claim that this right would equip psychologists with greater psychotherapeutic modalities and the capability of having richer doctor-patient relationships to diagnose and treat underserved populations. Nonetheless, the paucity of prescribing psychologist studies cannot allow the biopsychosocial community to make firm opinions, let alone a decision on this debate. This article reviews the history of clinical psychology and highlights the potential divergence into collaborative clinical and health psychologists and autonomous prescribing psychologists.

  8. Inappropriate prescribing in the older population: need for new criteria.

    LENUS (Irish Health Repository)

    O'Mahony, Denis

    2012-02-03

    Inappropriate prescribing (IP) is a common and serious global healthcare problem in elderly people, leading to increased risk of adverse drug reactions (ADRs), polypharmacy being the main risk factor for both IP and ADRs. IP in older people is highly prevalent but preventable; hence screening tools for IP have been devised, principally Beers\\' Criteria and the Inappropriate Prescribing in the Elderly Tool (IPET). Although Beers\\' Criteria have become the most widely cited IP criteria in the literature, nevertheless, they have serious deficiencies, including several drugs that are rarely prescribed nowadays, a lack of structure in the presentation of the criteria and omission of several important and common IP instances. New, more up-to-date, systems-based and easily applicable criteria are needed that can be applied in the routine clinical setting.

  9. Statin prescribing according to gender, age and indication

    DEFF Research Database (Denmark)

    Wallach-Kildemoes, Helle; Støvring, Henrik; Holme Hansen, Ebba

    2016-01-01

    RATIONALES, AIMS AND OBJECTIVES: The increasing dispensing of statins has raised concern about the appropriateness of prescribing to various population groups. We aimed to (1) investigate incident and prevalent statin prescribing according to indication, gender and age and (2) relate prescribing...... patterns to evidence on beneficial and adverse effects. METHODS: A cohort of Danish inhabitants (n = 4 424 818) was followed in nationwide registries for dispensed statin prescriptions and hospital discharge information. We calculated incidence rates (2005-2009), prevalence trends (2000-2010) and absolute...... numbers of statin users according to register proxies for indication, gender and age. RESULTS: In 2010, the prevalence became highest for ages 75-84 and was higher in men than women (37% and 33%, respectively). Indication-specific incidences and prevalences peaked at ages around 65-70, but in myocardial...

  10. The EHR-ARCHE project: Satisfying clinical information needs in a Shared Electronic Health Record System based on IHE XDS and Archetypes☆

    Science.gov (United States)

    Duftschmid, Georg; Rinner, Christoph; Kohler, Michael; Huebner-Bloder, Gudrun; Saboor, Samrend; Ammenwerth, Elske

    2013-01-01

    Purpose While contributing to an improved continuity of care, Shared Electronic Health Record (EHR) systems may also lead to information overload of healthcare providers. Document-oriented architectures, such as the commonly employed IHE XDS profile, which only support information retrieval at the level of documents, are particularly susceptible for this problem. The objective of the EHR-ARCHE project was to develop a methodology and a prototype to efficiently satisfy healthcare providers’ information needs when accessing a patient's Shared EHR during a treatment situation. We especially aimed to investigate whether this objective can be reached by integrating EHR Archetypes into an IHE XDS environment. Methods Using methodical triangulation, we first analysed the information needs of healthcare providers, focusing on the treatment of diabetes patients as an exemplary application domain. We then designed ISO/EN 13606 Archetypes covering the identified information needs. To support a content-based search for fine-grained information items within EHR documents, we extended the IHE XDS environment with two additional actors. Finally, we conducted a formative and summative evaluation of our approach within a controlled study. Results We identified 446 frequently needed diabetes-specific information items, representing typical information needs of healthcare providers. We then created 128 Archetypes and 120 EHR documents for two fictive patients. All seven diabetes experts, who evaluated our approach, preferred the content-based search to a conventional XDS search. Success rates of finding relevant information was higher for the content-based search (100% versus 80%) and the latter was also more time-efficient (8–14 min versus 20 min or more). Conclusions Our results show that for an efficient satisfaction of health care providers’ information needs, a content-based search that rests upon the integration of Archetypes into an IHE XDS-based Shared EHR system is

  11. The EHR-ARCHE project: satisfying clinical information needs in a Shared Electronic Health Record system based on IHE XDS and Archetypes.

    Science.gov (United States)

    Duftschmid, Georg; Rinner, Christoph; Kohler, Michael; Huebner-Bloder, Gudrun; Saboor, Samrend; Ammenwerth, Elske

    2013-12-01

    While contributing to an improved continuity of care, Shared Electronic Health Record (EHR) systems may also lead to information overload of healthcare providers. Document-oriented architectures, such as the commonly employed IHE XDS profile, which only support information retrieval at the level of documents, are particularly susceptible for this problem. The objective of the EHR-ARCHE project was to develop a methodology and a prototype to efficiently satisfy healthcare providers' information needs when accessing a patient's Shared EHR during a treatment situation. We especially aimed to investigate whether this objective can be reached by integrating EHR Archetypes into an IHE XDS environment. Using methodical triangulation, we first analysed the information needs of healthcare providers, focusing on the treatment of diabetes patients as an exemplary application domain. We then designed ISO/EN 13606 Archetypes covering the identified information needs. To support a content-based search for fine-grained information items within EHR documents, we extended the IHE XDS environment with two additional actors. Finally, we conducted a formative and summative evaluation of our approach within a controlled study. We identified 446 frequently needed diabetes-specific information items, representing typical information needs of healthcare providers. We then created 128 Archetypes and 120 EHR documents for two fictive patients. All seven diabetes experts, who evaluated our approach, preferred the content-based search to a conventional XDS search. Success rates of finding relevant information was higher for the content-based search (100% versus 80%) and the latter was also more time-efficient (8-14min versus 20min or more). Our results show that for an efficient satisfaction of health care providers' information needs, a content-based search that rests upon the integration of Archetypes into an IHE XDS-based Shared EHR system is superior to a conventional metadata-based XDS

  12. Construction of a multisite DataLink using electronic health records for the identification, surveillance, prevention, and management of diabetes mellitus: the SUPREME-DM project.

    Science.gov (United States)

    Nichols, Gregory A; Desai, Jay; Elston Lafata, Jennifer; Lawrence, Jean M; O'Connor, Patrick J; Pathak, Ram D; Raebel, Marsha A; Reid, Robert J; Selby, Joseph V; Silverman, Barbara G; Steiner, John F; Stewart, W F; Vupputuri, Suma; Waitzfelder, Beth

    2012-01-01

    Electronic health record (EHR) data enhance opportunities for conducting surveillance of diabetes. The objective of this study was to identify the number of people with diabetes from a diabetes DataLink developed as part of the SUPREME-DM (SUrveillance, PREvention, and ManagEment of Diabetes Mellitus) project, a consortium of 11 integrated health systems that use comprehensive EHR data for research. We identified all members of 11 health care systems who had any enrollment from January 2005 through December 2009. For these members, we searched inpatient and outpatient diagnosis codes, laboratory test results, and pharmaceutical dispensings from January 2000 through December 2009 to create indicator variables that could potentially identify a person with diabetes. Using this information, we estimated the number of people with diabetes and among them, the number of incident cases, defined as indication of diabetes after at least 2 years of continuous health system enrollment. The 11 health systems contributed 15,765,529 unique members, of whom 1,085,947 (6.9%) met 1 or more study criteria for diabetes. The nonstandardized proportion meeting study criteria for diabetes ranged from 4.2% to 12.4% across sites. Most members with diabetes (88%) met multiple criteria. Of the members with diabetes, 428,349 (39.4%) were incident cases. The SUPREME-DM DataLink is a unique resource that provides an opportunity to conduct comparative effectiveness research, epidemiologic surveillance including longitudinal analyses, and population-based care management studies of people with diabetes. It also provides a useful data source for pragmatic clinical trials of prevention or treatment interventions.

  13. Construction of a Multisite DataLink Using Electronic Health Records for the Identification, Surveillance, Prevention, and Management of Diabetes Mellitus: The SUPREME-DM Project

    Science.gov (United States)

    Desai, Jay; Elston Lafata, Jennifer; Lawrence, Jean M.; O’Connor, Patrick J.; Pathak, Ram D.; Raebel, Marsha A.; Reid, Robert J.; Selby, Joseph V.; Silverman, Barbara G.; Steiner, John F.; Stewart, W.F.; Vupputuri, Suma; Waitzfelder, Beth

    2012-01-01

    Introduction Electronic health record (EHR) data enhance opportunities for conducting surveillance of diabetes. The objective of this study was to identify the number of people with diabetes from a diabetes DataLink developed as part of the SUPREME-DM (SUrveillance, PREvention, and ManagEment of Diabetes Mellitus) project, a consortium of 11 integrated health systems that use comprehensive EHR data for research. Methods We identified all members of 11 health care systems who had any enrollment from January 2005 through December 2009. For these members, we searched inpatient and outpatient diagnosis codes, laboratory test results, and pharmaceutical dispensings from January 2000 through December 2009 to create indicator variables that could potentially identify a person with diabetes. Using this information, we estimated the number of people with diabetes and among them, the number of incident cases, defined as indication of diabetes after at least 2 years of continuous health system enrollment. Results The 11 health systems contributed 15,765,529 unique members, of whom 1,085,947 (6.9%) met 1 or more study criteria for diabetes. The nonstandardized proportion meeting study criteria for diabetes ranged from 4.2% to 12.4% across sites. Most members with diabetes (88%) met multiple criteria. Of the members with diabetes, 428,349 (39.4%) were incident cases. Conclusion The SUPREME-DM DataLink is a unique resource that provides an opportunity to conduct comparative effectiveness research, epidemiologic surveillance including longitudinal analyses, and population-based care management studies of people with diabetes. It also provides a useful data source for pragmatic clinical trials of prevention or treatment interventions. PMID:22677160

  14. Watchdog Project

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Rhett [Schweitzer Engineering Laboratories, Inc., Pullman, WA (United States); Campbell, Jack [CenterPoint Energy Houston Electric, TX (United States); Hadley, Mark [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-12-30

    The Watchdog Project completed 100% of the project Statement of Project Objective (SOPO). The Watchdog project was a very aggressive project looking to accomplish commercialization of technology that had never been commercialized, as a result it took six years to complete not the original three that were planned. No additional federal funds were requested from the original proposal and SEL contributed the additional cost share required to complete the project. The result of the Watchdog Project is the world’s first industrial rated Software Defined Network (SDN) switch commercially available. This technology achieved the SOPOO and DOE Roadmap goals to have strong network access control, improve reliability and network performance, and give the asset owner the ability to minimize attack surface before and during an attack. The Watchdog project is an alliance between CenterPoint Energy Houston Electric, Pacific Northwest National Laboratories (PNNL), and Schweitzer Engineering Laboratories, Inc. (SEL). SEL is the world’s leader in microprocessor-based electronic equipment for protecting electric power systems. PNNL performs basic and applied research to deliver energy, environmental, and national security for our nation. CenterPoint Energy is the third largest publicly traded natural gas delivery company in the U.S and third largest combined electricity and natural gas delivery company. The Watchdog Project efforts were combined with the SDN Project efforts to produce the entire SDN system solution for the critical infrastructure. The Watchdog project addresses Topic Area of Interest 5: Secure Communications, for the DEFOA- 0000359 by protecting the control system local area network itself and the communications coming from and going to the electronic devices on the local network. Local area networks usually are not routed and have little or no filtering capabilities. Combine this with the fact control system protocols are designed with inherent trust the control

  15. Effects of prescribed fires on soil properties: A review.

    Science.gov (United States)

    Alcañiz, M; Outeiro, L; Francos, M; Úbeda, X

    2018-02-01

    Soils constitute one of the most valuable resources on earth, especially because soil is renewable on human time scales. During the 20th century, a period marked by a widespread rural exodus and land abandonment, fire suppression policies were adopted facilitating the accumulation of fuel in forested areas, exacerbating the effects of wildfires, leading to severe degradation of soils. Prescribed fires emerged as an option for protecting forests and their soils from wildfires through the reduction of fuels levels. However such fires can serve other objectives, including stimulating the regeneration of a particular plant species, maintaining biological diversity or as a tool for recovering grasslands in encroached lands. This paper reviews studies examining the short- and long- term impacts of prescribed fires on the physical, chemical and biological soil properties; in so doing, it provides a summary of the benefits and drawbacks of this technique, to help determine if prescribed fires can be useful for managing the landscape. From the study conducted, we can affirm that prescribed fires affects soil properties but differ greatly depending on soil initial characteristics, vegetation or type of fire. Also, it is possible to see that soil's physical and biological properties are more strongly affected by prescribed fires than are its chemical properties. Finally, we conclude that prescribed fires clearly constitute a disturbance on the environment (positive, neutral or negative depending on the soil property studied), but most of the studies reviewed report a good recovery and their effects could be less pronounced than those of wildfires because of the limited soil heating and lower fire intensity and severity. Copyright © 2017. Published by Elsevier B.V.

  16. Nudging guideline-concordant antibiotic prescribing: a randomized clinical trial.

    Science.gov (United States)

    Meeker, Daniella; Knight, Tara K; Friedberg, Mark W; Linder, Jeffrey A; Goldstein, Noah J; Fox, Craig R; Rothfeld, Alan; Diaz, Guillermo; Doctor, Jason N

    2014-03-01

    "Nudges" that influence decision making through subtle cognitive mechanisms have been shown to be highly effective in a wide range of applications, but there have been few experiments to improve clinical practice. To investigate the use of a behavioral "nudge" based on the principle of public commitment in encouraging the judicious use of antibiotics for acute respiratory infections (ARIs). Randomized clinical trial in 5 outpatient primary care clinics. A total of 954 adults had ARI visits during the study timeframe: 449 patients were treated by clinicians randomized to the posted commitment letter (335 in the baseline period, 114 in the intervention period); 505 patients were treated by clinicians randomized to standard practice control (384 baseline, 121 intervention). The intervention consisted of displaying poster-sized commitment letters in examination rooms for 12 weeks. These letters, featuring clinician photographs and signatures, stated their commitment to avoid inappropriate antibiotic prescribing for ARIs. Antibiotic prescribing rates for antibiotic-inappropriate ARI diagnoses in baseline and intervention periods, adjusted for patient age, sex, and insurance status. Baseline rates were 43.5% and 42.8% for control and poster, respectively. During the intervention period, inappropriate prescribing rates increased to 52.7% for controls but decreased to 33.7% in the posted commitment letter condition. Controlling for baseline prescribing rates, we found that the posted commitment letter resulted in a 19.7 absolute percentage reduction in inappropriate antibiotic prescribing rate relative to control (P = .02). There was no evidence of diagnostic coding shift, and rates of appropriate antibiotic prescriptions did not diminish over time. Displaying poster-sized commitment letters in examination rooms decreased inappropriate antibiotic prescribing for ARIs. The effect of this simple, low-cost intervention is comparable in magnitude to costlier, more

  17. [Medication reconciliation errors according to patient risk and type of physician prescriber identified by prescribing tool used].

    Science.gov (United States)

    Bilbao Gómez-Martino, Cristina; Nieto Sánchez, Ángel; Fernández Pérez, Cristina; Borrego Hernando, Mª Isabel; Martín-Sánchez, Francisco Javier

    2017-01-01

    To study the frequency of medication reconciliation errors (MREs) in hospitalized patients and explore the profiles of patients at greater risk. To compare the rates of errors in prescriptions written by emergency physicians and ward physicians, who each used a different prescribing tool. Prospective cross-sectional study of a convenience sample of patients admitted to medical, geriatric, and oncology wards over a period of 6 months. A pharmacist undertook the medication reconciliation report, and data were analyzed for possible associations with risk factors or prescriber type (emergency vs ward physician). A total of 148 patients were studied. Emergency physicians had prescribed for 68 (45.9%) and ward physicians for 80 (54.1%). A total of 303 MREs were detected; 113 (76.4%) patients had at least 1 error. No statistically significant differences were found between prescriber types. Factors that conferred risk for a medication error were use polypharmacy (odds ratio [OR], 3.4; 95% CI, 1.2-9.0; P=.016) and multiple chronic conditions in patients under the age of 80 years (OR, 3.9; 95% CI, 1.1-14.7; P=.039). The incidence of MREs is high regardless of whether the prescriber is an emergency or ward physician. The patients who are most at risk are those taking several medications and those under the age of 80 years who have multiple chronic conditions.

  18. Physician Prescribing Practices of Vitamin D in a Psychiatric Hospital.

    Science.gov (United States)

    Mulcahy, Kimberly B; Trigoboff, Eileen; Opler, Lewis; Demler, Tammie Lee

    2016-01-01

    Vitamin D supplementation has become an increasingly popular prescribing practice, despite our limited knowledge of both the definition and degree of deficiency as well as the expected benefits or risks of exogenous administration. Many of the hypothesized benefits of vitamin D supplementation include a variety of improvements in mental health; however, these claims are not consistently or robustly supported by current research. In this paper, we provide a brief overview of what is currently known about vitamin D deficiency and about outcomes of supplementation as well as a summary of the data relative to prescribing practices for inpatients in an urban psychiatric hospital.

  19. Dichotomy in the definition of prescriptive information suggests both prescribed data and prescribed algorithms: biosemiotics applications in genomic systems

    Directory of Open Access Journals (Sweden)

    D'Onofrio David J

    2012-03-01

    Full Text Available Abstract The fields of molecular biology and computer science have cooperated over recent years to create a synergy between the cybernetic and biosemiotic relationship found in cellular genomics to that of information and language found in computational systems. Biological information frequently manifests its "meaning" through instruction or actual production of formal bio-function. Such information is called Prescriptive Information (PI. PI programs organize and execute a prescribed set of choices. Closer examination of this term in cellular systems has led to a dichotomy in its definition suggesting both prescribed data and prescribed algorithms are constituents of PI. This paper looks at this dichotomy as expressed in both the genetic code and in the central dogma of protein synthesis. An example of a genetic algorithm is modeled after the ribosome, and an examination of the protein synthesis process is used to differentiate PI data from PI algorithms.

  20. Dichotomy in the definition of prescriptive information suggests both prescribed data and prescribed algorithms: biosemiotics applications in genomic systems.

    Science.gov (United States)

    D'Onofrio, David J; Abel, David L; Johnson, Donald E

    2012-03-14

    The fields of molecular biology and computer science have cooperated over recent years to create a synergy between the cybernetic and biosemiotic relationship found in cellular genomics to that of information and language found in computational systems. Biological information frequently manifests its "meaning" through instruction or actual production of formal bio-function. Such information is called prescriptive information (PI). PI programs organize and execute a prescribed set of choices. Closer examination of this term in cellular systems has led to a dichotomy in its definition suggesting both prescribed data and prescribed algorithms are constituents of PI. This paper looks at this dichotomy as expressed in both the genetic code and in the central dogma of protein synthesis. An example of a genetic algorithm is modeled after the ribosome, and an examination of the protein synthesis process is used to differentiate PI data from PI algorithms.

  1. Do clinical practice education groups result in sustained change in GP prescribing?

    Science.gov (United States)

    Richards, Dee; Toop, Les; Graham, Patrick

    2003-04-01

    Concern has been expressed at the poor uptake of evidence into clinical practice. This is despite the fact that continuing education is an embedded feature of quality assurance in general practice. There are a variety of clinical practice education methods available for dissemination of new evidence. Recent systematic reviews indicate that the effectiveness of these different strategies is extremely variable. Our aim was to determine whether a peer-led small group education pilot programme used to promote rational GP prescribing is an effective tool in changing practice when added to prescribing audit and feedback, academic detailing and educational bulletins, and to determine whether any effect seen decays over time. A retrospective analysis of a controlled trial of a small group education strategy with 24 month follow-up was carried out. The setting was an independent GPs association (IPA) of 230 GPs in the Christchurch New Zealand urban area. All intervention and control group GPs were already receiving prescribing audit and feedback, academic detailing and educational bulletins. The intervention group were the first 52 GPs to respond to an invitation to pilot the project. Two control groups were used, one group who joined the pilot later and a second group which included all other GPs in the IPA. The main outcome measures were targeted prescribing data for 12 months before and 24 months after each of four education sessions. An effect in the expected direction was seen in six of the eight key messages studied. This effect was statistically significant for five of the eight messages studied. The effect size varied between 7 and 40%. Where a positive effect was seen, the effect decayed with time but persisted to a significant level for 6-24 months of observation. The results support a positive effect of the education strategy on prescribing behaviour in the intervention group for most outcomes measured. The effect seen is statistically significant, sustained and

  2. What supports hospital pharmacist prescribing in Scotland? - A mixed methods, exploratory sequential study.

    Science.gov (United States)

    Fisher, J; Kinnear, M; Reid, F; Souter, C; Stewart, D

    2018-05-01

    While approximately half of all qualified hospital pharmacist independent prescribers (PIPs) in Scotland are active prescribers, there are major differences in prescribing activity across geographical areas. This study aimed to explore, through focus groups, interviews and a questionnaire, hospital PIPs' perceptions of factors associated with prescribing activity and to investigate the infrastructure required to better support active prescribing by PIPs. Findings reinforced the perceived positive impact of supportive pharmacy leadership within the organisation, recognition that prescribing is integral to the clinical pharmacist role and a work environment conducive to prescribing. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Supporting the improvement and management of prescribing for urinary tract infections (SIMPle): protocol for a cluster randomized trial

    Science.gov (United States)

    2013-01-01

    Background The overuse of antimicrobials is recognized as the main selective pressure driving the emergence and spread of antimicrobial resistance in human bacterial pathogens. Urinary tract infections (UTIs) are among the most common infections presented in primary care and empirical antimicrobial treatment is currently recommended. Previous research has identified that a substantial proportion of Irish general practitioners (GPs) prescribe antimicrobials for UTIs that are not in accordance with the Guidelines for Antimicrobial Prescribing in Primary Care in Ireland. The aim of this trial is to design, implement and evaluate the effectiveness of a complex intervention on GP antimicrobial prescribing and adult (18 years of age and over) patients’ antimicrobial consumption when presenting with a suspected UTI. Methods/design The Supporting the Improvement and Management of Prescribing for urinary tract infections (SIMPle) study is a three-armed intervention with practice-level randomization. Adult patients presenting with suspected UTIs in primary care will be included in the study. The intervention integrates components for both GPs and patients. For GPs the intervention includes interactive workshops, audit and feedback reports and automated electronic prompts summarizing recommended first-line antimicrobial treatment and, for one intervention arm, a recommendation to consider delayed antimicrobial treatment. For patients, multimedia applications and information leaflets are included. Thirty practices will be recruited to the study; laboratory data indicate that 2,038 patients will be prescribed an antimicrobial in the study. The primary outcome is a change in prescribing of first-line antimicrobials for UTIs in accordance with the Guidelines for Antimicrobial Prescribing in Primary Care in Ireland. The study will take place over 15 months with a six-month intervention period. Data will be collected through a remote electronic anonymized data-extraction system

  4. Guidelines prescribed by general practitioners to patients with acute ...

    African Journals Online (AJOL)

    The aim of this study was to investigate the guidelines prescribed by general practitioners (GPs) to patients with acute low back pain (ALBP) regarding 'return to work'. Methods: A systematic sample of 212 GPs, selected from a list supplied by the Health Professions Council of South Africa (HPCSA), was selected to complete ...

  5. Improving the prescribing of antibiotics for urinary tract infection.

    Science.gov (United States)

    Peterson, G M; Stanton, L A; Bergin, J K; Chapman, G A

    1997-04-01

    In recent years there have been changes in the recommended antibiotic treatment for urinary tract infections (UTIs). In particular, the use of amoxycillin or co-trimoxazole is now discouraged, with amoxycillin-potassium clavulanate, cephalexin and trimethoprim becoming first-line agents for uncomplicated lower UTIs. To examine whether academic detailing, performed by a pharmacist, could modify prescribing practices for antibiotics used in the treatment of UTI in the community setting. The intervention was conducted in Southern Tasmania, using the remainder of the State as a control area. The target group of general practitioners was sent educational material designed to assist in the appropriate prescribing of antibiotics in the treatment of UTI. A pharmacist then visited each general practitioner and discussed the rational use of antibiotics for UTIs directly with him/her. Outcomes were measured using evaluation feedback from the general practitioners and pharmacoepidemiological data, which were not linked to diagnosis. The key variable examined was the total defined daily doses (DDDs) dispensed for the recommended first-line agents (amoxycillin-potassium clavulanate, cephalexin and trimethoprim) compared with amoxycillin (3 g single-dose form) and co-trimoxazole. The educational programme was very well received by the general practitioners. Changes in the prescribing of antibiotics commonly used for UTIs were evident in both study regions over the course of the study, but the improvements were significantly greater in the intervention area. Educational programmes utilizing academic detailing by pharmacists can modify prescribing practices within the community setting.

  6. Sources of drug information and their influence on the prescribing ...

    African Journals Online (AJOL)

    Sources of drug information and their influence on the prescribing behaviour of doctors in a teaching hospital in Ibadan, Nigeria. ... Drug information was sourced from colleagues (161, 98.8%), reference books (158, 96.9%), pharmaceutical sales representatives-PSRs (152, 93.2%), promotion materials (151, 92.6%), ...

  7. Retrospective Evaluation of Analgesics Prescribing Pattern in a ...

    African Journals Online (AJOL)

    The study was designed to retrospectively evaluate the analgesics prescribing pattern in the Accident and Emergency (A and E) Unit of University of Benin Teaching Hospital, Benin City. The data was retrieved from the pharmacy archives type of analgesics and its routes of administration whether oral or parenteral in all ...

  8. Practices in prescribing protein substitutes for PKU in Europe

    DEFF Research Database (Denmark)

    Aguiar, A; Ahring, K; Almeida, M F

    2015-01-01

    BACKGROUND: There appears little consensus concerning protein requirements in phenylketonuria (PKU). METHODS: A questionnaire completed by 63 European and Turkish IMD centres from 18 countries collected data on prescribed total protein intake (natural/intact protein and phenylalanine-free protein...

  9. Behaviour and effects of prescribed fire in masticated fuelbeds

    Science.gov (United States)

    Eric Knapp; J. Morgan Varner; Matt Busse; Carl Skinner; Carol Shestak

    2011-01-01

    Mechanical mastication converts shrub and small tree fuels into surface fuels, and this method is being widely used as a treatment to reduce fire hazard. The compactness of these fuelbeds is thought to moderate fire behaviour, but whether standard fuel models can accurately predict fire behaviour and effects is poorly understood. Prescribed burns were conducted in...

  10. Planning for prescribed burning in the inland northwest.

    Science.gov (United States)

    Robert E. Martin; John D. Dell

    1978-01-01

    Fire has historically played a role in forests and ranges of the inland Northwest. This guide has been prepared to help managers understand the role of fire and the potential uses of fire and to plan for fire use in managing these lands. Sections deal with these topics, and steps in planning a prescribed burn are outlined. A sample burning situation illustrates the...

  11. Patterns of prescribing and utilization of asthma medications in a ...

    African Journals Online (AJOL)

    Purpose: To assess the prescribing patterns of asthma medications in a hospital in Dubai, United Arab Emirates (UAE) with regard to the demographic pattern of the population. Methods: One hundred fifty four patients, 83 male and 71 female, were randomly selected from the outpatient respiratory diseases clinic of a tertiary ...

  12. CDC Vital Signs–Opioid Prescribing

    Centers for Disease Control (CDC) Podcasts

    2017-07-06

    This podcast is based on the July 2017 CDC Vital Signs report. Higher opioid prescribing puts patients at risk for addiction and overdose. Learn what can be done about this serious problem.  Created: 7/6/2017 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/6/2017.

  13. Rationalising prescribing: Evidence, marketing and practice-relevant knowledge.

    Science.gov (United States)

    Wadmann, Sarah; Bang, Lia E

    2015-06-01

    Initiatives in the name of 'rational pharmacotherapy' have been launched to alter what is seen as 'inappropriate' prescribing practices of physicians. Based on observations and interviews with 20 general practitioners (GPs) in 2009-2011, we explored how attempts to rationalise prescribing interact with chronic care management in Denmark. We demonstrate how attempts to rationalise prescribing by informing GPs about drug effects, adverse effects and price do not satisfy GPs' knowledge needs. We argue that, for GPs, 'rational' prescribing cannot be understood in separation from the processes that enable patients to use medication. Therefore, GPs do much more to obtain knowledge about medications than seek advice on 'rational pharmacotherapy'. For instance, GPs also seek opportunities to acquaint themselves with the material objects of medication and medical devices. We conceptualise the knowledge needs of GPs as a need for practice-relevant knowledge and argue that industry sales representatives are granted opportunity to access general practice because they understand this need of GPs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Heart failure guidelines and prescribing in primary care across Europe

    Directory of Open Access Journals (Sweden)

    Hobbs FD Richard

    2005-08-01

    Full Text Available Abstract Background Major international differences in heart failure treatment have been repeatedly described, but the reasons for these differences remain unclear. National guideline recommendations might be a relevant factor. This study, therefore, explored variation of heart failure guideline recommendations in Europe. Methods Treatment recommendations of 14 national guidelines published after 1994 were analyzed in relation to the heart failure treatment guideline of the European Society of Cardiology. To test potential relations between recommendations and prescribing, national prescribing patterns as obtained by a European study in primary care (IMPROVEMENT-HF were related to selected recommendations in those countries. Results Besides the 14 national guidelines used by primary care physicians in the countries contacted, the European guideline was used in four countries, and separate guidelines for specialists and primary care were available in another four countries. Two countries indicated that no guideline was used up to 2000. Comprehensiveness of the guidelines varied with respect to length, literature included and evidence ratings. Relevant differences in treatment recommendations were seen only in drug classes where evidence had changed recently (β-blockers and spironolactone. The relation between recommendation and prescribing for selected recommendations was inconsistent among countries. Conclusion Differences in guideline recommendations are not sufficient to explain variation of prescribing among countries, thus other factors must be considered.

  15. Primary non-adherence to prescribed medication in general practice

    DEFF Research Database (Denmark)

    Linnet, Kristján; Halldórsson, Matthías; Thengilsdóttir, Gudrún

    2013-01-01

    Primary non-adherence refers to the patient not redeeming a prescribed medication at some point during drug therapy. Research has mainly focused on secondary non-adherence. Prior to this study, the overall rate of primary non-adherence in general practice in Iceland was not known....

  16. Prescribing Patterns and Cost of Antihypertensive Drugs in Private ...

    African Journals Online (AJOL)

    Nx 6110

    Antihypertensive agents are used to prevent morbidity and mortality related to hypertension. Prescribing patterns and the cost of some antihypertensive were studied for 600 patients attending medical clinics in four private hospitals in Dar es. Salaam using the WHO drug use indicator forms. The average number of drugs ...

  17. Drug prescribing patterns for outpatients in three hospitals in north ...

    African Journals Online (AJOL)

    Background: Information about drug utilization at the out patient departments of the Hospitals in Ethiopia is scanty although a large segment of the patients are being served at the outpatient departments. Objective: To evaluate and compare patterns of drug prescribing practiced in the outpatient departments of three ...

  18. GPs motivations of prescribing antidepressants and their practical relevance.

    NARCIS (Netherlands)

    Volkers, A.; Jong, A. de; Braspenning, J.C.C.; Bakker, D. de; Dijk, L. van

    2004-01-01

    Background: Insight in the motivations of prescribing antidepressants may contribute to advance the efficiency of the current, large antidepressant prescription rate. Less is known about why general practitioners (GPs) treat patients with antidepressants or not and choose modern SSRIs instead of the

  19. Smoke management guide for prescribed and wildland fire: 2001 edition.

    Science.gov (United States)

    Colin C. Hardy; Roger D. Ottmar; Janice L Peterson; John E. Core; Paula Seamon

    2001-01-01

    The National Wildfire Coordinating Group's (NWCG) Fire Use Working Team has assumed overall responsibility for sponsoring the development and production of this revised Smoke Management Guide for Prescribed and Wildland Fire (the "Guide"). The Mission Statement for the Fire Use Working Team includes the need to coordinate and advocate the use of fire to...

  20. [Prescribing diuretics: what a practitioner needs to know].

    Science.gov (United States)

    Richard, C; Saudan, P; Ernandez, T

    2015-02-25

    Diuretics are among the most frequently prescribed drugs. Most of them act by inhibiting sodium reabsorption in various nephron segments. By understanding their pharmacological characteristics, it is possible to adapt the type of diuretic to different clinical situations. Practical aspects of their use, including in heart failure, cirrhosis, the nephrotic syndrome and renal failure, are discussed.

  1. Appropriateness of Omeprazole Prescribing in Quebec’s Senior Population

    Directory of Open Access Journals (Sweden)

    Jean-Pierre Grégoire

    2000-01-01

    Full Text Available BACKGROUND: Prescribing omeprazole for the treatment of digestive disorders accounts for an important part of the costs in Quebec’s drug benefit plan. In July 1993, the Quebec drug program listed omeprazole, with restriction, in its formulary. On January 1, 1994, this restriction was lifted; since then, omeprazole has been listed in the regular provincial formulary.

  2. Prescribed wind shear modelling with the actuator line technique

    DEFF Research Database (Denmark)

    Mikkelsen, Robert Flemming; Sørensen, Jens Nørkær; Troldborg, Niels

    2007-01-01

    A method for prescribing arbitrary steady atmospheric wind shear profiles combined with CFD is presented. The method is furthermore combined with the actuator line technique governing the aerodynamic loads on a wind turbine. Computation are carried out on a wind turbine exposed to a representative...

  3. Prescribing Errors in Cardiovascular Diseases in a Tertiary Health ...

    African Journals Online (AJOL)

    Prescription errors are now known to be contributing to a large number of deaths during the treatment of cardiovascular diseases. However, there is paucity of information about these errors occurring in health facilities in Nigeria. The objective of this study was to investigate the prevalence of prescribing errors in ...

  4. Prevalence and Correlates of “High Dose” Antipsychotic Prescribing ...

    African Journals Online (AJOL)

    of 1000 mg/day is considered as high dose prescribing. Furthermore ... genetic variations.[16] ... Annals of Medical and Health Sciences Research | Jan-Mar 2013 | Vol 3 | Issue 1 |. 63 ... the unreliability of the CPZeq criteria in the view of an increasing use of ... We obtained ethical clearance from the Ethics and Research.

  5. Impacts of prescribed fire on soil loss and soil quality

    NARCIS (Netherlands)

    Shakesby, Richard A.; Martins Bento, Celia; Ferreira, Carla S.S.; Ferreira, António J.D.; Stoof, C.R.; Urbanek, Emilia; Walsh, Rory P.D.

    2015-01-01

    Prescribed (controlled) fire has recently been adopted as an important wildfire-fighting strategy in the Mediterranean. Relatively little research, however, has assessed its impacts on soil erosion and soil quality. This paper investigates hillslope-scale losses of soil, organic matter and

  6. Airborne characterization of smoke marker ratios from prescribed burning

    Science.gov (United States)

    A. P. Sullivan; A. A. May; T. Lee; G. R. McMeeking; S. M. Kreidenweis; S. K. Akagi; R. J. Yokelson; S. P. Urbanski; J. L. Collett

    2014-01-01

    A Particle-Into-Liquid Sampler - Total Organic Carbon (PILS-TOC) and fraction collector system was flown aboard a Twin Otter aircraft sampling prescribed burning emissions in South Carolina in November 2011 to obtain smoke marker measurements. The fraction collector provided 2 min time-integrated offline samples for carbohydrate (i.e., smoke markers levoglucosan,...

  7. Prescribing of Antidiabetic Medicines before, during and after Pregnancy

    DEFF Research Database (Denmark)

    Charlton, Rachel A; Klungsøyr, Kari; Neville, Amanda J

    2016-01-01

    AIM: To explore antidiabetic medicine prescribing to women before, during and after pregnancy in different regions of Europe. METHODS: A common protocol was implemented across seven databases in Denmark, Norway, The Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the rest of the UK. Women...

  8. New drugs in general practice: prescribing patterns and external influences

    NARCIS (Netherlands)

    Florentinus, S.R.

    2006-01-01

    In this thesis several studies are presented with the objective to detect and elucidate the patterns by which new drugs are prescribed by general practitioners (GPs). Furthermore, we studied the influences of medical specialists and community pharmacists as important factors on the GP's decision to

  9. Exploring the Prevalence of Malaria and Prescribing Pattern of ...

    African Journals Online (AJOL)

    Background: The primary healthcare is the entry point of the populace into the healthcare sector and is aimed at providing effective and efficient healthcare services. It is paramount to prescribe drugs correctly; especially malaria which remains a major public health problem in Nigeria and a leading causes of outpatient visits ...

  10. Prescribing of methylphenidate to children and adolescents in South ...

    African Journals Online (AJOL)

    2008-11-13

    Nov 13, 2008 ... Background: Pharmacoepidemiological studies on ADHD are limited in South Africa. The primary aim was to analyse the prescribing of methylphenidate to patients aged 18 years and younger in the private health care sector. Methods: Data for a one-month period in 2004 were obtained from a large ...

  11. Prescribing of methylphenidate to children and adolescents in South ...

    African Journals Online (AJOL)

    Background: Pharmacoepidemiological studies on ADHD are limited in South Africa. The primary aim was to analyse the prescribing of methylphenidate to patients aged 18 years and younger in the private health care sector. Methods: Data for a one-month period in 2004 were obtained from a large medical aid ...

  12. Prescribing patterns of methylphenidate in a South African patient ...

    African Journals Online (AJOL)

    ADHD) in children. The primary aim of the study was to investigate the prescribing patterns of methylphenidate of a medical aid patient population in a private sector and to compare the results with previous studies. An exposure cohort drug ...

  13. HIV management by nurse prescribers compared with doctors at a ...

    African Journals Online (AJOL)

    Selected by stratified random sampling, 100 physician and 97 nurse prescriber encounters were retrospectively reviewed for successful documentation of eight separate clinically relevant variables: pill count charted; chief complaint listed; social history updated; disclosure reviewed; physical exam; laboratory testing; World ...

  14. Scheduling prescribed burns for hazard reduction in the southeast

    Science.gov (United States)

    Stephen S. Sackett

    1975-01-01

    Twelve-year studies in the southeastern Coastal Plain revealed that pine stands should be burned every three years to reduce natural fuels and thus forestall damage from possible wildfires. Rates of overstory growth were not significantly different in burned and unburned stands. Guidelines for prescribed burning of pine stands in this region are presented.

  15. Vegetation Responses to Prescribed Burning of Grazed Shortgrass Steppe

    Science.gov (United States)

    Over the past century, fire has been widely suppressed in the western Great Plains, in part due to potential negative effects on forage production for livestock. More recently, interest in the use of prescribed fire in shortgrass steppe has increased due to potential applications for wildlife manage...

  16. Prescribed burning with spot fires in the Georgia Coastal Plain

    Science.gov (United States)

    R. W. Johansen

    1984-01-01

    The use of prescribed fire in the management of pine forests is common throughout much of the South, but one recurring problem that worries the forest landowner is not having enough suitable burning weather to satisfactorily complete all scheduled fires. Being able to burn areas considerably faster, without causing undue damage, could be a solution.

  17. An experimental prescribed burn to reduce fuel hazard in chaparral

    Science.gov (United States)

    Lisle R. Green

    1970-01-01

    The feasibility of reducing fuel hazard in chaparral during safe weather conditions was studied in an experimental prescribed burn in southern California. Burning was done under fuel and weather conditions when untreated brush would not bum readily. Preparatory treatment included smashing of brush on strips with a bulldozer, and reduction of moisture content of leaves...

  18. Effects of Prescribed Burning on Grazed Shortgrass Steppe

    Science.gov (United States)

    Over the past century, fire has been widely suppressed in the western Great Plains, in part due to potential negative effects on forage production for livestock. Interest in the use of prescribed fire in shortgrass steppe has increased recently due to applications for wildlife management, control of...

  19. Topical antibiotic monotherapy prescribing practices in acne vulgaris.

    Science.gov (United States)

    Hoover, William D; Davis, Scott A; Fleischer, Alan B; Feldman, Steven R

    2014-04-01

    The aim of this study is to evaluate the frequency of dosing topical antibiotics as monotherapy in the treatment of acne vulgaris, and physician specialty prescribing these medications. This study is a retrospective review of all visits with a sole diagnosis of acne vulgaris (ICD-9-CM code 706.1) found on the National Ambulatory Medical Care Survey (NAMCS) in 1993-2010. We recorded the number of visits surveyed where acne vulgaris was the sole diagnosis, number of visits where topical antibiotics were the only treatment prescribed, and the specialty of physician in each encounter. Topical erythromycin or clindamycin were the sole medication prescribed in 0.81% of the visits recorded, with 60% of these prescriptions arising from dermatologists and 40% from non-dermatologists. The trend of prescribing topical antibiotic monotherapy is declining (p acnes to topical antibiotic regimens has led to the need to re-evaluate the use of topical antibiotics in the treatment of acne vulgaris. While the rate of topical antibiotic monotherapy is declining, their use should be reserved for situations where the direct need for antibiotics arises. If a clinician feels that antibiotics are a necessary component to acne therapy, they should be used as part of a combination regimen.

  20. A Study of Various Electronic Security Sensors Devices and Technology at Various Application Field Accompanied With Real Time Project Implementation of Sensor

    OpenAIRE

    Vijay Laxmi Kalyani; Parmeet Kour; Peram Navya

    2016-01-01

    Abstract: Nowadays electronics is everywhere and we are surrounded with electronic gazettes many of them are helping us in maintaining security at various places, there are many security problems faced by banks, homes etc. Without proper and strong security a vault can be penetrated. A security system is used in residential, commercial, industrial, Medical and Militaries as well as personal protection. In this paper we are discussing about the various electronic security sensor devices and te...