WorldWideScience

Sample records for elimination settings experience

  1. Maximizing research study effectiveness in malaria elimination settings: a mixed methods study to capture the experiences of field-based staff.

    Science.gov (United States)

    Canavati, Sara E; Quintero, Cesia E; Haller, Britt; Lek, Dysoley; Yok, Sovann; Richards, Jack S; Whittaker, Maxine Anne

    2017-09-11

    In a drug-resistant, malaria elimination setting like Western Cambodia, field research is essential for the development of novel anti-malarial regimens and the public health solutions necessary to monitor the spread of resistance and eliminate infection. Such field studies often face a variety of similar implementation challenges, but these are rarely captured in a systematic way or used to optimize future study designs that might overcome similar challenges. Field-based research staff often have extensive experience and can provide valuable insight regarding these issues, but their perspectives and experiences are rarely documented and seldom integrated into future research protocols. This mixed-methods analysis sought to gain an understanding of the daily challenges encountered by research field staff in the artemisinin-resistant, malaria elimination setting of Western Cambodia. In doing so, this study seeks to understand how the experiences and opinions of field staff can be captured, and used to inform future study designs. Twenty-two reports from six field-based malaria studies conducted in Western Cambodia were reviewed using content analysis to identify challenges to conducting the research. Informal Interviews, Focus Group Discussions and In-depth Interviews were also conducted among field research staff. Thematic analysis of the data was undertaken using Nvivo 9 ® software. Triangulation and critical case analysis was also used. There was a lack of formalized avenues through which field workers could report challenges experienced when conducting the malaria studies. Field research staff faced significant logistical barriers to participant recruitment and data collection, including a lack of available transportation to cover long distances, and the fact that mobile and migrant populations (MMPs) are usually excluded from studies because of challenges in follow-up. Cultural barriers to communication also hindered participant recruitment and created

  2. Engaging the private sector in malaria surveillance: a review of strategies and recommendations for elimination settings.

    Science.gov (United States)

    Bennett, Adam; Avanceña, Anton L V; Wegbreit, Jennifer; Cotter, Chris; Roberts, Kathryn; Gosling, Roly

    2017-06-14

    In malaria elimination settings, all malaria cases must be identified, documented and investigated. To facilitate complete and timely reporting of all malaria cases and effective case management and follow-up, engagement with private providers is essential, particularly in settings where the private sector is a major source of healthcare. However, research on the role and performance of the private sector in malaria diagnosis, case management and reporting in malaria elimination settings is limited. Moreover, the most effective strategies for private sector engagement in malaria elimination settings remain unclear. Twenty-five experts in malaria elimination, disease surveillance and private sector engagement were purposively sampled and interviewed. An extensive review of grey and peer-reviewed literature on private sector testing, treatment, and reporting for malaria was performed. Additional in-depth literature review was conducted for six case studies on eliminating and neighbouring countries in Southeast Asia and Southern Africa. The private health sector can be categorized based on their commercial orientation or business model (for-profit versus nonprofit) and their regulation status within a country (formal vs informal). A number of potentially effective strategies exist for engaging the private sector. Conducting a baseline assessment of the private sector is critical to understanding its composition, size, geographical distribution and quality of services provided. Facilitating reporting, referral and training linkages between the public and private sectors and making malaria a notifiable disease are important strategies to improve private sector involvement in malaria surveillance. Financial incentives for uptake of rapid diagnostic tests and artemisinin-based combination therapy should be combined with training and community awareness campaigns for improving uptake. Private sector providers can also be organized and better engaged through social

  3. Effectiveness of reactive case detection for malaria elimination in three archetypical transmission settings: a modelling study.

    Science.gov (United States)

    Gerardin, Jaline; Bever, Caitlin A; Bridenbecker, Daniel; Hamainza, Busiku; Silumbe, Kafula; Miller, John M; Eisele, Thomas P; Eckhoff, Philip A; Wenger, Edward A

    2017-06-12

    Reactive case detection could be a powerful tool in malaria elimination, as it selectively targets transmission pockets. However, field operations have yet to demonstrate under which conditions, if any, reactive case detection is best poised to push a region to elimination. This study uses mathematical modelling to assess how baseline transmission intensity and local interconnectedness affect the impact of reactive activities in the context of other possible intervention packages. Communities in Southern Province, Zambia, where elimination operations are currently underway, were used as representatives of three archetypes of malaria transmission: low-transmission, high household density; high-transmission, low household density; and high-transmission, high household density. Transmission at the spatially-connected household level was simulated with a dynamical model of malaria transmission, and local variation in vectorial capacity and intervention coverage were parameterized according to data collected from the area. Various potential intervention packages were imposed on each of the archetypical settings and the resulting likelihoods of elimination by the end of 2020 were compared. Simulations predict that success of elimination campaigns in both low- and high-transmission areas is strongly dependent on stemming the flow of imported infections, underscoring the need for regional-scale strategies capable of reducing transmission concurrently across many connected areas. In historically low-transmission areas, treatment of clinical malaria should form the cornerstone of elimination operations, as most malaria infections in these areas are symptomatic and onward transmission would be mitigated through health system strengthening; reactive case detection has minimal impact in these settings. In historically high-transmission areas, vector control and case management are crucial for limiting outbreak size, and the asymptomatic reservoir must be addressed through

  4. Malaria programme personnel's experiences, perceived barriers and facilitators to implementing malaria elimination strategy in South Africa.

    Science.gov (United States)

    Hlongwana, Khumbulani Welcome; Sartorius, Benn; Tsoka-Gwegweni, Joyce

    2018-01-10

    South Africa has set an ambitious goal targeting to eliminate malaria by 2018, which is consistent with the United Nations Sustainable Development Goals' call to end the epidemic of malaria by 2030 across the globe. There are conflicting views regarding the feasibility of malaria elimination, and furthermore studies investigating malaria programme personnel's perspectives on strategy implementation are lacking. The study was a cross-sectional survey conducted in 2014 through a face-to-face investigator-administered semi-structured questionnaire to all eligible and consenting malaria programme personnel (team leader to senior manager levels) in three malaria endemic provinces (KwaZulu-Natal, Mpumalanga, and Limpopo) of South Africa. The overall response rate was 88.6% (148/167) among all eligible malaria personnel. The mean age of participants was 47 years (SD 9.7, range 27-70), and the mean work experience of 19.4 years (SD 11.1, range 0-42). The majority were male (78.4%), and 66.9% had secondary level education. Awareness of the malaria elimination policy was high (99.3%), but 89% contended that they were never consulted when the policy was formulated and few had either seen (29.9%) or read (23%) the policy, either in full or in part. Having read the policy was positively associated with professional job designations (managers, EHPs and entomologists) (p = 0.010) and tertiary level education (p = 0.042). There was a sentiment that the policy was neither sufficiently disseminated to all key healthcare workers (76.4%) nor properly adapted (68.9%) for the local operational context in the elimination strategy. Most (89.1%) participants were not optimistic about eliminating malaria by 2018, as they viewed the elimination strategy in South Africa as too theoretical with unrealistic targets. Other identified barriers included inadequate resources (53.5%) and high cross-border movements (19.8%). Most participants were not positive that South Africa could achieve

  5. Examination of a recommended algorithm for eliminating nonsystematic delay discounting response sets.

    Science.gov (United States)

    White, Thomas J; Redner, Ryan; Skelly, Joan M; Higgins, Stephen T

    2015-09-01

    To examine (1) whether use of a recommended algorithm (Johnson and Bickel, 2008) improves upon conventional statistical model fit (R(2)) for identifying nonsystematic response sets in delay discounting (DD) data, (2) whether removing such data meaningfully effects research outcomes, and (3) to identify participant characteristics associated with nonsystematic response sets. Discounting of hypothetical monetary rewards was assessed among 349 pregnant women (231 smokers and 118 recent quitters) via a computerized task comparing $1000 at seven future time points with smaller values available immediately. Nonsystematic response sets were identified using the algorithm and conventional statistical model fit (R(2)). The association between DD and quitting was analyzed with and without nonsystematic response sets to examine whether the inclusion or exclusion impacts this relationship. Logistic regression was used to examine whether participant sociodemographics were associated with nonsystematic response sets. The algorithm excluded fewer cases than the R(2) method (14% vs. 16%), and was not correlated with logk as is R(2). The relationship between logk and the clinical outcome (spontaneous quitting) was unaffected by exclusion methods; however, other variables in the model were affected. Lower educational attainment and younger age were associated with nonsystematic response sets. The algorithm eliminated data that were inconsistent with the nature of discounting and retained data that were orderly. Neither method impacted the smoking/DD relationship in this data set. Nonsystematic response sets are more likely among younger and less educated participants, who may need extra training or support in DD studies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Current and cumulative malaria infections in a setting embarking on elimination: Amhara, Ethiopia.

    Science.gov (United States)

    Yalew, Woyneshet G; Pal, Sampa; Bansil, Pooja; Dabbs, Rebecca; Tetteh, Kevin; Guinovart, Caterina; Kalnoky, Michael; Serda, Belendia A; Tesfay, Berhane H; Beyene, Belay B; Seneviratne, Catherine; Littrell, Megan; Yokobe, Lindsay; Noland, Gregory S; Domingo, Gonzalo J; Getachew, Asefaw; Drakeley, Chris; Steketee, Richard W

    2017-06-08

    Since 2005, Ethiopia has aggressively scaled up malaria prevention and case management. As a result, the number of malaria cases and deaths has significantly declined. In order to track progress towards the elimination of malaria in Amhara Region, coverage of malaria control tools and current malaria transmission need to be documented. A cross-sectional household survey oversampling children under 5 years of age was conducted during the dry season in 2013. A bivalent rapid diagnostic test (RDT) detecting both Plasmodium falciparum and Plasmodium vivax and serology assays using merozoite antigens from both these species were used to assess the prevalence of malaria infections and exposure to malaria parasites in 16 woredas (districts) in Amhara Region. 7878 participants were included, with a mean age of 16.8 years (range 0.5-102.8 years) and 42.0% being children under 5 years of age. The age-adjusted RDT-positivity for P. falciparum and P. vivax infection was 1.5 and 0.4%, respectively, of which 0.05% presented as co-infections. Overall age-adjusted seroprevalence was 30.0% for P. falciparum, 21.8% for P. vivax, and seroprevalence for any malaria species was 39.4%. The prevalence of RDT-positive infections varied by woreda, ranging from 0.0 to 8.3% and by altitude with rates of 3.2, 0.7, and 0.4% at under 2000, 2000-2500, and >2500 m, respectively. Serological analysis showed heterogeneity in transmission intensity by area and altitude and evidence for a change in the force of infection in the mid-2000s. Current and historic malaria transmission across Amhara Region show substantial variation by age and altitude with some settings showing very low or near-zero transmission. Plasmodium vivax infections appear to be lower but relatively more stable across geography and altitude, while P. falciparum is the dominant infection in the higher transmission, low-altitude areas. Age-dependent seroprevalence analyses indicates a drop in transmission occurred in the mid

  7. Automated Experiments on Ad Privacy Settings

    Directory of Open Access Journals (Sweden)

    Datta Amit

    2015-04-01

    Full Text Available To partly address people’s concerns over web tracking, Google has created the Ad Settings webpage to provide information about and some choice over the profiles Google creates on users. We present AdFisher, an automated tool that explores how user behaviors, Google’s ads, and Ad Settings interact. AdFisher can run browser-based experiments and analyze data using machine learning and significance tests. Our tool uses a rigorous experimental design and statistical analysis to ensure the statistical soundness of our results. We use AdFisher to find that the Ad Settings was opaque about some features of a user’s profile, that it does provide some choice on ads, and that these choices can lead to seemingly discriminatory ads. In particular, we found that visiting webpages associated with substance abuse changed the ads shown but not the settings page. We also found that setting the gender to female resulted in getting fewer instances of an ad related to high paying jobs than setting it to male. We cannot determine who caused these findings due to our limited visibility into the ad ecosystem, which includes Google, advertisers, websites, and users. Nevertheless, these results can form the starting point for deeper investigations by either the companies themselves or by regulatory bodies.

  8. Malaria training for community health workers in the setting of elimination: a qualitative study from China.

    Science.gov (United States)

    Lu, Guangyu; Liu, Yaobao; Wang, Jinsong; Li, Xiangming; Liu, Xing; Beiersmann, Claudia; Feng, Yu; Cao, Jun; Müller, Olaf

    2018-02-23

    Continuous training of health workers is a key intervention to maintain their good performance and keep their vigilance during malaria elimination programmes. However, countries progressing toward malaria elimination have a largely decreased malaria disease burden, less frequent exposure of health workers to malaria patients, and new challenges in the epidemiology of the remaining malaria cases. Moreover, competing health priorities and usually a decline in resources and in political commitment also pose challenges to the elimination programme. As a consequence, the acceptability, sustainability, and impact of malaria training and education programmes face challenges. However, little is known of the perceptions and expectations of malaria training and education programmes of health workers being engaged in countries with malaria elimination programmes. This qualitative study provides information on perceptions and expectations of health workers of malaria training programmes from China, which aims to malaria elimination by the year 2020. This study was embedded into a larger study on the challenges and lessons learned during the malaria surveillance strategy in China, involving 42 interviews with malaria experts, health staff, laboratory practitioners, and village doctors at the provincial, city, county, township, and village levels from Gansu province (northwestern China) and Jiangsu province (southeastern China). In the context of an increasing number of imported malaria cases in China, the majority of respondents emphasized the necessity and importance of such programmes and complained about a decreasing frequency of training courses. Moreover, they called for innovative strategies to improve the implementation and sustainability of the malaria training programmes until the elimination goal has been achieved. Perceptions and expectations of health workers from different health centres were quite different. Health workers from higher-level facilities were more

  9. Nursing students’ experiences of clinical education setting

    Directory of Open Access Journals (Sweden)

    Rahnama M

    2015-08-01

    Full Text Available Background and Objective: Appropriate clinical environment has an important role in preparing students to use learned knowledge in practice through providing learning opportunities. Since the students’ experiences in the clinical setting affect on quality of their learning, the current study aimed to explain the experiences of nursing students concerning clinical education setting. Materials and Method: The current study was conducted based on conventional content analysis. Sampling was done purposively and the participants were 13 last year nursing students in Zabol Nursing and Midwifery School in 2013-2014. Data collection was done through in-depth semi-structured interviews. Data analysis was conducted through qualitative content analysis approach. Results: Based on the results, five major categories including threats, vision, dual forces, mindset and students’ action to clinical education and also10 subcategorie were identified. Conclusion: Since the formation of students’ experiences in these environments is one of the predictive factors in achieving their learning and in facilitating the professionalization process, thus the attention of managers in clinical settings is very important for decreasing the threats and concerns for students. In this way, the marred prospects of profession can be recovered through the meeting students’ expectations, attractiveness of the profession can be increased and the positive belief, actions and feelings can be created in students.

  10. Experiences From Developing and Upgrading a Web-Based Surveillance System for Malaria Elimination in Cambodia.

    Science.gov (United States)

    Fu, Clementine; Lopes, Sérgio; Mellor, Steve; Aryal, Siddhi; Sovannaroth, Siv; Roca-Feltrer, Arantxa

    2017-06-14

    Strengthening the surveillance component is key toward achieving country-wide malaria elimination in Cambodia. A Web-based upgraded malaria information system (MIS) was deemed to essentially act as the central component for surveillance strengthening. New functionality (eg, data visualization) and operational (eg, data quality) attributes of the system received particular attention. However, building from the lessons learned in previous systems' developments, other aspects unique to Cambodia were considered to be equally important; for instance, feasibility issues, particularly at the field level (eg, user acceptability at various health levels), and sustainability needs (eg, long-term system flexibility). The Cambodian process of identifying the essential changes and critical attributes for this new information system can provide a model for other countries at various stages of the disease control and elimination continuum. Sharing these experiences not only facilitates the establishment of "best practices" but also accelerates global and regional malaria elimination efforts. In this article, Cambodia's experience in developing and upgrading its MIS to remain responsive to country-specific needs demonstrates the necessity for considering functionality, operationalization, feasibility, and sustainability of an information system in the context of malaria elimination. ©Clementine Fu, Sérgio Lopes, Steve Mellor, Siddhi Aryal, Siv Sovannaroth, Arantxa Roca-Feltrer. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 14.06.2017.

  11. 'When measurements mean action' decision models for portal image review to eliminate systematic set-up errors

    International Nuclear Information System (INIS)

    Wratten, C.R.; Denham, J.W.; O; Brien, P.; Hamilton, C.S.; Kron, T.; London Regional Cancer Centre, London, Ontario

    2004-01-01

    The aim of the present paper is to evaluate how the use of decision models in the review of portal images can eliminate systematic set-up errors during conformal therapy. Sixteen patients undergoing four-field irradiation of prostate cancer have had daily portal images obtained during the first two treatment weeks and weekly thereafter. The magnitude of random and systematic variations has been calculated by comparison of the portal image with the reference simulator images using the two-dimensional decision model embodied in the Hotelling's evaluation process (HEP). Random day-to-day set-up variation was small in this group of patients. Systematic errors were, however, common. In 15 of 16 patients, one or more errors of >2 mm were diagnosed at some stage during treatment. Sixteen of the 23 errors were between 2 and 4 mm. Although there were examples of oversensitivity of the HEP in three cases, and one instance of undersensitivity, the HEP proved highly sensitive to the small (2-4 mm) systematic errors that must be eliminated during high precision radiotherapy. The HEP has proven valuable in diagnosing very small ( 4 mm) systematic errors using one-dimensional decision models, HEP can eliminate the majority of systematic errors during the first 2 treatment weeks. Copyright (2004) Blackwell Science Pty Ltd

  12. Set-up of experiment R606

    CERN Multimedia

    CERN PhotoLab

    1976-01-01

    Experiment R606 (Aachen, CERN, Harvard, Munich, Northwestern, Riverside)installed in the specially constructed pit at intersection 6. It was designed to investigate production of new particles in the fragmentation and diffraction regions. Use was made of a toroidal field provided by 12 flat copper coils, seen here as the rays of a wheel; in the free spaces between coils are housed Cerenkov counters. These counters, together with calorimetric shower detectors, located behind the magnet, provide separation of electrons from hadrons. The momenta of particles going through the system are measured with two sets of three drift chambers, two in front of the magnet, one behind, whose size increases from 1.5 m for the one seen in the picture, to 5 m for the one on the back. On the right the thin- walled cylindrical vacuum chamber.

  13. Experience of medical service of the Armed Forces during elimination of consequences of Chernobyl's disaster

    International Nuclear Information System (INIS)

    Chizh, I.M.

    1996-01-01

    The article analyzes ten-years experience (1986-1996) of the Armed Forces medical service participation in elimination of consequences of Chernobyl's accidents. The system of medical supply created soon after accidents (management and interaction, forces and means, peculiarities of sanitary-hygienic, antiepidemic, treatment-and-prophylactic supply) has been described in breaf, its positive sides and main deficiencies and also the ways of there elimination, the place of military-medical service in modern sate system of disaster medical supply have been discussed. The results of prolonged dynamic observation of rescuers by the All-Army medical-and-dosimetric register materials, the main directions, results and prospects of scientific study about problems of radiative disaster have been analyzed. 32 refs., 4 figs., 1 tab

  14. Simulated experiment for elimination of chemical and biological warfare agents by making use of microwave plasma torch

    International Nuclear Information System (INIS)

    Hong, Yong C.; Kim, Jeong H.; Uhm, Han S.

    2004-01-01

    The threat of chemical and biological warfare agents in a domestic terrorist attack and in military conflict is increasing worldwide. Elimination and decontamination of chemical and biological warfare (CBW) agents are immediately required after such an attack. Simulated experiment for elimination of CBW agents by making use of atmospheric-pressure microwave plasma torches is carried out. Elimination of biological warfare agents indicated by the vitrification or burnout of sewage sludge powders and decomposition of toluene gas as a chemical agent stimulant are presented. A detailed characterization for the elimination of the simulant chemicals using Fourier transform infrared and gas chromatography is also presented

  15. Simulated experiment for elimination of chemical and biological warfare agents by making use of microwave plasma torch

    Science.gov (United States)

    Hong, Yong C.; Kim, Jeong H.; Uhm, Han S.

    2004-02-01

    The threat of chemical and biological warfare agents in a domestic terrorist attack and in military conflict is increasing worldwide. Elimination and decontamination of chemical and biological warfare (CBW) agents are immediately required after such an attack. Simulated experiment for elimination of CBW agents by making use of atmospheric-pressure microwave plasma torches is carried out. Elimination of biological warfare agents indicated by the vitrification or burnout of sewage sludge powders and decomposition of toluene gas as a chemical agent stimulant are presented. A detailed characterization for the elimination of the simulant chemicals using Fourier transform infrared and gas chromatography is also presented.

  16. The National Airborne Field Experiment Data Sets

    DEFF Research Database (Denmark)

    Walker, J. P.; Balling, Jan E.; Bell, M.

    2007-01-01

    The National Airborne Field Experiment's (NAFE) were a series of intensive experiments recently conducted in different parts of Australia. These hydrologic-focused experiments have been designed to answer a range of questions which can only be resolved through carefully planned and executed field...

  17. Field Experience Study in a Traditional Setting.

    Science.gov (United States)

    Perenich, Theresa A.

    1978-01-01

    A field experience in fashion marketing for Kansas State University students is described. The functions and responsibilities of the coordinator, the student, and the departmental supervisor are outlined, along with the evaluation processes used. (Author/LBH)

  18. An Experiment of Ocular Artifacts Elimination from EEG Signals using ICA and PCA Methods

    Directory of Open Access Journals (Sweden)

    Arjon Turnip

    2014-12-01

    Full Text Available In the modern world of automation, biological signals, especially Electroencephalogram (EEG is gaining wide attention as a source of biometric information. Eye-blinks and movement of the eyeballs produce electrical signals (contaminate the EEG signals that are collectively known as ocular artifacts. These noise signals are required to be separated from the EEG signals to obtain the accurate results. This paper reports an experiment of ocular artifacts elimination from EEG signal using blind source separation algorithm based on independent component analysis and principal component analysis. EEG signals are recorded on three conditions, which are normal conditions, closed eyes, and blinked eyes. After processing, the dominant frequency of EEG signals in the range of 12-14 Hz either on normal, closed, and blinked eyes conditions is obtained. 

  19. Strategy for elimination of iodine deficiency in Belarus: evaluation of 10 years experience

    Directory of Open Access Journals (Sweden)

    V I Kachan

    2010-09-01

    Full Text Available Article presents results of implementation of successful program of elimination of iodine deficiency in Belarus. Government decree (2001 requires mandatory use of iodized salt in food industry and public catering. While retail trade of non-iodized salt is not prohibited, all foods shops must have iodized salt on sale. All these measures resulted in increase of iodized salt consumption: 94% of house-holds in Belarus were using iodized salt. Iodine nutrition of population also sig-nificantly improved: median urinary iodine levels in general population (school-children reached 169 mcg/l and in pregnant women – 224 mcg/l. Endemic goiter morbidity decreased significantly in children, adolescents and adults as well as frequency of transitory thyroid dysfunctions in newborns. Belarus experience in prevention of iodine deficiency can be used by other industrialized countries of Europe and rest of the world.

  20. Active-Set Reduced-Space Methods with Nonlinear Elimination for Two-Phase Flow Problems in Porous Media

    KAUST Repository

    Yang, Haijian

    2016-07-26

    Fully implicit methods are drawing more attention in scientific and engineering applications due to the allowance of large time steps in extreme-scale simulations. When using a fully implicit method to solve two-phase flow problems in porous media, one major challenge is the solution of the resultant nonlinear system at each time step. To solve such nonlinear systems, traditional nonlinear iterative methods, such as the class of the Newton methods, often fail to achieve the desired convergent rate due to the high nonlinearity of the system and/or the violation of the boundedness requirement of the saturation. In the paper, we reformulate the two-phase model as a variational inequality that naturally ensures the physical feasibility of the saturation variable. The variational inequality is then solved by an active-set reduced-space method with a nonlinear elimination preconditioner to remove the high nonlinear components that often causes the failure of the nonlinear iteration for convergence. To validate the effectiveness of the proposed method, we compare it with the classical implicit pressure-explicit saturation method for two-phase flow problems with strong heterogeneity. The numerical results show that our nonlinear solver overcomes the often severe limits on the time step associated with existing methods, results in superior convergence performance, and achieves reduction in the total computing time by more than one order of magnitude.

  1. Active-Set Reduced-Space Methods with Nonlinear Elimination for Two-Phase Flow Problems in Porous Media

    KAUST Repository

    Yang, Haijian; Yang, Chao; Sun, Shuyu

    2016-01-01

    Fully implicit methods are drawing more attention in scientific and engineering applications due to the allowance of large time steps in extreme-scale simulations. When using a fully implicit method to solve two-phase flow problems in porous media, one major challenge is the solution of the resultant nonlinear system at each time step. To solve such nonlinear systems, traditional nonlinear iterative methods, such as the class of the Newton methods, often fail to achieve the desired convergent rate due to the high nonlinearity of the system and/or the violation of the boundedness requirement of the saturation. In the paper, we reformulate the two-phase model as a variational inequality that naturally ensures the physical feasibility of the saturation variable. The variational inequality is then solved by an active-set reduced-space method with a nonlinear elimination preconditioner to remove the high nonlinear components that often causes the failure of the nonlinear iteration for convergence. To validate the effectiveness of the proposed method, we compare it with the classical implicit pressure-explicit saturation method for two-phase flow problems with strong heterogeneity. The numerical results show that our nonlinear solver overcomes the often severe limits on the time step associated with existing methods, results in superior convergence performance, and achieves reduction in the total computing time by more than one order of magnitude.

  2. The da vinci robot system eliminates multispecialty surgical trainees' hand dominance in open and robotic surgical settings.

    Science.gov (United States)

    Badalato, Gina M; Shapiro, Edan; Rothberg, Michael B; Bergman, Ari; RoyChoudhury, Arindam; Korets, Ruslan; Patel, Trushar; Badani, Ketan K

    2014-01-01

    Handedness, or the inherent dominance of one hand's dexterity over the other's, is a factor in open surgery but has an unknown importance in robot-assisted surgery. We sought to examine whether the robotic surgery platform could eliminate the effect of inherent hand preference. Residents from the Urology and Obstetrics/Gynecology departments were enrolled. Ambidextrous and left-handed subjects were excluded. After completing a questionnaire, subjects performed three tasks modified from the Fundamentals of Laparoscopic Surgery curriculum. Tasks were performed by hand and then with the da Vinci robotic surgical system (Intuitive Surgical, Sunnyvale, California). Participants were randomized to begin with using either the left or the right hand, and then switch. Left:right ratios were calculated from scores based on time to task completion. Linear regression analysis was used to determine the significance of the impact of surgical technique on hand dominance. Ten subjects were enrolled. The mean difference in raw score performance between the right and left hands was 12.5 seconds for open tasks and 8 seconds for robotic tasks (Probot tasks, respectively (Probotic and open approaches for raw time scores (Phand, prior robotic experience, and comfort level. These findings remain to be validated in larger cohorts. The robotic technique reduces hand dominance in surgical trainees across all task domains. This finding contributes to the known advantages of robotic surgery.

  3. Reactive case detection for malaria elimination: real-life experience from an ongoing program in Swaziland.

    Science.gov (United States)

    Sturrock, Hugh J W; Novotny, Joe M; Kunene, Simon; Dlamini, Sabelo; Zulu, Zulisile; Cohen, Justin M; Hsiang, Michelle S; Greenhouse, Bryan; Gosling, Roly D

    2013-01-01

    As countries move towards malaria elimination, methods to identify infections among populations who do not seek treatment are required. Reactive case detection, whereby individuals living in close proximity to passively detected cases are screened and treated, is one approach being used by a number of countries including Swaziland. An outstanding issue is establishing the epidemiologically and operationally optimal screening radius around each passively detected index case. Using data collected between December 2009 and June 2012 from reactive case detection (RACD) activities in Swaziland, we evaluated the effect of screening radius and other risk factors on the probability of detecting cases by reactive case detection. Using satellite imagery, we also evaluated the household coverage achieved during reactive case detection. Over the study period, 250 cases triggered RACD, which identified a further 74 cases, showing the value of RACD over passive surveillance alone. Results suggest that the odds of detecting a case within the household of the index case were significantly higher than in neighbouring households (odds ratio (OR) 13, 95% CI 3.1-54.4). Furthermore, cases were more likely to be detected when RACD was conducted within a week of the index presenting at a health facility (OR 8.7, 95% CI 1.1-66.4) and if the index household had not been sprayed with insecticide (OR sprayed vs not sprayed 0.11, 95% CI 0.03-0.46). The large number of households missed during RACD indicates that a 1 km screening radius may be impractical in such resource limited settings such as Swaziland. Future RACD in Swaziland could be made more effective by achieving high coverage amongst individuals located near to index cases and in areas where spraying has not been conducted. As well as allowing the programme to implement RACD more rapidly, this would help to more precisely define the optimal screening radius.

  4. Laboratory confirmation of measles in elimination settings: experience from the Republic of the Marshall Islands, 2003.

    Science.gov (United States)

    Hyde, Terri B; Nandy, Robin; Hickman, Carole J; Langidrik, Justina R; Strebel, Peter M; Papania, Mark J; Seward, Jane F; Bellini, William J

    2009-02-01

    To highlight the complications involved in interpreting laboratory tests of measles immunoglobulin M (IgM) for confirmation of infection during a measles outbreak in a highly vaccinated population after conducting a mass immunization campaign as a control measure. This case study was undertaken in the Republic of the Marshall Islands during a measles outbreak in 2003, when response immunization was conducted. A measles case was defined as fever and rash and one or more of cough, coryza or conjunctivitis. Between 13 July and 7 November 2003, serum samples were obtained from suspected measles cases for serologic testing and nasopharyngeal swabs were taken for viral isolation by reverse transcriptase polymerase chain reaction (RT-PCR). Specimens were collected from 201 suspected measles cases (19% of total): of the ones that satisfied the clinical case definition, 45% were IgM positive (IgM+) and, of these, 24% had received measles vaccination within the previous 45 days (up to 45 days after vaccination an IgM+ result could be due to either vaccination or wild-type measles infection). The proportion of IgM+ results varied with clinical presentation, the timing of specimen collection and vaccination status. Positive results on RT-PCR occurred in specimens from eight IgM-negative and four IgM+ individuals who had recently been vaccinated. During measles outbreaks, limiting IgM testing to individuals who meet the clinical case definition and have not been recently vaccinated allows for measles to be confirmed while conserving resources.

  5. Four years experience with filtration systems in commercial nurseries for eliminating Phytophthora species from recirculation water

    Science.gov (United States)

    T. Ufer; M. Posner; H.-P. Wessels; S. Wagner; K. Kaminski; T. Brand; Werres S.

    2008-01-01

    In a four year project, three different filtration systems were tested under commercial nursery conditions to eliminate Phytophthora spp. from irrigation water. Five nurseries were involved in the project. Slow sand filtration systems were tested in three nurseries. In the fourth nursery, a filtration system with lava grains (Shieer® Bio filtration)...

  6. Greenhouse Effect Detection Experiment (GEDEX). Selected data sets

    Science.gov (United States)

    Olsen, Lola M.; Warnock, Archibald, III

    1992-01-01

    This CD-ROM contains selected data sets compiled by the participants of the Greenhouse Effect Detection Experiment (GEDEX) workshop on atmospheric temperature. The data sets include surface, upper air, and/or satellite-derived measurements of temperature, solar irradiance, clouds, greenhouse gases, fluxes, albedo, aerosols, ozone, and water vapor, along with Southern Oscillation Indices and Quasi-Biennial Oscillation statistics.

  7. Novel molecular diagnostic tools for malaria elimination: a review of options from the point of view of high-throughput and applicability in resource limited settings.

    Science.gov (United States)

    Britton, Sumudu; Cheng, Qin; McCarthy, James S

    2016-02-16

    As malaria transmission continues to decrease, an increasing number of countries will enter pre-elimination and elimination. To interrupt transmission, changes in control strategies are likely to require more accurate identification of all carriers of Plasmodium parasites, both symptomatic and asymptomatic, using diagnostic tools that are highly sensitive, high throughput and with fast turnaround times preferably performed in local health service settings. Currently available immunochromatographic lateral flow rapid diagnostic tests and field microscopy are unlikely to consistently detect infections at parasite densities less than 100 parasites/µL making them insufficiently sensitive for detecting all carriers. Molecular diagnostic platforms, such as PCR and LAMP, are currently available in reference laboratories, but at a cost both financially and in turnaround time. This review describes the recent progress in developing molecular diagnostic tools in terms of their capacity for high throughput and potential for performance in non-reference laboratories for malaria elimination.

  8. The role of experience curves for setting MEPS for appliances

    International Nuclear Information System (INIS)

    Siderius, Hans-Paul

    2013-01-01

    Minimum efficiency performance standards (MEPS) are an important policy instrument to raise the efficiency of products. In most schemes the concept of life cycle costs (LCC) is used to guide setting the MEPS levels. Although a large body of literature shows that product cost is decreasing with increasing cumulative production, the experience curve, this is currently not used for setting MEPS. This article shows how to integrate the concept of the experience curve into LCC calculations for setting MEPS in the European Union and applies this to household laundry driers, refrigerator-freezers and televisions. The results indicate that for driers and refrigerator-freezers at least twice the energy savings compared to the current approach can be achieved. These products also show that energy label classes can successfully be used for setting MEPS. For televisions an experience curve is provided, showing a learning rate of 29%. However, television prices do not show a relation with energy efficiency but are to a large extent determined by the time the product is placed on the market. This suggests to policy makers that for televisions and other products with a short (re)design and market cycle timing is more important than the MEPS levels itself. - Highlights: • We integrate experience curves into life cycle cost calculations for MEPS. • For driers and refrigerators this results in at least twice the energy savings. • For flat panel televisions an experience curve is provided

  9. Recreation settings, scenery, and visitor experiences: a research assessment.

    Science.gov (United States)

    Daniel R. Williams

    2007-01-01

    A core task of recreation research is to understand the relation between settings, scenery, and visitor experiences. This paper uses environmental psychology to describe four conceptual models underlying these relations: inherent/aesthetic, opportunity/goal-directed, symbolic, and expressive. The paper then describes some challenges to applying results to recreation...

  10. The studies and experiments on size elimination of fine-grained feldspar from Asia Mining by using Vertical Air Classifier

    Directory of Open Access Journals (Sweden)

    Siribumrungsukha, B.

    2002-04-01

    Full Text Available Asia Mining Company produces feldspar and supplies to both domestic and overseas industries. Ore from the mine is crushed and ground and then classified by screening. That which is coarsely sized (+40 mesh can be sold to the market, while that which is finely sized is left unsold due to the market requirement that size must be of -40+140 mesh. This research designed and constructed a Vertical Air Classifier in which the fine mineral is fed to a vertical chamber while air is blown from the bottom. The main variables are air flow rates and the length of contact between the air and the mineral (at length of 10 and 15 cm. The air is blown in by air compressor and its rate is controlled by a thin plate orifice. Experiments show that the classifier can eliminate more of the size of -140 mesh as the air flow rate increases. The % fractional recovery at the size of -140 mesh is found to decrease as the air flow rate increases. The length of contact between the air and the mineral influences the elimination and the % fractional recovery as well. When the length is shorter (at 10 cm, the elimination of the size -140 mesh is better and the % fractional recovery at the size -140 mesh in the underflow is lower. At the air flow rate of 6.42 L/S and the length of contact of 10 cm, the size of -140 mesh can be reduced from 37.11% in the feed down to 17.70% in the underflow. The results demonstrate the potential of the Vertical Air Classifier to be further developed in eliminating the size -140 mesh by connecting the classifiers in series.

  11. Enhancing signal detection and completely eliminating scattering using quasi-phase-cycling in 2D IR experiments.

    Science.gov (United States)

    Bloem, Robbert; Garrett-Roe, Sean; Strzalka, Halina; Hamm, Peter; Donaldson, Paul

    2010-12-20

    We demonstrate how quasi-phase-cycling achieved by sub-cycle delay modulation can be used to replace optical chopping in a box-CARS 2D IR experiment in order to enhance the signal size, and, at the same time, completely eliminate any scattering contamination. Two optical devices are described that can be used for this purpose, a wobbling Brewster window and a photoelastic modulator. They are simple to construct, easy to incorporate into any existing 2D IR setup, and have attractive features such as a high optical throughput and a fast modulation frequency needed to phase cycle on a shot-to-shot basis.

  12. Designing Meaningful Game Experiences for Rehabilitation and Sustainable Mobility Settings

    Directory of Open Access Journals (Sweden)

    Silvia Gabrielli

    2014-03-01

    Full Text Available This paper presents the approach followed in two ongoing research projects aimed to designing meaningful game-based experiences to support home rehabilitation, eco-sustainable mobility goals and more in general better daily lifestyles. We first introduce the need for designing meaningful game-based experiences that are well-connected to the relevant non-game settings and can be customized by/for users, then, we show examples of how this approach can be realized in the rehabilitation and sustainable mobility contexts.

  13. Participatory health system priority setting: Evidence from a budget experiment.

    Science.gov (United States)

    Costa-Font, Joan; Forns, Joan Rovira; Sato, Azusa

    2015-12-01

    Budget experiments can provide additional guidance to health system reform requiring the identification of a subset of programs and services that accrue the highest social value to 'communities'. Such experiments simulate a realistic budget resource allocation assessment among competitive programs, and position citizens as decision makers responsible for making 'collective sacrifices'. This paper explores the use of a participatory budget experiment (with 88 participants clustered in social groups) to model public health care reform, drawing from a set of realistic scenarios for potential health care users. We measure preferences by employing a contingent ranking alongside a budget allocation exercise (termed 'willingness to assign') before and after program cost information is revealed. Evidence suggests that the budget experiment method tested is cognitively feasible and incentive compatible. The main downside is the existence of ex-ante "cost estimation" bias. Additionally, we find that participants appeared to underestimate the net social gain of redistributive programs. Relative social value estimates can serve as a guide to aid priority setting at a health system level. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Eliminating armaments

    International Nuclear Information System (INIS)

    Adams, R.

    1998-01-01

    The end of Cold War induced optimistic projections concerning disarmament, elimination of nuclear weapons, elimination of massive inequities - poverty, hatred, racism. All these goals should be achieved simultaneously, but little has been achieved so far

  15. Compact and lightweight support platform with electromagnetic disturbance elimination for interferometer on reversed field pinch Keda Torus eXperiment

    Science.gov (United States)

    Mao, Wenzhe; Yuan, Peng; Zheng, Jian; Ding, Weixing; Li, Hong; Lan, Tao; Liu, Adi; Liu, Wandong; Xie, Jinlin

    2016-11-01

    A compact and lightweight support platform has been used as a holder for the interferometer system on the Keda Torus eXperiment (KTX), which is a reversed field pinch device. The vibration caused by the interaction between the time-varying magnetic field and the induced current driven in the metal optical components has been measured and, following comparison with the mechanical vibration of the KTX device and the refraction effect of the ambient turbulent air flow, has been identified as the primary vibration source in this case. To eliminate this electromagnetic disturbance, nonmetallic epoxy resin has been selected as the material for the support platform and the commercially available metal optical mounts are replaced. Following these optimization steps and mechanical reinforcements, the stability of the interferometer platform has improved significantly. The phase shift caused by the vibration has been reduced to the level of background noise.

  16. Birth setting, labour experience, and postpartum psychological distress.

    Science.gov (United States)

    MacKinnon, Anna L; Yang, Lisa; Feeley, Nancy; Gold, Ian; Hayton, Barbara; Zelkowitz, Phyllis

    2017-07-01

    although psychosocial risk factors have been identified for postpartum depression (PPD) and perinatal posttraumatic stress disorder (PTSD), the role of labour- and birth-related factors remains unclear. The present investigation explored the impact of birth setting, subjective childbirth experience, and their interplay, on PPD and postpartum PTSD. in this prospective longitudinal cohort study, three groups of women who had vaginal births at a tertiary care hospital, a birthing center, and those transferred from the birthing centre to the tertiary care hospital were compared. Participants were followed twice during pregnancy (12-14 and 32-34 weeks gestation) and twice after childbirth (1-3 and 7-9 weeks postpartum). symptoms of PPD and PTSD did not significantly differ between birth groups; however, measures of subjective childbirth experience and obstetric factors did. Moderation analyses indicated a significant interaction between pain and birth group, such that higher ratings of pain among women who were transferred was associated with greater symptoms of postpartum PTSD. women who are transferred appear to have a unique experience that may put them at greater risk for postpartum psychological distress. It may be beneficial for care providers to help prepare women for pain management and potential unexpected complications, particularly if it is their first childbirth. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Toward Elimination of Dog-Mediated Human Rabies: Experiences from Implementing a Large-scale Demonstration Project in Southern Tanzania.

    Science.gov (United States)

    Mpolya, Emmanuel Abraham; Lembo, Tiziana; Lushasi, Kennedy; Mancy, Rebecca; Mbunda, Eberhard M; Makungu, Selemani; Maziku, Matthew; Sikana, Lwitiko; Jaswant, Gurdeep; Townsend, Sunny; Meslin, François-Xavier; Abela-Ridder, Bernadette; Ngeleja, Chanasa; Changalucha, Joel; Mtema, Zacharia; Sambo, Maganga; Mchau, Geofrey; Rysava, Kristyna; Nanai, Alphoncina; Kazwala, Rudovick; Cleaveland, Sarah; Hampson, Katie

    2017-01-01

    A Rabies Elimination Demonstration Project was implemented in Tanzania from 2010 through to 2015, bringing together government ministries from the health and veterinary sectors, the World Health Organization, and national and international research institutions. Detailed data on mass dog vaccination campaigns, bite exposures, use of post-exposure prophylaxis (PEP), and human rabies deaths were collected throughout the project duration and project areas. Despite no previous experience in dog vaccination within the project areas, district veterinary officers were able to implement district-wide vaccination campaigns that, for most part, progressively increased the numbers of dogs vaccinated with each phase of the project. Bite exposures declined, particularly in the southernmost districts with the smallest dog populations, and health workers successfully transitioned from primarily intramuscular administration of PEP to intradermal administration, resulting in major cost savings. However, even with improved PEP provision, vaccine shortages still occurred in some districts. In laboratory diagnosis, there were several logistical challenges in sample handling and submission but compared to the situation before the project started, there was a moderate increase in the number of laboratory samples submitted and tested for rabies in the project areas with a decrease in the proportion of rabies-positive samples over time. The project had a major impact on public health policy and practice with the formation of a One Health Coordination Unit at the Prime Minister's Office and development of the Tanzania National Rabies Control Strategy, which lays a roadmap for elimination of rabies in Tanzania by 2030 by following the Stepwise Approach towards Rabies Elimination (SARE). Overall, the project generated many important lessons relevant to rabies prevention and control in particular and disease surveillance in general. Lessons include the need for (1) a specific unit in the

  18. Patients' experiences of NPWT in an outpatient setting in Denmark

    DEFF Research Database (Denmark)

    Ottosen, B; Pedersen, B D

    2013-01-01

    qualitative interviews regarding their NPWT treatment. The French philosopher, Ricoeur's,theory of interpretation guided the data analysis, which included three levels: naive reading, structural analysis and critical interpretation and discussion. RESULTS: The patients experienced a high level of dependency......OBJECTIVE: To study patients' experiences of negative pressure wound therapy (NPWT) used for wounds of various aetiologies in the outpatient setting and the influences on daily life. METHOD: In this qualitative study, a phenomenological-hermeneutic approach was used. Ten patients underwent......, and they experienced embarrassment about odour,anxiety and uneasiness in relation to complications, a need for relatives' support and other social relation issues. It was important to include relatives as a resource and make use of the opportunity they presented to assist patients during information sessions about...

  19. The role of personal opinions and experiences in compliance with mass drug administration for lymphatic filariasis elimination in Kenya.

    Science.gov (United States)

    Njomo, Doris W; Amuyunzu-Nyamongo, Mary; Magambo, Japheth K; Njenga, Sammy M

    2012-01-01

    The main strategy adopted for Lymphatic Filariasis (LF) elimination globally is annual mass drug administration (MDA) for 4 to 6 rounds. At least 65% of the population at risk should be treated in each round for LF elimination to occur. In Kenya, MDA using diethylcarbamazine citrate (DEC) and albendazole data shows declining compliance (proportion of eligible populations who receive and swallow the drugs) levels (85%-62.8%). The present study's aim was to determine the role of personal opinions and experiences in compliance with MDA. This was a retrospective cross-sectional study conducted between January and September 2009 in two districts based on December 2008 MDA round. In each district, one location with high and one with low compliance was selected. Through systematic sampling, nine villages were selected and interviewer-based questionnaires administered to 965 household heads or adult representatives also systematically sampled. The qualitative data were generated from opinion leaders, LF patients with clinical signs and community drug distributors (CDDs) all purposively selected and interviewed. Sixteen focus group discussions (FGDs) were also conducted with single-sex adult and youth male and female groups. Chi square test was used to assess the statistical significance of differences in compliance with treatment based on the records reviewed. The house-to-house method of drug distribution influenced compliance. Over one-quarter (27%) in low compared to 15% in high compliance villages disliked this method. Problems related to size, number and taste of the drugs were more common in low (16.4%) than in high (14.4%) compliance villages. Reasons for failure to take the drugs were associated with compliance (pcompliance villages. Experience of side effects influenced compliance (Pcompliance in both types of villages (p>0.05). Community sensitization on treatment, drugs used, their regimen and distribution method involving all leaders should be strengthened by

  20. A large proportion of asymptomatic Plasmodium infections with low and sub-microscopic parasite densities in the low transmission setting of Temotu Province, Solomon Islands: challenges for malaria diagnostics in an elimination setting

    Directory of Open Access Journals (Sweden)

    Harris Ivor

    2010-09-01

    Full Text Available Abstract Background Many countries are scaling up malaria interventions towards elimination. This transition changes demands on malaria diagnostics from diagnosing ill patients to detecting parasites in all carriers including asymptomatic infections and infections with low parasite densities. Detection methods suitable to local malaria epidemiology must be selected prior to transitioning a malaria control programme to elimination. A baseline malaria survey conducted in Temotu Province, Solomon Islands in late 2008, as the first step in a provincial malaria elimination programme, provided malaria epidemiology data and an opportunity to assess how well different diagnostic methods performed in this setting. Methods During the survey, 9,491 blood samples were collected and examined by microscopy for Plasmodium species and density, with a subset also examined by polymerase chain reaction (PCR and rapid diagnostic tests (RDTs. The performances of these diagnostic methods were compared. Results A total of 256 samples were positive by microscopy, giving a point prevalence of 2.7%. The species distribution was 17.5% Plasmodium falciparum and 82.4% Plasmodium vivax. In this low transmission setting, only 17.8% of the P. falciparum and 2.9% of P. vivax infected subjects were febrile (≥38°C at the time of the survey. A significant proportion of infections detected by microscopy, 40% and 65.6% for P. falciparum and P. vivax respectively, had parasite density below 100/μL. There was an age correlation for the proportion of parasite density below 100/μL for P. vivax infections, but not for P. falciparum infections. PCR detected substantially more infections than microscopy (point prevalence of 8.71%, indicating a large number of subjects had sub-microscopic parasitemia. The concordance between PCR and microscopy in detecting single species was greater for P. vivax (135/162 compared to P. falciparum (36/118. The malaria RDT detected the 12 microscopy and

  1. The role of personal opinions and experiences in compliance with mass drug administration for lymphatic filariasis elimination in Kenya.

    Directory of Open Access Journals (Sweden)

    Doris W Njomo

    Full Text Available The main strategy adopted for Lymphatic Filariasis (LF elimination globally is annual mass drug administration (MDA for 4 to 6 rounds. At least 65% of the population at risk should be treated in each round for LF elimination to occur. In Kenya, MDA using diethylcarbamazine citrate (DEC and albendazole data shows declining compliance (proportion of eligible populations who receive and swallow the drugs levels (85%-62.8%. The present study's aim was to determine the role of personal opinions and experiences in compliance with MDA.This was a retrospective cross-sectional study conducted between January and September 2009 in two districts based on December 2008 MDA round. In each district, one location with high and one with low compliance was selected. Through systematic sampling, nine villages were selected and interviewer-based questionnaires administered to 965 household heads or adult representatives also systematically sampled. The qualitative data were generated from opinion leaders, LF patients with clinical signs and community drug distributors (CDDs all purposively selected and interviewed. Sixteen focus group discussions (FGDs were also conducted with single-sex adult and youth male and female groups. Chi square test was used to assess the statistical significance of differences in compliance with treatment based on the records reviewed. The house-to-house method of drug distribution influenced compliance. Over one-quarter (27% in low compared to 15% in high compliance villages disliked this method. Problems related to size, number and taste of the drugs were more common in low (16.4% than in high (14.4% compliance villages. Reasons for failure to take the drugs were associated with compliance (p0.05.Community sensitization on treatment, drugs used, their regimen and distribution method involving all leaders should be strengthened by the Programme Implementers. The communities need to be made aware of the potential side effects of the

  2. Digital breast tomosynthesis (DBT): initial experience in a clinical setting

    International Nuclear Information System (INIS)

    Skaane, Per; Gullien, Randi; Eben, Ellen B.; Haakenaasen, Unni; Naess Jebsen, Ingvild; Krager, Mona; Bjoerndal, Hilde; Ekseth, Ulrika; Jahr, Gunnar

    2012-01-01

    Background: Digital breast tomosynthesis (DBT) is a promising new technology. Some experimental clinical studies have shown positive results, but the future role and indications of this new technique, whether in a screening or clinical setting, need to be evaluated. Purpose: To compare digital mammography and DBT in a side-by-side feature analysis for cancer conspicuity, and to assess whether there is a potential additional value of DBT to standard state-of-the-art conventional imaging work-up with respect to detection of additional malignancies. Material and Methods: The study had ethics committee approval. A total of 129 women underwent 2D digital mammography including supplementary cone-down and magnification views and breast ultrasonography if indicated, as well as digital breast tomosynthesis. The indication for conventional imaging in the clinical setting included a palpable lump in 30 (23%), abnormal mammographic screening findings in 54 (42%), and surveillance in 45 (35%) of the women. The women were examined according to present guidelines, including spot-magnification views, ultrasonography, and needle biopsies, if indicated. The DBT examinations were interpreted several weeks after the conventional imaging without knowledge of the conventional imaging findings. In a later session, three radiologists performed a side-by-side feature analysis for cancer conspicuity in a sample of 50 cases. Results: State-of-the-art conventional imaging resulted in needle biopsy of 45 breasts, of which 20 lesions were benign and a total of 25 cancers were diagnosed. The remaining 84 women were dismissed with a normal/definitely benign finding and without indication for needle biopsy. The subsequent DBT interpretation found suspicious findings in four of these 84 women, and these four women had to be called back for repeated work-up with knowledge of the tomosynthesis findings. These delayed work-ups resulted in two cancers (increasing the cancer detection by 8%) and two

  3. Setting priorities for space research: An experiment in methodology

    Science.gov (United States)

    1995-01-01

    In 1989, the Space Studies Board created the Task Group on Priorities in Space Research to determine whether scientists should take a role in recommending priorities for long-term space research initiatives and, if so, to analyze the priority-setting problem in this context and develop a method by which such priorities could be established. After answering the first question in the affirmative in a previous report, the task group set out to accomplish the second task. The basic assumption in developing a priority-setting process is that a reasoned and structured approach for ordering competing initiatives will yield better results than other ways of proceeding. The task group proceeded from the principle that the central criterion for evaluating a research initiative must be its scientific merit -- the value of the initiative to the proposing discipline and to science generally. The group developed a two-stage methodology for priority setting and constructed a procedure and format to support the methodology. The first of two instruments developed was a standard format for structuring proposals for space research initiatives. The second instrument was a formal, semiquantitative appraisal procedure for evaluating competing proposals. This report makes available complete templates for the methodology, including the advocacy statement and evaluation forms, as well as an 11-step schema for a priority-setting process. From the beginning of its work, the task group was mindful that the issue of priority setting increasingly pervades all of federally supported science and that its work would have implications extending beyond space research. Thus, although the present report makes no recommendations for action by NASA or other government agencies, it provides the results of the task group's work for the use of others who may study priority-setting procedures or take up the challenge of implementing them in the future.

  4. Setting Standards and Primary School Teachers' Experiences of the Process

    Science.gov (United States)

    Scherman, Vanessa; Zimmerman, Lisa; Howie, Sarah J.; Bosker, Roel

    2014-01-01

    In South Africa, very few standard-setting exercises are carried out in education and, if they are, teachers are not involved in their execution. As a result, there is no clear understanding of what the standard is and how it was arrived at. This situation is compounded when teachers are held accountable when learners do not meet the prescribed…

  5. A new instrumental set-up for polarized neutron scattering experiments

    International Nuclear Information System (INIS)

    Schmidt, Wolfgang; Ohl, Michael

    2005-01-01

    Neutron scattering with polarization analysis is a powerful tool to determine magnetic structures and excitations. A common setup is to mount the sample at the center of a Helmholtz-type coil which can provide a magnetic field of any direction at the sample position and also a guide field along the neutron flight paths around the sample. Recent experiments showed quite a high demand for measurements at low momentum transfers. For the corresponding low scattering angles air scattering gives rise to a very large background. For this reason we have extended the standard setup to a combination of a large vacuum tank surrounded by electrical coils. The vacuum tank eliminates the air scattering and we can use the polarization analysis down to the lowest accessible momentum transfers. The coils themselves also show some new features: In contrary to the classic (symmetric) coil distribution we use an asymmetric setup which gives the advantage of a larger scattering window. Due to a more sophisticated current distribution this modified coil arrangement needs not to be rotated for different scattering conditions. The whole set-up will soon be available at IN12, a cold neutrons three-axis spectrometer operated by FZ Juelich in collaboration with CEA Grenoble as a CRG-B instrument at the Institut Laue Langevin in Grenoble

  6. Health Promotion in a Prison Setting: Experience in Villabona Prison

    Science.gov (United States)

    Muro, Pilar; Enjuanes, Jordi; Morata, Txus; Palasí, Eva

    2016-01-01

    Aim: The aim of this study was to analyse experiences of a health promotion intervention implemented by the Therapeutic and Educational Unit at Villabona prison in Spain, which aimed to create drug-free spaces as part of a model of social rehabilitation. Design: As part of a larger participatory evaluation study concerning the efficacy of…

  7. BICEP2. II. Experiment and three-year data set

    Energy Technology Data Exchange (ETDEWEB)

    Ade, P. A. R. [School of Physics and Astronomy, Cardiff University, Cardiff, CF24 3AA (United Kingdom); Aikin, R. W.; Bock, J. J.; Brevik, J. A.; Filippini, J. P.; Golwala, S. R.; Hildebrandt, S. R. [Department of Physics, California Institute of Technology, Pasadena, CA 91125 (United States); Amiri, M.; Davis, G.; Halpern, M.; Hasselfield, M. [Department of Physics and Astronomy, University of British Columbia, Vancouver, BC (Canada); Barkats, D. [Joint ALMA Observatory, ESO, Santiago (Chile); Benton, S. J. [Department of Physics, University of Toronto, Toronto, ON (Canada); Bischoff, C. A.; Buder, I. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, MA 02138 (United States); Bullock, E. [Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455 (United States); Day, P. K.; Dowell, C. D. [Jet Propulsion Laboratory, Pasadena, CA 91109 (United States); Duband, L. [Université Grenoble Alpes, CEA INAC-SBT, F-38000 Grenoble (France); Fliescher, S., E-mail: ogburn@stanford.edu [Department of Physics, University of Minnesota, Minneapolis, MN 55455 (United States); Collaboration: Bicep2 Collaboration; and others

    2014-09-01

    We report on the design and performance of the BICEP2 instrument and on its three-year data set. BICEP2 was designed to measure the polarization of the cosmic microwave background (CMB) on angular scales of 1°-5°(ℓ = 40-200), near the expected peak of the B-mode polarization signature of primordial gravitational waves from cosmic inflation. Measuring B-modes requires dramatic improvements in sensitivity combined with exquisite control of systematics. The BICEP2 telescope observed from the South Pole with a 26 cm aperture and cold, on-axis, refractive optics. BICEP2 also adopted a new detector design in which beam-defining slot antenna arrays couple to transition-edge sensor (TES) bolometers, all fabricated on a common substrate. The antenna-coupled TES detectors supported scalable fabrication and multiplexed readout that allowed BICEP2 to achieve a high detector count of 500 bolometers at 150 GHz, giving unprecedented sensitivity to B-modes at degree angular scales. After optimization of detector and readout parameters, BICEP2 achieved an instrument noise-equivalent temperature of 15.8 μK√s. The full data set reached Stokes Q and U map depths of 87.2 nK in square-degree pixels (5.'2 μK) over an effective area of 384 deg{sup 2} within a 1000 deg{sup 2} field. These are the deepest CMB polarization maps at degree angular scales to date. The power spectrum analysis presented in a companion paper has resulted in a significant detection of B-mode polarization at degree scales.

  8. Is Performance in Task-Cuing Experiments Mediated by Task Set Selection or Associative Compound Retrieval?

    Science.gov (United States)

    Forrest, Charlotte L. D.; Monsell, Stephen; McLaren, Ian P. L.

    2014-01-01

    Task-cuing experiments are usually intended to explore control of task set. But when small stimulus sets are used, they plausibly afford learning of the response associated with a combination of cue and stimulus, without reference to tasks. In 3 experiments we presented the typical trials of a task-cuing experiment: a cue (colored shape) followed,…

  9. Experiments simulation and design to set traffic lights operation rules

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez Garcia, J.A.

    2016-07-01

    In this paper it is used the experimental design to minimize the travel time of motor vehicles, in one of the most important avenues of Celaya City in Guanajuato, Mexico, by means of optimal synchronization of existing traffic lights. In the optimization process three factors are considered: the traffic lights’ cycle times, the synchrony defined as stepped, parallel and actual, and speed limit, each one with 3 evaluation levels. The response variables to consider are: motor vehicles’ travel time, fuel consumption and greenhouse effect gas (CO2) emissions. The different experiments are performed using the simulation model developed in the PTV-VISSIM software, which represents the vehicle traffic system. The obtained results for the different proposed scenarios allow to find proper levels at which the vehicle traffic system must be operated in order to improve mobility, to reduce contamination rates and decrease the fuel consumption for the different motor vehicles that use the avenue. (Author)

  10. [Blood transfusion in emergency settings: French military health service experience].

    Science.gov (United States)

    Sailliol, A; Ausset, S; Peytel, E

    2010-12-01

    Blood transfusion is required in a number of emergency settings and the French military health service (FMHS) has issued specific guidelines for the treatment of war casualties. These guidelines take into account European standards and laws, NATO standards, and also public sentiment regarding transfusion. These guidelines reflect a determination to control the process and to avoid the improvisation frequently associated with wartime transfusion. The evolution in warfare (terrorism and bombing more frequent than gunshot) and the wide use of body armor have deeply changed the clinical presentation of war injuries. These now involve the extremities in 80% of cases, with extensive tissue damage and heavy blood loss. The FMHS recommends that war casualties with hemorrhagic shock be brought quickly to a medical treatment facility (MTF) after first-line treatment applied through buddy aid or by medics. In the MTF, before an early Medevac, a damage control surgery will be performed, with resuscitation using freeze-dried plasma, red blood cells and fresh whole blood. The French military blood bank is responsible for blood product supply, training and medical advice regarding transfusion therapy during wartime, as well as hemovigilance. All transfusion therapy practices are periodically assessed but research on whole blood pathogen reduction is being conducted in order to reduce the residual infectious risk associated with this product. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  11. New nuclear data set ABBN-90 and its testing on macroscopic experiments

    International Nuclear Information System (INIS)

    Kosh'cheev, V.N.; Manturov, G.N.; Nikolaev, M.N.; Rineyskiy, A.A.; Sinitsa, V.V.; Tsyboolya, A.M.; Zabrodskaya, S.V.

    1993-01-01

    The new group constant set ABBN-90 is developed now. It based on the FOND-2 evaluated neutron data library processed with the code GRUCON. Some results of the testing ABBN-90 set in different macroscopic experiments are presented. (author)

  12. Experience in reconstruction of psychological reality for persons engaged in elimination of the Chernobyl' NPP accident effects

    International Nuclear Information System (INIS)

    Salamatov, V.A.; Nyagu, A.T.

    1990-01-01

    The results of psichosemantic studies of adaptation process are discussed, i.e. the consciousness contents for personnel (120 persons) engaged in works connected with the Chernobyl' NPP accident effect elimination and reconstruction of the subjective image of the Chernobyl' NPP 30-km zone on this basis are described. The mental tension for the zone personnel is estimated. The results obtained testify to the presence of chronic stress and exceeding the level of psychoemotional tension. Increases in the uneasiness level and emotional instability for the personnel are revealed

  13. Minding Rachlin's Eliminative Materialism

    Science.gov (United States)

    McDowell, J. J.

    2012-01-01

    Rachlin's teleological behaviorism eliminates the first-person ontology of conscious experience by identifying mental states with extended patterns of behavior, and thereby maintains the materialist ontology of science. An alternate view, informed by brain-based and externalist philosophies of mind, is shown also to maintain the materialist…

  14. Using Goal-Setting Strategies To Enrich the Practicum and Internship Experiences of Beginning Counselors.

    Science.gov (United States)

    Curtis, Russell C.

    2000-01-01

    Goal setting can be an effective way to help beginning counselors focus on important developmental issues. This article argues that counselors and supervisors must consider issues related to goal-setting theory and understand the process by which goals are set so that optimal learning experiences are created. (Author/MKA)

  15. Two Sets of Piwi Proteins Are Involved in Distinct sRNA Pathways Leading to Elimination of Germline-Specific DNA

    Directory of Open Access Journals (Sweden)

    Dominique I. Furrer

    2017-07-01

    Full Text Available Piwi proteins and piRNAs protect eukaryotic germlines against the spread of transposons. During development in the ciliate Paramecium, two Piwi-dependent sRNA classes are involved in the elimination of transposons and transposon-derived DNA: scan RNAs (scnRNAs, associated with Ptiwi01 and Ptiwi09, and iesRNAs, whose binding partners we now identify as Ptiwi10 and Ptiwi11. scnRNAs derive from the maternal genome and initiate DNA elimination during development, whereas iesRNAs continue DNA targeting until the removal process is complete. Here, we show that scnRNAs and iesRNAs are processed by distinct Dicer-like proteins and bind Piwi proteins in a mutually exclusive manner, suggesting separate biogenesis pathways. We also demonstrate that the PTIWI10 gene is transcribed from the developing nucleus and that its transcription depends on prior DNA excision, suggesting a mechanism of gene expression control triggered by the removal of short DNA segments interrupting the gene.

  16. Is mass drug administration against lymphatic filariasis required in urban settings? The experience in Kano, Nigeria.

    Science.gov (United States)

    Pam, Dung D; de Souza, Dziedzom K; D'Souza, Susan; Opoku, Millicent; Sanda, Safiya; Nazaradden, Ibrahim; Anagbogu, Ifeoma N; Okoronkwo, Chukwu; Davies, Emmanuel; Elhassan, Elisabeth; Molyneux, David H; Bockarie, Moses J; Koudou, Benjamin G

    2017-10-01

    The Global Programme to Eliminate Lymphatic Filariasis (GPELF), launched in 2000, has the target of eliminating the disease as a public health problem by the year 2020. The strategy adopted is mass drug administration (MDA) to all eligible individuals in endemic communities and the implementation of measures to reduce the morbidity of those suffering from chronic disease. Success has been recorded in many rural endemic communities in which elimination efforts have centered. However, implementation has been challenging in several urban African cities. The large cities of West Africa, exemplified in Nigeria in Kano are challenging for LF elimination program because reaching 65% therapeutic coverage during MDA is difficult. There is therefore a need to define a strategy which could complement MDA. Thus, in Kano State, Nigeria, while LF MDA had reached 33 of the 44 Local Government Areas (LGAs) there remained eleven 'urban' LGAs which had not been covered by MDA. Given the challenges of achieving at least 65% coverage during MDA implementation over several years in order to achieve elimination, it may be challenging to eliminate LF in such settings. In order to plan the LF control activities, this study was undertaken to confirm the LF infection prevalence in the human and mosquito populations in three urban LGAs. The prevalence of circulating filarial antigen (CFA) of Wuchereria bancrofti was assessed by an immuno-chromatography test (ICT) in 981 people in three urban LGAs of Kano state, Nigeria. Mosquitoes were collected over a period of 4 months from May to August 2015 using exit traps, gravid traps and pyrethrum knock-down spray sheet collections (PSC) in different households. A proportion of mosquitoes were analyzed for W. bancrofti, using dissection, loop-mediated isothermal amplification (LAMP) assay and conventional polymerase chain reaction (PCR). The results showed that none of the 981 subjects (constituted of West Africa may not be of significant importance

  17. Experiments with a novel content-based image retrieval software: can we eliminate classification systems in adolescent idiopathic scoliosis?

    Science.gov (United States)

    Menon, K Venugopal; Kumar, Dinesh; Thomas, Tessamma

    2014-02-01

    Study Design Preliminary evaluation of new tool. Objective To ascertain whether the newly developed content-based image retrieval (CBIR) software can be used successfully to retrieve images of similar cases of adolescent idiopathic scoliosis (AIS) from a database to help plan treatment without adhering to a classification scheme. Methods Sixty-two operated cases of AIS were entered into the newly developed CBIR database. Five new cases of different curve patterns were used as query images. The images were fed into the CBIR database that retrieved similar images from the existing cases. These were analyzed by a senior surgeon for conformity to the query image. Results Within the limits of variability set for the query system, all the resultant images conformed to the query image. One case had no similar match in the series. The other four retrieved several images that were matching with the query. No matching case was left out in the series. The postoperative images were then analyzed to check for surgical strategies. Broad guidelines for treatment could be derived from the results. More precise query settings, inclusion of bending films, and a larger database will enhance accurate retrieval and better decision making. Conclusion The CBIR system is an effective tool for accurate documentation and retrieval of scoliosis images. Broad guidelines for surgical strategies can be made from the postoperative images of the existing cases without adhering to any classification scheme.

  18. Can mother-to-child transmission of HIV be eliminated without addressing the issue of stigma? Modeling the case for a setting in South Africa.

    Science.gov (United States)

    Prudden, Holly J; Hamilton, Matthew; Foss, Anna M; Adams, Nicole Dzialowy; Stockton, Melissa; Black, Vivian; Nyblade, Laura

    2017-01-01

    Stigma and discrimination ontinue to undermine the effectiveness of the HIV response. Despite a growing body of evidence of the negative relationship between stigma and HIV outcomes, there is a paucity of data available on the prevalence of stigma and its impact. We present a probabilistic cascade model to estimate the magnitude of impact stigma has on mother-to-child-transmission (MTCT). The model was parameterized using 2010 data from Johannesburg, South Africa, from which loss-to-care at each stage of the antenatal cascade were available. Three scenarios were compared to assess the individual contributions of stigma, non-stigma related barriers, and drug ineffectiveness on the overall number of infant infections. Uncertainty analysis was used to estimate plausible ranges. The model follows the guidelines in place in 2010 when the data were extracted (WHO Option A), and compares this with model results had Option B+ been implemented at the time. The model estimated under Option A, 35% of infant infections being attributed to stigma. This compares to 51% of total infections had Option B+ been implemented in 2010. Under Option B+, the model estimated fewer infections than Option A, due to the availability of more effective drugs. Only 8% (Option A) and 9% (Option B+) of infant infections were attributed to drug ineffectiveness, with the trade-off in the proportion of infections being between stigma and non-stigma-related barriers. The model demonstrates that while the effect of stigma on retention of women at any given stage along the cascade can be relatively small, the cumulative effect can be large. Reducing stigma may be critical in reaching MTCT elimination targets, because as countries improve supply-side factors, the relative impact of stigma becomes greater. The cumulative nature of the PMTCT cascade results in stigma having a large effect, this feature may be harnessed for efficiency in investment by prioritizing interventions that can affect multiple

  19. Can mother-to-child transmission of HIV be eliminated without addressing the issue of stigma? Modeling the case for a setting in South Africa.

    Directory of Open Access Journals (Sweden)

    Holly J Prudden

    Full Text Available Stigma and discrimination ontinue to undermine the effectiveness of the HIV response. Despite a growing body of evidence of the negative relationship between stigma and HIV outcomes, there is a paucity of data available on the prevalence of stigma and its impact. We present a probabilistic cascade model to estimate the magnitude of impact stigma has on mother-to-child-transmission (MTCT.The model was parameterized using 2010 data from Johannesburg, South Africa, from which loss-to-care at each stage of the antenatal cascade were available. Three scenarios were compared to assess the individual contributions of stigma, non-stigma related barriers, and drug ineffectiveness on the overall number of infant infections. Uncertainty analysis was used to estimate plausible ranges. The model follows the guidelines in place in 2010 when the data were extracted (WHO Option A, and compares this with model results had Option B+ been implemented at the time.The model estimated under Option A, 35% of infant infections being attributed to stigma. This compares to 51% of total infections had Option B+ been implemented in 2010. Under Option B+, the model estimated fewer infections than Option A, due to the availability of more effective drugs. Only 8% (Option A and 9% (Option B+ of infant infections were attributed to drug ineffectiveness, with the trade-off in the proportion of infections being between stigma and non-stigma-related barriers.The model demonstrates that while the effect of stigma on retention of women at any given stage along the cascade can be relatively small, the cumulative effect can be large. Reducing stigma may be critical in reaching MTCT elimination targets, because as countries improve supply-side factors, the relative impact of stigma becomes greater. The cumulative nature of the PMTCT cascade results in stigma having a large effect, this feature may be harnessed for efficiency in investment by prioritizing interventions that can affect

  20. "Alert-Audit-Act": assessment of surveillance and response strategy for malaria elimination in three low-endemic settings of Myanmar in 2016.

    Science.gov (United States)

    Kyaw, Aye Mon Mon; Kathirvel, Soundappan; Das, Mrinalini; Thapa, Badri; Linn, Nay Yi Yi; Maung, Thae Maung; Lin, Zaw; Thi, Aung

    2018-01-01

    Myanmar, a malaria endemic country of Southeast Asia, adopted surveillance and response strategy similar to "1-3-7" Chinese strategy to achieve sub-national elimination in six low-endemic region/states of the country. Among these, Yangon, Bago-East, and Mon region/states have implemented this malaria surveillance and response strategy with modification in 2016. The current study was conducted to assess the case notification, investigation, classification, and response strategy (NICR) in these three states. This was a retrospective cohort study using routine program data of all patients with malaria diagnosed and reported under the National Malaria Control Programme in 2016 from the above three states. As per the program, all malaria cases need to be notified within 1 day and investigated within 3 days of diagnosis and response to control (active case detection and control) should be taken for all indigenous malaria cases within 7 days of diagnosis. A total of 959 malaria cases were diagnosed from the study area in 2016. Of these, the case NICR details were available only for 312 (32.5%) malaria cases. Of 312 cases, the case notification, investigation, and classification were carried out within 3 days of malaria diagnosis in 95.5% cases (298/312). Of 208 indigenous malaria cases (66.7%, 208/312), response to control was taken in 96.6% (201/208) within 7 days of diagnosis. The timeline at each stage of the strategy namely case notification, investigation, classification, and response to control was followed, and response action was taken in nearly all indigenous malaria cases for the available case information. Strengthening of health information and monitoring system is needed to avoid missing information. Future research on feasibility of mobile/tablet-based surveillance system and providing response to all cases including imported malaria can be further studied.

  1. Activity Settings and Daily Routines in Preschool Classrooms: Diverse Experiences in Early Learning Settings for Low-Income Children.

    Science.gov (United States)

    Fuligni, Allison Sidle; Howes, Carollee; Huang, Yiching; Hong, Sandra Soliday; Lara-Cinisomo, Sandraluz

    2012-06-01

    This paper examines activity settings and daily classroom routines experienced by 3- and 4-year-old low-income children in public center-based preschool programs, private center-based programs, and family child care homes. Two daily routine profiles were identified using a time-sampling coding procedure: a High Free-Choice pattern in which children spent a majority of their day engaged in child-directed free-choice activity settings combined with relatively low amounts of teacher-directed activity, and a Structured-Balanced pattern in which children spent relatively equal proportions of their day engaged in child-directed free-choice activity settings and teacher-directed small- and whole-group activities. Daily routine profiles were associated with program type and curriculum use but not with measures of process quality. Children in Structured-Balanced classrooms had more opportunities to engage in language and literacy and math activities, whereas children in High Free-Choice classrooms had more opportunities for gross motor and fantasy play. Being in a Structured-Balanced classroom was associated with children's language scores but profiles were not associated with measures of children's math reasoning or socio-emotional behavior. Consideration of teachers' structuring of daily routines represents a valuable way to understand nuances in the provision of learning experiences for young children in the context of current views about developmentally appropriate practice and school readiness.

  2. Experience-based design for integrating the patient care experience into healthcare improvement: Identifying a set of reliable emotion words.

    Science.gov (United States)

    Russ, Lauren R; Phillips, Jennifer; Brzozowicz, Keely; Chafetz, Lynne A; Plsek, Paul E; Blackmore, C Craig; Kaplan, Gary S

    2013-12-01

    Experience-based design is an emerging method used to capture the emotional content of patient and family member healthcare experiences, and can serve as the foundation for patient-centered healthcare improvement. However, a core tool-the experience-based design questionnaire-requires words with consistent emotional meaning. Our objective was to identify and evaluate an emotion word set reliably categorized across the demographic spectrum as expressing positive, negative, or neutral emotions for experience-based design improvement work. We surveyed 407 patients, family members, and healthcare workers in 2011. Participants designated each of 67 potential emotion words as positive, neutral, or negative based on their emotional perception of the word. Overall agreement was assessed using the kappa statistic. Words were selected for retention in the final emotion word set based on 80% simple agreement on classification of meaning across subgroups. The participants were 47.9% (195/407) patients, 19.4% (33/407) family members and 32.7% (133/407) healthcare staff. Overall agreement adjusted for chance was moderate (k=0.55). However, agreement for positive (k=0.69) and negative emotions (k=0.68) was substantially higher, while agreement in the neutral category was low (k=0.11). There were 20 positive, 1 neutral, and 14 negative words retained for the final experience-based design emotion word set. We identified a reliable set of emotion words for experience questionnaires to serve as the foundation for patient-centered, experience-based redesign of healthcare. Incorporation of patient and family member perspectives in healthcare requires reliable tools to capture the emotional content of care touch points. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Experiences of violence, burnout and job satisfaction in Korean nurses in the emergency medical centre setting.

    Science.gov (United States)

    Yoon, Hee Sook; Sok, Sohyune R

    2016-12-01

    The aim of this study was to examine the experience of violence in relation to burnout and job satisfaction in Korean nurses in the emergency medical centre setting. Participants were 236 nurses in the emergency medical centre setting of three metropolitan areas in Korea. Measures included a general characteristics form, characteristics related to experiences of violence, the Maslach Burnout Inventory and the Minnesota Satisfaction Questionnaire. Data were collected from June 2013 to February 2014. In the prediction model, 33.4% of burnout was explained and 35.7% for job satisfaction. The greatest influence on burnout was handling violence, followed by verbal abuse. The greatest influence on job satisfaction was physical threat, followed by handling violence. The study shows that burnout and job satisfaction of Korean nurses in the emergency medical centre setting are related to experiences of violence such as verbal abuse, physical threat and physical violence, as well as handling violence. © 2016 John Wiley & Sons Australia, Ltd.

  4. Is mass drug administration against lymphatic filariasis required in urban settings? The experience in Kano, Nigeria.

    Directory of Open Access Journals (Sweden)

    Dung D Pam

    2017-10-01

    Full Text Available The Global Programme to Eliminate Lymphatic Filariasis (GPELF, launched in 2000, has the target of eliminating the disease as a public health problem by the year 2020. The strategy adopted is mass drug administration (MDA to all eligible individuals in endemic communities and the implementation of measures to reduce the morbidity of those suffering from chronic disease. Success has been recorded in many rural endemic communities in which elimination efforts have centered. However, implementation has been challenging in several urban African cities. The large cities of West Africa, exemplified in Nigeria in Kano are challenging for LF elimination program because reaching 65% therapeutic coverage during MDA is difficult. There is therefore a need to define a strategy which could complement MDA. Thus, in Kano State, Nigeria, while LF MDA had reached 33 of the 44 Local Government Areas (LGAs there remained eleven 'urban' LGAs which had not been covered by MDA. Given the challenges of achieving at least 65% coverage during MDA implementation over several years in order to achieve elimination, it may be challenging to eliminate LF in such settings. In order to plan the LF control activities, this study was undertaken to confirm the LF infection prevalence in the human and mosquito populations in three urban LGAs.The prevalence of circulating filarial antigen (CFA of Wuchereria bancrofti was assessed by an immuno-chromatography test (ICT in 981 people in three urban LGAs of Kano state, Nigeria. Mosquitoes were collected over a period of 4 months from May to August 2015 using exit traps, gravid traps and pyrethrum knock-down spray sheet collections (PSC in different households. A proportion of mosquitoes were analyzed for W. bancrofti, using dissection, loop-mediated isothermal amplification (LAMP assay and conventional polymerase chain reaction (PCR.The results showed that none of the 981 subjects (constituted of <21% of children 5-10 years old tested

  5. Transcultural healthcare immersion: a unique interprofessional experience poised to influence collaborative practice in cultural settings.

    Science.gov (United States)

    Morton, Jennifer

    2012-01-01

    This paper describes a model for interprofessional and transcultural learning established by the author and supported by the University of New England and Ghana Health Mission, Inc. The model for interprofessional immersion in cultural settings represents a guiding framework predicated on a conceptual "brick and mortar" process for building cultural proficiency among individuals and within teams. It encompasses social, clinical and behavioral components (brick) and personal desire, cultural humility and values (mortar). The ``bounty'' aspect of the model is achieved by way of successful student learning outcomes, positive interprofessional and community-based collaborations, and finally, and to be measured over time, favorable patient and population (programmatic) outcomes. In partnership with the Ghana Health Mission, Inc and local community health workers, students and faculty from a range of health professions took part in a cultural-clinical experience known as Transcultural Immersion in Healthcare. The goal of the experience was to advance cultural proficiency and knowledge through intensive cultural immersion. An urban setting in Ghana, located in West Africa served as the setting for this unique experience. The transcultural immersion in healthcare experience achieved its ``bounty'' as seen in the enhanced cultural proficiency of students and faculty, seamless interprofessional communication and collaboration, and provision of primary care and related services to patients and the Ghanaian community. Future research is in development to test the Model for Interprofessional Immersion in Cultural Settings (MIICS) in a variety of other settings and with a cross section of health disciplines.

  6. Servicing HEP experiments with a complete set of ready integreated and configured common software components

    International Nuclear Information System (INIS)

    Roiser, Stefan; Gaspar, Ana; Perrin, Yves; Kruzelecki, Karol

    2010-01-01

    The LCG Applications Area at CERN provides basic software components for the LHC experiments such as ROOT, POOL, COOL which are developed in house and also a set of 'external' software packages (70) which are needed in addition such as Python, Boost, Qt, CLHEP, etc. These packages target many different areas of HEP computing such as data persistency, math, simulation, grid computing, databases, graphics, etc. Other packages provide tools for documentation, debugging, scripting languages and compilers. All these packages are provided in a consistent manner on different compilers, architectures and operating systems. The Software Process and Infrastructure project (SPI) [1] is responsible for the continous testing, coordination, release and deployment of these software packages. The main driving force for the actions carried out by SPI are the needs of the LHC experiments, but also other HEP experiments could profit from the set of consistent libraries provided and receive a stable and well tested foundation to build their experiment software frameworks. This presentation will first provide a brief description of the tools and services provided for the coordination, testing, release, deployment and presentation of LCG/AA software packages and then focus on a second set of tools provided for outside LHC experiments to deploy a stable set of HEP related software packages both as binary distribution or from source.

  7. Servicing HEP experiments with a complete set of ready integreated and configured common software components

    Energy Technology Data Exchange (ETDEWEB)

    Roiser, Stefan; Gaspar, Ana; Perrin, Yves [CERN, CH-1211 Geneva 23, PH Department, SFT Group (Switzerland); Kruzelecki, Karol, E-mail: stefan.roiser@cern.c, E-mail: ana.gaspar@cern.c, E-mail: yves.perrin@cern.c, E-mail: karol.kruzelecki@cern.c [CERN, CH-1211 Geneva 23, PH Department, LBC Group (Switzerland)

    2010-04-01

    The LCG Applications Area at CERN provides basic software components for the LHC experiments such as ROOT, POOL, COOL which are developed in house and also a set of 'external' software packages (70) which are needed in addition such as Python, Boost, Qt, CLHEP, etc. These packages target many different areas of HEP computing such as data persistency, math, simulation, grid computing, databases, graphics, etc. Other packages provide tools for documentation, debugging, scripting languages and compilers. All these packages are provided in a consistent manner on different compilers, architectures and operating systems. The Software Process and Infrastructure project (SPI) [1] is responsible for the continous testing, coordination, release and deployment of these software packages. The main driving force for the actions carried out by SPI are the needs of the LHC experiments, but also other HEP experiments could profit from the set of consistent libraries provided and receive a stable and well tested foundation to build their experiment software frameworks. This presentation will first provide a brief description of the tools and services provided for the coordination, testing, release, deployment and presentation of LCG/AA software packages and then focus on a second set of tools provided for outside LHC experiments to deploy a stable set of HEP related software packages both as binary distribution or from source.

  8. Exploring Rural High School Learners' Experience of Mathematics Anxiety in Academic Settings

    Science.gov (United States)

    Hlalele, Dipane

    2012-01-01

    The purpose of the study was to explore rural high school learners' experience of mathematics anxiety in academic settings. Mathematics anxiety has been found to have an adverse effect on confidence, motivation and achievement. This quantitative study is exploratory and descriptive in nature. The participants were 403 learners doing mathematics in…

  9. Goal setting with type 2 diabetes: a hermeneutic analysis of the experiences of diabetes educators.

    Science.gov (United States)

    Fleming, Susan E; Boyd, Angela; Ballejos, Miriam; Kynast-Gales, Susan A; Malemute, Charlene L; Armstrong Shultz, Jill; Vandermause, Roxanne K

    2013-01-01

    The purpose of this study was to explicate and interpret common experiences of diabetes educators (DEs) with patient goal setting for patients with type 2 diabetes in diabetes education. Transcripts (n = 10) from semi-structured interviews were analyzed using a hermeneutic phenomenological approach to more deeply explore the accounts of DEs' goal setting with patients with type 2 diabetes. The overarching pattern that emerged was "Striking a Balance," which subsumed 4 subthemes: Applying Theoretical-Practical Principles When Setting Goals, Identifying Idealistic-Realistic Expectations, Creating Patient-Educator-Centered Plans, and Readying-Living With Goal Setting. The pattern, "Striking a Balance," revealed a common meaning of DEs as experiences requiring balance and nuance in goal setting with patients. The results of this study combined with the tenets of the self-determination theory can provide the DEs with real-life exemplars and a theoretical framework to encourage their patients to self-manage, increase intrinsic motivation, and improve adherence related to their lifestyle changes and glycemic control. DEs, as facilitators of change, can implement these changes with flexible and reciprocal activities with their patients. The DEs owned these activities and they are: "building the bond," "sharing the session," "readying for change," "sending them home," and "bringing them back."

  10. Interprofessional education through shadowing experiences in multi-disciplinary clinical settings

    Directory of Open Access Journals (Sweden)

    Moore Ainsley E

    2010-12-01

    Full Text Available Abstract The World Health Organization has recently added Interprofessional Education (IPE to its global health agenda recognizing it as a necessary component of all health professionals' education. We suggest mandatory interprofessional shadowing experiences as a mechanism to be used by chiropractic institutions to address this agenda. IPE initiatives of other professions (pharmacy and medicine are described along with chiropractic. This relative comparison of professions local to our jurisdiction in Ontario, Canada is made so that the chiropractic profession may take note that they are behind other health care providers in implementing IPE. Interprofessional shadowing experiences would likely take place in a multi-disciplinary clinical setting. We offer an example of how two separate professions within a Family Health Team (FHT can work together in such a setting to enhance both student learning and patient care. For adult learners, using interprofessional shadowing experiences with learner-derived and active objectives across diverse health professional groups may help to improve the educational experience. Mandatory interprofessional shadowing experiences for chiropractors during their training can enhance future collaborative practice and provide success in reaching a goal common to each profession - improved patient care.

  11. COMPARING INTRA- AND INTERENVIRONMENTAL PARAMETERS OF OPTIMAL SETTING IN BREEDING EXPERIMENTS

    Directory of Open Access Journals (Sweden)

    Domagoj Šimić

    2004-06-01

    Full Text Available A series of biometrical and quantitative-genetic parameters, not well known in Croatia, are being used for the most important agronomic traits to determine optimal genotype setting within a location as well as among locations. Objectives of the study are to estimate and to compare 1 parameters of intra-environment setting (effective mean square error EMSE, in lattice design, relative efficiency RE, of lattice design LD, compared to randomized complete block design RCBD, and repeatability Rep, of a plot value, and 2 operative heritability h2, as a parameter of inter-environment setting in an experiment with 72 maize hybrids. Trials were set up at four environments (two locations in two years evaluating grain yield and stalk rot. EMSE values corresponded across environments for both traits, while the estimations for RE of LD varied inconsistently over environments and traits. Rep estimates were more different over environments than traits. Rep values did not correspond with h2 estimates: Rep estimates for stalk rot were higher than those for grain yield, while h2 for grain yield was higher than for stalk rot in all instances. Our results suggest that due to importance of genotype × environment interaction, there is a need for multienvironment trials for both traits. If the experiment framework should be reduced due to economic or other reasons, decreasing number of locations in a year rather than decreasing number of years of investigation is recommended.

  12. The experience of intimate partner violence in the context of the rural setting

    Science.gov (United States)

    Roush, karen

    Intimate partner violence (IPV) against women is a pervasive health and social problem in the United States; one in three women report being abused by an intimate partner at least once in their lifetime. IPV presents unique challenges to women living in rural areas that increase their vulnerability, limit their options for safety, and hamper efforts to leave an abusive relationship. Yet there is little research examining the lived experience of WV in a general population of women in the rural setting. Also, though there is a large body of research on TV screening and health care providers' attitudes and beliefs, little is known about rural providers specifically. A mixed methods study exploring the lived experience of IPV in women in the context of the rural setting was conducted. Along with qualitative interviews with women with experience of IPV, I conducted a survey to examine the TV-related knowledge, attitudes, beliefs and behaviors of the health care providers who interact with the women. The results from this study form a picture of the lives of women who experience IPV in the rural setting as one of isolation, fear, and uncertainty tempered by determination to understand and overcome the violence. Six major themes were identified, 1) living with violence, 2) protect self, 3) isolation, 4) search for understanding, 5) system level abuse, and 6) creating a new life. In contrast to earlier studies, health care providers demonstrated good overall knowledge and judicious attitudes about IPV and beliefs congruent with available evidence related to IPV. When looked at together the knowledge, attitudes, beliefs, and behaviors of the health care providers were aligned with the experiences voiced by the women participating in the interviews. The results of this study highlight the need for an interprofessional, public health approach that addresses the complex web of individual, social, cultural, economic, and political factors that create and feed the problem.

  13. Uptake and elimination kinetics of perfluoroalkyl substances in submerged and free-floating aquatic macrophytes: Results of mesocosm experiments with Echinodorus horemanii and Eichhornia crassipes.

    Science.gov (United States)

    Pi, N; Ng, J Z; Kelly, B C

    2017-06-15

    Studies investigating the bioaccumulation behavior of perfluoroalkyl substances (PFASs) in aquatic macrophytes are limited. The present study involved controlled mesocosm experiments to assess uptake and elimination rate constants (k u, k e ), bioconcentration factors (BCFs) and translocation factors (TFs) of several perfluoroalkyl carboxylic acids (PFCAs) and perfluoroalkane sulfonic acids (PFSAs) in two aquatic plant species, including one submerged species (Echinodorus horemanii) and one free-floating species (Eichhornia crassipes). The results indicated all PFASs were readily accumulated in these aquatic macrophytes. k u and BCFs increased with increasing perfluoroalkyl chain length. For PFCAs and PFSAs with identical perfluoroalkyl chain length, the corresponding PFSA exhibited higher bioaccumulation potential. On a whole-plant basis, the bioaccumulation potential of PFASs in submerged and free-floating macrophytes were comparable, indicating sorption to plant biomass is similar in the different species. Conversely, when considering accumulation in foliage, BCFs in the free-floating macrophyte were substantially lower compared to submerged species, especially for longer-chain PFASs. Compounds with shorter perfluoroalkyl chain length (PFBS, PFPeA and PFHxA) exhibited preferential translocation to leaf tissue (TFs >1). BCFs exhibited a sigmoidal relationship with pefluoroalkyl chain length, membrane-water distribution coefficients (D mw ), protein-water distribution coefficients (D pw ) and organic-water partition coefficients (K oc ). For these trends, maximum BCF values were exhibited by long-chain PFCAs, with a log D mw , log D pw and log K oc of 6.47, 5.72 and 5.04, respectively. These findings are useful for future design and implementation of phytoremediation systems, as well for future develop of mechanistic models for predicting the environmental fate and distribution of these contaminants of concern. Copyright © 2017. Published by Elsevier Ltd.

  14. Development of Data Acquisition Set-up for Steady-state Experiments

    Science.gov (United States)

    Srivastava, Amit K.; Gupta, Arnab D.; Sunil, S.; Khan, Ziauddin

    2017-04-01

    For short duration experiments, generally digitized data is transferred for processing and storage after the experiment whereas in case of steady-state experiment the data is acquired, processed, displayed and stored continuously in pipelined manner. This requires acquiring data through special techniques for storage and on-the-go viewing data to display the current data trends for various physical parameters. A small data acquisition set-up is developed for continuously acquiring signals from various physical parameters at different sampling rate for long duration experiment. This includes the hardware set-up for signal digitization, Field Programmable Gate Arrays (FPGA) based timing system for clock synchronization and event/trigger distribution, time slicing of data streams for storage of data chunks to enable viewing of data during acquisition and channel profile display through down sampling etc. In order to store a long data stream of indefinite/long time duration, the data stream is divided into data slices/chunks of user defined time duration. Data chunks avoid the problem of non-access of server data until the channel data file is closed at the end of the long duration experiment. A graphical user interface has been developed in Lab VIEW application development environment for configuring the data acquisition hardware and storing data chunks on local machine as well as at remote data server through Python for further data access. The data plotting and analysis utilities have been developed with Python software, which provides tools for further data processing. This paper describes the development and implementation of data acquisition for steady-state experiment.

  15. Does personalized goal setting and study planning improve academic performance and perception of learning experience in a developing setting?

    Directory of Open Access Journals (Sweden)

    Kazeem B. Yusuff, PhD

    2018-06-01

    .٢، والاختبارات النصفية ٢١.٩ (الانحراف المعياري = ٣.٧، والاختبارات النهائية ٤٢.٨ (الانحراف المعياري = ٥.٣، وكانت نسبة الإنجاز لأهداف المقرر أ (٧٧٪ و ب (٧٨٪ أعلى بكثير في مجموعة الدراسة. أظهرت التغذية الراجعة لنهاية المقرر اختلافات رئيسة في إدراك تجربة التعلم بين مجموعة الدراسة والمجموعة الضابطة. الاستنتاجات: يبدو أن تحديد الأهداف الشخصية والتخطيط للدراسة يؤدي إلى تحسن كبير في المشاركة المستمرة للتعلم، والتركيز على الأهداف الأكاديمية والأداء الأكاديمي. Abstract: Objective: The learning process for pharmacists must enable the skillful harnessing of metacognition, critical thinking, and effective application of specialized skills. This study assessed the impact of self-developed academic goals and study plans on pharmacy students' academic performance and perception of learning experience in a developing setting. Methods: A prospective cohort study was conducted at the College of Clinical Pharmacy, King Faisal University, KSA, in a compulsory 4th year course (Pharmacy management. The study group was exposed to goal setting and study planning while the control group had only routine teaching and learning activities planned for the course. Academic performance was determined with quizzes, midterm, and final exams, and the percentage achievement for the course objectives. An end-of-course evaluation, with a pre-tested questionnaire, was used to assess the perception of learning experience. Results: The study group constituted 41.4% (29, while 58.6% (41 were in the control group, with a mean ± SD age of 22.9 (SD = 3.2 and 21.6 (SD = 6.1 years, respectively. The mean ± SD scores for quizzes (8.4 (SD = 2

  16. Lessons learned from setting up the NOWESP research data base: Experiences in an interdisciplinary research project

    Science.gov (United States)

    Radach, Günther; Gekeler, Jens

    1996-09-01

    Research carried out within the framework of the MAST project NOWESP (North-West European Shelf Programme) was based on a multi-parameter data set of existing marine data, relevant for estimating trends, variability and fluxes on the Northwest European Shelf. The data sets were provided by the partners of the project. Additional data sets were obtained from several other institutions. During the project, the data were organized in the NOWESP Research Data Base (NRDB), for which a special data base scheme was defined that was capable of storing different types of marine data. Data products, like time series and interpolated fields, were provided to the partners for analysis (Radach et al. [1997]). After three years of project time, the feasibility of such an approach is discussed. Ways of optimizing data access and evaluation are proposed. A project-oriented Research Data Base is a useful tool because of its flexibility and proximity to the research being carried out. However, several requirements must be met to derive optimum benefits from this type of service unit. Since this task usually is carried out by a limited number of staff, an early start of project data management is recommended. To enable future projects to succeed in an analogous compilation of relevant data for their use, as performed in NOWESP, the task of organizing the data sets for any short-term project should be shared between a research data base group and a national or international data centre whose experience and software could be used. It must be ensured that only quality controlled data sets from the individual data-produ cing projects are delivered to the national data centres. It is recommended that data quality control should be performed by the originators and/or data centres before delivering any data sets to the research data base. Delivery of the (full) data sets should be checked and their quality should be approved by authorized data centres.

  17. Health professionals' experience of teamwork education in acute hospital settings: a systematic review of qualitative literature.

    Science.gov (United States)

    Eddy, Kylie; Jordan, Zoe; Stephenson, Matthew

    2016-04-01

    Teamwork is seen as an important element of patient care in acute hospital settings. The complexity of the journey of care for patients highlights the need for health professionals to collaborate and communicate clearly with each other. Health organizations in western countries are committed to improving patient safety through education of staff and teamwork education programs have been integral to this focus. There are no current systematic reviews of the experience of health professionals who participate in teamwork education in acute hospital settings. The objective of this systematic review was to search for the best available evidence on the experiences of health professionals who participate in teamwork education in acute hospital settings. This review considered studies reporting on experiences of registered health professionals who work in acute hospitals. This included medical, nursing and midwifery and allied health professionals. The focus of the meta-synthesis was the experiences and reflections of health professionals who were involved in teamwork education in acute hospital settings. The geographical context for this review was acute hospitals in rural or metropolitan settings in Australia and overseas countries. The review focused on the experiences of health professionals who work in acute hospitals and participated in teamwork education programs. This review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research.In the absence of research studies, other text such as opinion papers, discussion papers and reports were considered. Studies published in English and from 1990 to 2013 were included in this review. The literature search for relevant papers occurred between 13 September and 26 October 2013. A three-step search strategy was utilized in this review. The databases searched were PubMed, CINAHL, Embase and Scopus. The

  18. Fuzzy sets on step of planning of experiment for organization and management of construction processes

    Directory of Open Access Journals (Sweden)

    Lapidus Azariy

    2016-01-01

    Full Text Available In this article, problems of mathematical modeling and experiment planning of the organization and management of construction. The authors designated the basic restrictions and the difficulties in this field. Concluded that the planning of research experiment is possible in the information sphere with using of heuristic, graphical, mathematical models, as well as neural networks and genetic algorithms. The authors note the need for use of expert information in the case of the formalization of quality parameters. The article presented an overview of the translation methods of qualitative information into mathematical language. Comparison of methods the qualimetry of USSR scientists, the analytic hierarchy process and fuzzy set theory were performed. The benefits of the latter for interpretation of qualitative parameters were identified. The authors have given many examples of application fuzzy sets for formalization of organizational factors of construction processes. Finally, there conclusion was made about progressiveness and effectiveness of fuzzy set theory to describe the qualitative parameters of organization and management of construction.

  19. Nurse managers' experiences in continuous quality improvement in resource-poor healthcare settings.

    Science.gov (United States)

    Kakyo, Tracy Alexis; Xiao, Lily Dongxia

    2017-06-01

    Ensuring safe and quality care for patients in hospitals is an important part of a nurse manager's role. Continuous quality improvement has been identified as one approach that leads to the delivery of quality care services to patients and is widely used by nurse managers to improve patient care. Nurse managers' experiences in initiating continuous quality improvement activities in resource-poor healthcare settings remain largely unknown. Research evidence is highly demanded in these settings to address disease burden and evidence-based practice. This interpretive qualitative study was conducted to gain an understanding of nurse managers' Continuous Quality Improvement experiences in rural hospitals in Uganda. Nurse managers in rural healthcare settings used their role to prioritize quality improvement activities, monitor the Continuous Quality Improvement process, and utilize in-service education to support continuous quality improvement. The nurse managers in our sample encountered a number of barriers during the implementation of Continuous Quality Improvement, including: limited patient participation, lack of materials, and limited human resources. Efforts to address the challenges faced through good governance and leadership development require more attention. © 2017 John Wiley & Sons Australia, Ltd.

  20. Activity Settings and Daily Routines in Preschool Classrooms: Diverse Experiences in Early Learning Settings for Low-Income Children

    Science.gov (United States)

    Fuligni, Allison Sidle; Howes, Carollee; Huang, Yiching; Hong, Sandra Soliday; Lara-Cinisomo, Sandraluz

    2012-01-01

    This paper examines activity settings and daily classroom routines experienced by 3- and 4-year-old low-income children in public center-based preschool programs, private center-based programs, and family child care homes. Two daily routine profiles were identified using a time-sampling coding procedure: a High Free-Choice pattern in which…

  1. Children's moral experiences of crisis management in a child mental health setting.

    Science.gov (United States)

    Montreuil, Marjorie; Thibeault, Catherine; McHarg, Linda; Carnevale, Franco A

    2018-02-15

    The experiences of children related to conflict and crisis management in child mental health settings, especially those aged 12 and below, have been rarely studied. This study examined the moral experiences of children related to conflict and crisis management and the related use of restraint and seclusion in a child mental health setting. A 5-month focused ethnography using a participatory hermeneutic framework was conducted in a day hospital programme for children with severe disruptive disorders within a mental health institute. Children considered restraints and seclusion could help them feel safe in certain instances, for example if another child was being aggressive towards them or in exceptional cases to prevent self-injury. However, their own experiences of being restrained were predominantly negative, especially if not knowing the reason for their use, which they then found unfair. Some of the children emphasized the punitive nature of the use of restraints and seclusion, and most children disagreed with these practices when used as a punishment. Children's perspectives also highlighted the limits of the use of a uniform de-escalation approach by the staff to manage crises. Children considered discussing with the staff and developing a relationship with them as more helpful in case of a crisis then the use of a de-escalation approach or coercive strategies. © 2018 Australian College of Mental Health Nurses Inc.

  2. Midwives' experiences of labour care in midwifery units. A qualitative interview study in a Norwegian setting.

    Science.gov (United States)

    Skogheim, Gry; Hanssen, Tove A

    2015-12-01

    In some economically developed countries, women's choice of birth care and birth place is encouraged. The aim of this study was to explore and describe the experiences of midwives who started working in alongside/free-standing midwifery units (AMU/FMU) and their experiences with labour care in this setting. A qualitative explorative design using a phenomenographic approach was used. Semi-structured interviews were conducted with ten strategically sampled midwives working in midwifery units. The analysis revealed the following five categories of experiences noted by the midwives: mixed emotions and de-learning obstetric unit habits, revitalising midwifery philosophy, alertness and preparedness, presence and patience, and coping with time. Starting to work in an AMU/FMU can be a distressing period for a midwife. First, it may require de-learning the medical approach to birth, and, second, it may entail a revitalisation (and re-learning) of birth care that promotes physiological birth. Midwifery, particularly in FMUs, requires an especially careful assessment of the labouring process, the ability to be foresighted, and capability in emergencies. The autonomy of midwives may be constrained also in AMUs/FMUs. However, working in these settings is also viewed as experiencing "the art of midwifery" and enables revitalisation of the midwifery philosophy. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. A Qualitative Inquiry into Nursing Students’ Experience of Facilitating Reflection in Clinical Setting

    Directory of Open Access Journals (Sweden)

    Shahnaz Karimi

    2017-01-01

    Full Text Available Background and Aim. Reflection is known as a skill that is central to nursing students’ professional development. Due to the importance and the role of reflection in clinical areas of nursing, it is important to know how to achieve it. However, nursing trainers face the challenge of how to help their students to improve reflection in clinical settings. The aim of this study was to investigate the nursing students’ experiences of facilitating reflection during clinical practice. This qualitative study was conducted by qualitative content analysis approach. Twenty nursing students during the second to eighth semester of their educational program were selected for participation using purposive sampling. Data were collected through in-depth semistructured interviews. The interview was transcribed verbatim, and qualitative content analysis was used to analyze the data. From the data analysis, four main themes were extracted. Motivation to reflect, complex experiences, efficient trainer, and effective relations were four main themes obtained from study that, in interaction with each other, had facilitating roles in students’ reflective process on experiences. The findings revealed that the nursing students’ reflection in clinical settings is effective in personal and professional level. Reflection of nursing students depends on motivational and educational factors and these factors increase the quality of care in patients. Furthermore, nursing educators need to create nurturing climate as well as supporting reflective behaviors of nursing students.

  4. How Can We Identify the Elimination of Infectious Diseases? Experience From an Active Measles Laboratory Surveillance System in the Republic of Korea.

    Science.gov (United States)

    Yang, Tae Un; Kang, Hae Ji; Eom, Hye Eun; Park, Young-Joon; Park, Ok; Kim, Su Jin; Nam, Jeong-Gu; Kim, Sung Soon; Jeong, Eun Kyeong

    2015-11-01

    Global efforts have markedly decreased the disease burden of vaccine-preventable diseases. Many countries have made considerable progress toward the elimination of measles. As elimination is approached, the very low incidence achieved by high vaccination coverage has underscored the need for a sensitive and timely surveillance system. In the Republic of Korea, an active laboratory surveillance system (ALSS) was implemented to supplement the existing passive surveillance system in 2006. The ALSS connects 5 major commercial laboratories and the national measles reference laboratory, where referred samples with positive or equivocal results are retested. Annually, from 2009 to 2013, 3714 suspected cases were detected through the ALSS, an expansion of 8- to 57-fold, compared with only the passive surveillance system. The ALSS, with its sensitivity and timeliness, is a reasonable strategy to supplement the existing measles surveillance system and to help identify the elimination of measles. © 2015 APJPH.

  5. Improved set of criticality accident detectors used in the intercomparison experiment in Valduc

    International Nuclear Information System (INIS)

    Jozefowicz, K.; Golnik, N.

    1996-01-01

    An improved set of critically accident detectors has been elaborated for the needs of the Inst. of Atomic Energy in Swierk. The sets, which consist of fission track detectors, wide-base silicon diodes and RPL glasses, were tested in the international intercomparison experiment in Valduc, France. Comparison of our results with the reference measurements showed a good agreement (within 25%) for both the neutron and gamma measurements. Additionally, the diode response to neutron kerma was investigated more extensively in the dose range between 2 and 10 Gy, where the dependence of the diode signal versus neutron kerma was not well known. A possibility of the multiple use of the diodes has been proved. (author)

  6. Experiences With and Perceptions of Workplace Bullying Among Athletic Trainers in the Secondary School Setting.

    Science.gov (United States)

    Pitney, William A; Weuve, Celest; Mazerolle, Stephanie M

    2016-09-01

    Workplace bullying (WPB) has recently received much attention in society. Research on WPB in athletic training practice settings is limited. To determine the prevalence of WPB in the secondary school setting and explore the factors related to it. Mixed-methods study. Secondary school. A total of 567 athletic trainers (women = 322 [56.8%], men = 245 [43.2%]), aged 36.5 ± 11.1 years with 11.9 ± 9.5 years of experience took part in phase I. Ten participants (7 women and 3 men), aged 39.3 ± 10.1 years with 14.3 ± 8.3 years of experience, took part in phase II. For the online survey, we used the previously validated and reliable (Cronbach α = .84) Athletic Training Workplace Environment Survey, which included the Negative Acts Questionnaire-Revised. The prevalence of WPB was measured with descriptive statistics, and χ 2 analyses were used to compare differences between groups (ie, females and males, perpetrators' titles). The interview data were examined using an inductive content analysis. Of the participants, 44 (7.8%) were empirically identified as targets of bullying, though a higher percentage (12.4%, n = 70) self-identified as bullying targets. Men and women did not differ with respect to having experienced WPB, but more perpetrators were male (71.6%, n = 48) than female (28.4%, n = 19; χ 2 1 = 12.55, P = discrimination were antecedents of bullying. Stress, depression, and sleep disturbances were reported consequences. Participants coped with bullying by avoidance and role refocusing. Bullying was experienced by a small percentage of athletic trainers in the secondary school setting, a contrast to the findings in the collegiate practice setting.

  7. Transnational television audiences and modes of engagement: studying audience engagement as a set of experiences

    DEFF Research Database (Denmark)

    Keinonen, Heidi; Jensen, Pia Majbritt; Esser, Andrea

    2018-01-01

    Audience engagement is attracting increasing attention in various academic disciplines. Recently, the industry- and technology-oriented conceptualizations of engagement have been challenged by a more audience-oriented understanding. This article aims at contributing to the development of a more...... nuanced audience-oriented approach. First, we make a theoretical argument by bringing various key theories together and, second, we present an empirical contribution by analysing audience engagement as a set of experiences. Our analysis builds on the empirical material produced by conducting two rounds...... and ritualistic engagement, ludic engagement. We also discovered that audiences at times get disengaged or opt to actively resist engagement....

  8. Experiences of Nigerian Internationally Educated Nurses Transitioning to United States Health Care Settings.

    Science.gov (United States)

    Iheduru-Anderson, Kechinyere C; Wahi, Monika M

    2018-04-01

    Successful transition to practice of internationally educated nurses (IENs) can critically affect quality of care. The aim of this study was to characterize the facilitators and barriers to transition of Nigerian IENs (NIENs) to the United States health care setting. Using a descriptive phenomenology approach, 6 NIENs were interviewed about their transitional experiences in the United States. Thematic methods were used for data analysis. The three major themes identified from the participants' stories were "fear/anger and disappointment" (FAD), "road/journey to success/overcoming challenges" (RJO), and "moving forward" (MF). The FAD theme predominated, including experiences of racism, bullying, and inequality. The RJO theme included resilience, and the MF theme encompassed personal growth. NIENs face personal and organizational barriers to adaptation, especially fear, anger and disappointment. Future research should seek to develop a model for optimal adaptation that focuses on improving both personal and organizational facilitators and decreasing barriers.

  9. R20 Programme: Grout setting and strength development in ONKALO. Literature review, observations and experiments

    International Nuclear Information System (INIS)

    Karttunen, P.; Raivio, P.

    2008-12-01

    ONKALO is an underground rock characterisation facility planned to be a part of nuclear waste repository in future. ONKALO is located in Olkiluoto Finland. Posiva Oy owned by Teollisuuden Voima Oy and Fortum Power and Heat Oy is responsible for the repository, research, construction and use of the ONKALO and closing of the underground facility after use. During construction of ONKALO it has been observed that the setting and strength of grouting materials have not sporadically developed as expected (in ONKALO). The phenomenon has been observed for the first time in the year 2005. The observations examined in this report are made in the grouting field tests and in ordinary grouting during the year 2007. The phenomenon has been observed with low pH and standard grouts and bolt grouting mortars. The reasons for this phenomenon are studied based on literature review, observations and tests in the field and laboratory. The effect of reactions between groundwater and grout, the effect of the raw materials as well as curing conditions, temperature and pressure are studied. There are several potential factors that can cause observed phenomenon. Some factors are more probable than others. Laboratory experiments for the samples of poor strength development were done. These samples were taken from the grouting holes or packers in which the strength of the grout was not developed as expected. The results of these experiments were compared to the results gained from the samples cast from the same grout batches and cured in the tunnel conditions. The purpose was to find out the factor causing slow strength development of the grouted mixes. One single reason, which can slow the setting of the grouts in ONKALO is the low temperature in the rock, but the temperature cannot cause the phenomenon alone. Locally groundwater contains compounds that can create chemically aggressive environment for (the Portland) cement based grouts. The groundwater chemistry in ONKALO has not been proved

  10. Job Resources, Physician Work Engagement, and Patient Care Experience in an Academic Medical Setting.

    Science.gov (United States)

    Scheepers, Renée A; Lases, Lenny S S; Arah, Onyebuchi A; Heineman, Maas Jan; Lombarts, Kiki M J M H

    2017-10-01

    Physician work engagement is associated with better work performance and fewer medical errors; however, whether work-engaged physicians perform better from the patient perspective is unknown. Although availability of job resources (autonomy, colleague support, participation in decision making, opportunities for learning) bolster work engagement, this relationship is understudied among physicians. This study investigated associations of physician work engagement with patient care experience and job resources in an academic setting. The authors collected patient care experience evaluations, using nine validated items from the Dutch Consumer Quality index in two academic hospitals (April 2014 to April 2015). Physicians reported job resources and work engagement using, respectively, the validated Questionnaire on Experience and Evaluation of Work and the Utrecht Work Engagement Scale. The authors conducted multivariate adjusted mixed linear model and linear regression analyses. Of the 9,802 eligible patients and 238 eligible physicians, respectively, 4,573 (47%) and 185 (78%) participated. Physician work engagement was not associated with patient care experience (B = 0.01; 95% confidence interval [CI] = -0.02 to 0.03; P = .669). However, learning opportunities (B = 0.28; 95% CI = 0.05 to 0.52; P = .019) and autonomy (B = 0.31; 95% CI = 0.10 to 0.51; P = .004) were positively associated with work engagement. Higher physician work engagement did not translate into better patient care experience. Patient experience may benefit from physicians who deliver stable quality under varying levels of work engagement. From the physicians' perspective, autonomy and learning opportunities could safeguard their work engagement.

  11. Setting research priorities across science, technology, and health sectors: the Tanzania experience.

    Science.gov (United States)

    de Haan, Sylvia; Kingamkono, Rose; Tindamanyire, Neema; Mshinda, Hassan; Makandi, Harun; Tibazarwa, Flora; Kubata, Bruno; Montorzi, Gabriela

    2015-03-12

    Identifying research priorities is key to innovation and economic growth, since it informs decision makers on effectively targeting issues that have the greatest potential public benefit. As such, the process of setting research priorities is of pivotal importance for favouring the science, technology, and innovation (STI)-driven development of low- and middle-income countries. We report herein on a major cross-sectoral nationwide research priority setting effort recently carried out in Tanzania by the Tanzania Commission for Science and Technology (COSTECH) in partnership with the Council on Health Research for Development (COHRED) and the NEPAD Agency. The first of its type in the country, the process brought together stakeholders from 42 sub-sectors in science, technology, and health. The cross-sectoral research priority setting process consisted of a 'training-of-trainers' workshop, a demonstration workshop, and seven priority setting workshops delivered to representatives from public and private research and development institutions, universities, non-governmental organizations, and other agencies affiliated to COSTECH. The workshops resulted in ranked listings of research priorities for each sub-sector, totalling approximately 800 priorities. This large number was significantly reduced by an expert panel in order to build a manageable instrument aligned to national development plans that could be used to guide research investments. The Tanzania experience is an instructive example of the challenges and issues to be faced in when attempting to identify research priority areas and setting an STI research agenda in low- and middle-income countries. As countries increase their investment in research, it is essential to increase investment in research management and governance as well, a key and much needed capacity for countries to make proper use of research investments.

  12. Exploring rural high school learners' experience of mathematics anxiety in academic settings

    Directory of Open Access Journals (Sweden)

    Dipane Hlalele

    2012-01-01

    Full Text Available The purpose of the study was to explore rural high school learners' experience of mathematics anxiety in academic settings. Mathematics anxiety has been found to have an adverse effect on confidence, motivation and achievement. This quantitative study is exploratory and descriptive in nature. The participants were 403 learners doing mathematics in 18 rural schools in the Free State province of South Africa. Participants completed a 20-item questionnaire and 373 (92.5% questionnaires were found to contain valid responses and were analysed by a professional statistician at the University of the Free State using the Statistical Package for the Social Sciences (SPSS, Version 17.0. The questionnaire was testedfor reliability using the Cronbach alpha coefficient and was found to have a reliability score of .841, indicating an acceptable reliability coefficient. Findings reveal that all learners sometimes, often, or always experience mathematics anxiety in academic settings. It is therefore important for teachers and authorities in education to observe its prevalence and to implement strategies toward the alleviation of the effects ofmathematics anxiety.

  13. Cardiovascular disease prevention in low resource settings: lessons from the Heartfile experience in Pakistan.

    Science.gov (United States)

    Nishtar, Sania

    2003-01-01

    This paper outlines activities of the Heartfile Program in Pakistan (http://heartfile.org). The program focuses on cardiovascular disease prevention and health promotion, and includes several initiatives that encompass building policy, reorienting health services, and developing community interventions that utilize the print and electronic media and outreach at the grass-root level to incorporate social marketing approaches. Initiated by the nonprofit private sector, the program now links with major public sector primary healthcare programs, and is currently spearheading formulation of the National Action Plan on Noncommunicable Disease Prevention and Control in Pakistan. In addition, the program is being refined, validated, and packaged as a replicable model for other developing countries and in low resource settings, utilizing appropriate principles of franchising with inbuilt components sensitive to cultural and social adaptations. A review of the planning process, implementation strategy, and fund-raising experience is presented. Strategies unique to low resource settings, such as the development of cost- and time-efficient strategic alliances and partnerships, have also been highlighted. In addition, specific caveats are identified as being helpful to private sector development of chronic disease prevention programs in resource-constrained settings, and a road map to a sustainable public-private sector partnership is provided.

  14. [EXPERIENCE OF STUDY AND POSSIBLE WAYS OF ELIMINATION OF FALSE POSITIVE AND FALSE NEGATIVE RESULTS DURING EXECUTION OF POLYMERASE CHAIN REACTION ON AN EXAMPLE OF JUNIN VIRUS RNA DETECTION].

    Science.gov (United States)

    Sizikova, T E; Lebedev, V N; Pantyukhov, V B; Borisevich, S V; Merkulov, V A

    2015-01-01

    Experience of study and possible ways of elimination of false positive and false negative results during execution of polymerase chain reaction on an example of Junin virus RNA detection. MATERIALSS AND METHODS: Junin virus--causative agent of Argentine hemorrhagic fever (AHF) strain XJpR37/5787 was obtained from the State collection of pathogenicity group I causative agents of the 48th Central Research Institute. Reagent kit for detection of Junin virus RNA by RT-PCR was developed in the Institute and consists of 4 sets: for isolation of RNA, execution of reverse-transcription reaction, execution of PCR and electrophoretic detection of PCR products. RT-PCR was carried out by a standard technique. Continuous cell cultures of African green monkey Vero B, GMK-AH-1(D) were obtained from the museum of cell culture department of the Centre. An experimental study of the effect of various factors of impact on the sample under investigation ("thawing-freezing", presence of formaldehyde, heparin) on the obtaining of false negative results during Junin virus RNA detection by using RT-PCR was studied. Addition of 0.01% heparin to the samples was shown to completely inhibit PCR. Addition of 0.05% formaldehyde significantly reduces sensitivity of the method. A possibility of reduction of analysis timeframe from 15 to 5 days was shown during detection of the causative agent in samples with low concentration of the latter by growing the samples and subsequent analysis of the material obtained by using RT-PCR. During detection of causative agent by using RT-PCR false negative results could appear in the presence of formaldehyde and heparin in the sample. A possibility of elimination of false negative PCR results due to concentration of the causative agent in the sample under investigation at a level below sensitivity threshold was shown on the example of Junin virus RNA detection by using growing of the pathogen in appropriate accumulation system with subsequent analysis of the

  15. USCIS Backlog Elimination

    Data.gov (United States)

    Department of Homeland Security — USCIS is streamlining the way immigration benefits are delivered. By working smarter and eliminating redundancies, USCIS is bringing a business model to government....

  16. Consistent Set of Experiments from ICSBEP Handbook for Evaluation of Criticality Calculation Prediction of Apparatus of External Fuel Cycle with Different Fuel

    Energy Technology Data Exchange (ETDEWEB)

    Golovko, Yury E. [FSUE ' SSC RF-IPPE' , 249033, Bondarenko Square 1, Obninsk (Russian Federation)

    2008-07-01

    Experiments with plutonium, low enriched uranium and uranium-233 from the ICSBEP1 Handbook are being considered in this paper. Among these experiments it was selected only those, which seem to be the most relevant to the evaluation of uncertainty of critical mass of mixtures of plutonium or low enriched uranium or uranium-233 with light water. All selected experiments were examined and covariance matrices of criticality uncertainties were developed along with some uncertainties were revised. Statistical analysis of these experiments was performed and some contradictions were discovered and eliminated. Evaluation of accuracy of prediction of criticality calculations was performed using the internally consistent set of experiments with plutonium, low enriched uranium and uranium-233 remained after the statistical analyses. The application objects for the evaluation of calculational prediction of criticality were water-reflected spherical systems of homogeneous aqueous mixtures of plutonium or low enriched uranium or uranium-233 of different concentrations which are simplified models of apparatus of external fuel cycle. It is shows that the procedure allows to considerably reduce uncertainty in k{sub eff} caused by the uncertainties in neutron cross-sections. Also it is shows that the results are practically independent of initial covariance matrices of nuclear data uncertainties. (authors)

  17. Assessment of Barriers to Providing Introductory Pharmacy Practice Experiences (IPPEs in the Hospital Setting

    Directory of Open Access Journals (Sweden)

    Matthew J Gibson

    2016-07-01

    Full Text Available Objectives: The primary objective of the study is to identify the barriers to providing Introductory Pharmacy Practice Experiences (IPPEs in the hospital setting. Methods: Potential barriers to IPPEs were identified via literature review and interviews with current IPPE preceptors from various institutions. Based on this information, an electronic survey was developed and distributed to IPPE preceptors in order to assess student, preceptor, logistical and college or school of pharmacy related barriers that potentially exist for providing IPPE in the hospital setting. Results: Sixty-eight of the 287 eligible survey respondents (24% completed the electronic survey. Seventy-six percent of respondents agreed or strongly agreed that available time was a barrier to precepting IPPE students even though a majority of respondents reported spending a third or more of their day with an IPPE student when on rotation. Seventy-three percent of respondents disagreed or strongly disagreed that all preceptors have consistent performance expectations for students, while just 46% agreed or strongly agreed that they had adequate training to precept IPPEs. Sixty-five percent of respondents agreed that IPPE students have the ability to be a participant in patient care and 70% of preceptors believe that IPPE students should be involved in patient care. Conclusions: Conducting IPPEs in the institutional setting comes with challenges. Based on the results of this study, experiential directors and colleges/schools of pharmacy could make a positive impact on the quality and consistency of IPPEs by setting student expectations and training preceptors on appropriate and consistent expectations for students.   Type: Original Research

  18. Analysis of benchmark critical experiments with ENDF/B-VI data sets

    International Nuclear Information System (INIS)

    Hardy, J. Jr.; Kahler, A.C.

    1991-01-01

    Several clean critical experiments were analyzed with ENDF/B-VI data to assess the adequacy of the data for U 235 , U 238 and oxygen. These experiments were (1) a set of homogeneous U 235 -H 2 O assemblies spanning a wide range of hydrogen/uranium ratio, and (2) TRX-1, a simple, H 2 O-moderated Bettis lattice of slightly-enriched uranium metal rods. The analyses used the Monte Carlo program RCP01, with explicit three-dimensional geometry and detailed representation of cross sections. For the homogeneous criticals, calculated k crit values for large, thermal assemblies show good agreement with experiment. This supports the evaluated thermal criticality parameters for U 235 . However, for assemblies with smaller H/U ratios, k crit values increase significantly with increasing leakage and flux-spectrum hardness. These trends suggest that leakage is underpredicted and that the resonance eta of the ENDF/B-VI U 235 is too large. For TRX-1, reasonably good agreement is found with measured lattice parameters (reaction-rate ratios). Of primary interest is rho28, the ratio of above-thermal to thermal U 238 capture. Calculated rho28 is 2.3 (± 1.7) % above measurement, suggesting that U 238 resonance capture remains slightly overpredicted with ENDF/B-VI. However, agreement is better than observed with earlier versions of ENDF/B

  19. SeriousGeoGames - Geoscience Virtual Reality Experiences for Festival Settings

    Science.gov (United States)

    Skinner, Christopher

    2017-04-01

    Festivals, fairs and showcases provide scientists an opportunity to engage with potentially thousands of members of the public in a short space of time. However, the festival setting provides the same members of the public many exhibits competing for their attention - for family groups, this means a successful exhibit must both attract the attention of the group, and also entertain them long enough for the scientist to communicate their message. Here, we will discuss the use of short Virtual Reality (VR) experiences by the SeriousGeoGames project in engaging the public with research in a festival-like setting. SeriousGeoGames uses bespoke, immersive VR experiences to both attract and engage the user. They merge scientific models and/or research field data with popular gaming engines, and present them in VR using the Oculus Rift headset. The experiences are designed to last around four minutes and follow a basic script, although a conversational tone is encouraged. SeriousGeoGames applications have been successfully exhibited at several festivals of different sizes and intended audiences, such as the national-level week-long Cheltenham Science Festival, and the local arts and cultural festival, Hull Freedom Festival. The Flash Flood! application was developed for the Natural Environment Research Council UK (NERC) Flooding from Intense Rainfall (FFIR) programme as a Knowledge Transfer (KT) tool. It was demonstrated at the 5-day NERC Into the blue Science Showcase as one of 38 stands highlighting the UK's cutting edge environmental science research. Over 5000 members of the public attended, and more than 1000 demonstrations of Flash Flood! were made, with 400 booklets handed out. The exhibit received positive feedback from users, and won third prize in a public vote for favourite stand - but this had little visible impact on online metrics of the SeriousGeoGames web presence. In terms of providing a 'positive experience' with science the application was successfully

  20. The clinical nurse leader in the perioperative setting: a preceptor experience.

    Science.gov (United States)

    Wesolowski, Michael S; Casey, Gwendolyn L; Berry, Shirley J; Gannon, Jane

    2014-07-01

    The U.S. Veterans Administration (VA) has implemented the clinical nurse leader (CNL) role nationwide. Nursing leaders at the Malcolm Randall VA Medical Center in Gainesville, Florida, implemented the development of the CNL role in the perioperative setting during the summer of 2012. The perioperative department developed the position in partnership with the University of Florida College of Nursing, Gainesville, Florida. The team developed a description of the roles and experiences of the preceptors, the clinical nurse leader resident, and the University of Florida faculty member. The clinical nurse leader resident's successes and the positive outcomes, such as improved patient outcomes, experienced by the perioperative department demonstrated the importance of the CNL role. Published by Elsevier Inc.

  1. First year pre-service science teachers’ experiences of authentic instructional tasks in a PDS setting

    DEFF Research Database (Denmark)

    Pontoppidan, Birgitte; Nielsen, Birgitte Lund

    . The small groups gave the student teachers the opportunity to get on a level with the school students. They also refer to the iterative dimension and the importance of formative assessment. Based on the evaluative criteria it may be concluded that the two examples are successful models for authentic......Professional development schools (PDS) have been a source of inspiration for a new approach at the teacher education in Aarhus (DK). The importance of student teachers’ inquiries in authentic settings is in line with various research-based approaches to educating (science) teachers. The purpose...... for an authentic instructional task, are presented. Ten students were asked to describe their experiences of working with these tasks during repeated interviews. They refer to concrete examples of school students’ activities and/or learning when reflecting on their own learning and to dialogue with school students...

  2. Leisure-time youth centres as health-promoting settings: Experiences from multicultural neighbourhoods in Sweden.

    Science.gov (United States)

    Fredriksson, Ingela; Geidne, Susanna; Eriksson, Charli

    2018-02-01

    The aim of this paper is to advocate for the importance of meaningful leisure time for young people from a health-promotion perspective using experiences from two youth centres in multicultural neighbourhoods in Sweden. In this practice-based study, data were collected between 2012 and 2014 at two youth centres in multicultural, socially deprived suburbs in Sweden using surveys with 12- to 16-year-old adolescents ( n = 207), seven individual interviews with staff and three cooperation partners in the neighbourhoods, and six group interviews with adolescents (50% girls). Quantitative, qualitative and mixed methods were used for analysis. As part of the youth centres' strategies, they are open and inclusive, foster supportive relationships, emphasise youth empowerment, and integrate family, school and community in their work. The youth centres are health-promoting settings with regard to four of the action areas in the Ottawa Charter: build healthy public policy, create supportive environments, strengthen community actions and develop personal skills. There is a need for a variety and a combination of various structured and unstructured leisure-time activities because young people's background and life situation plays a role for their participation in leisure-time activities. We conclude that youth centres are well placed to be or to become health-promoting settings if the activities takes place in a structured environment.

  3. Supervisors' experiences of workplace supervision of nursing and paramedic students in rural settings: a scoping review.

    Science.gov (United States)

    Trede, Franziska; McEwen, Celina; Kenny, Amanda; O'Meara, Peter

    2014-05-01

    We present our findings from a scoping review that sought to identify what is known about nursing and paramedic clinical supervisors' experiences of their supervision practices in rural settings. Our interest in these two groups is based on the central role that nurses and paramedics play in rural health care. Scoping reviews support identification of a broad range of literature, including all types of study designs. We adopted Arksey and O'Malley's five-stage approach: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarising and reporting results. Databases searched included Academic Search Complete, Springer, Factiva, ProQuest, Ebsco, Informit, VOCEDplus and Scopus. Based on our research question and inclusion and exclusion criteria we selected relevant literature and summarised and reported it using Arksey and O'Malley's framework. The review yielded five articles from four countries: Sweden, Belgium, Malaysia and Australia. From this scoping review, we identified key themes related to supervisors' experiences, including clarification of expectations, support from managers and colleagues, the need for shared understanding between university, students and supervisors and required skills and competence in supervising students. © 2013.

  4. Aboriginal Australians' experience of social capital and its relevance to health and wellbeing in urban settings.

    Science.gov (United States)

    Browne-Yung, Kathryn; Ziersch, Anna; Baum, Fran; Gallaher, Gilbert

    2013-11-01

    Social capital has been linked to physical and mental health. While definitions of social capital vary, all include networks of social relationships and refer to the subsequent benefits and disadvantages accrued to members. Research on social capital for Aboriginal Australians has mainly focused on discrete rural and remote Aboriginal contexts with less known about the features and health and other benefits of social capital in urban settings. This paper presents findings from in-depth interviews with 153 Aboriginal people living in urban areas on their experiences of social capital. Of particular interest was how engagement in bonding and bridging networks influenced health and wellbeing. Employing Bourdieu's relational theory of capital where resources are unequally distributed and reproduced in society we found that patterns of social capital are strongly associated with economic, social and cultural position which in turn reflects the historical experiences of dispossession and disadvantage experienced by Aboriginal Australians. Social capital was also found to both reinforce and influence Aboriginal cultural identity, and had both positive and negative impacts on health and wellbeing. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Patients' self-interested preferences: empirical evidence from a priority setting experiment.

    Science.gov (United States)

    Alvarez, Begoña; Rodríguez-Míguez, Eva

    2011-04-01

    This paper explores whether patients act according to self-interest in priority setting experiments. The analysis is based on a ranking experiment, conducted in Galicia (Spain), to elicit preferences regarding the prioritization of patients on a waiting list for an elective surgical intervention (prostatectomy for benign prostatic hyperplasia). Participants were patients awaiting a similar intervention and members of the general populations. All of them were asked to rank hypothetical patients on a waiting list. A rank-ordered logit was then applied to their responses in order to obtain a prioritization scoring system. Using these estimations, we first test for differences in preferences between patients and general population. Second, we implement a procedure based on the similarity between respondents (true patients) and the hypothetical scenarios they evaluate (hypothetical patients) to analyze whether patients provide self-interested rankings. Our results show that patient preferences differ significantly from general population preferences. The findings also indicate that, when patients rank the hypothetical scenarios on the waiting list, they consider not only the explicit attributes but also the similarity of each scenario to their own. In particular, they assign a higher priority to scenarios that more closely match their own states. We also find that such a preference structure increases their likelihood of reporting "irrational" answers. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Experiences of a support group for interns in the setting of war and political turmoil.

    Science.gov (United States)

    El Jamil, Fatima; Hamadeh, Ghassan N; Osman, Hibah

    2007-10-01

    Intern support groups have been instituted in many residency programs to improve resident well-being. In this article, we discuss the themes that emerged in intern support group meetings in a family medicine program operating in a setting of war and political instability. We held support groups, led by a family physician and a psychologist, that met monthly. Participants were residents in the family medicine program at the American University of Beirut. These residents began their training days after the commencement of the 34-day war between Israel and Hizbollah in 2006. Themes and issues discussed by the residents were noted and are reported in this article. We found that despite the stressors of the political situation, our interns focused on the usual stress of internship, such as the difficulties of functioning as interns in other departments and dealing with the time demands of internship as their main sources of stress at the beginning of internship. The stresses associated with the war did not emerge in the group until later in the year. These included tension with patients and political confrontations with staff, as well as personal struggles with the lack of political stability and depressed mood. This paper serves to share our experience and highlight some areas of concern that residents experience when training in a country or region that is at war.

  7. Priority setting for risk assessment-The benefit of human experience

    International Nuclear Information System (INIS)

    Alonzo, Cristina; Laborde, Amalia

    2005-01-01

    The chemical risk assessment process plays an essential role in the potential human health risk evaluation. Setting priorities for this purpose is critical for better use of the available human and material resources. It has been generally accepted that all new chemicals require safety evaluation before manufacture and sale. This is a difficult task due to the large number of chemicals directly consumed by man, as well as those that are widely used. At present, more than 50% of chemicals do not have the minimum data requirements for risk assessment. Production and release volumes are well-established prioritization criteria, although volume itself does not directly reflect the likelihood of human exposure. This quantitative approach applied in setting priorities may be influenced by human experience. Human data provided by epidemiological investigations have been accepted as the most credible evidence for human toxicity although analytical studies are expensive and require long-term follow up. Unfortunately, some epidemiological studies continue to have difficulties with exposure documentation, controlling bias and confounding, and are not able to provide predictions of risk until humans are exposed. Clinical toxicology services and Poison Centres around the world accumulate a great amount of toxicological-related information that may contribute to the evidence-based medicine and research and so collaborate with all the risk assessment disciplines. The information obtained from these services and centers has the potential to prioritize existing chemical assessment processes or to influence scheduling of classes of chemicals. Prioritization process may be improved by evaluating Poisons Centres statistics about frequency of cases, severity of effects, detection of unusual circumstances of exposure, as well as vulnerable sub-populations. International efforts for the harmonization of these data offer a useful tool to take advantage of this global information. Case

  8. Why Is 10 Past 10 the Default Setting for Clocks and Watches in Advertisements? A Psychological Experiment

    Directory of Open Access Journals (Sweden)

    Ahmed A. Karim

    2017-08-01

    Full Text Available Have you ever noticed that in watch advertisements the time is usually set at 10:10? The reasons and psychological effects of this default time setting are elusive. In Experiment 1, we hypothesized that watches showing a time setting resembling a smiling face (10:10 would enhance emotional valence and intention to buy compared to a neutral time setting (11:30, whereas a time setting resembling a sad face (8:20 would have the opposite effect. Moreover, we investigated a possible interaction effect with the gender of the participants. In Experiment 2, we directly tested the hypotheses that watches set at 10:10 resemble a smiling face, whereas watches set at 8:20 resemble a sad face. The data of the first experiment reveal that watches set at 10:10 showed a significant positive effect on the emotion of the observer and the intention to buy. However, watches set at 8:20 did not show any effect on the emotion or the intention to buy. Moreover, watches set at 10:10 induced in women significantly stronger ratings of pleasure than in men. The data of the second experiment show that participants consistently perceive high resemblance between watches set at 10:10 and a smiling face as well as high resemblance between watches set at 8:20 and a sad face. This study provides for the first time empirical evidence for the notion that using watches with a time setting resembling a smiling face (like 10:10 can positively affect the emotional response of the observers and their evaluation of a seen watch, even though they are not aware of the fact that the shown time setting is inducing this effect. Practical implications of the observed findings and alternative explanations are discussed.

  9. Why Is 10 Past 10 the Default Setting for Clocks and Watches in Advertisements? A Psychological Experiment.

    Science.gov (United States)

    Karim, Ahmed A; Lützenkirchen, Britta; Khedr, Eman; Khalil, Radwa

    2017-01-01

    Have you ever noticed that in watch advertisements the time is usually set at 10:10? The reasons and psychological effects of this default time setting are elusive. In Experiment 1, we hypothesized that watches showing a time setting resembling a smiling face (10:10) would enhance emotional valence and intention to buy compared to a neutral time setting (11:30), whereas a time setting resembling a sad face (8:20) would have the opposite effect. Moreover, we investigated a possible interaction effect with the gender of the participants. In Experiment 2, we directly tested the hypotheses that watches set at 10:10 resemble a smiling face, whereas watches set at 8:20 resemble a sad face. The data of the first experiment reveal that watches set at 10:10 showed a significant positive effect on the emotion of the observer and the intention to buy. However, watches set at 8:20 did not show any effect on the emotion or the intention to buy. Moreover, watches set at 10:10 induced in women significantly stronger ratings of pleasure than in men. The data of the second experiment show that participants consistently perceive high resemblance between watches set at 10:10 and a smiling face as well as high resemblance between watches set at 8:20 and a sad face. This study provides for the first time empirical evidence for the notion that using watches with a time setting resembling a smiling face (like 10:10) can positively affect the emotional response of the observers and their evaluation of a seen watch, even though they are not aware of the fact that the shown time setting is inducing this effect. Practical implications of the observed findings and alternative explanations are discussed.

  10. Stigma of addiction and mental illness in healthcare: The case of patients' experiences in dental settings.

    Directory of Open Access Journals (Sweden)

    Mario A Brondani

    Full Text Available To explore the ways in which stigma is experienced in healthcare and dental settings by patients with a history of addiction and mental illness.Audio-recorded, semi-structured interviews with a purposefully selected convenience sample of residents from two community treatment centres in Vancouver, Canada were conducted. The interview guide contained questions about experiences while seeking health and dental care and was based on an existing framework of labeling, stereotyping, exclusion, discrimination, and power imbalance. Interviews were transcribed verbatim for coding and thematic analysis.Twenty-five participants between 23 and 67 years of age were interviewed; 17 were males. Most had a self-reported history of depression combined with use of alcohol and crack-cocaine; most of them only sought dental care for emergency purposes. Textual analysis of more than 300 pages of transcribed interviews revealed that participants perceived stigma when they were negatively stereotyped as 'unworthy', labeled as 'different', excluded from the decision-making process, discriminated against, 'treated unfairly', and felt powerless when interacting in the heath and dental care systems. Conversely, positive experiences were characterized by empathy, reassurance and good communication, which were empowering for patients.When associated with stigma, mental illness and addictions have negative implications for accessing health and dental care. From our participants' perspectives, it seems that the lack of understanding about their life conditions by the healthcare professionals was the origin of stigma. We suggest that an increased social awareness of these health issues be enhanced among current and future health and dental care professionals to help improve care experiences for this marginalized population.

  11. The Experience and Effectiveness of Nurse Practitioners in Orthopaedic Settings: A Comprehensive Systematic Review.

    Science.gov (United States)

    Taylor, Anita; Staruchowicz, Lynda

    This review asks "What is the experience and effectiveness of nurse practitioners in orthopaedic settings"?The objective of the quantitative component of this review is to synthesise the best available evidence on effectiveness of orthopaedic nurse practitioner specific care on patient outcomes and process indicators.The objective of the qualitative component of this review is to synthesise the best available evidence on the experience of becoming or being an orthopaedic nurse practitioner in relation to role development, role implementation and (ongoing) role evaluation.The objective of the text and opinion component of this review is to synthesise the best available evidence of the contemporary discourse on the effectiveness and experience of nurse practitioners in orthopaedic settings. Nurse practitioner roles have emerged in response to areas of unmet healthcare needs in a variety of settings. Nurse practitioners first evolved in the United States 40 years ago in response to a shortage of primary health care physicians. Nurse practitioners filled the void by providing access to primary health care services where otherwise there was none. Nurse practitioners comprise one branch of advanced nursing practice in the US along with Nurse Anaesthetists (NA), Clinical Nurse Specialists (CNS) and Nurse Midwives (NM). Canada soon followed America's lead by establishing the nurse practitioner role in 1967. Canada has two areas of advanced nursing practice, namely nurse practitioner and clinical nurse specialist; they are moving towards introducing nurse anaesthetists currently. The nurse practitioner role was introduced into the United Kingdom 20 years ago.There is commonality amongst the definition and characteristics of Nurse Practitioner (NP)/Advanced Practice Nurse (APN) role and practice internationally in terms of education, practice standards and regulation; operationally there is variability however. Australia's progress with nurse practitioners is very much

  12. Information-Analytic support of the programs of eliminating the consequences of the Chernobyl accident: gained experience and its future application

    International Nuclear Information System (INIS)

    Arutyunyan, R.V.; Bolshov, L.A.; Linge, I.I.; Abalkina, I.L.; Simonov, A.V.; Pavlovsky, O.A.

    1996-01-01

    On the initial stage of eliminating the consequences of the Chernobyl accident, the role of system-analytic and information support in the decision making process for protection of the population and rehabilitation of territories was. to a certain extent, underestimated. Starting from 1991, activity in system-analytic support was the part of the USSR (later on, Russian) stage programs. This activity covered three direction: development of the Central bank of the generalized data on the radiation catastrophes; development, implementation, and maintenance of the control informational system for the Federal bodies; computer-system integration

  13. Tropospheric Aerosol Radiative Forcing Observational eXperiment - University of Washington instrumented C-131A aircraft Data Set

    Data.gov (United States)

    National Aeronautics and Space Administration — TARFOX_UWC131A is the Tropospheric Aerosol Radiative Forcing Observational eXperiment (TARFOX) - University of Washington instrumented C-131A aircraft data set. The...

  14. Universal leakage elimination

    International Nuclear Information System (INIS)

    Byrd, Mark S.; Lidar, Daniel A.; Wu, L.-A.; Zanardi, Paolo

    2005-01-01

    'Leakage' errors are particularly serious errors which couple states within a code subspace to states outside of that subspace, thus destroying the error protection benefit afforded by an encoded state. We generalize an earlier method for producing leakage elimination decoupling operations and examine the effects of the leakage eliminating operations on decoherence-free or noiseless subsystems which encode one logical, or protected qubit into three or four qubits. We find that by eliminating a large class of leakage errors, under some circumstances, we can create the conditions for a decoherence-free evolution. In other cases we identify a combined decoherence-free and quantum error correcting code which could eliminate errors in solid-state qubits with anisotropic exchange interaction Hamiltonians and enable universal quantum computing with only these interactions

  15. Ethical violations in the clinical setting: the hidden curriculum learning experience of Pakistani nurses.

    Science.gov (United States)

    Jafree, Sara Rizvi; Zakar, Rubeena; Fischer, Florian; Zakar, Muhammad Zakria

    2015-03-19

    The importance of the hidden curriculum is recognised as a practical training ground for the absorption of medical ethics by healthcare professionals. Pakistan's healthcare sector is hampered by the exclusion of ethics from medical and nursing education curricula and the absence of monitoring of ethical violations in the clinical setting. Nurses have significant knowledge of the hidden curriculum taught during clinical practice, due to long working hours in the clinic and front-line interaction with patients and other practitioners. The means of inquiry for this study was qualitative, with 20 interviews and four focus group discussions used to identify nurses' clinical experiences of ethical violations. Content analysis was used to discover sub-categories of ethical violations, as perceived by nurses, within four pre-defined categories of nursing codes of ethics: 1) professional guidelines and integrity, 2) patient informed consent, 3) patient rights, and 4) co-worker coordination for competency, learning and patient safety. Ten sub-categories of ethical violations were found: nursing students being used as adjunct staff, nurses having to face frequent violence in the hospital setting, patient reluctance to receive treatment from nurses, the near-absence of consent taken from patients for most non-surgical medical procedures, the absence of patient consent taking for receiving treatment from student nurses, the practice of patient discrimination on the basis of a patient's socio-demographic status, nurses withdrawing treatment out of fear for their safety, a non-learning culture and, finally, blame-shifting and non-reportage of errors. Immediate and urgent attention is required to reduce ethical violations in the healthcare sector in Pakistan through collaborative efforts by the government, the healthcare sector, and ethics regulatory bodies. Also, changes in socio-cultural values in hospital organisation, public awareness of how to conveniently report ethical

  16. Tracking difference in gene expression in a time-course experiment using gene set enrichment analysis.

    Directory of Open Access Journals (Sweden)

    Pui Shan Wong

    Full Text Available Fistulifera sp. strain JPCC DA0580 is a newly sequenced pennate diatom that is capable of simultaneously growing and accumulating lipids. This is a unique trait, not found in other related microalgae so far. It is able to accumulate between 40 to 60% of its cell weight in lipids, making it a strong candidate for the production of biofuel. To investigate this characteristic, we used RNA-Seq data gathered at four different times while Fistulifera sp. strain JPCC DA0580 was grown in oil accumulating and non-oil accumulating conditions. We then adapted gene set enrichment analysis (GSEA to investigate the relationship between the difference in gene expression of 7,822 genes and metabolic functions in our data. We utilized information in the KEGG pathway database to create the gene sets and changed GSEA to use re-sampling so that data from the different time points could be included in the analysis. Our GSEA method identified photosynthesis, lipid synthesis and amino acid synthesis related pathways as processes that play a significant role in oil production and growth in Fistulifera sp. strain JPCC DA0580. In addition to GSEA, we visualized the results by creating a network of compounds and reactions, and plotted the expression data on top of the network. This made existing graph algorithms available to us which we then used to calculate a path that metabolizes glucose into triacylglycerol (TAG in the smallest number of steps. By visualizing the data this way, we observed a separate up-regulation of genes at different times instead of a concerted response. We also identified two metabolic paths that used less reactions than the one shown in KEGG and showed that the reactions were up-regulated during the experiment. The combination of analysis and visualization methods successfully analyzed time-course data, identified important metabolic pathways and provided new hypotheses for further research.

  17. Electronic data capture in a rural African setting: evaluating experiences with different systems in Malawi.

    Science.gov (United States)

    King, Carina; Hall, Jenny; Banda, Masford; Beard, James; Bird, Jon; Kazembe, Peter; Fottrell, Ed

    2014-01-01

    As hardware for electronic data capture (EDC), such as smartphones or tablets, becomes cheaper and more widely available, the potential for using such hardware as data capture tools in routine healthcare and research is increasing. We aim to highlight the advantages and disadvantages of four EDC systems being used simultaneously in rural Malawi: two for Android devices (CommCare and ODK Collect), one for PALM and Windows OS (Pendragon), and a custom-built application for Android (Mobile InterVA--MIVA). We report on the personal field and development experience of fieldworkers, project managers, and EDC system developers. Fieldworkers preferred using EDC to paper-based systems, although some struggled with the technology at first. Highlighted features include in-built skip patterns for all systems, and specifically the 'case' function that CommCare offers. MIVA as a standalone app required considerably more time and expertise than the other systems to create and could not be customised for our specific research needs; however, it facilitates standardised routine data collection. CommCare and ODK Collect both have user-friendly web-interfaces for form development and good technical support. CommCare requires Internet to build an application and download it to a device, whereas all steps can be done offline with ODK Collect, a desirable feature in low connectivity settings. Pendragon required more complex programming of logic, using a Microsoft Access application, and generally had less technical support. Start-up costs varied between systems, and all were considered more expensive than setting up a paper-based system; however running costs were generally low and therefore thought to be cost-effective over the course of our projects. EDC offers many opportunities for efficient data collection, but brings some issues requiring consideration when designing a study; the decision of which hardware and software to use should be informed by the aim of data collection

  18. A reaction time experiment on adult attachment: The development of a measure for neurophysiological settings

    Directory of Open Access Journals (Sweden)

    Theresia Wichmann

    2016-11-01

    Full Text Available In the last decades, there has been an increase of experimental research on automatic unconscious processes concerning the evaluation of the self and others. Previous research investigated implicit aspects of romantic attachment using self-report measures as explicit instruments for assessing attachment style. There is a lack of experimental procedures feasible for neurobiological settings. We developed a reaction time experiment (RT using a narrative attachment measure with an implicit nature and were interested to capture automatic processes, when the individuals’ attachment system is activated. We aimed to combine attachment methodology with knowledge from implicit measures by using a decision reaction time paradigm. This should serve as a means to capture implicit aspects of attachment. This experiment evaluated participants’ response to prototypic attachment sentences in association with their own attachment classification, measured with the Adult Attachment Projective Picture System (AAP.First the AAP was administered as the standardized interview procedure to 30 healthy participants, which were classified into a secure or insecure group. In the following experimental session, both experimenter and participants were blind with respect to classifications. 128 prototypically secure or insecure sentences related to the 8 pictures of the AAP were presented to the participants. Their response and reaction times were recorded. Based on the response (accept, reject a continuous security scale was defined. Both the AAP classification and security scale were related to the reaction times. Differentiated study hypotheses were confirmed for insecure sentences, which were accepted faster by participants from the insecure attachment group (or with lower security scale, and rejected faster by participants form secure attachment group (or with higher security scale. The elaborating unconscious processes were more activated by insecure sentences with

  19. Expansive learning in the university setting: the case for simulated clinical experience.

    Science.gov (United States)

    Haigh, Jacquelyn

    2007-03-01

    This paper argues that simulated practice in the university setting is not just a second best to learning in the clinical area but one which offers the potential for deliberation and deep learning [Eraut, M., 2000. Non-formal learning, implicit learning and tacit knowledge in professional work. Journal of Educational Psychology, 70, 113-136]. The context of student learning in an undergraduate midwifery programme is analysed using human activity theory [Engeström, Y., 2001. Expansive learning at work: toward an activity theoretical reconceptualization. Journal of Education and Work, 14, 133-156]. The advantages of this approach to student learning as opposed to situated learning theory and the concept of legitimate peripheral participation [Lave, J., Wenger, E., 1991. Situated Learning: Legitimate Peripheral Participation. Cambridge University Press, New York] are discussed. An activity system changes as a result of contradictions and tensions between what it purports to produce and the views of stakeholders (multi-voicedness) as well as its historical context (Historicity of activity). A focus group with students highlights their expressed need for more simulated practice experience. The views of midwifery lecturers are sought as an alternative voice on this tension in the current programme. Qualitative differences in types of simulated experience are explored and concerns about resources are raised in the analysis. Discussion considers the value of well planned simulations in encouraging the expression of tacit understanding through a group deliberative learning process [Eraut, M., 2000. Non-formal learning, implicit learning and tacit knowledge in professional work. Journal of Educational Psychology, 70, 113-136].

  20. How To Eliminate Narcissism Overnight

    Science.gov (United States)

    2011-01-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition appears likely to eliminate the diagnosis of narcissistic personality disorder. There are significant problems with the discriminant validity of the current narcissistic personality disorder critiera set; furthermore, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition's narrow focus on “grandiosity” probably contributes to the wide disparity between low narcissistic personality disorder prevalence rates in epidemiological studies and high rates of narcissistic personality disorder in clinical practice. Nevertheless, the best course of action may be to refine the narcissistic personality disorder criteria, followed by careful field testing and a search for biomarkers, rather than wholesale elimination of the narcissistic personality disorder category. The construct of “malignant narcissism” is also worthy of more intense empirical investigation. PMID:21468294

  1. Challenges beyond elimination in leprosy.

    Science.gov (United States)

    Naaz, Farah; Mohanty, Partha Sarathi; Bansal, Avi Kumar; Kumar, Dilip; Gupta, Umesh Datta

    2017-01-01

    Every year >200,000 new leprosy cases are registered globally. This number has been fairly stable over the past 8 years. The World Health Organization has set a target to interrupt the transmission of leprosy globally by 2020. It is important, in terms of global action and research activities, to consider the eventuality of multidrug therapy (MDT) resistance developing. It is necessary to measure disease burden comprehensively, and contact-centered preventive interventions should be part of a global elimination strategy. Drug resistance is the reduction in effectiveness of a drug such as an antimicrobial or an antineoplastic in curing a disease or condition. MDT has proven to be a powerful tool in the control of leprosy, especially when patients report early and start prompt treatment. Adherence to and its successful completion is equally important. This paper has reviewed the current state of leprosy worldwide and discussed the challenges and also emphasizes the challenge beyond the elimination in leprosy.

  2. Managing a work-life balance: the experiences of midwives working in a group practice setting.

    Science.gov (United States)

    Fereday, Jennifer; Oster, Candice

    2010-06-01

    To explore how a group of midwives achieved a work-life balance working within a caseload model of care with flexible work hours and on-call work. in-depth interviews were conducted and the data were analysed using a data-driven thematic analysis technique. Children, Youth and Women's Health Service (CYWHS) (previously Women's and Children's Hospital), Adelaide, where a midwifery service known as Midwifery Group Practice (MGP) offers a caseload model of care to women within a midwife-managed unit. 17 midwives who were currently working, or had previously worked, in MGP. analysis of the midwives' individual experiences provided insight into how midwives managed the flexible hours and on-call work to achieve a sustainable work-life balance within a caseload model of care. it is important for midwives working in MGP to actively manage the flexibility of their role with time on call. Organisational, team and individual structure influenced how flexibility of hours was managed; however, a period of adjustment was required to achieve this balance. the study findings offer a description of effective, sustainable strategies to manage flexible hours and on-call work that may assist other midwives working in a similar role or considering this type of work setting. Copyright 2008 Elsevier Ltd. All rights reserved.

  3. An analysis of fast critical experiments using JEF-1-based 50-group constant set

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Do; Gil, Choong Sup; Kim, Young Cheol [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1993-09-01

    JEF-1-based 50-group cross section set for fast reactor calculations was generated using NJOY system. The set was then examined by analyzing measured integral quantities such as criticality and central reaction rate ratios for 27 fast critical assemblies. The calculated results using the new set were also compared with those of ENDF/B-IV or -V based fast set. In general, the JEF-1-based set shows an improvement in predicting measured integral quantities in comparison with the previous set. With a few exceptions, JEF-1 results are compareble to those of ENDF/B-V.

  4. Teacher Experiences of Delivering an Obesity Prevention Programme (The WAVES Study Intervention) in a Primary School Setting

    Science.gov (United States)

    Griffin, Tania L; Clarke, Joanne L; Lancashire, Emma R; Pallan, Miranda J; Passmore, Sandra; Adab, Peymane

    2015-01-01

    Objective: There has been a wealth of childhood obesity prevention studies in school-based settings. However, few have investigated the experiences of school staff charged with delivery of such programmes. This study aimed to elicit teachers' experiences of delivering a childhood obesity prevention programme for children aged 6-7 years. Design:…

  5. Advocacy Interventions to Reduce or Eliminate Violence and Promote the Physical and Psychosocial Wellbeing of Women Who Experience Intimate Partner Abuse: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Rivas, C

    2016-01-01

    Full Text Available BACKGROUND Intimate partner abuse is common worldwide, damaging the short- and long-term physical, mental, and emotional health of survivors and children. Advocacy may contribute to reducing abuse, empowering women to improve their situation by providing informal counselling and support for safety planning and increasing access to different services. Advocacy may be a stand-alone service, accepting referrals from healthcare providers, or part of a multi-component (and possibly multi-agency intervention provided by service staff or others. OBJECTIVES To assess the effects of advocacy interventions within or outside healthcare settings in women who have experienced intimate partner abuse. SEARCH METHODS In April 2015, we searched CENTRAL, Ovid MEDLINE, EMBASE, and 10 other databases. We also searched WHO ICTRP, mRCT, and UK Clinical Research Network (UKCRN, and examined relevant websites and reference lists with forward citation tracking of included studies. For the original review we handsearched six key journals. We also contacted first authors of eligible papers and experts in the field. SELECTION CRITERIA Randomised or quasi-randomised controlled trials comparing advocacy interventions for women with experience of intimate partner abuse versus no intervention or usual care (if advocacy was minimal and fewer than 20% of women received it. DATA COLLECTION AND ANALYSIS Two review authors independently assessed risk of bias and undertook data extraction. We contacted authors for missing information needed to calculate statistics for the review and looked for adverse events. MAIN RESULTS We included 13 trials involving 2141 participants aged 15 to 65 years, frequently having low socioeconomic status. The studies were quite heterogeneous in terms of methodology, study processes and design, including with regard to the duration of follow-up (postintervention to three years, although this was not associated with differences in effect. The studies also

  6. Assessment of the Swedish EQ-5D experience-based value sets in a total hip replacement population.

    Science.gov (United States)

    Nemes, Szilárd; Burström, Kristina; Zethraeus, Niklas; Eneqvist, Ted; Garellick, Göran; Rolfson, Ola

    2015-12-01

    All patients undergoing elective total hip replacement (THR) in Sweden are asked to complete a survey, including the EQ-5D. Thus far, EQ-5D values have been presented using the UK TTO value set based on hypothetical values. Shift to the use of the recently introduced Swedish experience-based value set, derived from a representative Swedish population, is an appealing alternative. To investigate how accurate the Swedish experience-based VAS value set predicts observed EQ VAS values and to compare correlations between Swedish and UK value sets including two provisional value sets derived from the THR population. Pre- and one-year postoperative data from 56,062 THR patients from the Swedish Hip Arthroplasty Register were used. Agreement between the observed and the predicted EQ VAS values was assessed with correlation. Based on pre- and postoperative data, we constructed two provisional VAS value sets. Correlations between observed and calculated values using the Swedish VAS value set were moderate (r = 0.46) in preoperative data and high (r = 0.72) in postoperative data. Correlations between UK and register-based value sets were constantly lower compared to Swedish value sets. Register-based values and Swedish values were highly correlated. The Swedish value sets are more accurate in terms of representation of the Swedish THR patients than the currently used UK TTO value set. We find it feasible to use the experience-based Swedish value sets for further presentation of EQ-5D values in the Swedish THR population.

  7. Information overload or search-amplified risk? Set size and order effects on decisions from experience.

    Science.gov (United States)

    Hills, Thomas T; Noguchi, Takao; Gibbert, Michael

    2013-10-01

    How do changes in choice-set size influence information search and subsequent decisions? Moreover, does information overload influence information processing with larger choice sets? We investigated these questions by letting people freely explore sets of gambles before choosing one of them, with the choice sets either increasing or decreasing in number for each participant (from two to 32 gambles). Set size influenced information search, with participants taking more samples overall, but sampling a smaller proportion of gambles and taking fewer samples per gamble, when set sizes were larger. The order of choice sets also influenced search, with participants sampling from more gambles and taking more samples overall if they started with smaller as opposed to larger choice sets. Inconsistent with information overload, information processing appeared consistent across set sizes and choice order conditions, reliably favoring gambles with higher sample means. Despite the lack of evidence for information overload, changes in information search did lead to systematic changes in choice: People who started with smaller choice sets were more likely to choose gambles with the highest expected values, but only for small set sizes. For large set sizes, the increase in total samples increased the likelihood of encountering rare events at the same time that the reduction in samples per gamble amplified the effect of these rare events when they occurred-what we call search-amplified risk. This led to riskier choices for individuals whose choices most closely followed the sample mean.

  8. Electronic data capture in a rural African setting: evaluating experiences with different systems in Malawi

    Directory of Open Access Journals (Sweden)

    Carina King

    2014-10-01

    Full Text Available Background: As hardware for electronic data capture (EDC, such as smartphones or tablets, becomes cheaper and more widely available, the potential for using such hardware as data capture tools in routine healthcare and research is increasing. Objective: We aim to highlight the advantages and disadvantages of four EDC systems being used simultaneously in rural Malawi: two for Android devices (CommCare and ODK Collect, one for PALM and Windows OS (Pendragon, and a custom-built application for Android (Mobile InterVA – MIVA. Design: We report on the personal field and development experience of fieldworkers, project managers, and EDC system developers. Results: Fieldworkers preferred using EDC to paper-based systems, although some struggled with the technology at first. Highlighted features include in-built skip patterns for all systems, and specifically the ‘case’ function that CommCare offers. MIVA as a standalone app required considerably more time and expertise than the other systems to create and could not be customised for our specific research needs; however, it facilitates standardised routine data collection. CommCare and ODK Collect both have user-friendly web-interfaces for form development and good technical support. CommCare requires Internet to build an application and download it to a device, whereas all steps can be done offline with ODK Collect, a desirable feature in low connectivity settings. Pendragon required more complex programming of logic, using a Microsoft Access application, and generally had less technical support. Start-up costs varied between systems, and all were considered more expensive than setting up a paper-based system; however running costs were generally low and therefore thought to be cost-effective over the course of our projects. Conclusions: EDC offers many opportunities for efficient data collection, but brings some issues requiring consideration when designing a study; the decision of which hardware

  9. Comprehensive diagnostic set for intense lithium ion hohlraum experiments on PBFA II

    International Nuclear Information System (INIS)

    Leeper, R.J.; Bailey, J.E.; Carlson, A.L.

    1994-01-01

    A review of the comprehensive diagnostic package developed at Sandia National Laboratories for intense lithium ion hohlraum target experiments on PBFA II will be presented. This package contains an extensive suite of x-ray spectral and imaging diagnostics that enable measurements of target radiation smoothing, hydro-motion, and temperature. The x-ray diagnostics include time-integrated and time-resolved pinhole cameras, energy-resolved 1-D streaked imaging diagnostics that enable measurements of target radiation smoothing, hydro-motion, and temperature. The x-ray diagnostics include time-integrated and time-resolved pinhole cameras, energy-resolved 1-D streaked imaging diagnostics, time-integrated and time-resolved grazing incidence spectrographs, a transmission grating spectrography, an elliptical crystal spectrograph, a bolometer array, an eleven element x-ray diode (XRD) array, and an eleven element PIN diode detector array. A hohlraum temperature measurement technique under development is a shock breakout diagnostic that measures the radiation pressure at the hohlraum wall. The incident Li beam symmetry and an estimate of incident Li beam power density are measured from ion beam-induced characteristic x-ray line and neutron emissions. An attempt to measure the Li beam intensity directly on target used Rutherford scattered ions into an ion movie camera and a magnetic spectrograph. The philosophy used in designing all the diagnostics in the set has emphasized redundant and independent measurements of fundamental physical quantities relevant to the performance of the target. Details of each diagnostic, its integration, data reduction procedures, and recent PBFA-II data will be discussed

  10. Errorless learning for training individuals with schizophrenia at a community mental health setting providing work experience.

    Science.gov (United States)

    Kern, Robert S; Liberman, Robert P; Becker, Deborah R; Drake, Robert E; Sugar, Catherine A; Green, Michael F

    2009-07-01

    The effects of errorless learning (EL) on work performance, tenure, and personal well-being were compared with conventional job training in a community mental health fellowship club offering 12-week time-limited work experience. Participants were 40 clinically stable schizophrenia and schizoaffective disorder outpatients randomly assigned to EL vs conventional instruction (CI) at a thrift-type clothing store. EL participants received training on how to perform their assigned job tasks based on principles of EL, such as error reduction and automation of task performance. CI participants received training common to other community-based entry-level jobs that included verbal instruction, a visual demonstration, independent practice, and corrective feedback. Participants were scheduled to work 2 hours per week for 12 weeks. For both groups, job training occurred during the first 2 weeks at the worksite. Work performance (assessed using the Work Behavior Inventory, WBI) and personal well-being (self-esteem, job satisfaction, and work stress) were assessed at weeks 2, 4, and 12. Job tenure was defined as the number of weeks on the job or total number of hours worked prior to quitting or study end. The EL group performed better than the CI group on the Work Quality Scale from the WBI, and the group differences were relatively consistent over time. Results from the survival analyses of job tenure revealed a non-significant trend favoring EL. There were no group differences on self-esteem, job satisfaction, or work stress. The findings provide modest support for the extensions of EL to community settings for enhancing work performance.

  11. Radioactive wastes eliminating device

    International Nuclear Information System (INIS)

    Mitsutsuka, Norimasa.

    1979-01-01

    Purpose: To eliminate impurities and radioactive wastes by passing liquid sodium in a cold trap and an adsorption device. Constitution: Heated sodium is partially extracted from the core of a nuclear reactor by way of a pump, flown into and cooled in heat exchangers and then introduced into a cold trap for removal of impurities. The liquid sodium eliminated with impurities is introduced into an adsorption separator and purified by the elimination of radioactive wastes. The purified sodium is returned to the nuclear reactor. A heater is provided between the cold trap and the adsorption separator, so that the temperature of the liquid sodium introduced into the adsorption separator is not lower than the minimum temperature in the cold trap to thereby prevent deposition of impurities in the adsorption separator. (Kawakami, Y.)

  12. Flight Experiments for Living With a Star Space Environment Testbed (LWS-SET): Relationship to Technology

    Science.gov (United States)

    LaBel, Kenneth A.; Barth, Janet L.; Brewer, Dana A.

    2003-01-01

    This viewgraph presentation provides information on flight validation experiments for technologies to determine solar effects. The experiments are intended to demonstrate tolerance to a solar variant environment. The technologies tested are microelectronics, photonics, materials, and sensors.

  13. Eliminating Perinatal HIV Transmission

    Centers for Disease Control (CDC) Podcasts

    In this podcast, CDC’s Dr. Steve Nesheim discusses perinatal HIV transmission, including the importance of preventing HIV among women, preconception care, and timely HIV testing of the mother. Dr. Nesheim also introduces the revised curriculum Eliminating Perinatal HIV Transmission intended for faculty of OB/GYN and pediatric residents and nurse midwifery students.

  14. Consumer attitudes towards and satisfaction with emergency contraception counselling: experience from clinic and retail pharmacy settings.

    Science.gov (United States)

    Ragland, Denise; Battle, Marlene; Kueter, Teddi J; Payakachat, Nalin

    2015-10-01

    To collectively assess consumer attitudes towards and satisfaction with emergency contraception (EC) counselling by student pharmacists in two different locations: an academic healthcare clinic and a retail pharmacy. EC counselling was provided by trained student pharmacists utilizing a standardized education toolkit. Participants were asked to rate the counselling at the end of the knowledge survey. In addition to descriptive statistics, we compared the self-reported attitudes and satisfaction with the counselling between the two sites. The majority of participants from both settings rated 'strongly agree' on the attitude and satisfaction statements for the EC counselling. Participants from the clinic setting rated higher in two of the four statements than the participants from the retail setting. Participants had positive attitudes towards and were highly satisfied with the EC counselling in both settings. EC counselling should be encouraged in practice settings. © 2014 Royal Pharmaceutical Society.

  15. The experience of a nationwide Community of Practice to set up Regional Prevention Plans in Italy.

    Science.gov (United States)

    Giusti, Angela; Perra, Alberto; Lombardo, Flavia

    2017-07-27

    In 2010, the Italian Ministry of Health decided to start the planning process to elaborate the National Plan of Prevention 2010-2012 jointly with the 21 Regions. The National Institute of Health was responsible for supporting regional planners (RPs) by an original participatory approach of a web-based Community of Practice (CoP) to set up their own Regional Plans of Prevention. In this paper, we summarise the theoretical framework adopted, the main phases characterising the lifecycle of the nationwide CoP, the evaluation approach adopted and its findings. Following the CoP theoretical framework from Wenger, an initial group of RPs were trained on Project Cycle Management as a planning method and thereafter they started interacting on a web-based Moodle platform for 8 months. The CoP evaluation mainly took into account aspects of 'immediate value', such as members interactions within the website, and several quantitative and qualitative tools were used to monitor changes over time. Data were retrieved from Moodle statistics or directly from the RPs by the means of a Knowledge, Attitude and Practice survey, a reaction survey, SWOT analysis and focus groups. The level of individual RPs knowledge increased after the initial course from 55.7% to 75%, attitudes and competence perception about the planning process method also showed an overall favourable change. During the CoP life span, the number of members increased from the original 98 RPs to include up to 600 new members on the basis of spontaneous demand. From April 2010 to January 2011, the 'vital signs' of the CoP were monitored, including RP logins (13,450 total logins and 3744 unique logins), views (27,522) and posts (1606) distributed in 326 forum discussion threads. Data and information retrieved from quantitative and qualitative evaluation approaches proved to be useful for the management and follow-up of the CoP. The CoP experience was successful as 19 out of 20 Regions submitted their Regional Preventive

  16. Linked Data for Fighting Global Hunger:Experiences in setting standards for Agricultural Information Management

    Science.gov (United States)

    Baker, Thomas; Keizer, Johannes

    FAO, the Food and Agriculture Organization of the UN, has the global goal to defeat hunger and eliminate poverty. One of its core functions is the generation, dissemination and application of information and knowledge. Since 2000, the Agricultural InformationManagement Standards (AIMS) activity in FAO's Knowledge Exchange and Capacity Building Division has promoted the use of Semantic Web standards to improve information sharing within a global network of research institutes and related partner organizations. The strategy emphasizes the use of simple descriptive metadata, thesauri, and ontologies for integrating access to information from a wide range of sources for both scientific and non-expert audiences. An early adopter of Semantic Web technology, the AIMS strategy is evolving to help information providers in nineteen language areas use modern Linked Data methods to improve the quality of life in developing rural areas, home to seventy percent of the world's poor and hungry people.

  17. The Experience of Adolescents and Young Adults Treated for Cancer in an Adult Setting: A Review of the Literature.

    Science.gov (United States)

    Marshall, Steve; Grinyer, Anne; Limmer, Mark

    2018-02-13

    The purpose of this review is to explore the literature on the experience of adolescents and young adults (AYAs) having cancer treatment in an adult setting, rather than on a specialist adolescent cancer unit. The integrative review method was used to explore the current literature. Primary research on the topic was located systematically and then synthesized into a thematic narrative. The experience of AYAs undergoing treatment in an adult setting was generally negative. This can be attributed to three themes: feeling isolated in the adult setting; the lack of empathy from staff working in the adult setting; and the inappropriateness of the adult environment for this age group. As many AYAs with cancer will continue to have treatment in adult settings, staff working in this environment should be aware of the negative experience of this cohort and the impact this can have on a vulnerable group of patients. Staff could consider simple ways of improving the AYA experience, such as connecting AYA patients with their peers to reduce isolation; adapting their approach to take account of the unique emotional needs of this age group; and considering ways of making the environment more welcoming and age-appropriate.

  18. CRISP. D3.1. Specification of experiments and test set up

    International Nuclear Information System (INIS)

    Kamphuis, I.G.; Kester, J.C.P.; Kok, J.K.; Schaeffer, G.J.; Gajic, Z.; Karlsson, D.; Andrieu, C.; Fontela, M.; Raison, B.; Penkov, D.

    2005-08-01

    In the CRISP project three field experiments are implemented for using novel ICTs for better integration of Distributed Generation in the electricity grid. These experiments deal with: (a) supply demand matching; (b) fault detection and diagnostics; and (c) intelligent load shedding. For each of the experiments the problem statement, the project definition, the project description and the planning and organisation are described, respectively in section A, B and C of this document

  19. Setting a New Research Agenda: Professional Migration Experiences and Their Impact on Family Well-Being

    Science.gov (United States)

    Dunlop, Ted

    2011-01-01

    In this article, the author talks about the growing pattern of migration experiences for professional people and the impact these have on the well-being of the family as a whole and individual family members who reside outside their home countries for prescribed periods of time. It is easy to argue that the experiences of such families are far…

  20. The M-Learning Experience of Language Learners in Informal Settings

    Science.gov (United States)

    Sendurur, Emine; Efendioglu, Esra; Çaliskan, Neslihan Yondemir; Boldbaatar, Nomin; Kandin, Emine; Namazli, Sevinç

    2017-01-01

    This study is designed to understand the informal language learners' experiences of m-learning applications. The aim is two-folded: (i) to extract the reasons why m-learning applications are preferred and (ii) to explore the user experience of Duolingo m-learning application. We interviewed 18 voluntary Duolingo users. The findings suggest that…

  1. Factors affecting experiences of intensive care patients in Turkey: patient outcomes in critical care setting.

    Science.gov (United States)

    Demir, Yurdanur; Korhan, Esra Akin; Eser, Ismet; Khorshid, Leyla

    2013-07-01

    To determine the factors affecting a patient's intensive care experience. The descriptive study was conducted at an intensive care unit in the Aegean Region of Turkey, and comprised 158 patients who spent at least 48 hours at the unit between June and November 2009. A questionnaire form and the Intensive Care Experience Scale were used as data collection tools. SPSS 11.5 was used for statistical analysis of the data. Of the total, 86 (54.4%) patients related to the surgical unit, while 72 (45.5%) spent time at the intensive care unit. Most of the subjects (n=113; 71.5%) reported that they constantly experienced pain during hospitalisation. Patients receiving mechanical ventilation support and patients reporting no pain had significantly higher scores on the intensive care experience scale. Patients who reported pain remembered their experiences less than those having no pain. Interventions are needed to make the experiences of patients in intensive care more positive.

  2. Eliminating Perinatal HIV Transmission

    Centers for Disease Control (CDC) Podcasts

    2012-11-26

    In this podcast, CDC’s Dr. Steve Nesheim discusses perinatal HIV transmission, including the importance of preventing HIV among women, preconception care, and timely HIV testing of the mother. Dr. Nesheim also introduces the revised curriculum Eliminating Perinatal HIV Transmission intended for faculty of OB/GYN and pediatric residents and nurse midwifery students.  Created: 11/26/2012 by Division of HIV/AIDS Prevention.   Date Released: 11/26/2012.

  3. Prospective Validation of the Decalogue, a Set of Doctor-Patient Communication Recommendations to Improve Patient Illness Experience and Mood States within a Hospital Cardiologic Ambulatory Setting

    Directory of Open Access Journals (Sweden)

    Piercarlo Ballo

    2017-01-01

    Full Text Available Strategies to improve doctor-patient communication may have a beneficial impact on patient’s illness experience and mood, with potential favorable clinical effects. We prospectively tested the psychometric and clinical validity of the Decalogue, a tool utilizing 10 communication recommendations for patients and physicians. The Decalogue was administered to 100 consecutive patients referred for a cardiologic consultation, whereas 49 patients served as controls. The POMS-2 questionnaire was used to measure the total mood disturbance at the end of the consultation. Structural equation modeling showed high internal consistency (Cronbach alpha 0.93, good test-retest reproducibility, and high validity of the psychometric construct (all > 0.80, suggesting a positive effect on patients’ illness experience. The total mood disturbance was lower in the patients exposed to the Decalogue as compared to the controls (1.4±12.1 versus 14.8±27.6, p=0.0010. In an additional questionnaire, patients in the Decalogue group showed a trend towards a better understanding of their state of health (p=0.07. In a cardiologic ambulatory setting, the Decalogue shows good validity and reliability as a tool to improve patients’ illness experience and could have a favorable impact on mood states. These effects might potentially improve patient engagement in care and adherence to therapy, as well as clinical outcome.

  4. Being the Bridge: The Lived Experience of Educating with Online Courseware in the High School Blended Learning Setting

    Science.gov (United States)

    Rambo, Anna Lynn

    2011-01-01

    This dissertation explores the lived experiences of educators who teach in flex model blended learning settings using online, vendor-provided courseware. The tradition of hermeneutic phenomenology grounds this inquiry (Heidegger, 1927/2008). Phenomenological research activities designed by van Manen (1990, 2002) provide the methodological…

  5. Palliative care for cancer patients in a primary health care setting:Bereaved relatives' experience, a qualitative group interview study

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Olesen, Frede; Jensen, Anders Bonde

    2008-01-01

    care setting to explore barriers and facilitators for delivery of good palliative home care. Methods: Three focus group interviews with fourteen bereaved relatives in Aarhus County, Denmark. Results: Three main categories of experience were identified: 1) The health professionals' management, where...

  6. Impact of Vicarious Learning Experiences and Goal Setting on Preservice Teachers' Self-Efficacy for Technology Integration: A Pilot Study.

    Science.gov (United States)

    Wang, Ling; Ertmer, Peggy A.

    This pilot study was designed to explore how vicarious learning experiences and goal setting influence preservice teachers' self-efficacy for integrating technology into the classroom. Twenty undergraduate students who were enrolled in an introductory educational technology course at a large midwestern university participated and were assigned…

  7. Experiences from occupational exposure limits set on aerosols containing allergenic proteins

    DEFF Research Database (Denmark)

    Nielsen, Gunnar; Larsen, Søren; Hansen, Jitka S

    2012-01-01

    Occupational exposure limits (OELs) together with determined airborne exposures are used in risk assessment based managements of occupational exposures to prevent occupational diseases. In most countries, OELs have only been set for few protein-containing aerosols causing IgE-mediated allergies. ...... is available for setting OELs for proteins and protein-containing aerosols where the critical effect is IgE sensitization and IgE-mediated airway diseases.......Occupational exposure limits (OELs) together with determined airborne exposures are used in risk assessment based managements of occupational exposures to prevent occupational diseases. In most countries, OELs have only been set for few protein-containing aerosols causing IgE-mediated allergies...... for setting OELs. Our aim is to analyse prerequisites for setting OELs for the allergenic protein-containing aerosols. Opposite to the key effect of toxicological reactions, two thresholds, one for the sensitization phase and one for elicitation of IgE-mediated symptoms in sensitized individuals, are used...

  8. BellTest and CHSH experiments with more than two settings

    Energy Technology Data Exchange (ETDEWEB)

    Basoalto, R M; Percival, I C [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom)

    2003-07-04

    Strong nonlocality allows signals faster than light. Weak nonlocality is a statistical property of classical events for which there is no realistic local theory. This requires the violation of at least one general Bell inequality. The theory of ideal quantum measurements predicts weak nonlocality but not strong nonlocality. Bell experiment here refers to any experiment designed to demonstrate weak nonlocality. BellTest is a computer program generally available on the Web to help planning and analysis of such Bell experiments. In Mode 1 it obtains general Bell inequalities. In Mode 2 it tests for their violation. We describe its use, with some new results for illustration.

  9. The Multi-Faceted Experience of Empathy in Intellectual Disability Settings: An IPA Study

    OpenAIRE

    Renton, Ben

    2016-01-01

    This research thesis explored the concept of empathy. The specific purpose was to further understand the idea of empathy in relation to the experience of male support workers who provide residential care to adults with intellectual disabilities (ID) and challenging behaviour. The thesis aimed to provide some insights into how support workers develop and extract meaning from their experiences of relationships with clients and the impact of this on their own self-care, namely, self-compassion. ...

  10. The experience from operation of electronic personal dosimetry system at Dukovany, Temelin and Mochovce NPPs after repair of Siemens dosemeters eliminating false doses

    International Nuclear Information System (INIS)

    Malysak, J.; Kocvara, S.; Jurochova, B.; Zelenka, Z.; Schacherl, M.; Zrubec, M.; Kaiser, H.

    2003-01-01

    This presentation summarizes the operational experience of the Electronic Personal Dosimetry Systems installed at Dukovany, Temelin and Mochovce NPPs. The system consists of three basic parts: Electronic personal dosemeters (EPD); Physical layer (HW); Logical layer (SW). Number of false doses before and after correction is presented. This presentation has demonstrated the possibilities of SEOD system and the possibility of easy dose comparison between the individual NPPs after introducing this electronic dosimetry system. Basically, the results of film and electronic dosimetry systems are according to our findings nearly identical. Electronic dosemeter sensitivity to interfering electromagnetic fields is a problem which is easily re-movable. In addition, if we know this problem, these false doses in the SEOD system can be easily revealed (e.g. by investigation of histograms) and repaired

  11. Experience With Routine Vaginal pH Testing in a Family Practice Setting

    Directory of Open Access Journals (Sweden)

    Adriana J. Pavletic

    2004-01-01

    Full Text Available Background: Despite recommendations by Centers for Disease Control and the American College of Obstetricians and Gynecologists, pH testing is infrequently performed during the evaluation of vaginitis. Consequently, little information exists on its use in a primary care setting.

  12. Female Students' Experiences of Computer Technology in Single- versus Mixed-Gender School Settings

    Science.gov (United States)

    Burke, Lee-Ann; Murphy, Elizabeth

    2006-01-01

    This study explores how female students compare learning computer technology in a single- versus a mixed- gender school setting. Twelve females participated, all of whom were enrolled in a grade 12 course in Communications' Technology. Data collection included a questionnaire, a semi-structured interview and focus groups. Participants described…

  13. The Interplay of Space, Place and Identity: Transforming Our Learning Experiences in an Outdoor Setting

    Science.gov (United States)

    Cassidy, Alice L. E. V.; Wright, W. Alan; Strean, William B.; Watson, Gavan P. L.

    2015-01-01

    In this paper, we use a day-long professional development workshop for higher education faculty conducted in an outdoor setting as the starting point for an examination of the value of such activities. We explore the potential benefits, in terms of learning and holistic well-being, of educational activities designed to provide participants with…

  14. The Experiences of Registered Nurses Transitioning from Patient Care Settings to Academia

    Science.gov (United States)

    Gwin, Teresa

    2012-01-01

    Registered nurses (RNs) who make the move from a patient-care service setting to an academic teaching environment often go through a transition phase in their first semesters of teaching that is difficult and traumatic. RNs that go on to higher academic degrees often do so in order to teach in schools of nursing. However, graduate work in nursing…

  15. Use of Web 2.0 Technologies to Enhance Learning Experiences in Alternative School Settings

    Science.gov (United States)

    Karahan, Engin; Roehrig, Gillian

    2016-01-01

    As the learning paradigms are shifting to include various forms of digital technologies such as synchronous, asynchronous, and interactive methods, social networking technologies have been introduced to the educational settings in order to increase the quality of learning environments. The literature suggests that effective application of these…

  16. Special Education Teachers' Experiences Supporting and Supervising Paraeducators: Implications for Special and General Education Settings

    Science.gov (United States)

    Douglas, Sarah N.; Chapin, Shelley E.; Nolan, James F.

    2016-01-01

    In recent years, there has been an increase in paraeducator supports, in large part because students with low incidence disabilities are being included more frequently in general education settings. As a result, special education teachers have been given additional supervisory responsibilities related to directing the work of paraeducators in…

  17. Rank the Voltage across Light Bulbs … Then Set up the Live Experiment

    Science.gov (United States)

    Jacobs, Greg C.

    2018-01-01

    The Tasks Inspired by Physics Education Research (TIPERS) workbooks pose questions in styles quite different from the end-of-chapter problems that those of us of a certain age were assigned back in the days before Netscape. My own spin on TIPERS is not just to do them on paper, but to have students set up the situations in the laboratory to…

  18. Developing Archive Information Packages for Data Sets: Early Experiments with Digital Library Standards

    Science.gov (United States)

    Duerr, R. E.; Yang, M.; Gooyabadi, M.; Lee, C.

    2008-12-01

    The key to interoperability between systems is often metadata, yet metadata standards in the digital library and data center communities have evolved separately. In the data center world NASA's Directory Interchange Format (DIF), the Content Standard for Digital Geospatial Metadata (CSDGM), and most recently the international Geographic Information: Metadata (ISO 19115:2003) are used for descriptive metadata at the data set level to allow catalog interoperability; but use of anything other than repository- based metadata standards for the individual files that comprise a data set is rare, making true interoperability, at the data rather than data set level, across archives difficult. While the Open Archival Information Systems (OAIS) Reference Model with its call for creating Archive Information Packages (AIP) containing not just descriptive metadata but also preservation metadata is slowly being adopted in the community, the PREservation Metadata Implementation Strategies (PREMIS) standard, the only extant OAIS- compliant preservation metadata standard, has scarcely even been recognized as being applicable to the community. The digital library community in the meantime has converged upon the Metadata Encoding and Transmission Standard (METS) for interoperability between systems as evidenced by support for the standard by digital library systems such as Fedora and Greenstone. METS is designed to allow inclusion of other XML-based standards as descriptive and administrative metadata components. A recent Stanford study suggests that a combination of METS with included FGDC and PREMIS metadata could work well for individual granules of a data set. However, some of the lessons learned by the data center community over the last 30+ years of dealing with digital data are 1) that data sets as a whole need to be preserved and described and 2) that discovery and access mechanisms need to be hierarchical. Only once a user has reviewed a data set description and determined

  19. Characteristics of the Nordic Seas overflows in a set of Norwegian Earth System Model experiments

    Science.gov (United States)

    Guo, Chuncheng; Ilicak, Mehmet; Bentsen, Mats; Fer, Ilker

    2016-08-01

    Global ocean models with an isopycnic vertical coordinate are advantageous in representing overflows, as they do not suffer from topography-induced spurious numerical mixing commonly seen in geopotential coordinate models. In this paper, we present a quantitative diagnosis of the Nordic Seas overflows in four configurations of the Norwegian Earth System Model (NorESM) family that features an isopycnic ocean model. For intercomparison, two coupled ocean-sea ice and two fully coupled (atmosphere-land-ocean-sea ice) experiments are considered. Each pair consists of a (non-eddying) 1° and a (eddy-permitting) 1/4° horizontal resolution ocean model. In all experiments, overflow waters remain dense and descend to the deep basins, entraining ambient water en route. Results from the 1/4° pair show similar behavior in the overflows, whereas the 1° pair show distinct differences, including temperature/salinity properties, volume transport (Q), and large scale features such as the strength of the Atlantic Meridional Overturning Circulation (AMOC). The volume transport of the overflows and degree of entrainment are underestimated in the 1° experiments, whereas in the 1/4° experiments, there is a two-fold downstream increase in Q, which matches observations well. In contrast to the 1/4° experiments, the coarse 1° experiments do not capture the inclined isopycnals of the overflows or the western boundary current off the Flemish Cap. In all experiments, the pathway of the Iceland-Scotland Overflow Water is misrepresented: a major fraction of the overflow proceeds southward into the West European Basin, instead of turning westward into the Irminger Sea. This discrepancy is attributed to excessive production of Labrador Sea Water in the model. The mean state and variability of the Nordic Seas overflows have significant consequences on the response of the AMOC, hence their correct representations are of vital importance in global ocean and climate modelling.

  20. Experiences with workplace bullying among athletic trainers in the collegiate setting.

    Science.gov (United States)

    Weuve, Celest; Pitney, William A; Martin, Malissa; Mazerolle, Stephanie M

    2014-01-01

    Workplace bullying (WPB) is a series of persistent negative interactions that affect a clinician's ability to perform his or her role. Although WPB has been studied in other health professions, to date, no information exists pertaining to WPB in athletic training. To determine the prevalence of WPB in the collegiate setting and examine factors that influence its occurrence. Cross-sectional study. Collegiate setting. There were 723 (329 female, 394 male) athletic trainers (ATs) aged 37.5 ± 10.4 years. We collected data via the validated and reliable online Athletic Training Environment Survey. Descriptive statistics were obtained to determine a bullying score for each AT and examine the prevalence of WPB. Chi-square analyses were performed to examine the differences between (1) sex, (2) academic degree level, (3) employment title, and (4) National Athletic Trainers' Association district. A total of 106 participants (14.7%) had a score of 2 or higher, indicating they were bullied in the athletic training setting. Of those bullied, 47 (44.3%) were women and 59 (55.7%) were men. There was no difference between women and men with respect to having experienced bullying (χ(2)1 = 0.068, P = .794). Moreover, no difference existed in the prevalence of bullying among ATs holding various degrees (χ(2)3 = 6.73, P = .081) or among ATs holding various titles within an organization (χ(2)5 = 3.55, P = .616). More (χ(2)1 = 23.77, P = Bullying was experienced by both male and female ATs in the collegiate setting, and a higher number of bullies were male. More research is necessary to explore WPB in other work settings.

  1. International Experience with Key Program Elements of IndustrialEnergy Efficiency or Greenhouse Gas Emissions Reduction Target-SettingPrograms

    Energy Technology Data Exchange (ETDEWEB)

    Price, Lynn; Galitsky, Christina; Kramer, Klaas Jan

    2008-02-02

    Target-setting agreements, also known as voluntary ornegotiated agreements, have been used by a number of governments as amechanism for promoting energy efficiency within the industrial sector. Arecent survey of such target-setting agreement programs identified 23energy efficiency or GHG emissions reduction voluntary agreement programsin 18 countries. International best practice related to target-settingagreement programs calls for establishment of a coordinated set ofpolicies that provide strong economic incentives as well as technical andfinancial support to participating industries. The key program elementsof a target-setting program are the target-setting process,identification of energy-saving technologies and measures usingenergy-energy efficiency guidebooks and benchmarking as well as byconducting energy-efficiency audits, development of an energy-savingsaction plan, development and implementation of energy managementprotocols, development of incentives and supporting policies, monitoringprogress toward targets, and program evaluation. This report firstprovides a description of three key target-setting agreement programs andthen describes international experience with the key program elementsthat comprise such programs using information from the three keytarget-setting programs as well as from other international programsrelated to industrial energy efficiency or GHG emissionsreductions.

  2. Set of thermal neutron-scattering experiments for the Weapons Neutron Research Facility

    International Nuclear Information System (INIS)

    Brugger, R.M.

    1975-12-01

    Six classes of experiments form the base of a program of thermal neutron scattering at the Weapons Neutron Research (WNR) Facility. Three classes are to determine the average microscopic positions of atoms in materials and three are to determine the microscopic vibrations of these atoms. The first three classes concern (a) powder sample neutron diffraction, (b) small angle scattering, and (c) single crystal Laue diffraction. The second three concern (d) small kappa inelastic scattering, (e) scattering surface phonon measurements, and (f) line widths. An instrument to couple with the WNR pulsed source is briefly outlined for each experiment

  3. Information filtering based on corrected redundancy-eliminating mass diffusion.

    Science.gov (United States)

    Zhu, Xuzhen; Yang, Yujie; Chen, Guilin; Medo, Matus; Tian, Hui; Cai, Shi-Min

    2017-01-01

    Methods used in information filtering and recommendation often rely on quantifying the similarity between objects or users. The used similarity metrics often suffer from similarity redundancies arising from correlations between objects' attributes. Based on an unweighted undirected object-user bipartite network, we propose a Corrected Redundancy-Eliminating similarity index (CRE) which is based on a spreading process on the network. Extensive experiments on three benchmark data sets-Movilens, Netflix and Amazon-show that when used in recommendation, the CRE yields significant improvements in terms of recommendation accuracy and diversity. A detailed analysis is presented to unveil the origins of the observed differences between the CRE and mainstream similarity indices.

  4. Generation of covariance data among values from a single set of experiments

    International Nuclear Information System (INIS)

    Smith, D.L.

    1992-01-01

    Modern nuclear data evaluation methods demand detailed uncertainty information for all input results to be considered. It can be shown from basic statistical principles that provision of a covariance matrix for a set of data provides the necessary information for its proper consideration in the context of other included experimental data and/or a priori representations of the physical parameters in question. This paper examines how an experimenter should go about preparing the covariance matrix for any single experimental data set he intends to report. The process involves detailed examination of the experimental procedures, identification of all error sources (both random and systematic); and consideration of any internal discrepancies. Some specific examples are given to illustrate the methods and principles involved

  5. Experience in the operation of the diesel engines of emergency generating sets at Fessenheim and Bugey

    International Nuclear Information System (INIS)

    Dorey, J.

    1982-01-01

    The reliability parameters of the diesel engines in the emergency generating sets at Fessenheim and Bugey have been evaluated using informations assembled through the System for Collecting Reliability Data. The results thus obtained have been compared with those resulting from a previous theoretical study. Secondly, an examination of the incident report shows up certain difficulties in the evaluation of reliability that are specific to stand-by equipment [fr

  6. Set up of a method for the adjustment of resonance parameters on integral experiments

    International Nuclear Information System (INIS)

    Blaise, P.

    1996-01-01

    Resonance parameters for actinides play a significant role in the neutronic characteristics of all reactor types. All the major integral parameters strongly depend on the nuclear data of the isotopes in the resonance-energy regions.The author sets up a method for the adjustment of resonance parameters taking into account the self-shielding effects and restricting the cross section deconvolution problem to a limited energy region. (N.T.)

  7. Evolving Non-Dominated Parameter Sets for Computational Models from Multiple Experiments

    Science.gov (United States)

    Lane, Peter C. R.; Gobet, Fernand

    2013-03-01

    Creating robust, reproducible and optimal computational models is a key challenge for theorists in many sciences. Psychology and cognitive science face particular challenges as large amounts of data are collected and many models are not amenable to analytical techniques for calculating parameter sets. Particular problems are to locate the full range of acceptable model parameters for a given dataset, and to confirm the consistency of model parameters across different datasets. Resolving these problems will provide a better understanding of the behaviour of computational models, and so support the development of general and robust models. In this article, we address these problems using evolutionary algorithms to develop parameters for computational models against multiple sets of experimental data; in particular, we propose the `speciated non-dominated sorting genetic algorithm' for evolving models in several theories. We discuss the problem of developing a model of categorisation using twenty-nine sets of data and models drawn from four different theories. We find that the evolutionary algorithms generate high quality models, adapted to provide a good fit to all available data.

  8. Priority setting in health care: trends and models from Scandinavian experiences.

    Science.gov (United States)

    Hofmann, Bjørn

    2013-08-01

    The Scandinavian welfare states have public health care systems which have universal coverage and traditionally low influence of private insurance and private provision. Due to raises in costs, elaborate public control of health care, and a significant technological development in health care, priority setting came on the public agenda comparatively early in the Scandinavian countries. The development of health care priority setting has been partly homogeneous and appears to follow certain phases. This can be of broader interest as it may shed light on alternative models and strategies in health care priority setting. Some general trends have been identified: from principles to procedures, from closed to open processes, and from experts to participation. Five general approaches have been recognized: The moral principles and values based approach, the moral principles and economic assessment approach, the procedural approach, the expert based practice defining approach, and the participatory practice defining approach. There are pros and cons with all of these approaches. For the time being the fifth approach appears attractive, but its lack of true participation and the lack of clear success criteria may pose significant challenges in the future.

  9. Seeking to understand lived experiences of personal recovery in personality disorder in community and forensic settings - a qualitative methods investigation.

    Science.gov (United States)

    Shepherd, Andrew; Sanders, Caroline; Shaw, Jenny

    2017-08-01

    Understandings of personal recovery have emerged as an alternative framework to traditional ideas of clinical progression, or symptom remission, in clinical practice. Most research in this field has focussed on the experience of individuals suffering with psychotic disorders and little research has been conducted to explore the experience of individuals with a personality disorder diagnosis, despite the high prevalence of such difficulties. The nature of the personality disorder diagnosis, together with high prevalence rates in forensic settings, renders the understanding of recovery in these contexts particularly problematic. The current study seeks to map out pertinent themes relating to the recovery process in personality disorder as described by individuals accessing care in either community or forensic settings. Individual qualitative interviews were utilised to explore the lived experience of those receiving a personality disorder diagnosis and accessing mental health care in either community or forensic settings. A thematic analysis was conducted to identify shared concepts and understanding between participants. Fourty-one individual participant interviews were conducted across forensic and community settings. Recovery was presented by participants as a developing negotiated understanding of the self, together with looked for change and hope in the future. Four specific themes emerged in relation to this process: 1. Understanding early lived experience as informing sense of self 2. Developing emotional control 3. Diagnosis as linking understanding and hope for change 4. The role of mental health services. Through considering personal recovery in personality disorder as a negotiated understanding between the individual, their social networks and professionals this study illustrates the complexity of working through such a process. Clarity of understanding in this area is essential to avoid developing resistance in the recovery process. Understanding of

  10. Women's Leadership Development in Sport Settings: Factors Influencing the Transformational Learning Experience of Female Managers

    Science.gov (United States)

    Megheirkouni, Majd; Roomi, Muhammad Azam

    2017-01-01

    Purpose: This study explores the positive and negative factors influencing transformational learning experiences of female leaders in women's leadership development programmes in sports and examines the differences in learning/change factors cited by those who successfully addressed them and those who failed. Design/methodology/approach: The study…

  11. Initial experience with transperitoneal laparoscopic nephrectomy in an Irish hospital setting.

    LENUS (Irish Health Repository)

    Forde, J C

    2009-08-01

    Laparoscopic nephrectomy has gained widespread acceptance as a treatment for both benign and malignant conditions and is becoming increasingly popular in Irish hospitals. We report a single surgeon, single centre experience with 20 consecutive laparoscopic nephrectomies comparing them to 20 open cases performed prior to the establishment of a laparoscopic service.

  12. Lived experience of working with female patients in a high-secure mental health setting.

    Science.gov (United States)

    Beryl, Rachel; Davies, Jason; Völlm, Birgit

    2018-02-01

    Women's secure hospitals are often considered to be stressful and demanding places to work, with these environments characterized as challenging and violent. However, the staff experience of working in this environment is not well represented in the literature. The present study is the first to examine the 'lived experience' of seven nurses working in the National High Secure Healthcare Service for Women. Interview transcripts were analysed with the use of interpretative phenomenological analysis, and the findings presented within four superordinate themes 'horror', 'balancing acts', 'emotional hard labour', and 'the ward as a community'. These themes all depict the challenges that participants experience in their work, the ways in which they cope with these challenges, and how they make sense of these experiences. A meta-theme of 'making sense by understanding why' is also presented, which represents the importance for participants to attempt to make sense of the tensions and challenges by formulating a fuller meaning. The findings suggest the importance of workforce development in terms of allowing sufficient protected time for reflection and formulation (e.g. within the format of group supervision or reflective practice), and for staff-support mechanisms (e.g. clinical supervision, counselling, debriefs) to be inbuilt into the ethos of a service, so as to provide proactive support for staff 'on the frontline'. © 2016 Australian College of Mental Health Nurses Inc.

  13. Risks: diagnosing and eliminating

    Directory of Open Access Journals (Sweden)

    Yuriy A. Tikhomirov

    2016-01-01

    Full Text Available Objective to develop conceptual theoretical and legal provisions and scientific recommendations on the identification analysis and elimination of risk. Methods universal dialectic method of cognition as well as scientific and private research methods based on it. Results the system was researched of risks diagnostics in the legal sphere and mechanism of influencing the quotrisk situationsquot and their consequences damage to the environment and harm to society. The concept of risk in the legal sphere was formulated the author39s classification of risks in the legal sphere is presented. The rules of analysis evaluation and prevention of risks and the model risk management framework are elaborated. Scientific novelty the mechanism for the identification analysis and elimination of risk has been developed and introduced into scientific circulation the author has proposed the classification and types of risks the reasons and the conditions promoting the risk occurrence. Practical significance the provisions and conclusions of the article can be used in the scientific lawmaking and lawenforcement activity as well as in the educational process of higher educational establishments. nbsp

  14. South Asian immigrant women's experiences of being respected within cancer treatment settings.

    Science.gov (United States)

    Singh-Carlson, Savitri; Neufeld, Anne; Olson, Joanne

    2010-01-01

    The purpose of this focused ethnographic inquiry was to examine South Asian immigrant women's experiences and perceptions of respect within health professional-client relationships in the context of a Canadian outpatient treatment clinic. Characteristics of respect described by 11 women interviewed were the meaning of respect, health professional's way of being, their way of attending to the person, and their way of talking. Language, cultural values and beliefs, along with underlying societal, individual and institutional factors that coexist with health professionals' ability to create respect were some of the dimensions that influenced how immigrant women experienced respect. Health professionals' capacity to acknowledge South Asian immigrant women as individuals helped to formulate/construct respect for their individual identities. The need to be respected for 'my social identity' as an immigrant woman with cancer was woven throughout women's stories, illustrated by their personal experiences and perspectives.

  15. Earth Radiation Budget Experiment (ERBE) Data Sets for Global Environment and Climate Change Studies

    Science.gov (United States)

    Bess, T. Dale; Carlson, Ann B.; Denn, Fredrick M.

    1997-01-01

    For a number of years there has been considerable interest in the earth's radiation budget (ERB) or energy balance, and entails making the best measurements possible of absorbed solar radiation, reflected shortwave radiation (RSW), thermal outgoing longwave radiation (OLR), and net radiation. ERB data are fundamental to the development of realistic climate models and studying natural and anthropogenic perturbations of the climate. Much of the interest and investigations in the earth's energy balance predated the age of earth-orbiting satellites (Hunt et al., 1986). Beginning in the mid 1960's earth-orbiting satellites began to play an important role in making measurements of the earth's radiation flux although much effort had gone into measuring ERB parameters prior to 1960 (House et al., 1986). Beginning in 1974 and extending until the present time, three different satellite experiments (not all operating at the same time) have been making radiation budget measurements almost continually in time. Two of the experiments were totally dedicated to making radiation budget measurements of the earth, and the other experiment flown on NOAA sun-synchronous AVHRR weather satellites produced radiation budget parameters as a by-product. The heat budget data from the AVHRR satellites began collecting data in June 1974 and have operated almost continuously for 23 years producing valuable data for long term climate monitoring.

  16. Visceral Leishmaniasis : Potential for Control and Elimination

    NARCIS (Netherlands)

    E.A. le Rutte (Epke)

    2018-01-01

    markdownabstractOver the past years there has been a steep increase in awareness of visceral leishmaniasis (VL); many large-scale interventions are being implemented and targets for control and elimination have been set. In this thesis the potential of reaching these targets will be explored. To

  17. Investigating the experience of outdoor and adventurous project work in an educational setting using a self-determination framework

    OpenAIRE

    Sproule, J.; Martindale, R.; Wang, J.; Allison, P.; Nash, C.; Gray, S.

    2013-01-01

    The purpose of this study was to carry out a preliminary investigation to explore the use ofoutdoor and adventurous project work (PW) within an educational setting. Specifically, differencesbetween the PW and normal academic school experiences were examined using a selfdeterminationtheory framework integrated with a goal orientation and psychological skills perspective.Additionally, an exploratory investigation was carried out to examine the extent to which key motivation constructs predicted...

  18. Setting up the photoluminescence laboratory at ISOLDE & Perturbed Angular Correlation spectroscopy for BIO physics experiments using radioactive ions

    CERN Document Server

    Savva, Giannis

    2016-01-01

    The proposed project I was assigned was to set up the photoluminescence (PL) laboratory at ISOLDE, under the supervision of Karl Johnston. My first week at CERN coincided with the run of a BIO physics experiment using radioactive Hg(II) ions in which I also participated under the supervision of Stavroula Pallada. This gave me the opportunity to work in two projects during my stay at CERN and in the present report I describe briefly my contribution to them.

  19. Setting waste isolation times into a geological context: some experience with natural analogues in public information

    International Nuclear Information System (INIS)

    Fritschi, Markus

    2008-01-01

    The concept of geological repositories: Permanent protection of humans and the environment by long-term passive isolation of the radioactive materials from the environment. Permanent means until radioactivity has decayed to insignificant levels (Many tens of thousands of years up to one million years into the future). Human experience with timescales: - Personal: Some 10 years, maybe up to 2 to (3) generations; - 'Rapid' (normally experienced as slow) and relevant changes with regard to personal well-being during this time span; - 100 years of European history; - Human History up to 5,000 years: but relevant to experience? So there is a complete mismatch of personal experience with the question addressed in the safety case. Understandable explanation of a geological repository: - Why is a geological repository necessary? - Why are geological repositories safe? - How can one be sure, what happens in 100,000 years? Radioactive waste must be disposed of in a way to ensure permanent protection of humans and the environment (Swiss Nuclear Energy Law). A Containment is thus necessary. Today's containment (storage) needs maintenance, but how about stability of society? How about the future development on the surface where we live? Passive safety is based on multiple barrier system: passive containment without the need of maintenance in a geological environment. Requirements on the host rock and the geosphere: Sound science and expertise is available for all the components. The need for translation: What pictures do you use to explain the functioning of a geological repository over long time scales? Pictures, Symbols, 'Analogues' must be adapted to the specific situation in a country. So whatever may happen on the surface over the next one million years: Time stands still in the underground

  20. Experiences with fast breeder reactor education in laboratory and short course settings

    International Nuclear Information System (INIS)

    Waltar, A.E.

    1983-01-01

    The breeder reactor industry throughout the world has grown impressively over the last two decades. Despite the uncertainties in some national programs, breeder reactor technology is well established on a global scale. Given the magnitude of this technological undertaking, there has been surprisingly little emphasis on general breeder reactor education - either at the university or laboratory level. Many universities assume the topic too specialized for including appropriate courses in their curriculum - thus leaving students entering the breeder reactor industry to learn almost exclusively from on-the-job experience. The evaluation of four course presentations utilizing visual aids is presented

  1. Learning Physics Down a Slide: A Set of Experiments to Measure Reality Through Smartphone Sensors

    Directory of Open Access Journals (Sweden)

    Lander Martínez

    2014-06-01

    Full Text Available During the last decade, the use of smartphones among teenagers in their daily life has grown significantly. Despite the efforts to use tablets in learning processes, these teenagers are often prompted to switch off their personal devices before entering a classroom. Moreover, most mobile learning applications do not take advantage of the device sensors (e.g., touchscreen, accelerometer, or gyroscope. In order to overcome this situation, we have developed Serious Physics, a free mobile app that allows using smartphones as measuring tools to conduct experiments on Physics.

  2. Reciprocal Education Experiences In Two GK-12 Programs: Teachers Learning And Students Teaching In Diverse Settings

    Science.gov (United States)

    Mayo, M.; Williams, C.; Rodriguez, T.; Greely, T.; Pyrtle, A. J.; Rivera-Rentas, A. L.; Vilches, M.

    2004-12-01

    The National Science Foundation's Graduate Teaching Fellows in K-12 Education (GK-12) Program has enabled science, technology, engineering and mathematics (STEM) graduate schools across the country to become more active in local area K-12 schools. An overview of a graduate student's experiences, insights gained and lessons learned as a Fellow in the 2003-2004 Universidad Metropolitana's (UMET) environmental science and the 2004-2005 University of South Florida's (USF) ocean science GK-12 Programs is presented. The major goals of the 2003-2004 UMET GK-12 Program were 1) to enrich environmental science teaching and learning via a thematic approach in eight local public schools and 2) to provide UMET graduate students with exposure to teaching methodologies and practical teaching experience. Utilizing examples from local environments in and nearby Carolina, Puerto Rico to teach key science principles at Escuela de la Comunidad Juana Rodriguez Mundo provided numerous opportunities to relate science topics to students' daily life experiences. By 2004, the UMET GK-12 Program had successfully engaged the entire student body (primarily comprised of bilingual minority kindergarten to sixth graders), teachers and school administrators in environment-focused teaching and learning activities. Examples of such activities include tree planting projects to minimize local erosion, conducting a science fair for the first time in many years, and numerous opportunities to experience what "real scientists do" while conducting environmental science investigations. During the 2004-2005 academic year, skills, insights and lessons learned as a UMET GK-12 Fellow are being further enhanced through participation in the USF GK-12 OCEANS Program. The overall objectives of the 2004-2005 USF GK-12 OCEANS assignment at Madeira Beach Elementary School in Saint Petersburg, Florida are to 1) engage students from various ethnic backgrounds and cultures in hands-on science activities, 2) enhance the

  3. Results from a Set of Three-Dimensional Numerical Experiments of a Hot Jupiter Atmosphere

    Science.gov (United States)

    Mayne, Nathan J.; Debras, Flirian; Baraffe, Isabelle; Thuburn, John; Amundsen, David S.; Acreman, David M.; Smith, Chris; Browning, Matthew K.; Manners, James; Wood Nigel

    2017-01-01

    We present highlights from a large set of simulations of a hot Jupiter atmosphere, nominally based on HD 209458b, aimed at exploring both the evolution of the deep atmosphere, and the acceleration of the zonal flow or jet. We find the occurrence of a super-rotating equatorial jet is robust to changes in various parameters, and over long timescales, even in the absence of strong inner or bottom boundary drag. This jet is diminished in one simulation only, where we strongly force the deep atmosphere equator-to-pole temperature gradient over long timescales. Finally, although the eddy momentum fluxes in our atmosphere show similarities with the proposed mechanism for accelerating jets on tidally-locked planets, the picture appears more complex. We present tentative evidence for a jet driven by a combination of eddy momentum transport and mean flow.

  4. Challenges with controlling varicella in prison settings: experience of California, 2010 to 2011.

    Science.gov (United States)

    Leung, Jessica; Lopez, Adriana S; Tootell, Elena; Baumrind, Nikki; Mohle-Boetani, Janet; Leistikow, Bruce; Harriman, Kathleen H; Preas, Christopher P; Cosentino, Giorgio; Bialek, Stephanie R; Marin, Mona

    2014-10-01

    This article describes the epidemiology of varicella in one state prison in California during 2010 and 2011, control measures implemented, and associated costs. Eleven varicella cases were reported, of which nine were associated with two outbreaks. One outbreak consisted of three cases and the second consisted of six cases with two generations of spread. Among exposed inmates serologically tested, 98% (643/656) were varicella-zoster virus seropositive. The outbreaks resulted in > 1,000 inmates exposed, 444 staff exposures, and > $160,000 in costs. The authors documented the challenges and costs associated with controlling and managing varicella in a prison setting. A screening policy for evidence of varicella immunity for incoming inmates and staff and vaccination of susceptible persons has the potential to mitigate the impact of future outbreaks and reduce resources necessary to manage cases and outbreaks. © The Author(s) 2014.

  5. Challenges with controlling varicella in prison settings: Experience of California, 2010–2011

    Science.gov (United States)

    Leung, Jessica; Lopez, Adriana S.; Tootell, Elena; Baumrind, Nikki; Mohle-Boetani, Janet; Leistikow, Bruce; Harriman, Kathleen H.; Preas, Christopher P.; Cosentino, Giorgio; Bialek, Stephanie R.; Marin, Mona

    2015-01-01

    We describe the epidemiology of varicella in one state prison in California during 2010–2011, control measures implemented, and associated costs. Eleven varicella cases were reported, 9 associated with 2 outbreaks. One outbreak consisted of 3 cases and the second consisted of 6 cases with 2 generations of spread. Among exposed inmates serologically tested, 98% (643/656) were VZV sero-positive. The outbreaks resulted in >1,000 inmates exposed, 444 staff exposures, and >$160,000 in costs. We documented the challenges and costs associated with controlling and managing varicella in a prison setting. A screening policy for evidence of varicella immunity for incoming inmates and staff and vaccination of susceptible persons has the potential to mitigate the impact of future outbreaks and reduce resources necessary for managing cases and outbreaks. PMID:25201912

  6. Impact of ICTs on Open and Distance Learning in a Developing Country Setting: The Philippine experience

    Directory of Open Access Journals (Sweden)

    Melinda dela Pena Bandalaria

    2007-03-01

    Full Text Available The influence of the information and communication technologies (ICTs in open and distance learning (ODL in a developing country, the Philippines, is critically evaluated in this paper. Specifically, this paper examines how ICTs have influenced or shaped the development of ODL in this country. Also examined are the different stages or generations of distance education (DE in the Philippines, which are characterized mainly by the dominant technology used for the delivery of instructional content and student support services. The different ICTs being used in ODL and their specific applications to the various facets of this mode of delivery are also described. Also included is an examination on how quality of education is ensured in a technology-driven system of teaching and learning, which includes, among others, the employment of the ‘quality circle approach’ in the development of courses and learning packages, and the provision of appropriate technologies to perform academic processes and achieve institutional goals. Experiences of the various universities in the Philippines are also cited in this paper. Lessons have been drawn from the ODL experience to guide educators from other developing countries.

  7. Patient experience and use of probiotics in community-based health care settings.

    Science.gov (United States)

    Chin-Lee, Blake; Curry, William J; Fetterman, John; Graybill, Marie A; Karpa, Kelly

    2014-01-01

    To investigate patient experience with probiotics and factors that influence probiotic use among adult patients. Patients were invited to complete a questionnaire that assessed their experiences and opinions regarding probiotics. Questionnaires were distributed to patients seeking primary health care services at a family and community medicine practice site and a community pharmacy. Patients were invited to complete the questionnaire while awaiting the physician or waiting for prescriptions to be filled. Overall, 162 surveys were completed and returned (66% response rate) from patients aged 18 to 89 years of age (mean 49.5 years). Most patients (n=107; 65%) were familiar with the term "probiotic", and 49 patients (29.9%) had personally used the supplements in the past. Of those who had used probiotics, the majority (57%) had used the supplements to maintain "good gastrointestinal health" and most (59%) felt that the supplements had been beneficial. However, most (59%) had not informed their health care provider about their use of the supplements. Use of probiotic supplements is common among consumers, but may not be reported to health care providers.

  8. Patient experience and use of probiotics in community-based health care settings

    Directory of Open Access Journals (Sweden)

    Chin-Lee B

    2014-10-01

    Full Text Available Blake Chin-Lee,1 William J Curry,1 John Fetterman,2 Marie A Graybill,1 Kelly Karpa2 1Department of Family and Community Medicine, 2Department of Pharmacology, Pennsylvania State University, College of Medicine Hershey, PA, USA Objective: To investigate patient experience with probiotics and factors that influence probiotic use among adult patients.Method: Patients were invited to complete a questionnaire that assessed their experiences and opinions regarding probiotics. Questionnaires were distributed to patients seeking primary health care services at a family and community medicine practice site and a community pharmacy. Patients were invited to complete the questionnaire while awaiting the physician or waiting for prescriptions to be filled. Results: Overall, 162 surveys were completed and returned (66% response rate from patients aged 18 to 89 years of age (mean 49.5 years. Most patients (n=107; 65% were familiar with the term “probiotic”, and 49 patients (29.9% had personally used the supplements in the past. Of those who had used probiotics, the majority (57% had used the supplements to maintain “good gastrointestinal health” and most (59% felt that the supplements had been beneficial. However, most (59% had not informed their health care provider about their use of the supplements.Conclusion: Use of probiotic supplements is common among consumers, but may not be reported to health care providers. Keywords: primary care, community pharmacy, probiotic

  9. Organisational aspects of mammography screening in digital settings: First experiences of Luxembourg

    International Nuclear Information System (INIS)

    Shannoun, F.; Schanck, J. M.; Scharpantgen, A.; Wagnon, M. C.; Ben Daoud, M.; Back, C.

    2008-01-01

    Luxembourg has been conducting a breast cancer screening programme since 1992, like a large number of other European countries, as early detection and treatment of breast cancer have been proven to reduce mortality. The majority of these screening programmes are based on analogue X-ray technology and have optimised their organisation of transporting, archiving and reading with respect to films. Last decade is marked by enormous developments in digital mammography. Different technologies such as flat panel-, computed radiography- and scanning systems became available. Digital mammography is expected to have a major impact on quality and organisation of breast cancer screening programmes. Screening programmes are now faced with a huge challenge of incorporating the digital technology, including implementation of electronic image exchange, conception of new electronic work-flow, establishing adapted quality assurance programmes and training of radiologists and technical personnel. Initial experiences of the Luxembourg approach in organising digital mammography screening and its quality assurance are reported. (authors)

  10. Illness experiences of diabetes in the context of malaria in settings experiencing double burden of disease in southeastern Tanzania.

    Directory of Open Access Journals (Sweden)

    Emmy Metta

    Full Text Available Tanzania is doubly burdened with both non-communicable and infectious diseases, but information on how Tanzanians experience the co-existence of these conditions is limited. Using Kleinman's eight prompting questions the study synthesizes explanatory models from patients to describe common illness experiences of diabetes in a rural setting where malaria is the predominant health threat.We conducted 17 focus group discussions with adult members of the general community, diabetes patients, neighbours and relatives of diabetes patients to gain insight into shared experiences. To gain in-depth understanding of the individual illness experiences, we conducted 41 in-depth interviews with malaria or diabetes patients and family members of diabetes patients. The analysis followed grounded theory principles and the illness experiences were derived from the emerging themes.The illness experiences showed that malaria and diabetes are both perceived to be severe and fatal conditions, but over the years people have learned to live with malaria and the condition is relatively manageable compared with diabetes. In contrast, diabetes was perceived as a relatively new disease, with serious life-long consequences. Uncertainty, fear of those consequences, and the increased risk for severe malaria and other illnesses impacted diabetes patients and their families' illness experiences. Unpredictable ailments and loss of consciousness, memory, libido, and functional incapability were common problems reported by diabetes patients. These problems had an effect on their psychological and emotional health and limited their social life. Direct and indirect costs of illness pushed individuals and their families further into poverty and were more pronounced for diabetes patients.The illness experiences revealed both malaria and diabetes as distressing conditions, however, diabetes showed a higher level of stress because of its chronicity. Strategies for supporting social

  11. Formal reporting of second-opinion CT interpretation: experience and reimbursement in the emergency department setting.

    Science.gov (United States)

    Jeffers, Adam B; Saghir, Amina; Camacho, Marc

    2012-06-01

    The purpose of this study is to describe a system for formally reporting second-opinion interpretations of CT imaging exams accompanying patients transferred emergently to a tertiary care center. Second-opinion interpretations of cross-sectional imaging exams rendered in the emergency department setting over 6 months spanning 22 September 2009 to 22 March 2010 were reviewed and tallied by two radiologists and a research assistant, with a focus on professional fee reimbursement rates. A more in depth review was performed of those exams for which a clinical referral request form was available, detailing such information as the clinical history, content and source of available initial interpretation, and congruity of the initial interpretation with clinical data. Discrepancies between outside and second-opinion interpretations were also assessed. This quality assurance exercise was reviewed by our institutional review board, which waived formal informed consent. Formal second-opinion interpretation was rendered for 370 exams on 198 patients (mean age, 53.5 years; 45.1% female), received from 50 referring facilities. Head CT was the most common imaging exam referred for second opinion. Forty-one of 370 exams (11%) were submitted for self-pay, and 43 (12%) were written off as free care. The remaining 286 exams (77%) were submitted for reimbursement of the professional fee only. Ultimately, of the 286 exams submitted, 260 (91%) were reimbursed for professional fees, 199 (70%) on the initial submission. Of 29 health plans contracted with our facility, 22 ultimately approved all claims made. Three plans denied all claims submitted. The largest payer was Medicare, which reimbursed 88 of 90 submitted claims. Clinical intake forms were available for 184 exams on 107 patients (mean age, 52.7 years, 43.0% female). Trauma was the most common indication, or history, provided (55% of 184 exams, 40% of 107 patients). An outside report of some form was available for 112 of the 184

  12. Experiences of nurses working in a rural primary health-care setting in Mopani district, Limpopo Province

    Directory of Open Access Journals (Sweden)

    MP Mohale

    2008-09-01

    Full Text Available Professional nurses working in rural, primary health-care settings are experiencing burnout due to serious shortages of personnel. This is exacerbated by the brain drain of nurses leaving the country. Rural settings are resource constrained in terms of personnel and equipment. This results in dissatisfaction among nurses due to the unbearable working conditions which result in stress and frustration. A qualitative, explorative, descriptive study was conducted to explore and describe the experiences of nurses working in a rural primary health-care setting in the greater Letaba sub district in Limpopo Province. Purposive sampling was used to identify the participants. Data was collected in the form of in-depth interviews. The study revealed that nurses working in primary health-care settings were experiencing emotional and physical strain as a result of the shortage of human resources. It was recommended that policies that meet the health-care needs of rural communities be developed, and that strategies to retain professional nurses in primary health-care settings be formulated.

  13. Do Fitness Apps Need Text Reminders? An Experiment Testing Goal-Setting Text Message Reminders to Promote Self-Monitoring.

    Science.gov (United States)

    Liu, Shuang; Willoughby, Jessica F

    2018-01-01

    Fitness tracking apps have the potential to change unhealthy lifestyles, but users' lack of compliance is an issue. The current intervention examined the effectiveness of using goal-setting theory-based text message reminders to promote tracking activities on fitness apps. We conducted a 2-week experiment with pre- and post-tests with young adults (n = 50). Participants were randomly assigned to two groups-a goal-setting text message reminder group and a generic text message reminder group. Participants were asked to use a fitness tracking app to log physical activity and diet for the duration of the study. Participants who received goal-setting reminders logged significantly more physical activities than those who only received generic reminders. Further, participants who received goal-setting reminders liked the messages and showed significantly increased self-efficacy, awareness of personal goals, motivation, and intention to use the app. The study shows that incorporating goal-setting theory-based text message reminders can be useful to boost user compliance with self-monitoring fitness apps by reinforcing users' personal goals and enhancing cognitive factors associated with health behavior change.

  14. Experiences with developing and implementing a virtual clinic for glaucoma care in an NHS setting.

    Science.gov (United States)

    Kotecha, Aachal; Baldwin, Alex; Brookes, John; Foster, Paul J

    2015-01-01

    This article describes the development of a virtual glaucoma clinic, whereby technicians collect information for remote review by a consultant specialist. This was a hospital-based service evaluation study. Patients suitable for the stable monitoring service (SMS) were low-risk patients with "suspect", "early"-to-"moderate" glaucoma who were deemed stable by their consultant care team. Three technicians and one health care assistant ran the service. Patients underwent tests in a streamlined manner in a dedicated clinical facility, with virtual review of data by a consultant specialist through an electronic patient record. Feasibility of developing a novel service within a UK National Health Service setting and improvement of patient journey time within the service were studied. Challenges to implementation of virtual clinic include staffing issues and use of information technology. Patient journey time within the SMS averaged 51 minutes, compared with 92 minutes in the glaucoma outpatient department. Patient satisfaction with the new service was high. Implementing innovation into existing services of the National Health Service is challenging. However, the virtual clinic showed an improved patient journey time compared with that experienced within the general glaucoma outpatient department. There exists a discrepancy between patient management decisions of reviewers, suggesting that some may be more risk averse than others when managing patients seen within this model. Future work will assess the ability to detect progression of disease in this model compared with the general outpatient model of care.

  15. Setting up a parathyroid multidisciplinary team meeting: one year's experience, outcomes and learning points.

    Science.gov (United States)

    Hancox, S H; Sinnott, J D; Kirkland, P; Lipscomb, D; Owens, E; Howlett, D C

    2018-03-01

    A parathyroid multidisciplinary team meeting was set up at East Sussex Healthcare Trust, from November 2014 to November 2015, in order to improve and streamline services for patients with parathyroid pathology. Data were collected on all new referrals for hyperparathyroidism, and on the outcomes for each patient discussed at the meeting, including the number of operations and management outcomes. A survey was sent out to the members of the multidisciplinary team meeting to determine their perception of its effectiveness. Seventy-nine new referrals were discussed throughout the year; 43 per cent were recommended for surgery, 41 per cent had a trial of conservative or medical management before re-discussion, and 16 per cent required further imaging. Ninety-two per cent of patients underwent an ultrasound, single-photon emission computed tomography/computed tomography or nuclear medicine (sestamibi) scan prior to the meeting. All ultrasound scans were performed by a consultant radiologist. The multidisciplinary team meeting has been successful, with perceived benefits for patients, improved imaging evaluation and efficiency of referral pathways, leading to more appropriate patient management.

  16. Design expertise: how knowledge, experience, and skills set expert architects apart from novices

    Directory of Open Access Journals (Sweden)

    Wilson Florio

    2013-12-01

    Full Text Available The analysis of the design process under the cognitive theory proposes an understanding of internal mental processes, based on the processing of information derived from the knowledge, experience, and skills of the architect. Although it is difficult to trace the sources of the architects’ thoughts, the drawings they produce facilitate the identification of the successive approaches used during the design process. Since cognition, or the act of thinking, itself cannot be observed, we can only analyze the results of the thought that guided cognitive actions. The steps of the research conducted by the authors of this article were as follows: 1 three experienced architects and three novices were filmed individually, for 60 minutes, while they carried out a project; 2 these professionals were interviewed for 30 minutes after the end of the project; 3 physical, perceptual, functional, and conceptual cognitive actions were identified by segmenting and codifying the actions performed during the filming; 4 these data were translated into graphs; 5 the differences between novices and experts were identified from the response time in each of the four levels of cognitive actions; and 6 the qualitative analysis of actions and effectiveness were assessed. Experienced architects quickly recovered from their memory-specific knowledge and, based on scant evidence, select, combine, and generate different ideas during the design process. They can do so because the knowledge encoded in typical situations enables them to make faster and better supported decisions. Expertise is the human faculty that allows performance of cognitive operations that involve daily thinking and doing with quality, speed, and vitality. An expert is someone who performs a task significantly better than most other people do. We concluded that expert architects perform projects with greater ease than beginners, not only because they have more knowledge and experience, but

  17. Experiences with developing and implementing a virtual clinic for glaucoma care in an NHS setting

    Directory of Open Access Journals (Sweden)

    Kotecha A

    2015-10-01

    Full Text Available Aachal Kotecha,1,2 Alex Baldwin,1 John Brookes,1 Paul J Foster1,2 1Glaucoma Service, Moorfields Eye Hospital National Health Service Foundation Trust, 2NIHR BRC, Moorfields Eye Hospital, NHS Foundation Trust and UCL Institute of Ophthalmology, University College London, London, UK Background: This article describes the development of a virtual glaucoma clinic, whereby technicians collect information for remote review by a consultant specialist.Design and Methods: This was a hospital-based service evaluation study. Patients suitable for the stable monitoring service (SMS were low-risk patients with “suspect”, “early”-to-“moderate” glaucoma who were deemed stable by their consultant care team. Three technicians and one health care assistant ran the service. Patients underwent tests in a streamlined manner in a dedicated clinical facility, with virtual review of data by a consultant specialist through an electronic patient record.Main outcome measure: Feasibility of developing a novel service within a UK National Health Service setting and improvement of patient journey time within the service were studied.Results: Challenges to implementation of virtual clinic include staffing issues and use of information technology. Patient journey time within the SMS averaged 51 minutes, compared with 92 minutes in the glaucoma outpatient department. Patient satisfaction with the new service was high.Conclusion: Implementing innovation into existing services of the National Health Service is challenging. However, the virtual clinic showed an improved patient journey time compared with that experienced within the general glaucoma outpatient department. There exists a discrepancy between patient management decisions of reviewers, suggesting that some may be more risk averse than others when managing patients seen within this model. Future work will assess the ability to detect progression of disease in this model compared with the general

  18. Statistical homogeneity tests applied to large data sets from high energy physics experiments

    Science.gov (United States)

    Trusina, J.; Franc, J.; Kůs, V.

    2017-12-01

    Homogeneity tests are used in high energy physics for the verification of simulated Monte Carlo samples, it means if they have the same distribution as a measured data from particle detector. Kolmogorov-Smirnov, χ 2, and Anderson-Darling tests are the most used techniques to assess the samples’ homogeneity. Since MC generators produce plenty of entries from different models, each entry has to be re-weighted to obtain the same sample size as the measured data has. One way of the homogeneity testing is through the binning. If we do not want to lose any information, we can apply generalized tests based on weighted empirical distribution functions. In this paper, we propose such generalized weighted homogeneity tests and introduce some of their asymptotic properties. We present the results based on numerical analysis which focuses on estimations of the type-I error and power of the test. Finally, we present application of our homogeneity tests to data from the experiment DØ in Fermilab.

  19. Setting up experimental incineration system for low-level radioactive samples and combustion experiments

    International Nuclear Information System (INIS)

    Yumoto, Yasuhiro; Hanafusa, Tadashi; Nagamatsu, Tomohiro; Okada, Shigeru

    1997-01-01

    An incineration system was constructed which were composed of a combustion furnace (AP-150R), a cyclone dust collector, radioisotope trapping and measurement apparatus and a radioisotope storage room built in the first basement of the Radioisotope Center. Low level radioactive samples (LLRS) used for the combustion experiment were composed of combustible material or semi-combustible material containing 500 kBq of 99m TcO 4 or 23.25 kBq of 131 INa. The distribution of radioisotopes both in the inside and outside of combustion furnace were estimated. We measured radioactivity of a smoke duct gas in terminal exit of the exhaust port. In case of combustion of LLRS containing 99m TcO 4 or 131 INa, concentration of radioisotopes at the exhaust port showed less than legal concentration limit of these radioisotopes. In cases of combustion of LLRS containing 99m TcO 4 or 131 INa, decontamination factors of the incineration system were 120 and 1.1, respectively. (author)

  20. Policy on manager involvement in work re-integration: managers' experiences in a Canadian setting.

    Science.gov (United States)

    Maiwald, Karin; Meershoek, Agnes; de Rijk, Angelique; Nijhuis, Frans J N

    2014-01-01

    In Canada and other countries, sickness absence among workers is a significant concern. Local return-to-work policies developed by both management and workers' representatives are preferred to tackle the problem. This article examines how managers perceive this local bipartite agreed upon return-to-work policy, wherein a social constructivist view on the policy process is taken. In-depth interviews were held with 10 managers on their experiences with execution of this policy in a Canadian healthcare organization. Interviews were transcribed verbatim and qualitative analyses were completed to gain deep insight into the managers' perspectives. Results show that the managers viewed themselves as a linchpin between the workplace and the worker. They did not feel heard by the other stakeholders, wrestled with worker's limitations, struggled getting plans adjusted and became overextended to meet return-to-work objectives. The study shows that the managers felt unable to meet the responsibilities the policy demanded and got less involved in the return-to-work process than this policy intended. RTW policy needs to balance on the one hand, flexibility to safeguard active involvement of managers and, on the other hand, strictness regarding taking responsibility by stakeholders, particularly the health care and re-integration professionals.

  1. HNCA-TOCSY-CANH experiments with alternate 13C-12C labeling: a set of 3D experiment with unique supra-sequential information for mainchain resonance assignment

    International Nuclear Information System (INIS)

    Takeuchi, Koh; Gal, Maayan; Takahashi, Hideo; Shimada, Ichio; Wagner, Gerhard

    2011-01-01

    Described here is a set of three-dimensional (3D) NMR experiments that rely on CACA-TOCSY magnetization transfer via the weak 3 J(C α C α ) coupling. These pulse sequences, which resemble recently described 13 C detected CACA-TOCSY (Takeuchi et al. 2010) experiments, are recorded in 1 H 2 O, and use 1 H excitation and detection. These experiments require alternate 13 C- 12 C labeling together with perdeuteration, which allows utilizing the small 3 J(C α C α ) scalar coupling that is otherwise masked by the stronger 1 J CC couplings in uniformly 13 C labeled samples. These new experiments provide a unique assignment ladder-mark that yields bidirectional supra-sequential information and can readily straddle proline residues. Unlike the conventional HNCA experiment, which contains only sequential information to the 13 (C α ) of the preceding residue, the 3D hnCA-TOCSY-caNH experiment can yield sequential correlations to alpha carbons in positions i−1, i + 1 and i−2. Furthermore, the 3D hNca-TOCSY-caNH and Hnca-TOCSY-caNH experiments, which share the same magnetization pathway but use a different chemical shift encoding, directly couple the 15 N- 1 H spin pair of residue i to adjacent amide protons and nitrogens at positions i−2, i−1, i + 1 and i + 2, respectively. These new experimental features make protein backbone assignments more robust by reducing the degeneracy problem associated with the conventional 3D NMR experiments.

  2. Remediation Technologies Eliminate Contaminants

    Science.gov (United States)

    2012-01-01

    All research and development has a story behind it, says Jacqueline Quinn, environmental engineer at Kennedy Space Center. For Quinn, one such story begins with the Saturn 1B launch stand at Kennedy and ends with a unique solution to a challenging environmental problem. Used in a number of Apollo missions and during the Skylab program, the Saturn 1B launch stand was dismantled following the transition to the Space Shuttle Program and stored in an open field at Kennedy. Decades later, the Center s Environmental Program Office discovered evidence of chemicals called polychlorinated biphenyls (PCBs) in the field s soil. The findings were puzzling since PCBs a toxin classified as a probable carcinogen by the Environmental Protection Agency (EPA) have been banned in the United States since 1979. Before the ban, PCBs were commonly used in transformer oils that leached into the ground when the oils were changed out and dumped near transformer sites, but there were no electrical transformers near the dismantled stand. It soon became apparent that the source of the PCBs was the launch stand itself. Prior to the ban, PCBs were used extensively in paints to add elasticity and other desirable characteristics. The PCB-laden paint on the Saturn 1B launch stand was flaking off into the field s soil. Nobody knew there were PCBs in the paint, says Quinn, noting that the ingredient was not monitored carefully when it was in use in 1960s. In fact, she says, the U.S. EPA was not even established until 1970, a year after Neil Armstrong first set foot on the Moon. Nobody knew any better at the time, Quinn says, but today, we have the responsibility to return any natural environmental media to as close to pristine a condition as possible. Quinn, fellow engineer Kathleen Loftin, and other Kennedy colleagues already had experience developing unprecedented solutions for environmental contamination; the team invented the emulsified zero-valent iron (EZVI) technology to safely treat

  3. Screening for Adverse Childhood Experiences in a Family Medicine Setting: A Feasibility Study.

    Science.gov (United States)

    Glowa, Patricia T; Olson, Ardis L; Johnson, Deborah J

    2016-01-01

    The role of adverse childhood experiences (ACEs) in predicting later adverse adult health outcomes is being widely recognized by makers of public policy. ACE questionnaires have the potential to identify in clinical practice unaddressed key social issues that can influence current health risks, morbidity, and early mortality. This study seeks to explore the feasibility of implementing the ACE screening of adults during routine family medicine office visits. At 3 rural clinical practices, the 10-question ACE screen was used before visits with 111 consecutive patients of 7 clinicians. Clinician surveys about the use of the results and the effect on the visits were completed immediately after the visits. The presence of any ACE risk and "high-risk" ACE scores (≥4) were compared with clinician survey responses. A risk of ACEs was present in 62% of patients; 22% had scores ≥4. Clinicians were more likely to have discussed ACE issues for high-risk patients (score 0-3, 36.8%; score ≥4, 83.3%; P =. 00). Clinicians also perceived that they gained new information (score 0-3, 35.6%; score ≥4, 83.3%; P = .00). Clinical care changed for a small proportion of high-risk patients, with no change in immediate referrals or plan for follow-up. In 91% of visits where a risk of ACEs was present, visit length increased by ≤5 minutes. Incorporation of ACE screening during routine care is feasible and merits further study. ACE screening offers clinicians a more complete picture of important social determinants of health. Primary care-specific interventions that incorporate treatment of early life trauma are needed. © Copyright 2016 by the American Board of Family Medicine.

  4. A balancing act: a phenomenological exploration of medical students' experiences of using mobile devices in the clinical setting.

    Science.gov (United States)

    Rashid-Doubell, F; Mohamed, S; Elmusharaf, K; O'Neill, C S

    2016-05-03

    The aims of this study were to describe the experiences of senior students using mobile devices in a clinical setting while learning and interacting with clinical teachers, patients and each other, and to identify challenges that facilitated or impeded the use of such devices in the hospital. Interpretative phenomenology was chosen to guide our enquiry. Semi-structured interviews were conducted to examine the experiences of five senior medical students using mobile devices in the clinical setting. Senior medical students at an international medical school in the Middle East. Three main themes emerged from the data analysis: learning; professional identity and transitioning from student to doctor. The findings showed that using mobile devices in the clinical area as a learning tool was not a formalised process. Rather, it was opportunistic learning at the bedside and on occasion a source of distraction from clinical teaching. Students needed to negotiate relationships between themselves, the clinical teacher and patients in order to ensure that they maintained an acceptable professional image. Participants experienced and negotiated the change from student to doctor making them mindful of using their devices at the bedside. Mobile devices are part of daily life for a medical student and there is a need to adapt medical education in the clinical setting, to allow the students to use their devices in a sensitive manner. 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/

  5. Tracer experiment data sets for the verification of local and meso-scale atmospheric dispersion models including topographic effects

    International Nuclear Information System (INIS)

    Sartori, E.; Schuler, W.

    1992-01-01

    Software and data for nuclear energy applications are acquired, tested and distributed by several information centres; in particular, relevant computer codes are distributed internationally by the OECD/NEA Data Bank (France) and by ESTSC and EPIC/RSIC (United States). This activity is coordinated among the centres and is extended outside the OECD area through an arrangement with the IAEA. This article proposes more specifically a scheme for acquiring, storing and distributing atmospheric tracer experiment data (ATE) required for verification of atmospheric dispersion models especially the most advanced ones including topographic effects and specific to the local and meso-scale. These well documented data sets will form a valuable complement to the set of atmospheric dispersion computer codes distributed internationally. Modellers will be able to gain confidence in the predictive power of their models or to verify their modelling skills. (au)

  6. Experiences of stigma and discrimination in social and healthcare settings among trans people living with HIV in the UK.

    Science.gov (United States)

    Hibbert, M; Wolton, A; Crenna-Jennings, W; Benton, L; Kirwan, P; Lut, I; Okala, S; Ross, M; Furegato, M; Nambiar, K; Douglas, N; Roche, J; Jeffries, J; Reeves, I; Nelson, M; Weerawardhana, C; Jamal, Z; Hudson, A; Delpech, V

    2018-07-01

    The People Living with HIV StigmaSurvey UK 2015 was a community led national survey investigating experiences of people living with HIV in the UK in the past 12 months. Participants aged 18 and over were recruited through over 120 cross-sector community organisations and 46 HIV clinics to complete an anonymous online survey. Trans is an umbrella term which refers to individuals whose current gender identity is different to the gender they were assigned at birth. Trans participants self-identified via gender identity and gender at birth questions. Descriptive analyses of reported experiences in social and health care settings were conducted and multivariate logistic regression analyses were used to identify sociodemographic predictors of reporting being treated differently to non-HIV patients, and being delayed or refused healthcare treatment in the past 12 months. 31 out of 1576 participants (2%) identified as trans (19 trans women, 5 trans men, 2 gender queer/non-binary, 5 other). High levels of social stigma were reported for all participants, with trans participants significantly more likely to report worrying about verbal harassment (39% vs. 23%), and exclusion from family gatherings (23% vs. 9%) in the last 12 months, compared to cisgender participants. Furthermore, 10% of trans participants reported physical assault in the last 12 months, compared to 4% of cisgender participants. Identifying as trans was a predictor of reporting being treated differently to non-HIV patients (48% vs. 30%; aOR 2.61, CI 1.06, 6.42) and being delayed or refused healthcare (41% vs. 16%; aOR 4.58, CI 1.83, 11.44). Trans people living with HIV in the UK experience high levels of stigma and discrimination, including within healthcare settings, which is likely to impact upon health outcomes. Trans-specific education and awareness within healthcare settings could help to improve service provision for this demographic.

  7. Nurses' experiences providing palliative care to individuals living in rural communities: aspects of the physical residential setting.

    Science.gov (United States)

    Kaasalainen, S; Brazil, K; Williams, A; Wilson, D; Willison, K; Marshall, D; Taniguchi, A; Phillips, C

    2014-01-01

    Efforts are needed to improve palliative care in rural communities, given the unique characteristics and inherent challenges with respect to working within the physical aspects of residential settings. Nurses who work in rural communities play a key role in the delivery of palliative care services. Hence, the purpose of this study was to explore nurses' experiences of providing palliative care in rural communities, with a particular focus on the impact of the physical residential setting. This study was grounded in a qualitative approach utilizing an exploratory descriptive design. Individual telephone interviews were conducted with 21 community nurses. Data were analyzed by thematic content analysis. Nurses described the characteristics of working in a rural community and how it influences their perception of their role, highlighting the strong sense of community that exists but how system changes over the past decade have changed the way they provide care. They also described the key role that they play, which was often termed a 'jack of all trades', but focused on providing emotional, physical, and spiritual care while trying to manage many challenges related to transitioning and working with other healthcare providers. Finally, nurses described how the challenges of working within the physical constraints of a rural residential setting impeded their care provision to clients who are dying in the community, specifically related to the long distances that they travel while dealing with bad weather. These study findings contribute to our understanding of the experiences of nurses working in rural communities in terms of the provision of palliative care and the influence of the physical residential setting that surrounds them. These findings are important since nurses play a major role in caring for community-dwelling clients who are dying, but they are confronted with many obstacles. As such, these results may help inform future decisions about how to best improve

  8. Noise elimination algorithm for modal analysis

    Energy Technology Data Exchange (ETDEWEB)

    Bao, X. X., E-mail: baoxingxian@upc.edu.cn [Department of Naval Architecture and Ocean Engineering, China University of Petroleum (East China), Qingdao 266580 (China); Li, C. L. [Key Laboratory of Marine Geology and Environment, Institute of Oceanology, Chinese Academy of Sciences, Qingdao 266071 (China); Xiong, C. B. [The First Institute of Oceanography, State Oceanic Administration, Qingdao 266061 (China)

    2015-07-27

    Modal analysis is an ongoing interdisciplinary physical issue. Modal parameters estimation is applied to determine the dynamic characteristics of structures under vibration excitation. Modal analysis is more challenging for the measured vibration response signals are contaminated with noise. This study develops a mathematical algorithm of structured low rank approximation combined with the complex exponential method to estimate the modal parameters. Physical experiments using a steel cantilever beam with ten accelerometers mounted, excited by an impulse load, demonstrate that this method can significantly eliminate noise from measured signals and accurately identify the modal frequencies and damping ratios. This study provides a fundamental mechanism of noise elimination using structured low rank approximation in physical fields.

  9. Eliminating Rabies in Estonia

    Science.gov (United States)

    Cliquet, Florence; Robardet, Emmanuelle; Must, Kylli; Laine, Marjana; Peik, Katrin; Picard-Meyer, Evelyne; Guiot, Anne-Laure; Niin, Enel

    2012-01-01

    The compulsory vaccination of pets, the recommended vaccination of farm animals in grazing areas and the extermination of stray animals did not succeed in eliminating rabies in Estonia because the virus was maintained in two main wildlife reservoirs, foxes and raccoon dogs. These two species became a priority target therefore in order to control rabies. Supported by the European Community, successive oral vaccination (OV) campaigns were conducted twice a year using Rabigen® SAG2 baits, beginning in autumn 2005 in North Estonia. They were then extended to the whole territory from spring 2006. Following the vaccination campaigns, the incidence of rabies cases dramatically decreased, with 266 cases in 2005, 114 in 2006, four in 2007 and three in 2008. Since March 2008, no rabies cases have been detected in Estonia other than three cases reported in summer 2009 and one case in January 2011, all in areas close to the South-Eastern border with Russia. The bait uptake was satisfactory, with tetracycline positivity rates ranging from 85% to 93% in foxes and from 82% to 88% in raccoon dogs. Immunisation rates evaluated by ELISA ranged from 34% to 55% in foxes and from 38% to 55% in raccoon dogs. The rabies situation in Estonia was compared to that of the other two Baltic States, Latvia and Lithuania. Despite regular OV campaigns conducted throughout their territory since 2006, and an improvement in the epidemiological situation, rabies has still not been eradicated in these countries. An analysis of the number of baits distributed and the funding allocated by the European Commission showed that the strategy for rabies control is more cost-effective in Estonia than in Latvia and Lithuania. PMID:22393461

  10. Teachers' Perceptions of Their Mentoring Role in Three Different Clinical Settings: Student Teaching, Early Field Experiences, and Entry Year Teaching

    Science.gov (United States)

    Gut, Dianne M.; Beam, Pamela C.; Henning, John E.; Cochran, Deborah C.; Knight, Rhonda Talford

    2014-01-01

    The purpose of this study was to determine the differences in mentoring across three different clinical settings: student teaching, early field experiences, and entry year teachers. Eighteen teachers with mentoring experience in all three clinical settings were selected and interviewed. The teachers' expectations for teacher development,…

  11. Experiences of mental health nursing staff working with voice hearers in an acute setting: An interpretive phenomenological approach.

    Science.gov (United States)

    McMullan, E; Gupta, A; Collins, S C

    2018-04-01

    WHAT IS KNOWN ON THE SUBJECT?: Community mental health staff and their service users have reported mixed views on the importance of talking about the content of voices. Community staff have reported feeling that they do not have the skills to explore voice content and worry about making things worse. Voice hearers experiencing extreme distress due to the content of their voices can access support through acute inpatient mental health services. No previous studies have focused on the experiences of staff who nurse voice hearers at a time of acute distress. WHAT DOES THIS STUDY ADD TO EXISTING KNOWLEDGE?: MHNs and HSWs working with voice hearers in acute distress report feeling powerless and helpless, as they feel that they cannot lessen the distress experienced by the voice hearer. Despite these difficult feelings, staff report finding ways of coping, including using structured tools to help make sense of their service users' voice-hearing experiences and accessing reflective practice forums. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Due to the current context of increased acuity and limited resources in acute services, there may be a need to further protect time for staff to access reflective practice groups and supervision forums to help them manage the difficult feelings arising from their work with voice hearers. Introduction Mental health nursing (MHN) staff in acute settings work with voice hearers at times of crises when they experience high levels of distress. Previous research has focused on community mental health staff's experiences and their service users views on exploring the content of voices. No studies have explored this from an acute mental health service perspective. Aim This study therefore sought to explore the experiences of staff working with voice hearers in an acute mental health service. Method Due to the exploratory nature of the research, a qualitative design was chosen. Three MHNs and five healthcare support workers (HSWs) were

  12. The experience and views of mental health nurses regarding nursing care delivery in an integrated, inpatient setting.

    Science.gov (United States)

    Cleary, Michelle; Walter, Garry; Hunt, Glenn

    2005-06-01

    Positive and effective consumer outcomes hinge on having in place optimal models of nursing care delivery. The aim of this study was to ascertain the experience and views of mental health nurses, working in hospitals in an area mental health service, regarding nursing care delivery in those settings. Surveys (n = 250) were sent to all mental health nurses working in inpatient settings and 118 (47%) were returned. Results showed that the quality of nursing care achieved high ratings (by 87%), and that two-thirds of respondents were proud to be a mental health nurse and would choose to be a mental health nurse again. Similarly, the majority (71%) would recommend mental health nursing to others. Concern was, however, expressed about the continuity and consistency of nursing work and information technology resources. Nurses with community experiences rated the importance of the following items, or their confidence, higher than those without previous community placements: the importance of interdisciplinary teamwork; the importance of participating in case review; the importance of collaborating with community staff; confidence in performing mental state examinations; and confidence in collaborating with community staff, suggesting that this placement had positive effects on acute care nursing.

  13. Views and experiences of mental health nurses working with undergraduate assistants in nursing in an acute mental health setting.

    Science.gov (United States)

    Cleary, Michelle; Horsfall, Jan; O'Hara-Aarons, Maureen; Mannix, Judy; Jackson, Debra; Hunt, Glenn E

    2012-04-01

    Undergraduate nurses are employed as assistants in nursing (AIN) in inpatient mental health settings; however, there is a paucity of published research exploring registered nurses' (RN) views about the AIN role in these settings. This qualitative study documents the views and experiences of RN working with undergraduate AIN. Fifty structured face-to-face interviews were analysed, and the results are discussed in three sections. The first section outlines RN perceptions of qualities and skills required of AIN in mental health, and the responses primarily focus on communication skills, initiative, and willingness to learn. The second section targets factors in the workplace that might enhance the interest of AIN in a mental health nursing career; the responses emphasize their need to work with experienced staff. The last section outlines RN expectations of AIN, most of which are met and involve physical observations and technical tasks; less fulfilled activities primarily cluster around interactions with patients. Findings highlight the advantages and disadvantages of drawing on undergraduate nursing students as AIN in mental health settings. Communication skills, personal initiative, safety training to prevent violence, and education to increase knowledge and awareness about mental illness, diagnosis, and mental status-related skills were all important concerns articulated by RN. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  14. Effects of place identity, place dependence, and experience-use history on perceptions of recreation impacts in a natural setting.

    Science.gov (United States)

    White, Dave D; Virden, Randy J; van Riper, Carena J

    2008-10-01

    It is generally accepted that recreation use in natural environments results in some degree of negative social and environmental impact. Environmental managers are tasked with mitigating the impact while providing beneficial recreation opportunities. Research on the factors that influence visitors' perceptions of environmental and social conditions is necessary to inform sound environmental management of protected natural areas. This study examines the effect of prior experience with the setting and two dimensions of place attachment (i.e., place identity and place dependence) on visitors' perceptions of three types of recreation impacts (i.e., depreciative behavior, environmental impacts, and recreation conflict). Principal components analysis, confirmatory factor analysis, and structural equation modeling were used to test the study hypotheses using data collected from 351 visitors through on-site questionnaires (response rate of 93 percent). The results show that prior experience exhibited a moderate and significant direct positive effect on place identity, place dependence, and visitors' perceptions of recreation impacts. Contrary to study hypotheses and prior research, neither place dependence nor place identity exhibited a significant effect on the dependent variables. The results show that prior experience causes visitors to be more sensitive to depreciative behaviors, environmental impacts, and recreation conflict. These findings raise concerns over potential visitor displacement and deterioration of site conditions. Implications for resource managers are discussed, which include education, modifying visitor use patterns, and site design strategies.

  15. Effects of Place Identity, Place Dependence, and Experience-Use History on Perceptions of Recreation Impacts in a Natural Setting

    Science.gov (United States)

    White, Dave D.; Virden, Randy J.; van Riper, Carena J.

    2008-10-01

    It is generally accepted that recreation use in natural environments results in some degree of negative social and environmental impact. Environmental managers are tasked with mitigating the impact while providing beneficial recreation opportunities. Research on the factors that influence visitors’ perceptions of environmental and social conditions is necessary to inform sound environmental management of protected natural areas. This study examines the effect of prior experience with the setting and two dimensions of place attachment (i.e., place identity and place dependence) on visitors’ perceptions of three types of recreation impacts (i.e., depreciative behavior, environmental impacts, and recreation conflict). Principal components analysis, confirmatory factor analysis, and structural equation modeling were used to test the study hypotheses using data collected from 351 visitors through on-site questionnaires (response rate of 93 percent). The results show that prior experience exhibited a moderate and significant direct positive effect on place identity, place dependence, and visitors’ perceptions of recreation impacts. Contrary to study hypotheses and prior research, neither place dependence nor place identity exhibited a significant effect on the dependent variables. The results show that prior experience causes visitors to be more sensitive to depreciative behaviors, environmental impacts, and recreation conflict. These findings raise concerns over potential visitor displacement and deterioration of site conditions. Implications for resource managers are discussed, which include education, modifying visitor use patterns, and site design strategies.

  16. Elimination device for metal impurities

    International Nuclear Information System (INIS)

    Yanagisawa, Ko.

    1982-01-01

    Purpose: To enable reuse of adsorbing materials by eliminating Fe 3 O 4 films reduced with adsorbing performance by way of electrolytic polishing and then forming fresh membranes using high temperature steams. Constitution: An elimination device is provided to a coolant clean-up system of a reactor for eliminating impurities such as cobalt. The elimination device comprises adsorbing materials made of stainless steel tips or the likes having Fe 3 O 4 films. The adsorbing materials are regenerated by applying an electric current between grid-like cathode plates and anode plates to leach out the Fe 3 O 4 films, washing out the electrolytic solution by cleaning water and then applying steams at high temperature onto the adsorbing materials to thereby form fresh Fe 3 O 4 films again thereon. The regeneration of the adsorbing materials enables to eliminate Co 60 and the like in the primary coolant efficiently. (Moriyama, K.)

  17. Benchmark Data Set for Wheat Growth Models: Field Experiments and AgMIP Multi-Model Simulations.

    Science.gov (United States)

    Asseng, S.; Ewert, F.; Martre, P.; Rosenzweig, C.; Jones, J. W.; Hatfield, J. L.; Ruane, A. C.; Boote, K. J.; Thorburn, P.J.; Rotter, R. P.

    2015-01-01

    The data set includes a current representative management treatment from detailed, quality-tested sentinel field experiments with wheat from four contrasting environments including Australia, The Netherlands, India and Argentina. Measurements include local daily climate data (solar radiation, maximum and minimum temperature, precipitation, surface wind, dew point temperature, relative humidity, and vapor pressure), soil characteristics, frequent growth, nitrogen in crop and soil, crop and soil water and yield components. Simulations include results from 27 wheat models and a sensitivity analysis with 26 models and 30 years (1981-2010) for each location, for elevated atmospheric CO2 and temperature changes, a heat stress sensitivity analysis at anthesis, and a sensitivity analysis with soil and crop management variations and a Global Climate Model end-century scenario.

  18. Priority setting in the Austrian healthcare system: results from a discrete choice experiment and implications for mental health.

    Science.gov (United States)

    Mentzakis, Emmanouil; Paolucci, Francesco; Rubicko, Georg

    2014-06-01

    The impact of mental conditions is expected to be among the highest ranked causes of illness in high income countries by 2020. With changing health needs, policy makers have to make choices in an environment with increasingly constrained resources and competing demands. Discrete choice experiments have been identified as a useful approach to inform and support decision-making in health care systems and, in particular, its rationing. Policymakers, researchers and health practitioners from Austria participated in an experiment designed to elicit preferences for efficiency and equity in a generic priority setting framework. Using aggregate criteria an empirical measure of the efficiency/equity trade-off is calculated and a selection of health care interventions, including mental health, are ranked in composite league tables (CLTs). With the exception of severity of the condition, all equity parameters decrease attractiveness of an intervention, whereas the opposite holds for all three efficiency criteria. The efficiency/equity ratio (i.e. decision-makers' preference for efficiency over equity) is 3.5 and 5 for interventions targeted at younger and middle age populations, respectively, while for older populations this ratio is negative implying a rejection of all equity criteria. Irrespective of such differences interventions targeting mental health rank highly on all CLTs. Based on system-wide generic decision making criteria, mental health is shown to be a top priority for Austria. Preference-based approaches might offer complementary information to policymakers in priority setting decisions and a useful tool to support rationale rather than ad hoc decision-making.

  19. An integrated methods study of the experiences of youth with severe disabilities in leisure activity settings: the importance of belonging, fun, and control and choice.

    Science.gov (United States)

    King, Gillian; Gibson, Barbara E; Mistry, Bhavnita; Pinto, Madhu; Goh, Freda; Teachman, Gail; Thompson, Laura

    2014-01-01

    The aim was to examine the leisure activity setting experiences of two groups of youth with severe disabilities - those with complex continuing care (CCC) needs and those who have little functional speech and communicate using augmentative and alternative communication (AAC). Twelve youth took part in a mixed methods study, in which their experiences were ascertained using qualitative methods (observations, photo elicitation and interviews) and the measure of Self-Reported Experiences of Activity Settings (SEAS). Data integration occurred using a "following a thread" technique and case-by-case analysis. The analysis revealed several highly valued aspects of leisure activity setting experiences for youth, including engagement with others, enjoying the moment, and control and choice in selection and participation in activity settings. The findings provide preliminary insights into the nature of optimal activity settings for youth with severe disabilities, and the mediators of these experiences. Compared to other youth, the data illustrate both the commonalities of experiences and differences in the ways in which these experiences are attained. Implications for research concern the utility of mixed methods approaches in understanding the complex nature of participation experiences. Implications for clinical practice concern the importance of not assuming the nature of youths' experiences.

  20. Ultrasound-guided Breast Biopsy in the Resource-limited Setting: An Initial Experience in Rural Uganda

    Directory of Open Access Journals (Sweden)

    Christopher R. Stark

    2017-06-01

    Full Text Available Purpose: To describe the methodology and initial experience behind creation of an ultrasoundguided percutaneous breast core biopsy program in rural Uganda. Methods and Materials: Imaging the World Africa (ITWA is the registered non-governmental organization division of Imaging the World (ITW, a not-for-profit organization whose primary aim is the integration of affordable high-quality ultrasound into rural health centers. In 2013, ITWA began the pilot phase of an IRB-approved breast care protocol at a rural health center in Uganda. As part of the protocol’s diagnostic arm, an ultrasound-guided percutaneous breast core biopsy training curriculum was implemented in tandem with creation of regionally supplied biopsy kits. Results: A surgeon at a rural regional referral hospital was successfully trained and certified to perform ultrasound-guided percutaneous breast core biopsies. Affordable and safe biopsy kits were created using locally available medical supplies with the cost of each kit totaling $10.62 USD. Conclusion: Successful implementation of an ultrasound-guided percutaneous breast core biopsy program in the resource-limited setting is possible and can be made sustainable through incorporation of local health care personnel and regionally supplied biopsy materials. Our hope is that ITWA’s initial experience in rural Uganda can serve as a model for similar programs in the future.

  1. Experiences of stigma in healthcare settings among adults living with HIV in the Islamic Republic of Iran.

    Science.gov (United States)

    Rahmati-Najarkolaei, Fatemeh; Niknami, Shamsaddin; Aminshokravi, Farkhondeh; Bazargan, Mohsen; Ahmadi, Fazlollah; Hadjizadeh, Ebrahim; Tavafian, Sedigheh S

    2010-07-22

    People living with HIV (PLHIV) sometimes experience discrimination. There is little understanding of the causes, forms and consequences of this stigma in Islamic countries. This qualitative study explored perceptions and experiences of PLHIV regarding both the quality of healthcare and the attitudes and behaviours of their healthcare providers in the Islamic Republic of Iran. In-depth, semi-structured interviews were held with a purposively selected group of 69 PLHIV recruited from two HIV care clinics in Tehran. Data were analyzed using the content analysis approach. Nearly all participants reported experiencing stigma and discrimination by their healthcare providers in a variety of contexts. Participants perceived that their healthcare providers' fear of being infected with HIV, coupled with religious and negative value-based assumptions about PLHIV, led to high levels of stigma. Participants mentioned at least four major forms of stigma: (1) refusal of care; (2) sub-optimal care; (3) excessive precautions and physical distancing; and (4) humiliation and blaming. The participants' healthcare-seeking behavioural reactions to perceived stigma and discrimination included avoiding or delaying seeking care, not disclosing HIV status when seeking healthcare, and using spiritual healing. In addition, emotional responses to perceived acts of stigma included feeling undeserving of care, diminished motivation to stay healthy, feeling angry and vengeful, and experiencing emotional stress. While previous studies demonstrate that most Iranian healthcare providers report fairly positive attitudes towards PLHIV, our participants' experiences tell a different story. Therefore, it is imperative to engage both healthcare providers and PLHIV in designing interventions targeting stigma in healthcare settings. Additionally, specialized training programmes in universal precautions for health providers will lead to stigma reduction. National policies to strengthen medical training and

  2. Automatic reduction of large X-ray fluorescence data-sets applied to XAS and mapping experiments

    International Nuclear Information System (INIS)

    Martin Montoya, Ligia Andrea

    2017-02-01

    In this thesis two automatic methods for the reduction of large fluorescence data sets are presented. The first method is proposed in the framework of BioXAS experiments. The challenge of this experiment is to deal with samples in ultra dilute concentrations where the signal-to-background ratio is low. The experiment is performed in fluorescence mode X-ray absorption spectroscopy with a 100 pixel high-purity Ge detector. The first step consists on reducing 100 fluorescence spectra into one. In this step, outliers are identified by means of the shot noise. Furthermore, a fitting routine which model includes Gaussian functions for the fluorescence lines and exponentially modified Gaussian (EMG) functions for the scattering lines (with long tails at lower energies) is proposed to extract the line of interest from the fluorescence spectrum. Additionally, the fitting model has an EMG function for each scattering line (elastic and inelastic) at incident energies where they start to be discerned. At these energies, the data reduction is done per detector column to include the angular dependence of scattering. In the second part of this thesis, an automatic method for texts separation on palimpsests is presented. Scanning X-ray fluorescence is performed on the parchment, where a spectrum per scanned point is collected. Within this method, each spectrum is treated as a vector forming a basis which is to be transformed so that the basis vectors are the spectra of each ink. Principal Component Analysis is employed as an initial guess of the seek basis. This basis is further transformed by means of an optimization routine that maximizes the contrast and minimizes the non-negative entries in the spectra. The method is tested on original and self made palimpsests.

  3. BRANCHIAL ELIMINATION OF SUPERHYDROPHOBIC ORGANIC COMPOUNDS BY RAINBOW TROUT (ONCORHYNCHUS MYKISS)

    Science.gov (United States)

    The branchial elimination of pentachloroethane and four congeneric polychlorinated bephenyls by rainbow trout was measured using a fish respirometer-metabolism chamber and an adsorption resin column. Branchial elimination was characterized by calculating a set of apparent in vivo...

  4. Proportional counter end effects eliminator

    International Nuclear Information System (INIS)

    Meekins, J.F.

    1976-01-01

    An improved gas-filled proportional counter which includes a resistor network connected between the anode and cathode at the ends of the counter in order to eliminate ''end effects'' is described. 3 Claims, 2 Drawing Figures

  5. Defense Logistics Agency Revenue Eliminations

    National Research Council Canada - National Science Library

    1996-01-01

    The issue of revenue eliminations was identified during our work on the Defense Logistics Agency portion of the Audit of Revenue Accounts in the FY 1996 Financial Statements of the Defense Business Operations Fund...

  6. Challenges in interprofessional collaboration: experiences of care providers and policymakers in a newly set-up Dutch assault centre.

    Science.gov (United States)

    Zijlstra, Elza; Lo Fo Wong, Sylvie; Teerling, Anne; Hutschemaekers, Giel; Lagro-Janssen, Antoine

    2018-03-01

    Sexual and family violence are problems that affect many women and men, and the negative health consequences of violence are numerous. As adequate acute interprofessional care can prevent negative health consequences and improve forensic medical examination, a Centre for Sexual and Family Violence was set up. We aimed to improve our understanding of the challenges in interprofessional collaboration in a newly set-up centre for sexual and family violence. We conducted a qualitative study with semi-structured interviews about the experiences with interprofessional collaboration of 16 stakeholders involved in the Centre for Sexual and Family Violence Nijmegen. Participants were selected by purposive sampling. Participants found that the interprofessional collaboration had improved communication and competences. However, there were challenges too. Firstly, the interprofessional collaboration had brought parties closer together, but the collaboration also forced professionals to strongly define their boundaries. Mutual trust and understanding needed to be built up. Secondly, a balance had to be struck between pursuing the shared vision - which was to improve quality of care for victims - and giving space to organizations' and professionals' own interest. Thirdly, care for victims of sexual and family violence could be demanding on healthcare providers in an emotional sense, which might jeopardize professional's initial motivation for joining the Centre for Sexual and Family Violence Nijmegen. The interprofessional collaboration in an assault centre improves quality of care for victims, but there are also challenges. The tasks of an assault centre are to create opportunities to discuss professional roles and professional interests, to build up good interpersonal relations in which trust and understanding can grow, to formulate a strong and shared victim-centred vision and to support care providers with training, feedback and supervision. © 2017 Nordic College of Caring

  7. New set of convective heat transfer coefficients established for pools and validated against CLARA experiments for application to corium pools

    Energy Technology Data Exchange (ETDEWEB)

    Michel, B., E-mail: benedicte.michel@irsn.fr

    2015-05-15

    Highlights: • A new set of 2D convective heat transfer correlations is proposed. • It takes into account different horizontal and lateral superficial velocities. • It is based on previously established correlations. • It is validated against recent CLARA experiments. • It has to be implemented in a 0D MCCI (molten core concrete interaction) code. - Abstract: During an hypothetical Pressurized Water Reactor (PWR) or Boiling Water Reactor (BWR) severe accident with core meltdown and vessel failure, corium would fall directly on the concrete reactor pit basemat if no water is present. The high temperature of the corium pool maintained by the residual power would lead to the erosion of the concrete walls and basemat of this reactor pit. The thermal decomposition of concrete will lead to the release of a significant amount of gases that will modify the corium pool thermal hydraulics. In particular, it will affect heat transfers between the corium pool and the concrete which determine the reactor pit ablation kinetics. A new set of convective heat transfer coefficients in a pool with different lateral and horizontal superficial gas velocities is modeled and validated against the recent CLARA experimental program. 155 tests of this program, in two size configurations and a high range of investigated viscosity, have been used to validate the model. Then, a method to define different lateral and horizontal superficial gas velocities in a 0D code is proposed together with a discussion about the possible viscosity in the reactor case when the pool is semi-solid. This model is going to be implemented in the 0D ASTEC/MEDICIS code in order to determine the impact of the convective heat transfer in the concrete ablation by corium.

  8. Modeling decisions from experience: How models with a set of parameters for aggregate choices explain individual choices

    Directory of Open Access Journals (Sweden)

    Neha Sharma

    2017-10-01

    Full Text Available One of the paradigms (called “sampling paradigm” in judgment and decision-making involves decision-makers sample information before making a final consequential choice. In the sampling paradigm, certain computational models have been proposed where a set of single or distribution parameters is calibrated to the choice proportions of a group of participants (aggregate and hierarchical models. However, currently little is known on how aggregate and hierarchical models would account for choices made by individual participants in the sampling paradigm. In this paper, we test the ability of aggregate and hierarchical models to explain choices made by individual participants. Several models, Ensemble, Cumulative Prospect Theory (CPT, Best Estimation and Simulation Techniques (BEAST, Natural-Mean Heuristic (NMH, and Instance-Based Learning (IBL, had their parameters calibrated to individual choices in a large dataset involving the sampling paradigm. Later, these models were generalized to two large datasets in the sampling paradigm. Results revealed that the aggregate models (like CPT and IBL accounted for individual choices better than hierarchical models (like Ensemble and BEAST upon generalization to problems that were like those encountered during calibration. Furthermore, the CPT model, which relies on differential valuing of gains and losses, respectively, performed better than other models during calibration and generalization on datasets with similar set of problems. The IBL model, relying on recency and frequency of sampled information, and the NMH model, relying on frequency of sampled information, performed better than other models during generalization to a challenging dataset. Sequential analyses of results from different models showed how these models accounted for transitions from the last sample to final choice in human data. We highlight the implications of using aggregate and hierarchical models in explaining individual choices

  9. Experience with low-cost telemedicine in three different settings. Recommendations based on a proposed framework for network performance evaluation

    Science.gov (United States)

    Wootton, Richard; Vladzymyrskyy, Anton; Zolfo, Maria; Bonnardot, Laurent

    2011-01-01

    Background Telemedicine has been used for many years to support doctors in the developing world. Several networks provide services in different settings and in different ways. However, to draw conclusions about which telemedicine networks are successful requires a method of evaluating them. No general consensus or validated framework exists for this purpose. Objective To define a basic method of performance measurement that can be used to improve and compare teleconsultation networks; to employ the proposed framework in an evaluation of three existing networks; to make recommendations about the future implementation and follow-up of such networks. Methods Analysis based on the experience of three telemedicine networks (in operation for 7–10 years) that provide services to doctors in low-resource settings and which employ the same basic design. Findings Although there are many possible indicators and metrics that might be relevant, five measures for each of the three user groups appear to be sufficient for the proposed framework. In addition, from the societal perspective, information about clinical- and cost-effectiveness is also required. The proposed performance measurement framework was applied to three mature telemedicine networks. Despite their differences in terms of activity, size and objectives, their performance in certain respects is very similar. For example, the time to first reply from an expert is about 24 hours for each network. Although all three networks had systems in place to collect data from the user perspective, none of them collected information about the coordinator's time required or about ease of system usage. They had only limited information about quality and cost. Conclusion Measuring the performance of a telemedicine network is essential in understanding whether the network is working as intended and what effect it is having. Based on long-term field experience, the suggested framework is a practical tool that will permit

  10. Experience with low-cost telemedicine in three different settings. Recommendations based on a proposed framework for network performance evaluation

    Directory of Open Access Journals (Sweden)

    Richard Wootton

    2011-12-01

    Full Text Available Telemedicine has been used for many years to support doctors in the developing world. Several networks provide services in different settings and in different ways. However, to draw conclusions about which telemedicine networks are successful requires a method of evaluating them. No general consensus or validated framework exists for this purpose.To define a basic method of performance measurement that can be used to improve and compare teleconsultation networks; to employ the proposed framework in an evaluation of three existing networks; to make recommendations about the future implementation and follow-up of such networks.Analysis based on the experience of three telemedicine networks (in operation for 7–10 years that provide services to doctors in low-resource settings and which employ the same basic design.Although there are many possible indicators and metrics that might be relevant, five measures for each of the three user groups appear to be sufficient for the proposed framework. In addition, from the societal perspective, information about clinical- and cost-effectiveness is also required. The proposed performance measurement framework was applied to three mature telemedicine networks. Despite their differences in terms of activity, size and objectives, their performance in certain respects is very similar. For example, the time to first reply from an expert is about 24 hours for each network. Although all three networks had systems in place to collect data from the user perspective, none of them collected information about the coordinator's time required or about ease of system usage. They had only limited information about quality and cost.Measuring the performance of a telemedicine network is essential in understanding whether the network is working as intended and what effect it is having. Based on long-term field experience, the suggested framework is a practical tool that will permit organisations to assess the performance of

  11. Information filtering based on corrected redundancy-eliminating mass diffusion.

    Directory of Open Access Journals (Sweden)

    Xuzhen Zhu

    Full Text Available Methods used in information filtering and recommendation often rely on quantifying the similarity between objects or users. The used similarity metrics often suffer from similarity redundancies arising from correlations between objects' attributes. Based on an unweighted undirected object-user bipartite network, we propose a Corrected Redundancy-Eliminating similarity index (CRE which is based on a spreading process on the network. Extensive experiments on three benchmark data sets-Movilens, Netflix and Amazon-show that when used in recommendation, the CRE yields significant improvements in terms of recommendation accuracy and diversity. A detailed analysis is presented to unveil the origins of the observed differences between the CRE and mainstream similarity indices.

  12. Experiences of registered nurses who supervise international nursing students in the clinical and classroom setting: an integrative literature review.

    Science.gov (United States)

    Newton, Louise; Pront, Leeanne; Giles, Tracey M

    2016-06-01

    To examine the literature reporting the experiences and perceptions of registered nurses who supervise international nursing students in the clinical and classroom setting. Nursing education relies on clinical experts to supervise students during classroom and clinical education, and the quality of that supervision has a significant impact on student development and learning. Global migration and internationalisation of nursing education have led to increasing numbers of registered nurses supervising international nursing students. However, a paucity of relevant literature limits our understanding of these experiences. An integrative literature review. Comprehensive database searches of CINAHL, Informit, PubMed, Journals@Ovid, Findit@flinders and Medline were undertaken. Screening of 179 articles resulted in 10 included for review. Appraisal and analysis using Whittemore and Knafl's (Journal of Advanced Nursing, 52, 2005, 546) five stage integrative review recommendations was undertaken. This review highlighted some unique challenges for registered nurses supervising international nursing students. Identified issues were, a heightened sense of responsibility, additional pastoral care challenges, considerable time investments, communication challenges and cultural differences between teaching and learning styles. It is possible that these unique challenges could be minimised by implementing role preparation programmes specific to international nursing student supervision. Further research is needed to provide an in-depth exploration of current levels of preparation and support to make recommendations for future practice, education and policy development. An awareness of the specific cultural learning needs of international nursing students is an important first step to the provision of culturally competent supervision for this cohort of students. There is an urgent need for education and role preparation for all registered nurses supervising international nursing

  13. How policy on employee involvement in work reintegration can yield its opposite: employee experiences in a Canadian setting.

    Science.gov (United States)

    Maiwald, Karin; Meershoek, Agnes; de Rijk, Angelique; Nijhuis, Frans

    2013-04-01

    Canada has a long tradition of involving employee representatives in developing work reintegration policies and expects this to positively affect employee involvement to improve work reintegration success. The purpose of this study was to examine employee involvement in reintegration in a Canadian province as experienced by employees. Fourteen semi-structured interviews were held with employees in a healthcare organization. The interview topic list was based on a review of local reintegration policy documents and literature. Interviews were transcribed verbatim and analysed using ethnographic methodology. Employees do not feel in control of their reintegration trajectory. In the phase of reporting sickness absence, they wrestle with a lack of understanding on how to report in sick. In the phase of reintegration planning and coordination, they hesitate to get involved in the organization of reintegration. In the phase of reintegration plan execution, employees encounter unfulfilled expectations on interventions. Employee involvement in the organization of reintegration makes them responsible for the development of reintegration trajectories. However, they consider themselves often incapable of completing this in practice. Moreover, employees experience that their contribution can boomerang on them. • It is not that employees are not able to think along or decide on their reintegration trajectory but rather they are expected to do so at times when they cannot oversee their illness and/or recovery trajectory. • Settings out reintegration procedures that are inflexible in practice do not recognize that employee involvement in work reintegration trajectories can develop over time. • The disability management professional has a central role in organizing and supporting employee involvement in work reintegration, however, the employees do not experience this is indeed happening.

  14. Elimination reactions. V. Steric effects in Hofmann elimination

    International Nuclear Information System (INIS)

    Coke, J.L.; Smith, G.D.; Britton, G.H. Jr.

    1975-01-01

    Earlier Hofmann elimination studies were extended, and the percent syn eliminations in several ring systems have been correlated using cis-d 1 and trans-d 1 models. The measurements of several syn and anti k/sub H//k/sub D/ kinetic isotope effects are reported. Results indicate that Hofmann elimination of N,N,N-trimethyl-3,3-dimethylcyclopentylammonium hydroxide goes by 97 percent syn mechanism to give 3,3-dimethylcyclopentene and by 70 + - 6 percent syn mechanism to give 4,4-dimethylcyclopentene. There appears to be severe steric interactions in the anti mechanism in the 3,3-dimethylcyclopentyl system. Results indicate that, for Hofmann pyrolysis of trimethylammonium hydroxides, cyclopentene is formed by a 39 +- 7 percent syn mechanism, cyclohexene is formed by a 2 + - 2 percent syn mechanism, and cycloheptene is formed by a 30 +- 2 percent syn mechanism. Steric effects on isotope effects and mechanisms are discussed. (U.S.)

  15. A set of triple-resonance nuclear magnetic resonance experiments for structural characterization of organophosphorus compounds in mixture samples

    Energy Technology Data Exchange (ETDEWEB)

    Koskela, Harri, E-mail: Harri.T.Koskela@helsinki.fi [VERIFIN, University of Helsinki, P.O. Box 55, FIN-00014 Helsinki (Finland)

    2012-11-02

    Highlights: Black-Right-Pointing-Pointer New {sup 1}H, {sup 13}C, {sup 31}P triple-resonance NMR pulse experiments. Black-Right-Pointing-Pointer Analysis of organophosphorus (OP) compounds in complex matrix. Black-Right-Pointing-Pointer Selective extraction of {sup 1}H, {sup 31}P, and {sup 13}C chemical shifts and connectivities. Black-Right-Pointing-Pointer More precise NMR identification of OP nerve agents and their degradation products. - Abstract: The {sup 1}H, {sup 13}C correlation NMR spectroscopy utilizes J{sub CH} couplings in molecules, and provides important structural information from small organic molecules in the form of carbon chemical shifts and carbon-proton connectivities. The full potential of the {sup 1}H, {sup 13}C correlation NMR spectroscopy has not been realized in the Chemical Weapons Convention (CWC) related verification analyses due to the sample matrix, which usually contains a high amount of non-related compounds obscuring the correlations of the relevant compounds. Here, the results of the application of {sup 1}H, {sup 13}C, {sup 31}P triple-resonance NMR spectroscopy in characterization of OP compounds related to the CWC are presented. With a set of two-dimensional triple-resonance experiments the J{sub HP}, J{sub CH} and J{sub PC} couplings are utilized to map the connectivities of the atoms in OP compounds and to extract the carbon chemical shift information. With the use of the proposed pulse sequences the correlations from the OP compounds can be recorded without significant artifacts from the non-OP compound impurities in the sample. Further selectivity of the observed correlations is achieved with the application of phosphorus band-selective pulse in the pulse sequences to assist the analysis of multiple OP compounds in mixture samples. The use of the triple-resonance experiments in the analysis of a complex sample is shown with a test mixture containing typical scheduled OP compounds, including the characteristic degradation

  16. The Dynamics of Visual Art Dialogues: Experiences to Be Used in Hospital Settings with Visual Art Enrichment

    Directory of Open Access Journals (Sweden)

    Britt-Maj Wikström

    2011-01-01

    Full Text Available Objectives. Given that hospitals have environmental enrichment with paintings and visual art arrangement, it would be meaningful to develop and document how hospital art could be used by health professionals. Methods. The study was undertaken at an art site in Sweden. During 1-hour sessions, participants (=20 get together in an art gallery every second week five times. Results. According to the participants a new value was perceived. From qualitative analyses, three themes appear: raise association, mentally present, and door-opener. In addition 72% of the participants reported makes me happy and gives energy and inspiration, and 52% reported that dialogues increase inspiration, make you involved, and stimulate curiosity. Conclusion. The present study supported the view that visual art dialogue could be used by health care professionals in a structured manner and that meaningful art stimulation, related to a person’s experiences, could be of importance for the patients. Implementing art dialogues in hospital settings could be a fruitful working tool for nurses, a complementary manner of patient communication.

  17. The effect of drive frequency and set point amplitude on tapping forces in atomic force microscopy: simulation and experiment

    International Nuclear Information System (INIS)

    Legleiter, Justin

    2009-01-01

    In tapping mode atomic force microscopy (AFM), a sharp probe tip attached to an oscillating cantilever is allowed to intermittently strike a surface. By raster scanning the probe while monitoring the oscillation amplitude of the cantilever via a feedback loop, topographical maps of surfaces with nanoscale resolution can be acquired. While numerous studies have employed numerical simulations to elucidate the time-resolved tapping force between the probe tip and surface, until recent technique developments, specific read-outs from such models could not be experimentally verified. In this study, we explore, via numerical simulation, the impact of imaging parameters, i.e. set point ratio and drive frequency as a function of resonance, on time-varying tip-sample force interactions, which are directly compared to reconstructed tapping forces from real AFM experiments. As the AFM model contains a feedback loop allowing for the simulation of the entire scanning process, we further explore the impact that various tip-sample force have on the entire imaging process.

  18. "Looking and Listening-In": A Methodological Approach to Generating Insights into Infants' Experiences of Early Childhood Education and Care Settings

    Science.gov (United States)

    Sumsion, Jennifer; Goodfellow, Joy

    2012-01-01

    In this article, we describe an observational approach, "looking and listening-in," that we have used to try to understand the experience of an infant in an Australian family day-care home. The article is drawn from a larger study of infants' experiences of early childhood education and care settings. In keeping with the mosaic…

  19. In vivo thermoterapy: attempt to eliminate virus in potato tuber

    Science.gov (United States)

    Ayu Astarini, Ida; Margareth, Deborah; Temaja, I. Gede Rai Maya

    2018-03-01

    Potato is one of an important vegetable crop in Indonesia, including Bali. Main potato production areas in Bali are at Bedugul region, 1.200 m above sea level. Potato production in Bali continued to decrease due to diseases infection, such as early blight, late blight, black leg and virus diseases. Potato farmers in Bali usually set aside their harvest as seed potatoes, resulting in virus diseases being carried out on the next planting seasons and eventually would decrease potato production both in quantity and quality. Four types of virus were confirmed: PVY, PVX, PVS and PRLV. A number of studies have reported thermotherapy technique has been employed to eliminate potato virus in vitro. However, this technique is not readily available for farmers, since there is no established tissue culture laboratory to support. Therefore, there is an urgent need to develop a more practical method. The objective of this study was to eliminate virus on seed potatoes using thermotherapy on tuber. Seed potatoes with 1 cm sprout which were virus positive were placed on sterile charred rice paddy husk, and then put into a humidified incubator. Tubers were exposed to 37°C for four days followed by 34°C for three days alternately for two weeks and three weeks duration. Four tubers received heat exposure regime for each virus type. After thermotherapy, potato tubers were transferred to pots containing charred rice paddy husk and maintain for three weeks until new leaves emerge for virus analyses. Results show that seed tubers experienced delayed growth after thermotherapy. Control plants sprout one week after thermotherapy, while treated plants were not yet sprouting. Experiment is currently underway. It is expected that heat treatment on tuber will give a practical method for farmers to eliminate virus of seed potatoes.

  20. An Optimization Study on Listening Experiments to Improve the Comparability of Annoyance Ratings of Noise Samples from Different Experimental Sample Sets.

    Science.gov (United States)

    Di, Guoqing; Lu, Kuanguang; Shi, Xiaofan

    2018-03-08

    Annoyance ratings obtained from listening experiments are widely used in studies on health effect of environmental noise. In listening experiments, participants usually give the annoyance rating of each noise sample according to its relative annoyance degree among all samples in the experimental sample set if there are no reference sound samples, which leads to poor comparability between experimental results obtained from different experimental sample sets. To solve this problem, this study proposed to add several pink noise samples with certain loudness levels into experimental sample sets as reference sound samples. On this basis, the standard curve between logarithmic mean annoyance and loudness level of pink noise was used to calibrate the experimental results and the calibration procedures were described in detail. Furthermore, as a case study, six different types of noise sample sets were selected to conduct listening experiments using this method to examine the applicability of it. Results showed that the differences in the annoyance ratings of each identical noise sample from different experimental sample sets were markedly decreased after calibration. The determination coefficient ( R ²) of linear fitting functions between psychoacoustic annoyance (PA) and mean annoyance (MA) of noise samples from different experimental sample sets increased obviously after calibration. The case study indicated that the method above is applicable to calibrating annoyance ratings obtained from different types of noise sample sets. After calibration, the comparability of annoyance ratings of noise samples from different experimental sample sets can be distinctly improved.

  1. Atmosphere surface storm track response to resolved ocean mesoscale in two sets of global climate model experiments

    Science.gov (United States)

    Small, R. Justin; Msadek, Rym; Kwon, Young-Oh; Booth, James F.; Zarzycki, Colin

    2018-05-01

    It has been hypothesized that the ocean mesoscale (particularly ocean fronts) can affect the strength and location of the overlying extratropical atmospheric storm track. In this paper, we examine whether resolving ocean fronts in global climate models indeed leads to significant improvement in the simulated storm track, defined using low level meridional wind. Two main sets of experiments are used: (i) global climate model Community Earth System Model version 1 with non-eddy-resolving standard resolution or with ocean eddy-resolving resolution, and (ii) the same but with the GFDL Climate Model version 2. In case (i), it is found that higher ocean resolution leads to a reduction of a very warm sea surface temperature (SST) bias at the east coasts of the U.S. and Japan seen in standard resolution models. This in turn leads to a reduction of storm track strength near the coastlines, by up to 20%, and a better location of the storm track maxima, over the western boundary currents as observed. In case (ii), the change in absolute SST bias in these regions is less notable, and there are modest (10% or less) increases in surface storm track, and smaller changes in the free troposphere. In contrast, in the southern Indian Ocean, case (ii) shows most sensitivity to ocean resolution, and this coincides with a larger change in mean SST as ocean resolution is changed. Where the ocean resolution does make a difference, it consistently brings the storm track closer in appearance to that seen in ERA-Interim Reanalysis data. Overall, for the range of ocean model resolutions used here (1° versus 0.1°) we find that the differences in SST gradient have a small effect on the storm track strength whilst changes in absolute SST between experiments can have a larger effect. The latter affects the land-sea contrast, air-sea stability, surface latent heat flux, and the boundary layer baroclinicity in such a way as to reduce storm track activity adjacent to the western boundary in the N

  2. Post procedural complications of cardiac implants done in a resource limited setting under 'C' arm: A single centre experience.

    Science.gov (United States)

    Jayachandra, A; Aggarwal, Vivek; Kumar, Sandeep; Nagesh, I V

    2018-04-01

    Cardiology interventions in peripheral hospitals is a challenging task where cardiologist have to fight against time and limited resources. Most of the sudden cardiac deaths occur due to arrhythmia and heart blocks/sinus node dysfunction. Our study is a single peripheral center experience of cardiac devices implantation using a 'C' Arm. The aim of this study was to post procedural complications of cardiac implants done in aresource limited setting under 'C' arm. This study is done at a peripheral cardiology center with no cardiac catheterization laboratory (CCL) facilities. Consecutive patients reporting to cardiology center, between Jan 2015 and Oct 2016, with a definite indication for cardiac device implant were included in the study. All the procedure of implantation was done in the operation theatre under 'C' arm under local anesthesia with continuous cardiac monitoring and critical care back up. Total 58 device implantations were done from Jan 2015 to Oct 2016. The mean age of the patients was 67.15 ± 10.85 years. Males constituted almost two third (68.9%) of patients. The commonest indication for device implantation was sinus node dysfunction in 60.34% followed by complete heart block in 25.86% and ventricular tachycardia in 12.06%. No post procedure infection was observed in our study. Device implantation constitute a major group of life saving interventions in cardiology practice. Our study has emphasised that when appropriate aseptic measures are taken during device implantation at peripheral centres, the complications rate are comparable to interventions done at advance cardiac centres.

  3. Breaking bad news in clinical setting - health professionals' experience and perceived competence in Southwestern Nigeria: a cross sectional study.

    Science.gov (United States)

    Adebayo, Philip Babatunde; Abayomi, Olukayode; Johnson, Peter O; Oloyede, Taofeeq; Oyelekan, Abimbola A A

    2013-01-01

    Communication skills are vital in clinical settings because the manner in which bad news is delivered could be a huge determinant of responses to such news; as well as compliance with beneficial treatment option. Information on training, institutional guidelines and protocols for breaking bad news (BBN) is scarce in Nigeria. We assessed the training, experience and perceived competence of BBN among medical personnel in southwestern Nigeria. The study was a cross-sectional descriptive study conducted out among doctors and nurses in two healthcare institutions in southwestern Nigeria using an anonymous questionnaire (adapted from the survey by Horwitz et al.), which focused on the respondents training, awareness of protocols in BBN; and perceived competence (using a Five-Point Likert Scale) in five clinical scenarios. We equally asked the respondents about an instance of BBN they have recently witnessed. A total of 113 of 130 selected (response rate 86.9%) respondents were studied. Eight (7.1%) of the respondents knew of the guidelines on BBN in the hospital in which they work. Twenty-three (20.3%) respondents claimed knowledge of a protocol. The median perceived competence rating was 4 out of 5 in all the clinical scenarios. Twenty-five (22.1%) respondents have had a formal training in BBN and they generally had significant higher perceived competence rating (P = 0.003-0.021). There is poor support from fellow workers during instances of BBN. It appears that the large proportion of the respondents in this study were unconsciously incompetent in BBN in view of the low level of training and little or no knowledge of well known protocols for BBN even though self-rated competence is high. Continuous medical education in communication skills among health personnel in Nigeria is advocated.

  4. SU-F-P-33: Combining Research and Professional Practice in the Clinical Setting: A Medical Physicist Personal Experience

    International Nuclear Information System (INIS)

    Lopez-Tarjuelo, J

    2016-01-01

    Purpose: To initiate a discussion on the current and evolving role of Medical Physicists based on author’s professional and research experience in patient safety and quality control. Methods: Several professionals of the departments of Medical Physics and Radiation Oncology, chiefly devoted to clinical tasks, began a research program on patient safety and quality control in a framework provided by the implementation of intraoperative radiotherapy (IORT). We performed studies on virtual simulation for IORT, in vivo dosimetry, failure mode and effect analysis (FMEA), statistical process control (SPC), and receiver operating characteristics of dosimetric equipment. This was done with the support of our research foundation and different grants while continuing with our departmental clinical routine involving about 1600 annual treatments with two linacs and different brachytherapy techniques. Results: We published 5 papers in international journals in the last two years. This author conducted a doctoral research which resulted in a dissertation in 2015. The extra time spent after treatments was essential to succeed. Funding and support achieved via our foundation played a crucial role; but this would have not been possible without punctual external mentoring and partnership. FMEA conclusions were able to be implemented only with staff commitment; however, conclusions concerning equipment cannot be easily communicated to manufacturers. These tasks required extra training in the appropriated methods. Conclusion: Research needed the support of a dedicated foundation, which would have been very difficult to obtain with the sole participation of our departments. FMEA and SPC results may need engagement of staff and manufacturers, respectively, hard to achieve without strong recommendations or even a regulatory framework. All these fields need evolution of Medical Physicists’ roles and additional training. Devotion to both clinical tasks and research could be unfeasible

  5. Losing connections and receiving support to reconnect: experiences of frail older people within care programmes implemented in primary care settings.

    Science.gov (United States)

    Bindels, Jill; Cox, Karen; De La Haye, Jean; Mevissen, Ger; Heijing, Servé; van Schayck, Onno C P; Widdershoven, Guy; Abma, Tineke A

    2015-09-01

    The objective of this study was to evaluate whether care provided in the care programmes matched the needs of older people. Care programmes were implemented in primary-care settings in the Netherlands to identify frail older people and to prevent further deterioration of health. In total, 23 older people participated in in-depth interviews. Within this study, three older people participated as co-researchers; they gathered and analysed the data together with the academic researchers. Content analysis was used to analyse the data. Two categories emerged from the data: 'Losing connections' and 'Receiving support to reconnect.' 'Losing connections' reflects the needs of older people and 'Receiving support to reconnect' reflects their experience and the appreciated aspects of the provided care. A relationship of trust with the practice nurse (PN) appeared to be an important aspect of care, as it fostered the sharing of feelings and issues other than physical or medical problems that could not be shared with the general practitioner. The PNs are experienced as connectors, who help to restore feelings of connectedness and older peoples' access to resources in the community. The relationship with the PN was experienced as valuable because of the feelings of 'connectedness' it created. Through this connectedness, older people could discuss feelings of loneliness, depression and frustration in receiving and acquiring the appropriate resources and services with the PNs. Furthermore, the relationship with the PN helped the older people to gain access to other health professionals and services. The results imply that care for frail older people should include an awareness of the importance of the trusting relationship. Nurses can play a vital role in creating a trusting relationship and are able to bridge the gap between older people and other professionals and services. © 2014 John Wiley & Sons Ltd.

  6. Assessing the rebound effect using a natural experiment setting: Evidence from the private transportation sector in Israel

    International Nuclear Information System (INIS)

    Steren, Aviv; Rubin, Ofir D.; Rosenzweig, Stav

    2016-01-01

    Subsidizing energy-efficient technologies is considered by energy and environmental organizations to be one of the most effective policies for decreasing energy consumption. In the transportation sector such policies are becoming ever more popular, and have been implemented in a considerable number of countries in recent years. Because these policies promote energy-efficient cars with lower usage costs, they may rebound and increase the distances traveled by households that have switched to energy-efficient cars. From an econometric perspective, a subsidization policy can be used as a valid instrument to identify the households’ choice of energy efficiency levels of the cars they own. This identification, in turn, can be utilized to account for endogeneity in the estimation of a rebound effect. The present study uses a natural experiment setting of such a policy implemented in Israel in 2009. The empirical results indicate a fairly large average rebound effect of 40%. The results also indicate that while the policy indeed encouraged the purchase of energy-efficient cars, households that bought a new or used car during the surveyed period did not generate a rebound effect of a different magnitude compared with other households that did not. We discuss the implications of our findings. - Highlights: •Subsidizing energy-efficient cars has become a popular policy in many countries. •We are unaware of studies identifying rebound via cars’ subsidization policy. •We explored a rebound in light of such a policy in Israel. •Household expenditure survey data, fuel prices and car characteristics were employed. •We found an average rebound effect of 40%.

  7. SU-F-P-33: Combining Research and Professional Practice in the Clinical Setting: A Medical Physicist Personal Experience

    Energy Technology Data Exchange (ETDEWEB)

    Lopez-Tarjuelo, J [Consorcio Hospitalario Provincial de Castello, Castello de la Plana (Spain)

    2016-06-15

    Purpose: To initiate a discussion on the current and evolving role of Medical Physicists based on author’s professional and research experience in patient safety and quality control. Methods: Several professionals of the departments of Medical Physics and Radiation Oncology, chiefly devoted to clinical tasks, began a research program on patient safety and quality control in a framework provided by the implementation of intraoperative radiotherapy (IORT). We performed studies on virtual simulation for IORT, in vivo dosimetry, failure mode and effect analysis (FMEA), statistical process control (SPC), and receiver operating characteristics of dosimetric equipment. This was done with the support of our research foundation and different grants while continuing with our departmental clinical routine involving about 1600 annual treatments with two linacs and different brachytherapy techniques. Results: We published 5 papers in international journals in the last two years. This author conducted a doctoral research which resulted in a dissertation in 2015. The extra time spent after treatments was essential to succeed. Funding and support achieved via our foundation played a crucial role; but this would have not been possible without punctual external mentoring and partnership. FMEA conclusions were able to be implemented only with staff commitment; however, conclusions concerning equipment cannot be easily communicated to manufacturers. These tasks required extra training in the appropriated methods. Conclusion: Research needed the support of a dedicated foundation, which would have been very difficult to obtain with the sole participation of our departments. FMEA and SPC results may need engagement of staff and manufacturers, respectively, hard to achieve without strong recommendations or even a regulatory framework. All these fields need evolution of Medical Physicists’ roles and additional training. Devotion to both clinical tasks and research could be unfeasible

  8. The patient experience of patient-centered communication with nurses in the hospital setting: a qualitative systematic review protocol.

    Science.gov (United States)

    Newell, Stephanie; Jordan, Zoe

    2015-01-01

    The objective of this systematic review is to synthesize the eligible evidence of patients' experience of engaging and interacting with nurses, in the medical-surgical ward setting.This review will consider the following questions: Communication is a way in which humans make sense of the world around them. Communication takes place as an interactive two-way process or interaction, involving two or more people and can occur by nonverbal, verbal, face-to-face or non-face-to-face methods. Effective communication is described to occur when the sender of a message sends their message in a way that conveys the intent of their message and then is understood by the receiver of the message. As a result of the communication from both the sender and the receiver of the message a shared meaning is created between both parties.Communication can therefore be viewed as a reciprocal process. In the health care literature the terms communication and interaction are used interchangeably.Communication failures between clinicians are the most common primary cause of errors and adverse events in health care. Communication is a significant factor in patient satisfaction and complaints about care. Communication plays an integral role in service quality in all service professions including health care professions.Within healthcare, quality care has been defined by the Institute of Medicine as 'care that is safe, effective, timely, efficient, equitable and patient-centred'. Patient-centered care is defined as 'care that is respectful of and responsive to individual patient preferences, needs and values, and ensuring that patient's values guide all clinical decisions. Patient centered-care encompasses the 'individual experiences of a patient, the clinical service, the organizational and the regulatory levels of health care'. At the individual patient level, patient-centered care is care that is 'provided in a respectful manner, assures open and ongoing sharing of useful information in an

  9. Which structural rules admit cut elimination? An algebraic criterion

    OpenAIRE

    Terui, Kazushige

    2007-01-01

    Consider a general class of structural inference rules such as exchange, weakening, contraction and their generalizations. Among them, some are harmless but others do harm to cut elimination. Hence it is natural to ask under which condition cut elimination is preserved when a set of structural rules is added to a structure-free logic. The aim of this work is to give such a condition by using algebraic semantics. ¶ We consider full Lambek calculus (FL), i.e., intuitioni...

  10. Does the number of choice sets matter? Results from a web survey applying a discrete choice experiment

    DEFF Research Database (Denmark)

    Bech, Mickael; Kjær, Trine; Lauridsen, Jørgen Trankjær

    2011-01-01

    choice sets presented to each respondent on response rate, self-reported choice certainty, perceived choice difficulty, willingness-to-pay (WTP) estimates, and response variance. A sample of 1053 respondents was exposed to 5, 9 or 17 choice sets in a DCE eliciting preferences for dental services. Our...... results showed no differences in response rates and no systematic differences in the respondents' self-reported perception of the uncertainty of their DCE answers. There were some differences in WTP estimates suggesting that estimated preferences are to some extent context-dependent, but no differences...... in standard deviations for WTP estimates or goodness-of-fit statistics. Respondents exposed to 17 choice sets had somewhat higher response variance compared to those exposed to 5 choice sets, indicating that cognitive burden may increase with the number of choice sets beyond a certain threshold. Overall, our...

  11. Eliciting preferences for priority setting in genetic testing: a pilot study comparing best-worst scaling and discrete-choice experiments

    OpenAIRE

    Severin, Franziska; Schmidtke, Jörg; Mühlbacher, Axel; Rogowski, Wolf H

    2013-01-01

    Given the increasing number of genetic tests available, decisions have to be made on how to allocate limited health-care resources to them. Different criteria have been proposed to guide priority setting. However, their relative importance is unclear. Discrete-choice experiments (DCEs) and best-worst scaling experiments (BWSs) are methods used to identify and weight various criteria that influence orders of priority. This study tests whether these preference eliciting techniques can be used f...

  12. Cancer risks: Strategies for elimination

    International Nuclear Information System (INIS)

    Bannasch, P.

    1987-01-01

    This book deals with the possibilities for identifying and eliminating cancer risk factors. The current state of knowledge on the detection, assessment and elimination of chemical, physical (radiation), and biological (viruses) risk factors are comprehensively presented in 15 contributions. Chemical risk factors resulting from smoking and environmental contamination are given special attention. The coverage of cancer risks by radiation includes some of the consequences of the Chernobyl disaster. Finally, the discussion of the possible risks that certain viruses hold for cancer in man is intended to further the development of vaccinations against these viral infections. The information is directed not only at specialists, but also at a wider interested audience. Its primary aim is to convey established findings that are already being used for cancer prevention. Furthermore, the book aims to promote more intense research in the field of primary cancer prevention. Contents: General aspects; chemical carcinogens: Risk assessment; chemical carcinogens: Primary prevention; physical carcinogens - Oncogenic viruses and subject index

  13. Instructor Experiences with a Social Networking Site in a Higher Education Setting: Expectations, Frustrations, Appropriation, and Compartmentalization

    Science.gov (United States)

    Veletsianos, George; Kimmons, Royce; French, Karen D.

    2013-01-01

    Researchers and practitioners have suggested that the use of social networking sites in formal education may be a worthwhile endeavor. Toward this goal, emerging learning platforms have included social networking features. Nevertheless, empirical literature examining user experiences, and more specifically instructor experiences, with these tools…

  14. Students' Experiences of Attending an Innovative Occupational Therapy Professional Practice Placement in a Childcare Setting

    Science.gov (United States)

    Yu, Mong-lin; Brown, Ted; Etherington, Jamie

    2018-01-01

    This study investigated occupational therapy students' experiences of their alternative fieldwork placement at one childcare center where there was no established occupational therapy service. A semi-structured focus group interview explored four students' placement experiences. The interview was audio-recorded, transcribed verbatim, and content…

  15. Change Management Model for Implementing an Effective First-Year Experience Program in the Community College Setting

    Science.gov (United States)

    Tucker, Joy C.

    2015-01-01

    This study provides evidence that systematic management of change can facilitate the implementation of first-year experience programming that leads to improved results in retention and student success for community college students. The study includes four major themes: (a) first-year experience, (b) change management, (c) change leadership, and…

  16. Mass Drug Administration and beyond: how can we strengthen health systems to deliver complex interventions to eliminate neglected tropical diseases?

    Science.gov (United States)

    Macpherson, Eleanor E; Adams, Emily R; Bockarie, Moses J; Hollingsworth, T Deirdre; Kelly-Hope, Louise A; Lehane, Mike; Kovacic, Vanja; Harrison, Robert A; Paine, Mark Ji; Reimer, Lisa J; Torr, Stephen J

    2015-01-01

    Achieving the 2020 goals for Neglected Tropical Diseases (NTDs) requires scale-up of Mass Drug Administration (MDA) which will require long-term commitment of national and global financing partners, strengthening national capacity and, at the community level, systems to monitor and evaluate activities and impact. For some settings and diseases, MDA is not appropriate and alternative interventions are required. Operational research is necessary to identify how existing MDA networks can deliver this more complex range of interventions equitably. The final stages of the different global programmes to eliminate NTDs require eliminating foci of transmission which are likely to persist in complex and remote rural settings. Operational research is required to identify how current tools and practices might be adapted to locate and eliminate these hard-to-reach foci. Chronic disabilities caused by NTDs will persist after transmission of pathogens ceases. Development and delivery of sustainable services to reduce the NTD-related disability is an urgent public health priority. LSTM and its partners are world leaders in developing and delivering interventions to control vector-borne NTDs and malaria, particularly in hard-to-reach settings in Africa. Our experience, partnerships and research capacity allows us to serve as a hub for developing, supporting, monitoring and evaluating global programmes to eliminate NTDs.

  17. Smoke/Sulfates, Clouds and Radiation Experiment in Brazil (SCAR-B) Data Set Version 5.5

    Data.gov (United States)

    National Aeronautics and Space Administration — SCAR_B_G8_FIRE data are Smoke/Sulfates, Clouds and Radiation Experiment in Brazil, GOES-8 ABBA Diurnal Fire Product (1995 Fire Season) data.Smoke/Sulfates, Clouds...

  18. How do Millennial Engineering and Technology Students Experience Learning Through Traditional Teaching Methods Employed in the University Setting?

    OpenAIRE

    Howard, Elizabeth A

    2011-01-01

    The purpose of the study was to document and analyze how Millennial engineering and technology students experience learning in large lecture classrooms. To help achieve this purpose, perceptions Millennials have toward traditional teaching methods employed in large lecture classes were analyzed and discussed. Additionally, this study documented how Millennials experienced technology within large lecture classrooms. A learning model depicting how Millennials experience learning within the larg...

  19. Online communication in a rehabilitation setting: Experiences of patients with chronic conditions using a web portal in Denmark.

    Science.gov (United States)

    Cerdan, Jose; Catalan-Matamoros, Daniel; Berg, Sarah Warny

    2017-12-01

    To gain insight into the experiences of patients with long-term conditions enrolled in an online rehabilitation programme using a web portal. Danish outpatients were recruited from a rehabilitation department and were granted access to a web portal which included an online rehabilitation programme with key information, clinical advice, and self-management activities. After two weeks, patients were invited to participate in focus groups. A topic guide was used to explore this new online rehabilitation programme in relation to participants' experiences. Fourteen participants, ranging from 42 to 72 years old, were allocated into three focus groups. Participants mainly reported negative experiences by the following four themes: 'patients' experiences', 'technical aspects', 'areas for improvement', and 'digitalization added value'. Participants mainly reported negative experiences and suggested combining both face-to-face consultations with online care by user-friendly web portals. This will ensure a positive contribution from digital communication tools to rehabilitation. Patients' experiences should be considered in the design of web portals in rehabilitation which could help healthcare organizations when developing online rehabilitation programmes. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Investing in organisational culture: nursing students' experience of organisational learning culture in aged care settings following a program of cultural development.

    Science.gov (United States)

    Grealish, Laurie; Henderson, Amanda

    2016-10-01

    Concerns around organisational learning culture limit nursing student placements in aged care settings to first year experiences. Determine the impact of an extended staff capacity building program on students' experiences of the organisational learning culture in the aged care setting. Pre and post-test design. A convenience sample of first, second and third year Bachelor of Nursing students attending placements at three residential aged care facilities completed the Clinical Learning Organisational Culture Survey. Responses between the group that attended placement before the program (n = 17/44; RR 38%) and the group that attended following the program (n = 33/72; RR 45%) were compared. Improvements were noted in the areas of recognition, accomplishment, and influence, with decreases in dissatisfaction. Organisational investment in building staff capacity can produce a positive learning culture. The aged care sector offers a rich learning experience for students when staff capacity to support learning is developed.

  1. Losing connections and receiving support to reconnect: experiences of frail older people within care programmes implemented in primary care settings

    NARCIS (Netherlands)

    Bindels, J.; Cox, K.; De La Haye, J.; Mevissen, G.; Heijing, S.; van Schayck, O.C.P.; Widdershoven, G.; Abma, T.A.

    2015-01-01

    Aims and objectives: The objective of this study was to evaluate whether care provided in the care programmes matched the needs of older people. Background: Care programmes were implemented in primary-care settings in the Netherlands to identify frail older people and to prevent further

  2. Advance Care Planning: Understanding Clinical Routines and Experiences of Interprofessional Team Members in Diverse Health Care Settings.

    Science.gov (United States)

    Arnett, Kelly; Sudore, Rebecca L; Nowels, David; Feng, Cindy X; Levy, Cari R; Lum, Hillary D

    2017-12-01

    Interprofessional health care team members consider advance care planning (ACP) to be important, yet gaps remain in systematic clinical routines to support ACP. A clearer understanding of the interprofessional team members' perspectives on ACP clinical routines in diverse settings is needed. One hundred eighteen health care team members from community-based clinics, long-term care facilities, academic clinics, federally qualified health centers, and hospitals participated in a 35-question, cross-sectional online survey to assess clinical routines, workflow processes, and policies relating to ACP. Respondents were 53% physicians, 18% advanced practice nurses, 11% nurses, and 18% other interprofessional team members including administrators, chaplains, social workers, and others. Regarding clinical routines, respondents reported that several interprofessional team members play a role in facilitating ACP (ie, physician, social worker, nurse, others). Most (62%) settings did not have, or did not know of, policies related to ACP documentation. Only 14% of settings had a patient education program. Two-thirds of the respondents said that addressing ACP is a high priority and 85% felt that nonphysicians could have ACP conversations with appropriate training. The clinical resources needed to improve clinical routines included training for providers and staff, dedicated staff to facilitate ACP, and availability of patient/family educational materials. Although interprofessional health care team members consider ACP a priority and several team members may be involved, clinical settings lack systematic clinical routines to support ACP. Patient educational materials, interprofessional team training, and policies to support ACP clinical workflows that do not rely solely on physicians could improve ACP across diverse clinical settings.

  3. Online communication in a rehabilitation setting: Experiences of patients with chronic conditions using a web portal in Denmark

    DEFF Research Database (Denmark)

    Cerdan de Las Heras, Jose Manuel; Catalan-Matamoros, Daniel; Warny, Sarah

    2017-01-01

    mainly reported negative experiences and suggested combining both face-to-face consultations with online care by user-friendly web portals. This will ensure a positive contribution from digital communication tools to rehabilitation. Practice implications Patients’ experiences should be considered......Abstract Objective To gain insight into the experiences of patients with long-term conditions enrolled in an online rehabilitation programme using a web portal. Methods Danish outpatients were recruited from a rehabilitation department and were granted access to a web portal which included...... in the design of web portals in rehabilitation which could help healthcare organizations when developing online rehabilitation programmes. Keywords CommunicationWeb portalPatient's experienceseHealthRehabilitation...

  4. Online communication in a rehabilitation setting: Experiences of patients with chronic conditions using a web portal in Denmark

    DEFF Research Database (Denmark)

    Cerdan de Las Heras, Jose Manuel; Catalan-Matamoros, Daniel; Warny, Sarah

    2017-01-01

    an online rehabilitation programme with key information, clinical advice, and self-management activities. After two weeks, patients were invited to participate in focus groups. A topic guide was used to explore this new online rehabilitation programme in relation to participants’ experiences. Results...... Fourteen participants, ranging from 42 to 72 years old, were allocated into three focus groups. Participants mainly reported negative experiences by the following four themes: ‘patients’ experiences’, ‘technical aspects’, ‘areas for improvement’, and ‘digitalization added value’. Conclusion Participants...

  5. Training experience to improve and reinforce associated aspects to the control room operators' behaviour in the simulator setting

    International Nuclear Information System (INIS)

    Santiago Lucas Soriano, A.

    2002-01-01

    The experience, explained below, is based on the latest works carried out in TECNATOM, to improve the behaviour of the control room personnel, by an effective involvement of the operators in their own improvement, in which they create their own expectations and the instructors are only guides and advisors in a working place very close to the reality, that is, the simulator. The experience mainly deals with aspects such as: Teamwork, effective communications, use of procedures, self-checking, decision making, diagnose, motivation and other aspects that are present in the control room. (author)

  6. Glycaemic control of diabetic patients in an urban primary health care setting in Sarawak: the Tanah Puteh Health Centre experience.

    Science.gov (United States)

    Wong, J S; Rahimah, N

    2004-08-01

    Achieving glycaemic goals in diabetics has always been a problem, especially in a developing country with inadequate facilities such as in Sarawak in Malaysia. There are no reported studies on the control of diabetes mellitus in a diabetic clinic in the primary health care setting in Sarawak. This paper describes the profile of 1031 patients treated in Klinik Kesihatan Tanah Puteh Health Centre. The mean age was 59 years, the mean BMI 27 kg/m2. There was a female preponderance and mainly type-2 diabetes. Mean HbA1c was 7.4%. Glycaemic control was optimal in 28% (HbA1c 7.5%). Reasonable glycaemic control can be achieved in the primary health care setting in Sarawak.

  7. Political strategies in difficult times - The "backstage" experience of Swedish politicians on formal priority setting in healthcare.

    Science.gov (United States)

    Garpenby, Peter; Nedlund, Ann-Charlotte

    2016-08-01

    This paper contributes to the knowledge on the governing of healthcare in a democratic context in times of austerity. Resource allocation in healthcare is a highly political issue but the political nature of healthcare is not always made clear and the role of politicians is often obscure. The absence of politicians in rationing/disinvestment arrangements is usually explained with blame-shifting arguments; they prefer to delegate "the burden of responsibility" to administrative agencies or professionals. Drawing on a case where Swedish regional politicians involved themselves in setting priorities at a more detailed level than previously, the findings suggest that the subject of "blame avoidance" is more complicated than usually assumed. A qualitative case study was designed, involving semi-structured interviews with 14 regionally elected politicians in one Swedish health authority, conducted in June 2011. The interviews were analysed through a thematic analysis in accordance with the "framework approach" by Ritchie and Lewis. Findings show that an overarching strategy among the politicians was to appear united and to suppress conflict, which served to underpin the vital strategy of bringing the medical profession into the process. A key finding is the importance that politicians, when appearing "backstage", attach to the prevention of blame from the medical profession. This case illustrates that one has to take into account that priority settings requires various types of skills and knowledges - not only technical but also political and social. Another important lesson points toward the need to broaden the political leadership repertoire, as leadership in the case of priority setting is not about politicians being all in or all out. The results suggest that in a priority-setting process it is of importance to have politics on-board at an early stage to secure loyalty to the process, although not necessarily being involved in all details. Copyright © 2016 Elsevier

  8. Challenging Thoughts, Changing Minds: Preservice Teachers' Reflections on Their Experience Working in an Alternative School Setting

    Science.gov (United States)

    Blevins, Brooke; Moore, Brandon; Dexter Torti, Cameron

    2017-01-01

    This study was designed to use critical reflective journaling practices to explore the experiences of preservice teachers working in a juvenile justice education program called the Reach Academy. Using a qualitative case study design, the researchers explored how 48 preservice teachers utilized critical reflective journaling to examine their own…

  9. Illness experiences of diabetes in the context of malaria in settings experiencing double burden of disease in southeastern Tanzania

    NARCIS (Netherlands)

    Metta, Emmy; Bailey, Ajay; Kessy, Flora; Geubbels, Eveline; Haisma, Hinke

    2017-01-01

    BACKGROUND: Tanzania is doubly burdened with both non-communicable and infectious diseases, but information on how Tanzanians experience the co-existence of these conditions is limited. Using Kleinman's eight prompting questions the study synthesizes explanatory models from patients to describe

  10. Nanoparticle Synthesis, Characterization, and Ecotoxicity: A Research-Based Set of Laboratory Experiments for a General Chemistry Course

    Science.gov (United States)

    Amaris, Zoe N.; Freitas, Daniel N.; Mac, Karen; Gerner, Kyle T.; Nameth, Catherine; Wheeler, Korin E.

    2017-01-01

    A series of laboratory experiments were developed to introduce first-year chemistry students to nanoscience through a green chemistry approach. Students made and characterized the stability of silver nanoparticles using two different methods: UV-visible spectroscopy and dynamic light scattering. They then assessed the ecotoxicity of silver…

  11. Elastic and inelastic electrons in the double-slit experiment: A variant of Feynman's which-way set-up.

    Science.gov (United States)

    Frabboni, Stefano; Gazzadi, Gian Carlo; Grillo, Vincenzo; Pozzi, Giulio

    2015-07-01

    Modern nanotechnology tools allowed us to prepare slits of 90 nm width and 450 nm spacing in a screen almost completely opaque to 200 keV electrons. Then by covering both slits with a layer of amorphous material and carrying out the experiment in a conventional transmission electron microscope equipped with an energy filter we can demonstrate that the diffraction pattern, taken by selecting the elastically scattered electrons, shows the presence of interference fringes, but with a bimodal envelope which can be accounted for by taking into account the non-constant thickness of the deposited layer. However, the intensity of the inelastically scattered electrons in the diffraction plane is very broad and at the limit of detectability. Therefore the experiment was repeated using an aluminum film and a microscope also equipped with a Schottky field emission gun. It was thus possible to observe also the image due to the inelastically scattered electron, which does not show interference phenomena both in the Fraunhofer or Fresnel regimes. If we assume that inelastic scattering through the thin layer covering the slits provides the dissipative process of interaction responsible for the localization mechanism, then these experiments can be considered a variant of the Feynman which-way thought experiment. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Herbivory eliminates fitness costs of mutualism exploiters.

    Science.gov (United States)

    Simonsen, Anna K; Stinchcombe, John R

    2014-04-01

    A common empirical observation in mutualistic interactions is the persistence of variation in partner quality and, in particular, the persistence of exploitative phenotypes. For mutualisms between hosts and symbionts, most mutualism theory assumes that exploiters always impose fitness costs on their host. We exposed legume hosts to mutualistic (nitrogen-fixing) and exploitative (non-nitrogen-fixing) symbiotic rhizobia in field conditions, and manipulated the presence or absence of insect herbivory to determine if the costly fitness effects of exploitative rhizobia are context-dependent. Exploitative rhizobia predictably reduced host fitness when herbivores were excluded. However, insects caused greater damage on hosts associating with mutualistic rhizobia, as a consequence of feeding preferences related to leaf nitrogen content, resulting in the elimination of fitness costs imposed on hosts by exploitative rhizobia. Our experiment shows that herbivory is potentially an important factor in influencing the evolutionary dynamic between legumes and rhizobia. Partner choice and host sanctioning are theoretically predicted to stabilize mutualisms by reducing the frequency of exploitative symbionts. We argue that herbivore pressure may actually weaken selection on choice and sanction mechanisms, thus providing one explanation of why host-based discrimination mechanisms may not be completely effective in eliminating nonbeneficial partners. © 2014 The Authors. New Phytologist © 2014 New Phytologist Trust.

  13. Experiences of participation in goal setting for people with stroke-induced aphasia in Norway. A qualitative study.

    Science.gov (United States)

    Berg, Karianne; Askim, Torunn; Balandin, Susan; Armstrong, Elizabeth; Rise, Marit By

    2017-06-01

    The body of research into client participation in aphasia rehabilitation is increasing, but the evidence on how it is implemented into clinical practice is still scarce. Particularly, the importance of including the "insider's perspective" has been demanded. The aim of this study was to explore how people with aphasia experienced client participation during the process of goal setting and clinical decision making in language rehabilitation. Fifteen people with stroke-induced aphasia participated in semi-structured in-depth interviews. A qualitative analysis using Systematic Text Condensation was undertaken. Analysis revealed four main themes: (1) pleased with services, (2) vagueness in language rehabilitation, (3) personal goals exist, and (4) desired level of participation. Even though people with stroke-induced aphasia overall are pleased with the language rehabilitation, there is a need for greater emphasis on making the framework of language rehabilitation less vague. Therapists should also spend more time on collaboration with people with stroke-induced aphasia and use available methods to support communication and collaboration. The findings underscore the need for further exploration of the potential outcomes of implementing client participation in goal setting and clinical decision making for persons with stroke-induced aphasia. Implications for rehabilitation All persons with stroke induced aphasia should be asked about their goals for rehabilitation not only once, but during the whole continuum of their rehabilitation journey. Rehabilitation professionals should place greater emphasis on client participation by asking people with stroke induced aphasia how they prefer to participate at different stages of rehabilitation. To ensure active participation for those who wants it, existing tools and techniques which promoted collaborative goal setting should be better incorporated.

  14. Provision of antiretroviral treatment in conflict settings: the experience of Médecins Sans Frontières.

    Science.gov (United States)

    O'Brien, Daniel P; Venis, Sarah; Greig, Jane; Shanks, Leslie; Ellman, Tom; Sabapathy, Kalpana; Frigati, Lisa; Mills, Clair

    2010-06-17

    Many countries ravaged by conflict have substantial morbidity and mortality attributed to HIV/AIDS yet HIV treatment is uncommonly available. Universal access to HIV care cannot be achieved unless the needs of populations in conflict-affected areas are addressed. From 2003 Médecins Sans Frontières introduced HIV care, including antiretroviral therapy, into 24 programmes in conflict or post-conflict settings, mainly in sub-Saharan Africa. HIV care and treatment activities were usually integrated within other medical activities. Project data collected in the Fuchia software system were analysed and outcomes compared with ART-LINC data. Programme reports and other relevant documents and interviews with local and headquarters staff were used to develop lessons learned. In the 22 programmes where ART was initiated, more than 10,500 people were diagnosed with HIV and received medical care, and 4555 commenced antiretroviral therapy, including 348 children. Complete data were available for adults in 20 programmes (n = 4145). At analysis, 2645 (64%) remained on ART, 422 (10%) had died, 466 (11%) lost to follow-up, 417 (10%) transferred to another programme, and 195 (5%) had an unclear outcome. Median 12-month mortality and loss to follow-up were 9% and 11% respectively, and median 6-month CD4 gain was 129 cells/mm 3.Patient outcomes on treatment were comparable to those in stable resource-limited settings, and individuals and communities obtained significant benefits from access to HIV treatment. Programme disruption through instability was uncommon with only one program experiencing interruption to services, and programs were adapted to allow for disruption and population movements. Integration of HIV activities strengthened other health activities contributing to health benefits for all victims of conflict and increasing the potential sustainability for implemented activities. With commitment, simplified treatment and monitoring, and adaptations for potential

  15. Provision of antiretroviral treatment in conflict settings: the experience of Médecins Sans Frontières

    Directory of Open Access Journals (Sweden)

    Ellman Tom

    2010-06-01

    Full Text Available Abstract Introduction Many countries ravaged by conflict have substantial morbidity and mortality attributed to HIV/AIDS yet HIV treatment is uncommonly available. Universal access to HIV care cannot be achieved unless the needs of populations in conflict-affected areas are addressed. Methods From 2003 Médecins Sans Frontières introduced HIV care, including antiretroviral therapy, into 24 programmes in conflict or post-conflict settings, mainly in sub-Saharan Africa. HIV care and treatment activities were usually integrated within other medical activities. Project data collected in the Fuchia software system were analysed and outcomes compared with ART-LINC data. Programme reports and other relevant documents and interviews with local and headquarters staff were used to develop lessons learned. Results In the 22 programmes where ART was initiated, more than 10,500 people were diagnosed with HIV and received medical care, and 4555 commenced antiretroviral therapy, including 348 children. Complete data were available for adults in 20 programmes (n = 4145. At analysis, 2645 (64% remained on ART, 422 (10% had died, 466 (11% lost to follow-up, 417 (10% transferred to another programme, and 195 (5% had an unclear outcome. Median 12-month mortality and loss to follow-up were 9% and 11% respectively, and median 6-month CD4 gain was 129 cells/mm 3. Patient outcomes on treatment were comparable to those in stable resource-limited settings, and individuals and communities obtained significant benefits from access to HIV treatment. Programme disruption through instability was uncommon with only one program experiencing interruption to services, and programs were adapted to allow for disruption and population movements. Integration of HIV activities strengthened other health activities contributing to health benefits for all victims of conflict and increasing the potential sustainability for implemented activities. Conclusions With commitment, simplified

  16. Graphical reduction of reaction networks by linear elimination of species

    DEFF Research Database (Denmark)

    Saez Cornellana, Meritxell; Wiuf, Carsten; Feliu, Elisenda

    2017-01-01

    We give a graphically based procedure to reduce a reaction network to a smaller reaction network with fewer species after linear elimination of a set of noninteracting species. We give a description of the reduced reaction network, its kinetics and conservations laws, and explore properties...

  17. Military experience helps setting reasonable personality characteristics but does not alter the criminal behavior-related impression of negative parental experience and alcoholism in a Chinese population.

    Science.gov (United States)

    Xu, Hongyu; Ye, Yuqin; Zhang, Xuesi; Hao, Yelu; Shi, Fei; Yuan, Guohao; Wu, Yan; Fei, Zhou; He, Xiaosheng

    2016-10-30

    Personalities are determined by convergent factors, including physical environment, culture, special experience, and heredity. It has been shown that abuse of substance and alcohol among individuals with personality disorders predict criminality (Glenn and Raine, 2014; Hernandez-Avila et al., 2000). Thus, it is important to clarify the relationship between psychological characteristics and valence of criminal practice, even in the population without substance abuse. Here, we focused on a population with military experience in Shaanxi province of China to screen the psychological characteristics and correlate these characteristics to criminal behaviors. The study population included incarcerated veterans, incarcerated civilians, and three groups of military troops with different lengths of active duty history (criminal behavior of incarcerated veterans seem to be unrelated to their military service per se as evidenced by the control groups. Conversely, military service may benefit the personnel characteristics even in the incarcerated veteran population. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Films, Affective Computing and Aesthetic Experience: Identifying Emotional and Aesthetic Highlights from Multimodal Signals in a Social Setting

    OpenAIRE

    Kostoulas, Theodoros; Chanel, Guillaume; Muszynski, Michal; Lombardo, Patrizia; Pun, Thierry

    2017-01-01

    Over the last years, affective computing has been strengthening its ties with the humanities, exploring and building understanding of people’s responses to specific artistic multimedia stimuli. “Aesthetic experience” is acknowledged to be the subjective part of some artistic exposure, namely, the inner affective state of a person exposed to some artistic object. In this work, we describe ongoing research activities for studying the aesthetic experience of people when exposed to movie artistic...

  19. Patients' and professionals' experiences and perspectives of obesity in health-care settings: a synthesis of current research.

    Science.gov (United States)

    Mold, Freda; Forbes, Angus

    2013-06-01

    Obesity-related stigma likely influences how obese people interact with health-care professionals and access health care. To undertake a synthesis of studies examining the views and experiences of both obese people in relation to their health-care provision and health-care professionals in providing care to obese patients. A systematic search of key electronic databases relating to professional or patient experiences of, or perspectives on, obesity was performed in 2008 and updated in 2010. Reference lists of article bibliographies were searched, along with hand searches of relevant journals.   Studies were screened against explicit inclusion criteria and published between 1990 and 2010. Findings were examined and organized thematically.   Data were extracted focusing on obesity, stigma and access to health-care services. All included studies were subject to critical appraisal to assess the quality of the research. Thirty studies were identified. All the studies reported obesity impacting on health-care interactions. Key themes identified were experiences of stigma and feelings of powerlessness, treatment avoidance, psycho-emotional functioning, professional attitudes, confidence and training, variations in health contact time and finally, differences in treatment options and preventative measures. Obesity is a stigmatized condition that impacts negatively on the relationship between patients and health-care providers. Given the increasing prevalence of obesity and the range of therapeutic options available, further work is necessary to understand how the presence of obesity affects health-care interactions and decision making. © 2011 John Wiley & Sons Ltd.

  20. Solar set asides and renewable electricity certificates: Early lessons from North Carolina's experience with its renewable portfolio standard

    International Nuclear Information System (INIS)

    Gaul, Chip; Carley, Sanya

    2012-01-01

    This paper assesses the market developments in North Carolina's solar energy industry following the state's adoption of a renewable portfolio standard (RPS). It first reviews how solar renewable electricity certificates (SRECs) are intended to act as a support mechanism for the installation and financing of solar power in North Carolina's RPS compliance market. The paper then analyzes why SRECs have not precipitated growth in the solar industry thus far. Instead of attracting a diversity of solar installation and SREC trading businesses to create a competitive market to North Carolina, the RPS has only enabled a few large solar power producers to compete with utility companies to finance, install, and operate solar generating systems. A comparison between the SREC markets in North Carolina, Pennsylvania, and New Jersey reveals that transparency in prices and volumes of SRECs, limits on utility company self-ownership of solar generators, and more aggressive solar set-aside targets are required to create a competitive market environment that will attract a sustainable and growing solar industry. - Highlights: ► Assesses developments in NC's solar industry from renewable portfolio standard. ► Comparisons between the SREC markets in North Carolina, Pennsylvania, New Jersey. ► Transparency in prices and limits on utility self-ownership are necessary. ► More aggressive solar set-aside targets would also help develop the solar market.

  1. An Intervention To Enhance the Food Environment in Public Recreation and Sport Settings: A Natural Experiment in British Columbia, Canada.

    Science.gov (United States)

    Naylor, Patti-Jean; Olstad, Dana Lee; Therrien, Suzanne

    2015-08-01

    Publicly funded recreation and sports facilities provide children with access to affordable physical activities, although they often have unhealthy food environments that may increase child obesity risk. This study evaluated the impact of a capacity-building intervention (Healthy Food and Beverage Sales; HFBS) on organizational capacity for providing healthy food environments, health of vending machine products, and food policy development in recreation and sport facilities in British Columbia, Canada. Twenty-one HFBS communities received training, resources, and technical support to improve their food environment over 8 months in 2009-2010, whereas 23 comparison communities did not. Communities self-reported organizational capacity, food policies, and audited vending machine products at baseline and follow-up. Repeated-measures analysis of variance evaluated intervention impact. Intervention and comparison communities reported higher organizational capacity at follow-up; however, improvements were greater in HFBS communities (pfood policy, whereas 48% reported one at follow-up. No comparison communities had food policies. This is the first large, controlled study to examine the impact of an intervention to improve recreation and sport facility food environments. HFBS communities increased their self-rated capacity to provide healthy foods, healthy vending product offerings, and food policies to a greater extent than comparison communities. Recreation and sport settings are a priority setting for supporting healthy dietary behaviors among children.

  2. Eliminating US hospital medical errors.

    Science.gov (United States)

    Kumar, Sameer; Steinebach, Marc

    2008-01-01

    Healthcare costs in the USA have continued to rise steadily since the 1980s. Medical errors are one of the major causes of deaths and injuries of thousands of patients every year, contributing to soaring healthcare costs. The purpose of this study is to examine what has been done to deal with the medical-error problem in the last two decades and present a closed-loop mistake-proof operation system for surgery processes that would likely eliminate preventable medical errors. The design method used is a combination of creating a service blueprint, implementing the six sigma DMAIC cycle, developing cause-and-effect diagrams as well as devising poka-yokes in order to develop a robust surgery operation process for a typical US hospital. In the improve phase of the six sigma DMAIC cycle, a number of poka-yoke techniques are introduced to prevent typical medical errors (identified through cause-and-effect diagrams) that may occur in surgery operation processes in US hospitals. It is the authors' assertion that implementing the new service blueprint along with the poka-yokes, will likely result in the current medical error rate to significantly improve to the six-sigma level. Additionally, designing as many redundancies as possible in the delivery of care will help reduce medical errors. Primary healthcare providers should strongly consider investing in adequate doctor and nurse staffing, and improving their education related to the quality of service delivery to minimize clinical errors. This will lead to an increase in higher fixed costs, especially in the shorter time frame. This paper focuses additional attention needed to make a sound technical and business case for implementing six sigma tools to eliminate medical errors that will enable hospital managers to increase their hospital's profitability in the long run and also ensure patient safety.

  3. Progress Toward Regional Measles Elimination - Worldwide, 2000-2016.

    Science.gov (United States)

    Dabbagh, Alya; Patel, Minal K; Dumolard, Laure; Gacic-Dobo, Marta; Mulders, Mick N; Okwo-Bele, Jean-Marie; Kretsinger, Katrina; Papania, Mark J; Rota, Paul A; Goodson, James L

    2017-10-27

    The fourth United Nations Millennium Development Goal, adopted in 2000, set a target to reduce child mortality by two thirds by 2015. One indicator of progress toward this target was measles vaccination coverage (1). In 2010, the World Health Assembly (WHA) set three milestones for measles control by 2015: 1) increase routine coverage with the first dose of a measles-containing vaccine (MCV1) among children aged 1 year to ≥90% at the national level and to ≥80% in every district; 2) reduce global annual measles incidence to measles mortality by 95% from the 2000 estimate (2).* In 2012, WHA endorsed the Global Vaccine Action Plan, † with the objective of eliminating measles in four World Health Organization (WHO) regions by 2015 and in five regions by 2020. Countries in all six WHO regions have adopted goals for measles elimination by or before 2020. Measles elimination is defined as the absence of endemic measles virus transmission in a region or other defined geographic area for ≥12 months, in the presence of a high quality surveillance system that meets targets of key performance indicators. This report updates a previous report (3) and describes progress toward global measles control milestones and regional measles elimination goals during 2000-2016. During this period, annual reported measles incidence decreased 87%, from 145 to 19 cases per million persons, and annual estimated measles deaths decreased 84%, from 550,100 to 89,780; measles vaccination prevented an estimated 20.4 million deaths. However, the 2015 milestones have not yet been met; only one WHO region has been verified as having eliminated measles. Improved implementation of elimination strategies by countries and their partners is needed, with focus on increasing vaccination coverage through substantial and sustained additional investments in health systems, strengthening surveillance systems, using surveillance data to drive programmatic actions, securing political commitment, and raising

  4. Simulations of smog-chamber experiments using the two-dimensional volatility basis set: linear oxygenated precursors.

    Science.gov (United States)

    Chacon-Madrid, Heber J; Murphy, Benjamin N; Pandis, Spyros N; Donahue, Neil M

    2012-10-16

    We use a two-dimensional volatility basis set (2D-VBS) box model to simulate secondary organic aerosol (SOA) mass yields of linear oxygenated molecules: n-tridecanal, 2- and 7-tridecanone, 2- and 7-tridecanol, and n-pentadecane. A hybrid model with explicit, a priori treatment of the first-generation products for each precursor molecule, followed by a generic 2D-VBS mechanism for later-generation chemistry, results in excellent model-measurement agreement. This strongly confirms that the 2D-VBS mechanism is a predictive tool for SOA modeling but also suggests that certain important first-generation products for major primary SOA precursors should be treated explicitly for optimal SOA predictions.

  5. Optimizing the management of neuromyelitis optica and spectrum disorders in resource poor settings: Experience from the Mangalore demyelinating disease registry

    Directory of Open Access Journals (Sweden)

    Lekha Pandit

    2013-01-01

    Full Text Available Background: In resource-poor settings, the management of neuromyelitis optica (NMO and NMO spectrum (NMOS disorders is limited because of delayed diagnosis and financial constraints. Aim: To device a cost-effective strategy for the management of NMO and related disorders in India. Materials and Methods: A cost-effective and disease-specific protocol was used for evaluating the course and treatment outcome of 70 consecutive patients. Results: Forty-five patients (65% had a relapse from the onset and included NMO (n = 20, recurrent transverse myelitis (RTM; n = 10, and recurrent optic neuritis (ROPN; n = 15. In 38 (84.4% patients presenting after multiple attacks, the diagnosis was made clinically. Only 7 patients with a relapsing course were seen at the onset and included ROPN (n = 5, NMO (n = 1, and RTM (n = 1. They had a second attack after a median interval of 1 ± 0.9 years, which was captured through our dedicated review process. Twenty-five patients had isolated longitudinally extensive transverse myelitis (LETM, of which 20 (80% remained ambulant at follow-up of 3 ± 1.9 years. Twelve patients (17% with median expanded disability status scale (EDSS of 8.5 at entry had a fatal outcome. Serum NMO-IgG testing was done in selected patients, and it was positive in 7 of 18 patients (39%. Irrespective of the NMO-IgG status, the treatment compliant patients (44.4% showed significant improvement in EDSS (P ≤ 0.001. Conclusions : Early clinical diagnosis and treatment compliance were important for good outcome. Isolated LETM was most likely a post-infectious demyelinating disorder in our set-up. NMO and NMOS disorders contributed to 14.9% (45/303 of all demyelinating disorders in our registry.

  6. A cultural setting where the other-race effect on face recognition has no social-motivational component and derives entirely from lifetime perceptual experience.

    Science.gov (United States)

    Wan, Lulu; Crookes, Kate; Reynolds, Katherine J; Irons, Jessica L; McKone, Elinor

    2015-11-01

    Competing approaches to the other-race effect (ORE) see its primary cause as either a lack of motivation to individuate social outgroup members, or a lack of perceptual experience with other-race faces. Here, we argue that the evidence supporting the social-motivational approach derives from a particular cultural setting: a high socio-economic status group (typically US Whites) looking at the faces of a lower status group (US Blacks) with whom observers typically have at least moderate perceptual experience. In contrast, we test motivation-to-individuate instructions across five studies covering an extremely wide range of perceptual experience, in a cultural setting of more equal socio-economic status, namely Asian and Caucasian participants (N = 480) tested on Asian and Caucasian faces. We find no social-motivational component at all to the ORE, specifically: no reduction in the ORE with motivation instructions, including for novel images of the faces, and at all experience levels; no increase in correlation between own- and other-race face recognition, implying no increase in shared processes; and greater (not the predicted less) effort applied to distinguishing other-race faces than own-race faces under normal ("no instructions") conditions. Instead, the ORE was predicted by level of contact with the other-race. Our results reject both pure social-motivational theories and also the recent Categorization-Individuation model of Hugenberg, Young, Bernstein, and Sacco (2010). We propose a new dual-route approach to the ORE, in which there are two causes of the ORE-lack of motivation, and lack of experience--that contribute differently across varying world locations and cultural settings. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Feasibility of the Participatory Experience Survey and the Setting Affordances Survey for use in evaluation of programmes serving youth with intellectual and developmental disabilities.

    Science.gov (United States)

    Liljenquist, K; Coster, W; Kramer, J; Rossetti, Z

    2017-07-01

    Participation by youth with disabilities in recreational activities has been shown to promote the development of important skills needed for transition to adulthood. The Participatory Experience Survey (PES) and the Setting Affordances Survey (SAS) were developed for use by recreational programmes serving youth with significant intellectual and developmental disabilities (SIDD) to assess participant experiences and ensure that participants are afforded optimal opportunities to develop these skills. This paper presents a feasibility evaluation to determine the appropriateness of the PES and the SAS for use in a programme evaluation context. The PES and the SAS were used to evaluate a programme serving youth with SIDD in the greater northwest region of the United States. Three recreational activities were evaluated: an art project, trip to a zoo and a track practice. Programme volunteers used the SAS to assess opportunities and affordances offered within each activity. The PES was then given to 10 young people in each activity to capture their experiences. It was hypothesized that each setting would afford different experiences and developmental opportunities because of the differing nature of the activities. The PES and SAS were found to be feasible for conducting a programme evaluation. All three settings offered varying types of experiences and affordances. Notably, as measured by the SAS, opportunity for skill development was greater in more structured activities; the zoo had the fewest opportunities for skill development and the art project had the most skill development opportunities. Youth answered 'no' most often to 'asking for help' and 'helping a kid', suggesting changes to offer more opportunities to develop these skills would be beneficial in all three activities. These new instruments offer programmes a means to more fully include young people with disabilities during programme evaluations, leading to better-structured, more supportive programmes.

  8. The perceptions and experiences of people injured in motor vehicle crashes in a compensation scheme setting: a qualitative study.

    Science.gov (United States)

    Murgatroyd, Darnel; Lockwood, Keri; Garth, Belinda; Cameron, Ian D

    2015-04-25

    The evidence that compensation related factors are associated with poor recovery is substantial but these measures are generic and do not consider the complexity of scheme design. The objectives of this study were to understand people's perceptions and experiences of the claims process after sustaining a compensable injury in a motor vehicle crash (including why people seek legal representation); and to explore ways to assist people following a compensable injury and improve their experience with the claims process. A qualitative study in a Compulsory Third Party (CTP) personal injury scheme covering the state of New South Wales (NSW), Australia. A series of five focus groups, with a total of 32 participants who had sustained mild to moderate injuries in a motor vehicle crash, were conducted from May to June 2011 with four to eight attendees in each group. These were audio-recorded and transcribed. The methodology was based on a grounded theory approach using thematic analysis and constant comparison to generate coding categories for themes. Data saturation was reached. Analyst triangulation was used to ensure credibility of the results. Five primary themes were identified: complexity of the claims process; requirement of legal representation; injury recovery expectations; importance of timely healthcare decision making; and improvements for injury recovery. Some participants struggled, finding the claims process stressful and subsequently sought legal advice; whilst others reported a straight forward recovery, helpful insurer interactions and no legal representation. Most participants were influenced by injury recovery expectations, and timely healthcare decision making. To assist with injury recovery, access to objective information about the claims process using online technology and social media was considered paramount. Participants had contrasting injury recovery experiences and their perceptions of the claims process differed and were influenced by injury

  9. Evaluation of one-dimensional and two-dimensional volatility basis sets in simulating the aging of secondary organic aerosol with smog-chamber experiments.

    Science.gov (United States)

    Zhao, Bin; Wang, Shuxiao; Donahue, Neil M; Chuang, Wayne; Hildebrandt Ruiz, Lea; Ng, Nga L; Wang, Yangjun; Hao, Jiming

    2015-02-17

    We evaluate the one-dimensional volatility basis set (1D-VBS) and two-dimensional volatility basis set (2D-VBS) in simulating the aging of SOA derived from toluene and α-pinene against smog-chamber experiments. If we simulate the first-generation products with empirical chamber fits and the subsequent aging chemistry with a 1D-VBS or a 2D-VBS, the models mostly overestimate the SOA concentrations in the toluene oxidation experiments. This is because the empirical chamber fits include both first-generation oxidation and aging; simulating aging in addition to this results in double counting of the initial aging effects. If the first-generation oxidation is treated explicitly, the base-case 2D-VBS underestimates the SOA concentrations and O:C increase of the toluene oxidation experiments; it generally underestimates the SOA concentrations and overestimates the O:C increase of the α-pinene experiments. With the first-generation oxidation treated explicitly, we could modify the 2D-VBS configuration individually for toluene and α-pinene to achieve good model-measurement agreement. However, we are unable to simulate the oxidation of both toluene and α-pinene with the same 2D-VBS configuration. We suggest that future models should implement parallel layers for anthropogenic (aromatic) and biogenic precursors, and that more modeling studies and laboratory research be done to optimize the "best-guess" parameters for each layer.

  10. Inherited occipital hypoplasia/syringomyelia in the cavalier King Charles spaniel: experiences in setting up a worldwide DNA collection.

    Science.gov (United States)

    Rusbridge, Clare; Knowler, Penny; Rouleau, Guy A; Minassian, Berge A; Rothuizen, Jan

    2005-01-01

    Inherited diseases commonly emerge within pedigree dog populations, often due to use of repeatedly bred carrier sire(s) within a small gene pool. Accurate family records are usually available making linkage analysis possible. However, there are many factors that are intrinsically difficult about collecting DNA and collating pedigree information from a large canine population. The keys to a successful DNA collection program include (1) the need to establish and maintain support from the pedigree breed clubs and pet owners; (2) committed individual(s) who can devote the considerable amount of time and energy to coordinating sample collection and communicating with breeders and clubs; and (3) providing means by which genotypic and phenotypic information can be easily collected and stored. In this article we described the clinical characteristics of inherited occipital hypoplasia/syringomyelia (Chiari type I malformation) in the cavalier King Charles spaniel and our experiences in establishing a pedigree and DNA database to study the disease.

  11. Developing antitobacco mass media campaign messages in a low-resource setting: experience from the Kingdom of Tonga.

    Science.gov (United States)

    Sugden, C; Phongsavan, P; Gloede, S; Filiai, S; Tongamana, V O

    2017-05-01

    Tobacco use has become the leading cause of preventable death in Tonga, a small island nation in the South Pacific. One pragmatic and economical strategy to address this worrying trend is to adapt effective antitobacco mass media materials developed in high-income countries for local audiences. Using Tonga as an example, this paper shares the practical steps involved in adapting antitobacco campaign materials for local audiences with minimal resources, a limited budget and without the need for an external production team. The Tongan experience underscores the importance of an adaptation process that draws from evidence-based best-practice models and engages local and regional stakeholders to ensure that campaign materials are tailored to the local context and are embedded within a mix of antitobacco strategies. 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/.

  12. Developing antitobacco mass media campaign messages in a low-resource setting: experience from the Kingdom of Tonga

    Science.gov (United States)

    Sugden, C; Phongsavan, P; Gloede, S; Filiai, S; Tongamana, V O

    2017-01-01

    Tobacco use has become the leading cause of preventable death in Tonga, a small island nation in the South Pacific. One pragmatic and economical strategy to address this worrying trend is to adapt effective antitobacco mass media materials developed in high-income countries for local audiences. Using Tonga as an example, this paper shares the practical steps involved in adapting antitobacco campaign materials for local audiences with minimal resources, a limited budget and without the need for an external production team. The Tongan experience underscores the importance of an adaptation process that draws from evidence-based best-practice models and engages local and regional stakeholders to ensure that campaign materials are tailored to the local context and are embedded within a mix of antitobacco strategies. PMID:26969171

  13. Elimination of copper in tissues and organs of rainbow trout

    Directory of Open Access Journals (Sweden)

    Gaye Dogan

    2011-01-01

    Full Text Available Copper (Cu elimination was investigated in the tissue and organs of rainbow trout (Oncorhynchus mykiss, Walbaum, 1792, after Cu-free diets exposure. In the current study, fish were fed to satiation on diets containing 0.022 (Group 1; Control, 0.043 (Group 2, 0.123 (Group 3, 0.424 (Group 4 g Cu*kg-1 diet for 60 days before elimination experiment. A total of 288 fish (mean weight 84.28±1.05 g were randomly transferred to 12 fibreglass tanks. The fish were fed the Cu-free diet twice daily, until apparent satiation, during 60 days. Subsequently, the experiment was established for a period of elimination, during which samples were taken at days 15, 30, 45 and 60. Cu concentration in the muscle, gill tissue, digestive system, liver and whole body of fish were determined after 60 days depuration. Cu concentrations in tissues of rainbow trout decreased during depuration period, and the order of Cu elimination in tissue and organs of rainbow trout was: digestive system (73.1 %, then gill (41.1 %, muscle (31.5 % and liver (17.2 % for group 2; digestive system (74.1%, then muscle (65.8%, gill (60.0% and liver (34.6% for group 3; and digestive system (85.8%, then muscle (80.8%, liver (50.5% and less/equal in gill (50.2% for group 4. In statistical analysis, both groups and time were significant factors (P less than 0.05 on elimination rate. Moreover, significant interaction between groups and time were identified on elimination rate. Digestive system showed the fastest elimination rates of Cu at all groups compared with other tissues.

  14. Eliciting preferences for priority setting in genetic testing: a pilot study comparing best-worst scaling and discrete-choice experiments.

    Science.gov (United States)

    Severin, Franziska; Schmidtke, Jörg; Mühlbacher, Axel; Rogowski, Wolf H

    2013-11-01

    Given the increasing number of genetic tests available, decisions have to be made on how to allocate limited health-care resources to them. Different criteria have been proposed to guide priority setting. However, their relative importance is unclear. Discrete-choice experiments (DCEs) and best-worst scaling experiments (BWSs) are methods used to identify and weight various criteria that influence orders of priority. This study tests whether these preference eliciting techniques can be used for prioritising genetic tests and compares the empirical findings resulting from these two approaches. Pilot DCE and BWS questionnaires were developed for the same criteria: prevalence, severity, clinical utility, alternatives to genetic testing available, infrastructure for testing and care established, and urgency of care. Interview-style experiments were carried out among different genetics professionals (mainly clinical geneticists, researchers and biologists). A total of 31 respondents completed the DCE and 26 completed the BWS experiment. Weights for the levels of the six attributes were estimated by conditional logit models. Although the results derived from the DCE and BWS experiments differed in detail, we found similar valuation patterns in the DCE and BWS experiments. The respondents attached greatest value to tests with high clinical utility (defined by the availability of treatments that reduce mortality and morbidity) and to testing for highly prevalent conditions. The findings from this study exemplify how decision makers can use quantitative preference eliciting methods to measure aggregated preferences in order to prioritise alternative clinical interventions. Further research is necessary to confirm the survey results.

  15. Clinical audit on "Evaluation of special issues in adolescents with cancer treated in an adult cancer setting": An Indian experience

    Directory of Open Access Journals (Sweden)

    Naveen S Salins

    2012-01-01

    Results: Pain was the most common physical symptom seen in all 10 patients. 3 out of 10 patients were involved in decision making, 3 out of 10 patients had identity issues and 4 out of 10 patients had peer group isolation issues. Only 3 were aware of diagnosis and none were aware of treatment outcomes and mortality. 4 out of 10 had anxiety and depression and 3 out of 10 had body image issues. Sexuality, spiritual and existential issues were not explored in any of the patients studied. Conclusion: The outcomes of the study were in an adult oncology setting there was a poor recognition of key adolescent issues such as sexuality, body image, identity and peer group isolation. The psychosocial supports to these adolescents were minimal and spiritual and existential issues were not explored. The inferences drawn from this study suggested a need for multidisciplinary team approach oriented in handling adolescent care needs and preferably to have a dedicated space that will help the peer group to interact, bond and cope better with the illness.

  16. A retrieval-based approach to eliminating hindsight bias.

    Science.gov (United States)

    Van Boekel, Martin; Varma, Keisha; Varma, Sashank

    2017-03-01

    Individuals exhibit hindsight bias when they are unable to recall their original responses to novel questions after correct answers are provided to them. Prior studies have eliminated hindsight bias by modifying the conditions under which original judgments or correct answers are encoded. Here, we explored whether hindsight bias can be eliminated by manipulating the conditions that hold at retrieval. Our retrieval-based approach predicts that if the conditions at retrieval enable sufficient discrimination of memory representations of original judgments from memory representations of correct answers, then hindsight bias will be reduced or eliminated. Experiment 1 used the standard memory design to replicate the hindsight bias effect in middle-school students. Experiments 2 and 3 modified the retrieval phase of this design, instructing participants beforehand that they would be recalling both their original judgments and the correct answers. As predicted, this enabled participants to form compound retrieval cues that discriminated original judgment traces from correct answer traces, and eliminated hindsight bias. Experiment 4 found that when participants were not instructed beforehand that they would be making both recalls, they did not form discriminating retrieval cues, and hindsight bias returned. These experiments delineate the retrieval conditions that produce-and fail to produce-hindsight bias.

  17. Spectrum and antimicrobial susceptibility pattern of pathogens causing urinary tract infection experience in a tertiary care setting

    International Nuclear Information System (INIS)

    Amjad, A.; Mirza, I.A.; Abbasi, S.A.; Farwa, U.; Sattar, A.; Qureshi, Z.A.

    2012-01-01

    Objective: To determine the spectrum and antimicrobial susceptibility pattern of pathogens causing urinary tract infection from the samples received at AFIP Rawalpindi. Place and duration of study. The study was carried out at Department of Microbiology, Armed Forces Institute of Pathology from January 2010 to June 2010. Material and Method: This was descriptive cross-sectional study. A total of 500 bacterial isolates out of 2050 urine culture samples, for a period of six month were included in the study. Indentification was carried out by standard biochemical profile of the organisms. The antimicrobial susceptibilities of isolated organisms were performed by disk diffusion method as recommended by Clinical Laboratory Standard Institute. Results Out of the culture positive cases, gram-negative bacteria constituted the largest group with a total of 434 (87%) isolates, while gram-positive bacteria constituted only 44 (8.8%) isolates. E. coli was the most common isolate accounting for 63% of the total positive bacterial cultures followed by Klebsiella spp (9%) and P. aernginosa (7%). Susceptibility pattern of E. coli revealed that 96% of isolates were sensitive to imipenem, 91% to piperacillin-tazobactam and 87% to Nitrofurantoin. For Klebsiella spp, 86% of Isolates were susceptible to Imipenem and 71 % to piperacillin-tazobactam. As regards acinetobacter spp, 94% of Isolates were susceptible to piperacillin-tazobactam and 70 % to Imipenem an piperacilline-sulbactam. Antibiogram of P. aeruginosa revealed that 94% of isolates were sensitive to ceftazidime and 86% to imipenem. Nitrofurantoin was the most effective urinary antibiotic in case of enterococcus spp as 85% of isolates were susceptible to this compound. Conclusion: From the present study we conclude that E. coli was the predominant urinary pathogen in our set up. The antimicrobial susceptibility patterns of E. coli revealed that majority of isolates were susceptible to imipenem and piperacilline

  18. Initial Experience with "Honoring Choices Wisconsin": Implementation of an Advance Care Planning Pilot in a Tertiary Care Setting.

    Science.gov (United States)

    Peltier, Wendy L; Gani, Faiz; Blissitt, Jennifer; Walczak, Katherine; Opper, Kristi; Derse, Arthur R; Johnston, Fabian M

    2017-09-01

    Although previous research on advance care planning (ACP) has associated ACP with improved quality of care at the end of life, the appropriate use of ACP remains limited. To evaluate the impact of a pilot program using the "Honoring Choices Wisconsin" (HCW) model for ACP in a tertiary care setting, and to understand barriers to system-wide implementation. Retrospective review of prospectively collected data. Patients who received medical or surgical oncology care at Froedtert and the Medical College of Wisconsin. Patient demographics, disease characteristics, patient satisfaction, and clinical outcomes. Data from 69 patients who died following the implementation of the HCW program were reviewed; 24 patients were enrolled in the HCW program while 45 were not. Patients enrolled in HCW were proportionally less likely to be admitted to the ICU (12.5% vs. 17.8%) and were more likely to be "do not resuscitate" (87.5% vs. 80.0%), as well as have a completed ACP (83.3% vs. 79.1%). Furthermore, admission to a hospice was also higher among patients who were enrolled in the HCW program (79.2% vs. 25.6%), with patients enrolled in HCW more likely to die in hospice (70.8% vs. 53.3%). The HCW program was favorably viewed by patients, patient caregivers, and healthcare providers. Implementation of a facilitator-based ACP care model was associated with fewer ICU admissions, and a higher use of hospice care. System-level changes are required to overcome barriers to ACP that limit patients from receiving end-of-life care in accordance with their preferences.

  19. Interpretation of astrophysical neutrinos observed by IceCube experiment by setting Galactic and extra-Galactic spectral components

    CERN Document Server

    Marinelli, Antonio; Grasso, Dario; Urbano, Alfredo; Valli, Mauro

    2016-01-01

    The last IceCube catalog of High Energy Starting Events (HESE) obtained with a livetime of 1347 days comprises 54 neutrino events equally-distributed between the three families with energies between 25 TeV and few PeVs. Considering the homogeneous flavors distribution (1:1:1) and the spectral features of these neutrinos the IceCube collaboration claims the astrophysical origin of these events with more than $5\\sigma$. The spatial distribution of cited events does not show a clear correlation with known astrophysical accelerators leaving opened both the Galactic and the extra-Galactic origin interpretations. Here, we compute the neutrino diffuse emission of our Galaxy on the basis of a recently proposed phenomenological model characterized by radially-dependent cosmic-ray (CR) transport properties. We show that the astrophysical spectrum measured by IceCube experiment can be well explained adding to the diffuse Galactic neutrino flux (obtained with this new model) a extra-Galactic component derived from the as...

  20. Hearing the voices of children and young people to develop and test a patient-reported experience measure in a specialist paediatric setting.

    Science.gov (United States)

    Wray, Jo; Hobden, Sylvie; Knibbs, Sarah; Oldham, Geralyn

    2018-03-01

    To develop and test patient-reported experience measures (PREMs) for children and young people in a specialist paediatric hospital setting. Six PREMs were developed and tested by children and young people for children and young people aged 8-11, 12-13 and 14-16 years in inpatient and outpatient settings. A week-long pilot was implemented across inpatient wards and outpatient clinics to identify facilitators and barriers to the routine use of PREMs in a real-time setting across our organisation. Tertiary paediatric hospital. Final PREMs; identified facilitators and barriers to implementation. 543 children and young people aged 8-16 years attending outpatient clinics or inpatient wards across a range of specialties. Three key themes about hospital experience were identified during focus groups: facilities, treatment and tests and people working at the hospital, and these provided the structure for the questionnaires. During cognitive testing the questionnaires were generally understood but some revisions to language and length of the questionnaires were required. Two designs were selected for the final PREMs. During acceptability and feasibility testing it was evident that children and young people liked the PREMs and wanted to give feedback on their hospital experience. Particular challenges for routine use of the PREMs focused on sustainability and resources. The new PREMs will provide children and young people receiving care in specialist paediatric hospitals with the opportunity to provide feedback on their experience. Sustainability and ensuring that feedback results in improvements need to be addressed in future work. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Operations for Suspected Neoplasms in a Resource-Limited Setting: Experience and Challenges in the Eastern Democratic of Congo.

    Science.gov (United States)

    Kalisya, Luc Malemo; Bake, Jacques Fadhili; Bigabwa, Richard; Rothstein, David H; Cairo, Sarah B

    2018-07-01

    faces a multitude of challenges. Access to surgical services for diagnosis and management as well as chemotherapeutic agents is prohibitively limited. Increased collaboration with local clinicians and remote specialist consultants is needed to deliver subspecialty care in resource-poor settings.

  2. Cross-Calibration and Comparison of Variability in Two Bone Densitometers in a Research Setting: The Framingham Experience

    Science.gov (United States)

    Gagnon, David R.; McLean, Robert R.; Hannan, Marian T.; Cupples, L. Adrienne; Hogan, Mary; Kiel, Douglas P.

    2010-01-01

    New technology introduced over time results in changes in densitometers during longitudinal studies of bone mineral density (BMD). This requires that a cross-calibration process be completed to translate measurements from the old densitometer to the new one. Previously described cross-calibration methods for research settings have collected single measures on each densitometer and used linear regression to estimate cross-calibration corrections. Thus, these methods may produce corrections that have limited precision and underestimate the variability in converted BMD values. Furthermore, most prior studies have included small samples recruited from specialized populations. Increasing the sample size, obtaining multiple measures on each machine, and utilizing linear mixed models to account for between- and within-subject variability may improve cross-calibration estimates. The purpose of this study was to conduct an in vivo cross-calibration of a Lunar DPX-L with a Lunar Prodigy densitometer using a sample of 249 healthy volunteers who were scanned twice on each densitometer, without repositioning, at both the femur and spine. Scans were analyzed using both automated and manual placement of regions of interest. Wilcoxon rank-sum tests and Bland-Altman plots were used to examine possible differences between repeat scans within and across densitometers. We used linear mixed models to determine the cross-calibration equations for the femoral neck, trochanter, total hip and lumbar spine (L2-L4) regions. Results using automated and manual placement of the regions of interest did not differ significantly The DPX–L exhibited larger median absolute differences in repeat scans for femoral neck [0.016 vs. 0.012, p=0.1] and trochanter [0.011 vs. 0.009, p=0.06] BMD values compared to the Prodigy. The Bland-Altman plots revealed no statistically significant linear relation between the difference in paired measures between machines and mean BMD. In our large sample of healthy

  3. THCM Coupled Model for Hydrate-Bearing Sediments: Data Analysis and Design of New Field Experiments (Marine and Permafrost Settings)

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, Marcelo J. [Texas A & M Univ., College Station, TX (United States); Santamarina, J. Carlos [King Abdullah Univ. of Science and Technology (Saudi Arabia)

    2017-02-14

    Gas hydrates are solid compounds made of water molecules clustered around low molecular weight gas molecules such as methane, hydrogen, and carbon dioxide. Methane hydrates form under pressure (P) and temperature (T) conditions that are common in sub-permafrost layers and in deep marine sediments. Stability conditions constrain the occurrence of gas hydrates to submarine sediments and permafrost regions. The amount of technically recoverable methane trapped in gas hydrate may exceed 104tcf. Gas hydrates are a potential energy resource, can contribute to climate change, and can cause large-scale seafloor instabilities. In addition, hydrate formation can be used for CO2 sequestration (also through CO2-CH4 replacement), and efficient geological storage seals. The experimental study of hydrate bearing sediments has been hindered by the very low solubility of methane in water (lab testing), and inherent sampling difficulties associated with depressurization and thermal changes during core extraction. This situation has prompted more decisive developments in numerical modeling in order to advance the current understanding of hydrate bearing sediments, and to investigate/optimize production strategies and implications. The goals of this research has been to addresses the complex thermo-hydro-chemo-mechanical THCM coupled phenomena in hydrate-bearing sediments, using a truly coupled numerical model that incorporates sound and proven constitutive relations, satisfies fundamental conservation principles. Analytical solutions aimed at verifying the proposed code have been proposed as well. These tools will allow to better analyze available data and to further enhance the current understanding of hydrate bearing sediments in view of future field experiments and the development of production technology.

  4. Elimination of some unknown parameters and its effect on outlier detection

    Directory of Open Access Journals (Sweden)

    Serif Hekimoglu

    Full Text Available Outliers in observation set badly affect all the estimated unknown parameters and residuals, that is because outlier detection has a great importance for reliable estimation results. Tests for outliers (e.g. Baarda's and Pope's tests are frequently used to detect outliers in geodetic applications. In order to reduce the computational time, sometimes elimination of some unknown parameters, which are not of interest, is performed. In this case, although the estimated unknown parameters and residuals do not change, the cofactor matrix of the residuals and the redundancies of the observations change. In this study, the effects of the elimination of the unknown parameters on tests for outliers have been investigated. We have proved that the redundancies in initial functional model (IFM are smaller than the ones in reduced functional model (RFM where elimination is performed. To show this situation, a horizontal control network was simulated and then many experiences were performed. According to simulation results, tests for outlier in IFM are more reliable than the ones in RFM.

  5. Crisis leadership in an acute clinical setting: christchurch hospital, new zealand ICU experience following the february 2011 earthquake.

    Science.gov (United States)

    Zhuravsky, Lev

    2015-04-01

    On Tuesday, February 22, 2011, a 6.3 magnitude earthquake struck Christchurch, New Zealand. This qualitative study explored the intensive care units (ICUs) staff experiences and adopted leadership approaches to manage a large-scale crisis resulting from the city-wide disaster. To date, there have been a very small number of research publications to provide a comprehensive overview of crisis leadership from the perspective of multi-level interactions among staff members in the acute clinical environment during the process of the crisis management. The research was qualitative in nature. Participants were recruited into the study through purposive sampling. A semi-structured, audio-taped, personal interview method was chosen as a single data collection method for this study. This study employed thematic analysis. Formal team leadership refers to the actions undertaken by a team leader to ensure the needs and goals of the team are met. Three core, formal, crisis-leadership themes were identified: decision making, ability to remain calm, and effective communication. Informal leaders are those individuals who exert significant influence over other members in the group to which they belong, although no formal authority has been assigned to them. Four core, informal, crisis-leadership themes were identified: motivation to lead, autonomy, emotional leadership, and crisis as opportunity. Shared leadership is a dynamic process among individuals in groups for which the objective is to lead one another to the achievement of group or organizational goals. Two core, shared-leadership themes were identified: shared leadership within formal medical and nursing leadership groups, and shared leadership between formal and informal leaders in the ICU. The capabilities of formal leaders all contributed to the overall management of a crisis. Informal leaders are a very cohesive group of motivated people who can make a substantial contribution and improve overall team performance in a

  6. "I get hungry all the time": experiences of poverty and pregnancy in an urban healthcare setting in South Africa.

    Science.gov (United States)

    Scorgie, Fiona; Blaauw, Duane; Dooms, Tessa; Coovadia, Ashraf; Black, Vivian; Chersich, Matthew

    2015-08-25

    For pregnancy to result in a healthy mother and infant, women require adequate nutrition and to be able to access antenatal care, both of which require finances. While most women working in the formal sector in South Africa obtain some form of maternity leave, unemployed women receive no such support. Additional interventions in the form of expanded social assistance to vulnerable pregnant women are needed. To help inform such an approach, we undertook a series of qualitative interviews with low-income pregnant women in Johannesburg. Qualitative, in-depth interviews were held with 22 pregnant women at a public sector antenatal clinic in Johannesburg in 2011 to gather data on their greatest needs and priorities during pregnancy, their access to financial resources to meet these needs, and the overall experience of poverty while pregnant. A total of 22 women were interviewed, 5 of whom were primagravid. One woman was in the first trimester of pregnancy, while nine were almost full-term. All but one of the pregnancies were unplanned. Most participants (15/22) were unemployed, two were employed and on paid maternity leave, and the remaining five doing casual, part-time work. In most cases, pregnancy reduced participants' earning potential and heightened reliance on their partners. Women not living with the father of their children generally received erratic financial support from them. The highest monthly expenses mentioned were food, accommodation and transport costs, and shortfalls in all three were reportedly common. Some participants described insufficient food in the household, and expressed concern about whether they were meeting the additional dietary requirements of pregnancy. Preparing for the arrival of a new baby was also a considerable source of anxiety, and was prioritized even above meeting women's own basic needs. Though pregnancy is a normal life occurrence, it has the potential to further marginalise women and children living in already vulnerable

  7. Eliminating the Influence of Harmonic Components in Operational Modal Analysis

    DEFF Research Database (Denmark)

    Jacobsen, Niels-Jørgen; Andersen, Palle; Brincker, Rune

    2007-01-01

    structures, in contrast, are subject inherently to deterministic forces due to the rotating parts in the machinery. These forces are seen as harmonic components in the responses, and their influence should be eliminated before extracting the modes in their vicinity. This paper describes a new method based...... on the well-known Enhanced Frequency Domain Decomposition (EFDD) technique for eliminating these harmonic components in the modal parameter extraction process. For assessing the quality of the method, various experiments were carried out where the results were compared with those obtained with pure stochastic...

  8. Dual-Laser vibrometry: Elimination or extraction of pseudo vibration

    DEFF Research Database (Denmark)

    Jakobsen, Michael Linde; Bækbo, Martin Jesper; Hanson, Steen Grüner

    2014-01-01

    This paper investigates the principal idea of a method using two identical laser vibrometers to eliminate pseudovibrations, occurring as structured noise in laser-vibrometer measurements of angular velocity of a rotating object. Thetwo vibrometers monitor the same surface path on the rotating...... in angularvelocity of the object occur simultaneously at the two vibrometers. Knowing the angular separation between thevibrometers, simple trigonometry canbe used to eliminate the pseudo vibrations. These vibrometers are based oncameras, therefore the experiments demonstrate the principle of the method only...

  9. Elimination of Onchocerciasis from Mexico

    Science.gov (United States)

    Rodríguez-Pérez, Mario A.; Fernández-Santos, Nadia A.; Orozco-Algarra, María E.; Rodríguez-Atanacio, José A.; Domínguez-Vázquez, Alfredo; Rodríguez-Morales, Kristel B.; Real-Najarro, Olga; Prado-Velasco, Francisco G.; Cupp, Eddie W.; Richards, Frank O.; Hassan, Hassan K.; González-Roldán, Jesús F.; Kuri-Morales, Pablo A.; Unnasch, Thomas R.

    2015-01-01

    Background Mexico is one of the six countries formerly endemic for onchocerciasis in Latin America. Transmission has been interrupted in the three endemic foci of that country and mass drug distribution has ceased. Three years after mass drug distribution ended, post-treatment surveillance (PTS) surveys were undertaken which employed entomological indicators to check for transmission recrudescence. Methodology/Principal findings In-depth entomologic assessments were performed in 18 communities in the three endemic foci of Mexico. None of the 108,212 Simulium ochraceum s.l. collected from the three foci were found to contain parasite DNA when tested by polymerase chain reaction-enzyme-linked immunosorbent assay (PCR-ELISA), resulting in a maximum upper bound of the 95% confidence interval (95%-ULCI) of the infective rate in the vectors of 0.035/2,000 flies examined. This is an order of magnitude below the threshold of a 95%-ULCI of less than one infective fly per 2,000 flies tested, the current entomological criterion for interruption of transmission developed by the international community. The point estimate of seasonal transmission potential (STP) was zero, and the upper bound of the 95% confidence interval for the STP ranged from 1.2 to 1.7 L3/person/season in the different foci. This value is below all previous estimates for the minimum transmission potential required to maintain the parasite population. Conclusions/Significance The results from the in-depth entomological post treatment surveillance surveys strongly suggest that transmission has not resumed in the three foci of Mexico during the three years since the last distribution of ivermectin occurred; it was concluded that transmission remains undetectable without intervention, and Onchocerca volvulus has been eliminated from Mexico. PMID:26161558

  10. Elimination of Onchocerciasis from Mexico.

    Directory of Open Access Journals (Sweden)

    Mario A Rodríguez-Pérez

    Full Text Available Mexico is one of the six countries formerly endemic for onchocerciasis in Latin America. Transmission has been interrupted in the three endemic foci of that country and mass drug distribution has ceased. Three years after mass drug distribution ended, post-treatment surveillance (PTS surveys were undertaken which employed entomological indicators to check for transmission recrudescence.In-depth entomologic assessments were performed in 18 communities in the three endemic foci of Mexico. None of the 108,212 Simulium ochraceum s.l. collected from the three foci were found to contain parasite DNA when tested by polymerase chain reaction-enzyme-linked immunosorbent assay (PCR-ELISA, resulting in a maximum upper bound of the 95% confidence interval (95%-ULCI of the infective rate in the vectors of 0.035/2,000 flies examined. This is an order of magnitude below the threshold of a 95%-ULCI of less than one infective fly per 2,000 flies tested, the current entomological criterion for interruption of transmission developed by the international community. The point estimate of seasonal transmission potential (STP was zero, and the upper bound of the 95% confidence interval for the STP ranged from 1.2 to 1.7 L3/person/season in the different foci. This value is below all previous estimates for the minimum transmission potential required to maintain the parasite population.The results from the in-depth entomological post treatment surveillance surveys strongly suggest that transmission has not resumed in the three foci of Mexico during the three years since the last distribution of ivermectin occurred; it was concluded that transmission remains undetectable without intervention, and Onchocerca volvulus has been eliminated from Mexico.

  11. State plans to force companies to eliminate environmental burdens

    International Nuclear Information System (INIS)

    Marcan, P.

    2004-01-01

    The Ministry of Environment is preparing legislation aimed at forcing the state and especially private enterprises to map and eliminate tips, refuse from company premises and farmyards, and manure heaps. It is expected that the main burden will fall on private enterprises. The department is still working on the wording of this new Act on environmental burdens and so it is not yet clear whether it will be of assistance in the elimination of environmental burdens. The Ministry is aware that economic aspects must also be taken into account when exercising pressure on the companies. Closing down a company that cannot meet environmental criteria would result in redundancies and so the time schedule for the elimination of environmental burdens will be adjusted to fit the financial situation of the company involved. The ministry plans to first find companies responsible for environmental debts and then set a deadline for the preparation of a project to eliminate the environmental burden. The project would have to contain a description of elimination methods, in addition to a time schedule and cost assessment. If a private company does not report an environmental burden, the competent public authority will have the power to request access to the premises to undertake an inspection. (author)

  12. Experiences, opportunities and challenges of implementing task shifting in underserved remote settings: the case of Kongwa district, central Tanzania

    Directory of Open Access Journals (Sweden)

    Munga Michael A

    2012-11-01

    Full Text Available Abstract Background Tanzania is experiencing acute shortages of Health Workers (HWs, a situation which has forced health managers, especially in the underserved districts, to hastily cope with health workers’ shortages by adopting task shifting. This has however been due to limited options for dealing with the crisis of health personnel. There are on-going discussions in the country on whether to scale up task shifting as one of the strategies for addressing health personnel crisis. However, these discussions are not backed up by rigorous scientific evidence. The aim of this paper is two-fold. Firstly, to describe the current situation of implementing task shifting in the context of acute shortages of health workers and, secondly, to provide a descriptive account of the potential opportunities or benefits and the likely challenges which might ensue as a result of implementing task shifting. Methods We employed in-depth interviews with informants at the district level and supplemented the information with additional interviews with informants at the national level. Interviews focussed on the informants’ practical experiences of implementing task shifting in their respective health facilities (district level and their opinions regarding opportunities and challenges which might be associated with implementation of task shifting practices. At the national level, the main focus was on policy issues related to management of health personnel in the context of implementation of task shifting, in addition to seeking their opinions and perceptions regarding opportunities and challenges of implementing task shifting if formally adopted. Results Task shifting has been in practice for many years in Tanzania and has been perceived as an inevitable coping mechanism due to limited options for addressing health personnel shortages in the country. Majority of informants had the concern that quality of services is likely to be affected if appropriate policy

  13. Experiences and shared meaning of teamwork and interprofessional collaboration among health care professionals in primary health care settings: a systematic review.

    Science.gov (United States)

    Sangaleti, Carine; Schveitzer, Mariana Cabral; Peduzzi, Marina; Zoboli, Elma Lourdes Campos Pavone; Soares, Cassia Baldini

    2017-11-01

    During the last decade, teamwork has been addressed under the rationale of interprofessional practice or collaboration, highlighted by the attributes of this practice such as: interdependence of professional actions, focus on user needs, negotiation between professionals, shared decision making, mutual respect and trust among professionals, and acknowledgment of the role and work of the different professional groups. Teamwork and interprofessional collaboration have been pointed out as astrategy for effective organization of health care services as the complexity of healthcare requires integration of knowledge and practices from differente professional groups. This integration has a qualitative dimension that can be identified through the experiences of health professionals and to the meaning they give to teamwork. The objective of this systematic review was to synthesize the best available evidence on the experiences of health professionals regarding teamwork and interprofessional collaboration in primary health care settings. The populations included were all officially regulated health professionals that work in primary health settings: dentistry, medicine, midwifery, nursing, nutrition, occupational therapy, pharmacy, physical education, physiotherapy, psychology, social work and speech therapy. In addition to these professionals, community health workers, nursing assistants, licensed practical nurses and other allied health workers were also included. The phenomena of interest were experiences of health professionals regarding teamwork and interprofessional collaboration in primary health care settings. The context was primary health care settings that included health care centers, health maintenance organizations, integrative medicine practices, integrative health care, family practices, primary care organizations and family medical clinics. National health surgery as a setting was excluded. The qualitative component of the review considered studies that

  14. Experiences of mental health professionals and patients in the use of pro re nata medication in acute adult mental healthcare settings: a systematic review.

    Science.gov (United States)

    Morkunas, Bernadette; Porritt, Kylie; Stephenson, Matthew

    2016-10-01

    The use of pro re nata (PRN) medication, a medication that is given when needed, as opposed to medication that is given at a regular time, is surrounded by claims of misuse and poor accountability within the mental health setting. Gaining insight into and understanding of the experiences of health professionals' and patients' use of PRN medication will assist in contributing to improving education and safety around this common intervention. To analyze and synthesize the best available evidence on the perspectives of patients and mental health professionals (MHPs) with their experiences of PRN medication in mental health settings. Participants considered for inclusion in this review include MHPs working in, and adult patients admitted to, an acute adult mental healthcare setting. This review will consider studies that investigated the experience of MHPs' and patients' use of PRN medication in acute adult mental healthcare settings. The current review will consider studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. The context of the review is acute adult mental healthcare settings with no restriction on geographical location. The search strategy aims to find both published and unpublished studies. The databases searched include CINAHL, PubMed, Scopus, PsycINFO and Embase. A gray literature search included ProQuest Dissertations and Theses, Mednar and Google Scholar. Papers selected for retrieval were assessed by two independent reviewers for methodological validity before inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). The standardized data extraction tool from the JBI-QARI was used to extract data from the papers. Qualitative research findings were pooled using the JBI-QARI. This involved the aggregation of findings to generate a

  15. Experiences of Work-Life Conflict for the Athletic Trainer Employed Outside the National Collegiate Athletic Association Division I Clinical Setting

    Science.gov (United States)

    Mazerolle, Stephanie M.; Pitney, William A.; Eason, Christianne M.

    2015-01-01

    Context The intercollegiate setting receives much of the scholarly attention related to work-life conflict (WLC). However research has been focused on the National Collegiate Athletic Association Division I setting. Multiple factors can lead to WLC for the athletic trainer (AT), including hours, travel, and lack of flexibility in work schedules. Objective To investigate the experiences of WLC among ATs working in the non-Division I collegiate setting and to identify factors that contribute to fulfillment of work-life balance in this setting. Design Qualitative study. Setting Institutions in the National Collegiate Athletic Association Divisions II and III, the National Association of Intercollegiate Athletics, and the National Junior College Athletic Association. Patients or Other Participants A total of 244 ATs (128 women, 114 men; age = 37.5 ± 13.3 years, experience = 14 ± 12 years) completed phase I. Thirteen participants (8 women, 5 men; age = 38 ± 13 years, experience = 13.1 ± 11.4 years) completed phase II. Data Collection and Analysis For phase I, participants completed a previously validated and reliable (Cronbach α > .90) Web-based survey measuring their levels of WLC and work-family conflict (WFC). This phase included 2 WFC scales defining family; scale 1 defined family as having a partner or spouse with or without children, and scale 2 defined family as those individuals, including parents, siblings, grandparents, and any other close relatives, involved in one's life. Phase II consisted of an interview. Qualitative data were evaluated using content analysis. Data source and multiple-analyst triangulation secured credibility. Results The WFC scores were 26.33 ± 7.37 for scale 1 and 20.46 ± 10.14 for scale 2, indicating a moderate level of WFC for scale 1 and a low level of WFC for scale 2. Qualitative analyses revealed that organizational dimensions, such as job demands and staffing issues, can negatively affect WLC, whereas a combination of

  16. Intra-facility linkage of HIV-positive mothers and HIV-exposed babies into HIV chronic care: rural and urban experience in a resource limited setting.

    Directory of Open Access Journals (Sweden)

    Christine Mugasha

    Full Text Available INTRODUCTION: Linkage of HIV-infected pregnant women to HIV care remains critical for improvement of maternal and child outcomes through prevention of maternal-to-child transmission of HIV (PMTCT and subsequent chronic HIV care. This study determined proportions and factors associated with intra-facility linkage to HIV care and Early Infant Diagnosis care (EID to inform strategic scale up of PMTCT programs. METHODS: A cross-sectional review of records was done at 2 urban and 3 rural public health care facilities supported by the Infectious Diseases Institute (IDI. HIV-infected pregnant mothers, identified through routine antenatal care (ANC and HIV-exposed babies were evaluated for enrollment in HIV clinics by 6 weeks post-delivery. RESULTS: Overall, 1,025 HIV-infected pregnant mothers were identified during ANC between January and June, 2012; 267/1,025 (26% in rural and 743/1,025 (74% in urban facilities. Of these 375/1,025 (37% were linked to HIV clinics [67/267(25% rural and 308/758(41% urban]. Of 636 HIV-exposed babies, 193 (30% were linked to EID. Linkage of mother-baby pairs to HIV chronic care and EID was 16% (101/636; 8/179 (4.5%] in rural and 93/457(20.3% in urban health facilities. Within rural facilities, ANC registration <28 weeks-of-gestation was associated with mothers' linkage to HIV chronic care [AoR, 2.0 95% CI, 1.1-3.7, p = 0.019] and mothers' multi-parity was associated with baby's linkage to EID; AoR 4.4 (1.3-15.1, p = 0.023. Stigma, long distance to health facilities and vertical PMTCT services affected linkage in rural facilities, while peer mothers, infant feeding services, long patient queues and limited privacy hindered linkage to HIV care in urban settings. CONCLUSION: Post-natal linkage of HIV-infected mothers to chronic HIV care and HIV-exposed babies to EID programs was low. Barriers to linkage to HIV care vary in urban and rural settings. We recommend targeted interventions to rapidly improve linkage to

  17. Experiences of Work-Life Conflict for the Athletic Trainer Employed Outside the National Collegiate Athletic Association Division I Clinical Setting.

    Science.gov (United States)

    Mazerolle, Stephanie M; Pitney, William A; Eason, Christianne M

    2015-07-01

    The intercollegiate setting receives much of the scholarly attention related to work-life conflict (WLC). However research has been focused on the National Collegiate Athletic Association Division I setting. Multiple factors can lead to WLC for the athletic trainer (AT), including hours, travel, and lack of flexibility in work schedules. To investigate the experiences of WLC among ATs working in the non-Division I collegiate setting and to identify factors that contribute to fulfillment of work-life balance in this setting. Qualitative study. Institutions in the National Collegiate Athletic Association Divisions II and III, the National Association of Intercollegiate Athletics, and the National Junior College Athletic Association. A total of 244 ATs (128 women, 114 men; age = 37.5 ± 13.3 years, experience = 14 ± 12 years) completed phase I. Thirteen participants (8 women, 5 men; age = 38 ± 13 years, experience = 13.1 ± 11.4 years) completed phase II. For phase I, participants completed a previously validated and reliable (Cronbach α > .90) Web-based survey measuring their levels of WLC and work-family conflict (WFC). This phase included 2 WFC scales defining family; scale 1 defined family as having a partner or spouse with or without children, and scale 2 defined family as those individuals, including parents, siblings, grandparents, and any other close relatives, involved in one's life. Phase II consisted of an interview. Qualitative data were evaluated using content analysis. Data source and multiple-analyst triangulation secured credibility. The WFC scores were 26.33 ± 7.37 for scale 1 and 20.46 ± 10.14 for scale 2, indicating a moderate level of WFC for scale 1 and a low level of WFC for scale 2. Qualitative analyses revealed that organizational dimensions, such as job demands and staffing issues, can negatively affect WLC, whereas a combination of organizational and personal dimensions can positively affect WLC. Overload continues to be a prevalent

  18. A systematic review of professional supervision experiences and effects for allied health practitioners working in non-metropolitan health care settings

    Directory of Open Access Journals (Sweden)

    Ducat WH

    2015-08-01

    Full Text Available Wendy H Ducat,1,3 Saravana Kumar2 1Cunningham Centre, Darling Downs Hospital and Health Service, Australia; 2School of Health Sciences, International Centre for Allied Health Evidence, Sansom Institute, University of South Australia, Adelaide, SA, Australia; 3Rural Clinical School, School of Medicine, University of Queensland, Brisbane, QLD, Australia Introduction: In regional, rural, and remote settings, allied health professional supervision is one organizational mechanism designed to support and retain the workforce, provide clinical governance, and enhance service delivery. A systematic approach to evaluating the evidence of the experience and effects of professional supervision for non-metropolitan allied health practitioners and their service delivery is needed. Methods: Studies investigating the experience and effects of professional supervision across 17 allied health disciplines in non-metropolitan health services were systematically searched for using standardized keywords across seven databases. The initial search identified 1,574 references. Of these studies, five met inclusion criteria and were subject to full methodological appraisal by both reviewers. Two studies were primarily qualitative with three studies primarily quantitative in their approach. Studies were appraised using McMaster critical appraisal tools and data were extracted and synthesized. Results: Studies reported the context specific benefits and challenges of supervision in non-metropolitan areas and the importance of supervision in enhancing satisfaction and support in these areas. Comparison of findings between metropolitan and non-metropolitan settings within one study suggested that allied health in non-metropolitan settings were more satisfied with supervision though less likely to access it and preferred supervision with other non-metropolitan practitioners over access to more experienced supervisors. One study in a regional health service identified the lack

  19. Modification of Gaussian Elimination to the Complex Seismic Data

    International Nuclear Information System (INIS)

    Smaglichenko, Tatyana A.

    2011-01-01

    A method for solution of large and sparse systems with complex seismic observations has been developed by revising of the classical Gaussian elimination. The observation matrix is divided into a set of smaller cells that can be determined based on clusters of a seismic activity. Reliable inversion solutions with minimum error rating are selected within each cell, then solutions that are non-stable with respect to the same unknown are rejected After the final sifting the found unknowns are eliminated from the initial system with subsequent decreasing of its size. A numerical example is provided to demonstrate how the method can be applied to a real data set (a case study of the Nagano fault area, Central Japan). Results of processing of a huge volume of data and their importance for the Earthquake Early Warning (EEW) system are briefly discussed.

  20. HNCA-TOCSY-CANH experiments with alternate {sup 13}C-{sup 12}C labeling: a set of 3D experiment with unique supra-sequential information for mainchain resonance assignment

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Koh; Gal, Maayan [Harvard Medical School, Department of Biochemistry and Molecular Pharmacology (United States); Takahashi, Hideo; Shimada, Ichio [National Institute of Advanced Industrial Science and Technology, Biomedicinal Information Research Center (Japan); Wagner, Gerhard, E-mail: gerhard_wagner@hms.harvard.edu [Harvard Medical School, Department of Biochemistry and Molecular Pharmacology (United States)

    2011-01-15

    Described here is a set of three-dimensional (3D) NMR experiments that rely on CACA-TOCSY magnetization transfer via the weak {sup 3}J(C{sub {alpha}}C{sub {alpha}}) coupling. These pulse sequences, which resemble recently described {sup 13}C detected CACA-TOCSY (Takeuchi et al. 2010) experiments, are recorded in {sup 1}H{sub 2}O, and use {sup 1}H excitation and detection. These experiments require alternate {sup 13}C-{sup 12}C labeling together with perdeuteration, which allows utilizing the small {sup 3}J(C{sub {alpha}}C{sub {alpha}}) scalar coupling that is otherwise masked by the stronger {sup 1}J{sub CC} couplings in uniformly {sup 13}C labeled samples. These new experiments provide a unique assignment ladder-mark that yields bidirectional supra-sequential information and can readily straddle proline residues. Unlike the conventional HNCA experiment, which contains only sequential information to the {sup 13}(C{sub {alpha}}) of the preceding residue, the 3D hnCA-TOCSY-caNH experiment can yield sequential correlations to alpha carbons in positions i-1, i + 1 and i-2. Furthermore, the 3D hNca-TOCSY-caNH and Hnca-TOCSY-caNH experiments, which share the same magnetization pathway but use a different chemical shift encoding, directly couple the {sup 15}N-{sup 1}H spin pair of residue i to adjacent amide protons and nitrogens at positions i-2, i-1, i + 1 and i + 2, respectively. These new experimental features make protein backbone assignments more robust by reducing the degeneracy problem associated with the conventional 3D NMR experiments.

  1. Modern Approach to the Identification and Elimination of Periodontal Infection

    OpenAIRE

    Atanasovska-Stojanovska, Aneta

    2012-01-01

    In global terms, periodontitis is the leading cause of tooth loss, and causes serious aesthetic and functional problems. There are numerous scientific evidence that power periopathogenic microorganisms may have influence on some systemic conditions and diseases. If we add the fact that periimplantitis are caused by identical periopathogenes, management or effective identification and elimination of periodontal inflammation set as imperative in successful periodontal treatment and possible com...

  2. Feasibility of establishing a biosafety level 3 tuberculosis culture laboratory of acceptable quality standards in a resource-limited setting: an experience from Uganda.

    Science.gov (United States)

    Ssengooba, Willy; Gelderbloem, Sebastian J; Mboowa, Gerald; Wajja, Anne; Namaganda, Carolyn; Musoke, Philippa; Mayanja-Kizza, Harriet; Joloba, Moses Lutaakome

    2015-01-15

    Despite the recent innovations in tuberculosis (TB) and multi-drug resistant TB (MDR-TB) diagnosis, culture remains vital for difficult-to-diagnose patients, baseline and end-point determination for novel vaccines and drug trials. Herein, we share our experience of establishing a BSL-3 culture facility in Uganda as well as 3-years performance indicators and post-TB vaccine trials (pioneer) and funding experience of sustaining such a facility. Between September 2008 and April 2009, the laboratory was set-up with financial support from external partners. After an initial procedure validation phase in parallel with the National TB Reference Laboratory (NTRL) and legal approvals, the laboratory registered for external quality assessment (EQA) from the NTRL, WHO, National Health Laboratories Services (NHLS), and the College of American Pathologists (CAP). The laboratory also instituted a functional quality management system (QMS). Pioneer funding ended in 2012 and the laboratory remained in self-sustainability mode. The laboratory achieved internationally acceptable standards in both structural and biosafety requirements. Of the 14 patient samples analyzed in the procedural validation phase, agreement for all tests with NTRL was 90% (P 80% in all years from NTRL, CAP, and NHLS, and culture was 100% for CAP panels and above regional average scores for all years with NHLS. Quarterly DST scores from WHO-EQA ranged from 78% to 100% in 2010, 80% to 100% in 2011, and 90 to 100% in 2012. From our experience, it is feasible to set-up a BSL-3 TB culture laboratory with acceptable quality performance standards in resource-limited countries. With the demonstrated quality of work, the laboratory attracted more research groups and post-pioneer funding, which helped to ensure sustainability. The high skilled experts in this research laboratory also continue to provide an excellent resource for the needed national discussion of the laboratory and quality management systems.

  3. Polio elimination in Nigeria: A review.

    Science.gov (United States)

    Nasir, Usman Nakakana; Bandyopadhyay, Ananda Sankar; Montagnani, Francesca; Akite, Jacqueline Elaine; Mungu, Etaluka Blanche; Uche, Ifeanyi Valentine; Ismaila, Ahmed Mohammed

    2016-03-03

    Nigeria has made tremendous strides towards eliminating polio and has been free of wild polio virus (WPV) for more than a year as of August 2015. However, sustained focus towards getting rid of all types of poliovirus by improving population immunity and enhancing disease surveillance will be needed to ensure it sustains the polio-free status. We reviewed the pertinent literature including published and unpublished, official reports and working documents of the Global Polio Eradication Initiative (GPEI) partners as well as other concerned organizations. The literature were selected based on the following criteria: published in English Language, published after year 2000, relevant content and conformance to the theme of the review and these were sorted accordingly. The challenges facing the Polio Eradication Initiative (PEI) in Nigeria were found to fall into 3 broad categories viz failure to vaccinate, failure of the Oral Polio Vaccine (OPV) and epidemiology of the virus. Failure to vaccinate resulted from insecurity, heterogeneous political support, programmatic limitation in implementation of vaccination campaigns, poor performance of vaccination teams in persistently poor performing Local Government areas and sporadic vaccine refusals in Northern Nigeria. Sub optimal effectiveness of OPV in some settings as well as the rare occurrence of VDPVs associated with OPV type 2 in areas of low immunization coverage were also found to be key issues. Some of the innovations which helped to manage the threats to the PEI include a strong government accountability frame work, change from type 2 containing OPV to bi valent OPVs for supplementary immunization activities (SIA), enhancing environmental surveillance in key states (Sokoto, Kano and Borno) along with an overall improvement in SIA quality. There has been an improvement in coverage of routine immunization and vaccination campaigns, which has resulted in Nigeria being removed from the list of endemic countries

  4. Human movement data for malaria control and elimination strategic planning.

    Science.gov (United States)

    Pindolia, Deepa K; Garcia, Andres J; Wesolowski, Amy; Smith, David L; Buckee, Caroline O; Noor, Abdisalan M; Snow, Robert W; Tatem, Andrew J

    2012-06-18

    Recent increases in funding for malaria control have led to the reduction in transmission in many malaria endemic countries, prompting the national control programmes of 36 malaria endemic countries to set elimination targets. Accounting for human population movement (HPM) in planning for control, elimination and post-elimination surveillance is important, as evidenced by previous elimination attempts that were undermined by the reintroduction of malaria through HPM. Strategic control and elimination planning, therefore, requires quantitative information on HPM patterns and the translation of these into parasite dispersion. HPM patterns and the risk of malaria vary substantially across spatial and temporal scales, demographic and socioeconomic sub-groups, and motivation for travel, so multiple data sets are likely required for quantification of movement. While existing studies based on mobile phone call record data combined with malaria transmission maps have begun to address within-country HPM patterns, other aspects remain poorly quantified despite their importance in accurately gauging malaria movement patterns and building control and detection strategies, such as cross-border HPM, demographic and socioeconomic stratification of HPM patterns, forms of transport, personal malaria protection and other factors that modify malaria risk. A wealth of data exist to aid filling these gaps, which, when combined with spatial data on transport infrastructure, traffic and malaria transmission, can answer relevant questions to guide strategic planning. This review aims to (i) discuss relevant types of HPM across spatial and temporal scales, (ii) document where datasets exist to quantify HPM, (iii) highlight where data gaps remain and (iv) briefly put forward methods for integrating these datasets in a Geographic Information System (GIS) framework for analysing and modelling human population and Plasmodium falciparum malaria infection movements.

  5. Human movement data for malaria control and elimination strategic planning

    Directory of Open Access Journals (Sweden)

    Pindolia Deepa K

    2012-06-01

    Full Text Available Abstract Recent increases in funding for malaria control have led to the reduction in transmission in many malaria endemic countries, prompting the national control programmes of 36 malaria endemic countries to set elimination targets. Accounting for human population movement (HPM in planning for control, elimination and post-elimination surveillance is important, as evidenced by previous elimination attempts that were undermined by the reintroduction of malaria through HPM. Strategic control and elimination planning, therefore, requires quantitative information on HPM patterns and the translation of these into parasite dispersion. HPM patterns and the risk of malaria vary substantially across spatial and temporal scales, demographic and socioeconomic sub-groups, and motivation for travel, so multiple data sets are likely required for quantification of movement. While existing studies based on mobile phone call record data combined with malaria transmission maps have begun to address within-country HPM patterns, other aspects remain poorly quantified despite their importance in accurately gauging malaria movement patterns and building control and detection strategies, such as cross-border HPM, demographic and socioeconomic stratification of HPM patterns, forms of transport, personal malaria protection and other factors that modify malaria risk. A wealth of data exist to aid filling these gaps, which, when combined with spatial data on transport infrastructure, traffic and malaria transmission, can answer relevant questions to guide strategic planning. This review aims to (i discuss relevant types of HPM across spatial and temporal scales, (ii document where datasets exist to quantify HPM, (iii highlight where data gaps remain and (iv briefly put forward methods for integrating these datasets in a Geographic Information System (GIS framework for analysing and modelling human population and Plasmodium falciparum malaria infection movements.

  6. Set-up of a pre-test mock-up experiment in preparation for the HCPB Breeder Unit mock-up experimental campaign

    Energy Technology Data Exchange (ETDEWEB)

    Hernández, F., E-mail: francisco.hernandez@kit.edu [Karlsruhe Institute of Technology (KIT), Institute for Neutron Physics and Reactor Technology (INR) (Germany); Kolb, M. [Karlsruhe Institute of Technology (KIT), Institute for Applied Materials (IAM-WPT) (Germany); Ilić, M.; Kunze, A. [Karlsruhe Institute of Technology (KIT), Institute for Neutron Physics and Reactor Technology (INR) (Germany); Németh, J. [KFKI Research Institute for Particle and Nuclear Physics (Hungary); Weth, A. von der [Karlsruhe Institute of Technology (KIT), Institute for Neutron Physics and Reactor Technology (INR) (Germany)

    2013-10-15

    Highlights: ► As preparation for the HCPB-TBM Breeder Unit out-of-pile testing campaign, a pre-test experiment (PREMUX) has been prepared and described. ► A new heater system based on a wire heater matrix has been developed for imitating the neutronic volumetric heating and it is compared with the conventional plate heaters. ► The test section is described and preliminary thermal results with the available models are presented and are to be benchmarked with PREMUX. ► The PREMUX integration in the air cooling loop L-STAR/LL in the Karlsruhe Institute for Technology is shown and future steps are discussed. -- Abstract: The complexity of the experimental set-up for testing a full-scaled Breeder Unit (BU) mock-up for the European Helium Cooled Pebble Bed Test Blanket Module (HCPB-TBM) has motivated to build a pre-test mock-up experiment (PREMUX) consisting of a slice of the BU in the Li{sub 4}SiO{sub 4} region. This pre-test aims at verifying the feasibility of the methods to be used for the subsequent testing of the full-scaled BU mock-up. Key parameters needed for the modeling of the breeder material is also to be determined by the Hot Wire Method (HWM). The modeling tools for the thermo-mechanics of the pebble beds and for the mock-up structure are to be calibrated and validated as well. This paper presents the setting-up of PREMUX in the L-STAR/LL facility at the Karlsruhe Institute of Technology. A key requirement of the experiments is to mimic the neutronic volumetric heating. A new heater concept is discussed and compared to several conventional heater configurations with respect to the estimated temperature distribution in the pebble beds. The design and integration of the thermocouple system in the heater matrix and pebble beds is also described, as well as other key aspects of the mock-up (dimensions, layout, cooling system, purge gas line, boundary conditions and integration in the test facility). The adequacy of these methods for the full-scaled BU

  7. Michaëlis--Menten kinetics of phenazone elimination in the perfused pig liver

    DEFF Research Database (Denmark)

    Andreasen, B; Tonnesen, K; Rabol, A

    1977-01-01

    The purpose of the present study was to define the elimination kinetics of phenazone (NFN) in the isolated perfused pig liver. In five experiments phenazone was administered as constant infusion to obtain steady-state periods over a wide range of concentrations. The elimination of phenazone follo...

  8. [An Algorithm to Eliminate Power Frequency Interference in ECG Using Template].

    Science.gov (United States)

    Shi, Guohua; Li, Jiang; Xu, Yan; Feng, Liang

    2017-01-01

    Researching an algorithm to eliminate power frequency interference in ECG. The algorithm first creates power frequency interference template, then, subtracts the template from the original ECG signals, final y, the algorithm gets the ECG signals without interference. Experiment shows the algorithm can eliminate interference effectively and has none side effect to normal signal. It’s efficient and suitable for practice.

  9. Pulse shape analysis for the GERDA experiment to set a new limit on the half-life of 0νββ decay of {sup 76}Ge

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Victoria Elisabeth

    2017-01-25

    The GERDA experiment searches for neutrinoless double beta (0νββ) decay of {sup 76}Ge using high purity germanium (HPGe) detectors operated in liquid argon (LAr). The aim is to explore half-lives of the order of 10{sup 26} yr. Therefore, GERDA relies on improved active background reduction techniques such as pulse shape discrimination (PSD) in which the time structure of the germanium signals is analyzed to discriminate signal- from background-like events. Two types of HPGe detectors are operated: semi-coaxial detectors previously used in the Heidelberg-Moscow and IGEX experiments and new Broad Energy Germanium (BEGe) detectors which feature an improved energy resolution and enhanced PSD. In Phase I of the experiment, five enriched BEGe detectors were used for the first time in the search for 0νββ decay. A PSD based on a single parameter, the ratio of the maximum current amplitude over the energy A/E is applied. 83% of the background events in a 232 keV region around Q{sub ββ} are rejected with a high signal efficiency of (92.1 ± 1.9) %. The achieved background index (BI) is (5.4{sup +4.1}{sub -3.4}) . 10{sup -3} (counts)/(keV.kg.yr). This is an improvement by a factor of 10 compared to previous germanium based 0νββ experiments. Phase II of the experiment includes a major upgrade: for further background rejection, the LAr cryostat is instrumented to detect argon scintillation light. Additional 25 BEGe detectors are installed. After PSD and LAr veto a BI of (0.7{sup +1.3}{sub -0.5}) . 10{sup -3} (counts)/(keV.kg.yr) is achieved. This is the best BI achieved in 0νββ experiments so far. A frequentist statistical analysis is performed on the combined data collected in GERDA Phase I and the first Phase II release. A new limit on the half-life of 0νββ decay of {sup 76}Ge is set to T{sup 0ν}{sub 1/2}>5.3.10{sup 25} yr at 90% C.L., with a median sensitivity of T{sup 0ν}{sub 1/2}>4.0.10{sup 25} yr at 90% C.L.

  10. Multi-parameter brain tissue microsensor and interface systems: calibration, reliability and user experiences of pressure and temperature sensors in the setting of neurointensive care.

    Science.gov (United States)

    Childs, Charmaine; Wang, Li; Neoh, Boon Kwee; Goh, Hok Liok; Zu, Mya Myint; Aung, Phyo Wai; Yeo, Tseng Tsai

    2014-10-01

    The objective was to investigate sensor measurement uncertainty for intracerebral probes inserted during neurosurgery and remaining in situ during neurocritical care. This describes a prospective observational study of two sensor types and including performance of the complete sensor-bedside monitoring and readout system. Sensors from 16 patients with severe traumatic brain injury (TBI) were obtained at the time of removal from the brain. When tested, 40% of sensors achieved the manufacturer temperature specification of 0.1 °C. Pressure sensors calibration differed from the manufacturers at all test pressures in 8/20 sensors. The largest pressure measurement error was in the intraparenchymal triple sensor. Measurement uncertainty is not influenced by duration in situ. User experiences reveal problems with sensor 'handling', alarms and firmware. Rigorous investigation of the performance of intracerebral sensors in the laboratory and at the bedside has established measurement uncertainty in the 'real world' setting of neurocritical care.

  11. The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.

    Science.gov (United States)

    Berglas, Nancy F; Battistelli, Molly F; Nicholson, Wanda K; Sobota, Mindy; Urman, Richard D; Roberts, Sarah C M

    2018-01-01

    Over recent decades, numerous medical procedures have migrated out of hospitals and into freestanding ambulatory surgery centers (ASCs) and physician offices, with possible implications for patient outcomes. In response, states have passed regulations for office-based surgeries, private organizations have established standards for facility accreditation, and professional associations have developed clinical guidelines. While abortions have been performed in office setting for decades, states have also enacted laws requiring that facilities that perform abortions meet specific requirements. The extent to which facility requirements have an impact on patient outcomes-for any procedure-is unclear. We conducted a systematic review to examine the effect of outpatient facility type (ASC vs. office) and specific facility characteristics (e.g., facility accreditation, emergency response protocols, clinician qualifications, physical plant characteristics, other policies) on patient safety, patient experience and service availability in non-hospital-affiliated outpatient settings. To identify relevant research, we searched databases of the published academic literature (PubMed, EMBASE, Web of Science) and websites of governmental and non-governmental organizations. Two investigators reviewed 3049 abstracts and full-text articles against inclusion/exclusion criteria and assessed the quality of 22 identified articles. Most studies were hampered by methodological challenges, with 12 of 22 not meeting minimum quality criteria. Of 10 studies included in the review, most (6) examined the effect of facility type on patient safety. Existing research appears to indicate no difference in patient safety for outpatient procedures performed in ASCs vs. physician offices. Research about specific facility characteristics is insufficient to draw conclusions. More and higher quality research is needed to determine if there is a public health problem to be addressed through facility

  12. Elimination of Ideas and Professional Socialisation

    DEFF Research Database (Denmark)

    Gravengaard, Gitte; Rimestad, Lene

    2012-01-01

    . Our aim is to study how this building of expertise takes place at meetings with a particular focus on the decision-making process concerning ideas for new news stories. In order to do this, we perform linguistic analysis of news production practices, as we investigate how the journalists' ideas...... for potential news stories are eliminated by the editor at the daily newsroom meetings. The elimination of ideas for news stories are not just eliminations; they are also corrections of culturally undesirable behaviour producing and reproducing the proper perception of an important object of knowledge...

  13. Cut elimination in multifocused linear logic

    DEFF Research Database (Denmark)

    Guenot, Nicolas; Brock-Nannestad, Taus

    2015-01-01

    We study cut elimination for a multifocused variant of full linear logic in the sequent calculus. The multifocused normal form of proofs yields problems that do not appear in a standard focused system, related to the constraints in grouping rule instances in focusing phases. We show that cut...... elimination can be performed in a sensible way even though the proof requires some specific lemmas to deal with multifocusing phases, and discuss the difficulties arising with cut elimination when considering normal forms of proofs in linear logic....

  14. Clinical Documentation and Data Transfer from Ebola and Marburg Virus Disease Wards in Outbreak Settings: Health Care Workers’ Experiences and Preferences

    Directory of Open Access Journals (Sweden)

    Silja Bühler

    2014-02-01

    Full Text Available Understanding human filovirus hemorrhagic fever (FHF clinical manifestations and evaluating treatment strategies require the collection of clinical data in outbreak settings, where clinical documentation has been limited. Currently, no consensus among filovirus outbreak-response organisations guides best practice for clinical documentation and data transfer. Semi-structured interviews were conducted with health care workers (HCWs involved in FHF outbreaks in sub-Saharan Africa, and with HCWs experienced in documenting and transferring data from high-risk areas (isolation wards or biosafety level 4 laboratories. Methods for data documentation and transfer were identified, described in detail and categorised by requirement for electricity and ranked by interviewee preference. Some methods involve removing paperwork and other objects from the filovirus disease ward without disinfection. We believe that if done properly, these methods are reasonably safe for certain settings. However, alternative methods avoiding the removal of objects, or involving the removal of paperwork or objects after non-damaging disinfection, are available. These methods are not only safer, they are also perceived as safer and likely more acceptable to health workers and members of the community. The use of standardised clinical forms is overdue. Experiments with by sunlight disinfection should continue, and non-damaging disinfection of impregnated paper, suitable tablet computers and underwater cameras should be evaluated under field conditions.

  15. Measurement of metabolism of worker ants by using the elimination of caesium-134

    International Nuclear Information System (INIS)

    Nielsen, M.G.; Jensen, T.F.

    1977-01-01

    In order to find a method for measuring field metabolism of worker ants the elimination of 134 Cs by two ant species has been investigated. Equations relating temperature to radiocaesium elimination and metabolism have been found. From these equations the relationship between elimination and metabolism is calculated. Consequently, the elimination of the isotope can be used for measuring metabolism. A pilot field experiment with Lasius alienus (Foerst.) reveals that the traditional methods of estimating field metabolism give values which are considerably lower than the value based on caesium elimination rate. This difference is supposed to be mainly due to greater motor activity of the animals in the field. Consequently, the value of the caesium elimination method is closer to the 'true' value of field metabolism. (orig.) [de

  16. Women’s experiences of referral to a domestic violence advocate in UK primary care settings: a service-user collaborative study

    Science.gov (United States)

    Malpass, Alice; Sales, Kim; Johnson, Medina; Howell, Annie; Agnew-Davies, Roxane; Feder, Gene

    2014-01-01

    Background Women experiencing domestic violence and abuse (DVA) are more likely to be in touch with health services than any other agency, yet doctors and nurses rarely ask about abuse, often failing to identify signs of DVA in their patients. Aim To understand women’s experience of disclosure of DVA in primary care settings and subsequent referral to a DVA advocate in the context of a DVA training and support programme for primary care clinicians: Identification and Referral to Improve Safety (IRIS). Design and setting A service-user collaborative study using a qualitative study design. Recruitment was from across IRIS trial settings in Bristol and Hackney, London. Method Twelve women who had been referred to one of two specialist DVA advocates (based at specialist DVA agencies) were recruited by a GP taking part in IRIS. Women were interviewed by a survivor of DVA and interviews were recorded and transcribed verbatim. Analysis was thematic using constant comparison. Results GPs and nurses can play an important role in identifying women experiencing DVA and referring them to DVA specialist agencies. GPs may also have an important role to play in helping women maintain any changes they make as a result of referral to an advocate, by asking about DVA in subsequent consultations. Conclusion A short time interval between a primary care referral and initial contact with an advocate was valued by some women. For the initial contact with an advocate to happen as soon as possible after a primary care referral has been made, a close working relationship between primary care and the third sector needs to be cultivated. PMID:24567654

  17. TOWARDS THE ELIMINATION OF PREVENTABLE DISEASES

    Directory of Open Access Journals (Sweden)

    O. V. Shamsheva

    2013-01-01

    Full Text Available The article presents incidence rates of major vaccine-preventable diseases in the world and the Russian Federation and cites mitigation measures that, in the end, must lead to the elimination of the diseases. 

  18. Pupils' Activities in a Multimaterial Learning Environment in Craft subject A Pilot Study using an Experience Sampling Method based on a Mobile Application in Classroom Settings

    Directory of Open Access Journals (Sweden)

    Juha Jaatinen

    2017-12-01

    Full Text Available This study investigates holistic craft processes in craft education with an instrument for data-collection and self-assessment. Teaching in a study context is based on co-teaching and a design process, highlighted by the Finnish Basic Education Core Curriculum 2014. The school architecture and web-based learning environment is combined. Division for textiles and technical work is no longer supported in this multimaterial learning environment. The aim of the study is to 1 make pupils’ holistic craft processes visible in everyday classroom practices with information collected by a mobile-application and 2 point out the curriculum topics that are covered during everyday classroom practices as defined by the teachers. The data is collected using an Experience Sampling Method with a gamified learning analytics instrument. Teachers’ classroom activities were used as the backbone for the thematic mapping of the craft curriculum. Preliminary measurements were carried out in a Finnish primary school in grades 5–6 (age 10–12, n = 125 during a four-week period in October-November 2016. The list of classroom activities was updated after the four weeks’ experiment and was tested in March-May 2017 with all the pupils of the pilot school (N = 353. The key findings were that a for pupils the self-assessment was easy as a technical process but there were several factors in the everyday classroom settings that made the process challenging and b it was relatively difficult for teachers to describe the classroom activities in terms of the new curriculum; however, after four weeks they could not only described the activities in more details but had also developed new activities that supported the ideas of the new curriculum better.Keywords: multi-material craft, learning environment, holistic craft process, experience sampling method

  19. Comprehensive ecosystem model-data synthesis using multiple data sets at two temperate forest free-air CO2 enrichment experiments: Model performance at ambient CO2 concentration

    Science.gov (United States)

    Walker, Anthony P.; Hanson, Paul J.; De Kauwe, Martin G.; Medlyn, Belinda E.; Zaehle, Sönke; Asao, Shinichi; Dietze, Michael; Hickler, Thomas; Huntingford, Chris; Iversen, Colleen M.; Jain, Atul; Lomas, Mark; Luo, Yiqi; McCarthy, Heather; Parton, William J.; Prentice, I. Colin; Thornton, Peter E.; Wang, Shusen; Wang, Ying-Ping; Warlind, David; Weng, Ensheng; Warren, Jeffrey M.; Woodward, F. Ian; Oren, Ram; Norby, Richard J.

    2014-05-01

    Free-air CO2 enrichment (FACE) experiments provide a remarkable wealth of data which can be used to evaluate and improve terrestrial ecosystem models (TEMs). In the FACE model-data synthesis project, 11 TEMs were applied to two decadelong FACE experiments in temperate forests of the southeastern U.S.—the evergreen Duke Forest and the deciduous Oak Ridge Forest. In this baseline paper, we demonstrate our approach to model-data synthesis by evaluating the models' ability to reproduce observed net primary productivity (NPP), transpiration, and leaf area index (LAI) in ambient CO2 treatments. Model outputs were compared against observations using a range of goodness-of-fit statistics. Many models simulated annual NPP and transpiration within observed uncertainty. We demonstrate, however, that high goodness-of-fit values do not necessarily indicate a successful model, because simulation accuracy may be achieved through compensating biases in component variables. For example, transpiration accuracy was sometimes achieved with compensating biases in leaf area index and transpiration per unit leaf area. Our approach to model-data synthesis therefore goes beyond goodness-of-fit to investigate the success of alternative representations of component processes. Here we demonstrate this approach by comparing competing model hypotheses determining peak LAI. Of three alternative hypotheses—(1) optimization to maximize carbon export, (2) increasing specific leaf area with canopy depth, and (3) the pipe model—the pipe model produced peak LAI closest to the observations. This example illustrates how data sets from intensive field experiments such as FACE can be used to reduce model uncertainty despite compensating biases by evaluating individual model assumptions.

  20. Initializing numerical weather prediction models with satellite-derived surface soil moisture: Data assimilation experiments with ECMWF's Integrated Forecast System and the TMI soil moisture data set

    Science.gov (United States)

    Drusch, M.

    2007-02-01

    Satellite-derived surface soil moisture data sets are readily available and have been used successfully in hydrological applications. In many operational numerical weather prediction systems the initial soil moisture conditions are analyzed from the modeled background and 2 m temperature and relative humidity. This approach has proven its efficiency to improve surface latent and sensible heat fluxes and consequently the forecast on large geographical domains. However, since soil moisture is not always related to screen level variables, model errors and uncertainties in the forcing data can accumulate in root zone soil moisture. Remotely sensed surface soil moisture is directly linked to the model's uppermost soil layer and therefore is a stronger constraint for the soil moisture analysis. For this study, three data assimilation experiments with the Integrated Forecast System (IFS) of the European Centre for Medium-Range Weather Forecasts (ECMWF) have been performed for the 2-month period of June and July 2002: a control run based on the operational soil moisture analysis, an open loop run with freely evolving soil moisture, and an experimental run incorporating TMI (TRMM Microwave Imager) derived soil moisture over the southern United States. In this experimental run the satellite-derived soil moisture product is introduced through a nudging scheme using 6-hourly increments. Apart from the soil moisture analysis, the system setup reflects the operational forecast configuration including the atmospheric 4D-Var analysis. Soil moisture analyzed in the nudging experiment is the most accurate estimate when compared against in situ observations from the Oklahoma Mesonet. The corresponding forecast for 2 m temperature and relative humidity is almost as accurate as in the control experiment. Furthermore, it is shown that the soil moisture analysis influences local weather parameters including the planetary boundary layer height and cloud coverage.

  1. Fabrication techniques to eliminate postweld heat treatment

    International Nuclear Information System (INIS)

    Lochhead, J.C.

    1978-01-01

    Postweld heat treatments to reduce residual stresses (stress relief operations) have been a common practice in the pressure vessel industry for a large number of years. A suitable heat treatment operation can, in particular for low alloy steels, have additional beneficial effects, i.e. a reduction in peak hardness values in the heat-affected zone, an improvement in weld metal properties, and a lowering of the adverse effects of the welding process on the mechanical properties of the parent material adjacent to the weld metal. However, continuing studies in the field of brittle fracture, improved parent materials, and more sophisticated nondestructive testing techniques have led to the elimination of such a practice in ever-increasing thickness ranges and types of material. For instance, the recently issued BS 5500 compared with BS 1113 (1969) lifts the thickness limit requiring stress relief in certain circumstances from 19 to 35mm for C steels. With respect to materials the CEGB has stated that as a result of successful operational experience it will no longer be necessary to postweld heat treat butt welds in 2 1/4 Cr-1Mo tubes of certain dimensions. Despite this trend, over a period of years a number of instances have arisen where, because of some factor, postweld heat treatment, although perhaps desirable, is not possible. This Paper describes several such examples. It must be noted that the examples quoted consist of relatively important and major items. It has been necessary within the confines of this Paper to condense the reports. It is hoped that no significant factors have been omitted. (author)

  2. A mathematical model for carbon dioxide elimination: an insight for tuning mechanical ventilation.

    Science.gov (United States)

    Pomprapa, Anake; Schwaiberger, David; Lachmann, Burkhard; Leonhardt, Steffen

    2014-01-01

    The aim is to provide better understanding of carbon dioxide (CO2) elimination during ventilation for both the healthy and atelectatic condition, derived in a pressure-controlled mode. Therefore, we present a theoretical analysis of CO2 elimination of healthy and diseased lungs. Based on a single-compartment model, CO2 elimination is mathematically modeled and its contours were plotted as a function of temporal settings and driving pressure. The model was validated within some level of tolerance on an average of 4.9% using porcine dynamics. CO2 elimination is affected by various factors, including driving pressure, temporal variables from mechanical ventilator settings, lung mechanics and metabolic rate. During respiratory care, CO2 elimination is a key parameter for bedside monitoring, especially for patients with pulmonary disease. This parameter provides valuable insight into the status of an atelectatic lung and of cardiopulmonary pathophysiology. Therefore, control of CO2 elimination should be based on the fine tuning of the driving pressure and temporal ventilator settings. However, for critical condition of hypercapnia, airway resistance during inspiration and expiration should be additionally measured to determine the optimal percent inspiratory time (%TI) to maximize CO2 elimination for treating patients with hypercapnia.

  3. Diffusion of e-health innovations in 'post-conflict' settings: a qualitative study on the personal experiences of health workers.

    Science.gov (United States)

    Woodward, Aniek; Fyfe, Molly; Handuleh, Jibril; Patel, Preeti; Godman, Brian; Leather, Andrew; Finlayson, Alexander

    2014-04-23

    Technological innovations have the potential to strengthen human resources for health and improve access and quality of care in challenging 'post-conflict' contexts. However, analyses on the adoption of technology for health (that is, 'e-health') and whether and how e-health can strengthen a health workforce in these settings have been limited so far. This study explores the personal experiences of health workers using e-health innovations in selected post-conflict situations. This study had a cross-sectional qualitative design. Telephone interviews were conducted with 12 health workers, from a variety of cadres and stages in their careers, from four post-conflict settings (Liberia, West Bank and Gaza, Sierra Leone and Somaliland) in 2012. Everett Roger's diffusion of innovation-decision model (that is, knowledge, persuasion, decision, implementation, contemplation) guided the thematic analysis. All health workers interviewed held positive perceptions of e-health, related to their beliefs that e-health can help them to access information and communicate with other health workers. However, understanding of the scope of e-health was generally limited, and often based on innovations that health workers have been introduced through by their international partners. Health workers reported a range of engagement with e-health innovations, mostly for communication (for example, email) and educational purposes (for example, online learning platforms). Poor, unreliable and unaffordable Internet was a commonly mentioned barrier to e-health use. Scaling-up existing e-health partnerships and innovations were suggested starting points to increase e-health innovation dissemination. Results from this study showed ICT based e-health innovations can relieve information and communication needs of health workers in post-conflict settings. However, more efforts and investments, preferably driven by healthcare workers within the post-conflict context, are needed to make e-health more

  4. Interparameter trade-off quantification and reduction in isotropic-elastic full-waveform inversion: synthetic experiments and Hussar land data set application

    Science.gov (United States)

    Pan, Wenyong; Geng, Yu; Innanen, Kristopher A.

    2018-05-01

    The problem of inverting for multiple physical parameters in the subsurface using seismic full-waveform inversion (FWI) is complicated by interparameter trade-off arising from inherent ambiguities between different physical parameters. Parameter resolution is often characterized using scattering radiation patterns, but these neglect some important aspects of interparameter trade-off. More general analysis and mitigation of interparameter trade-off in isotropic-elastic FWI is possible through judiciously chosen multiparameter Hessian matrix-vector products. We show that products of multiparameter Hessian off-diagonal blocks with model perturbation vectors, referred to as interparameter contamination kernels, are central to the approach. We apply the multiparameter Hessian to various vectors designed to provide information regarding the strengths and characteristics of interparameter contamination, both locally and within the whole volume. With numerical experiments, we observe that S-wave velocity perturbations introduce strong contaminations into density and phase-reversed contaminations into P-wave velocity, but themselves experience only limited contaminations from other parameters. Based on these findings, we introduce a novel strategy to mitigate the influence of interparameter trade-off with approximate contamination kernels. Furthermore, we recommend that the local spatial and interparameter trade-off of the inverted models be quantified using extended multiparameter point spread functions (EMPSFs) obtained with pre-conditioned conjugate-gradient algorithm. Compared to traditional point spread functions, the EMPSFs appear to provide more accurate measurements for resolution analysis, by de-blurring the estimations, scaling magnitudes and mitigating interparameter contamination. Approximate eigenvalue volumes constructed with stochastic probing approach are proposed to evaluate the resolution of the inverted models within the whole model. With a synthetic

  5. Mid-Pliocene global climate simulation with MRI-CGCM2.3: set-up and initial results of PlioMIP Experiments 1 and 2

    Directory of Open Access Journals (Sweden)

    Y. Kamae

    2012-05-01

    Full Text Available The mid-Pliocene (3.3 to 3.0 million yr ago, a globally warm period before the Quaternary, is recently attracting attention as a new target for paleoclimate modelling and data-model synthesis. This paper reports set-ups and results of experiments proposed in Pliocene Model Intercomparison Project (PlioMIP using a global climate model, MRI-CGCM2.3. We conducted pre-industrial and mid-Pliocene runs by using the coupled atmosphere-ocean general circulation model (AOGCM and its atmospheric component (AGCM for the PlioMIP Experiments 2 and 1, respectively. In addition, we conducted two types of integrations in AOGCM simulation, with and without flux adjustments on sea surface. General characteristics of differences in the simulated mid-Pliocene climate relative to the pre-industrial in the three integrations are compared. In addition, patterns of predicted mid-Pliocene biomes resulting from the three climate simulations are compared in this study. Generally, difference of simulated surface climate between AGCM and AOGCM is larger than that between the two AOGCM runs, with and without flux adjustments. The simulated climate shows different pattern between AGCM and AOGCM particularly over low latitude oceans, subtropical land regions and high latitude oceans. The AOGCM simulations do not reproduce wetter environment in the subtropics relative to the present-day, which is suggested by terrestrial proxy data. The differences between the two types of AOGCM runs are small over the land, but evident over the ocean particularly in the North Atlantic and polar regions.

  6. Martian Atmospheric Pressure Static Charge Elimination Tool

    Science.gov (United States)

    Johansen, Michael R.

    2014-01-01

    A Martian pressure static charge elimination tool is currently in development in the Electrostatics and Surface Physics Laboratory (ESPL) at NASA's Kennedy Space Center. In standard Earth atmosphere conditions, static charge can be neutralized from an insulating surface using air ionizers. These air ionizers generate ions through corona breakdown. The Martian atmosphere is 7 Torr of mostly carbon dioxide, which makes it inherently difficult to use similar methods as those used for standard atmosphere static elimination tools. An initial prototype has been developed to show feasibility of static charge elimination at low pressure, using corona discharge. A needle point and thin wire loop are used as the corona generating electrodes. A photo of the test apparatus is shown below. Positive and negative high voltage pulses are sent to the needle point. This creates positive and negative ions that can be used for static charge neutralization. In a preliminary test, a floating metal plate was charged to approximately 600 volts under Martian atmospheric conditions. The static elimination tool was enabled and the voltage on the metal plate dropped rapidly to -100 volts. This test data is displayed below. Optimization is necessary to improve the electrostatic balance of the static elimination tool.

  7. Body elimination attitude family resemblance in Kuwait.

    Science.gov (United States)

    Al-Fayez, Ghenaim; Awadalla, Abdelwahid; Arikawa, Hiroko; Templer, Donald I; Hutton, Shane

    2009-12-01

    The purpose of the present study was to determine the family resemblance of attitude toward body elimination in Kuwaiti participants. This study was conceptualized in the context of the theories of moral development, importance of cleanliness in the Muslim religion, cross-cultural differences in personal hygiene practices, previous research reporting an association between family attitudes and body elimination attitude, and health implications. The 24-item Likert-type format Body Elimination Attitude Scale-Revised was administered to 277 Kuwaiti high school students and 437 of their parents. Females scored higher, indicating greater disgust, than the males. Moreover, sons' body elimination attitude correlated more strongly with fathers' attitude (r = .85) than with that of the mothers (r = .64). Daughters' attitude was similarly associated with the fathers' (r = .89) and the mothers' attitude (r = .86). The high correlations were discussed within the context of Kuwait having a collectivistic culture with authoritarian parenting style. The higher adolescent correlations, and in particular the boys' correlation with fathers than with mothers, was explained in terms of the more dominant role of the Muslim father in the family. Public health and future research implications were suggested. A theoretical formulation was advanced in which "ideal" body elimination attitude is relative rather than absolute, and is a function of one's life circumstances, one's occupation, one's culture and subculture, and the society that one lives in.

  8. Health Services OutPatient Experience questionnaire: factorial validity and reliability of a patient-centered outcome measure for outpatient settings in Italy

    Directory of Open Access Journals (Sweden)

    Coluccia A

    2014-09-01

    Full Text Available Anna Coluccia, Fabio Ferretti, Andrea PozzaDepartment of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital, University of Siena, Siena, ItalyPurpose: The patient-centered approach to health care does not seem to be sufficiently developed in the Italian context, and is still characterized by the biomedical model. In addition, there is a lack of validated outcome measures to assess outpatient experience as an aspect common to a variety of settings. The current study aimed to evaluate the factorial validity, reliability, and invariance across sex of the Health Services OutPatient Experience (HSOPE questionnaire, a short ten-item measure of patient-centeredness for Italian adult outpatients. The rationale for unidimensionality of the measure was that it could cover global patient experience as a process common to patients with a variety of diseases and irrespective of the phase of treatment course.Patients and methods: The HSOPE was compiled by 1,532 adult outpatients (51% females, mean age 59.22 years, standard deviation 16.26 receiving care in ten facilities at the Santa Maria alle Scotte University Hospital of Siena, Italy. The sample represented all the age cohorts. Twelve percent were young adults, 57% were adults, and 32% were older adults. Exploratory and confirmatory factor analyses were conducted to evaluate factor structure. Reliability was evaluated as internal consistency using Cronbach’s α. Factor invariance was assessed through multigroup analyses.Results: Both exploratory and confirmatory analyses suggested a clearly defined unidimensional structure of the measure, with all the ten items having salient loadings on a single factor. Internal consistency was excellent (α=0.95. Indices of model fit supported a single-factor structure for both male and female outpatient groups. Young adult outpatients had significantly lower scores on perceived patient-centeredness relative to older adults. No

  9. Older Adults With a Combination of Vision and Hearing Impairment Experience Higher Rates of Cognitive Impairment, Functional Dependence, and Worse Outcomes Across a Set of Quality Indicators.

    Science.gov (United States)

    Davidson, Jacob G S; Guthrie, Dawn M

    2017-08-01

    Hearing and vision impairment were examined across several health-related outcomes and across a set of quality indicators (QIs) in home care clients with both vision and hearing loss (or dual sensory impairment [DSI]). Data collected using the Resident Assessment Instrument for Home Care (RAI-HC) were analyzed in a sample of older home care clients. The QIs represent the proportion of clients experiencing negative outcomes (e.g., falls, social isolation). The average age of clients was 82.8 years ( SD = 7.9), 20.5% had DSI and 8.5% had a diagnosis of Alzheimer's disease (AD). Clients with DSI were more likely to have a diagnosis of dementia (not AD), have functional impairments, report loneliness, and have higher rates across 20 of the 22 QIs, including communication difficulty and cognitive decline. Clients with highly impaired hearing, and any visual impairment, had the highest QI rates. Individuals with DSI experience higher rates of adverse events across many health-related outcomes and QIs. Understanding the unique contribution of hearing and vision in this group can promote optimal quality of care.

  10. Evaluating performance of high efficiency mist eliminators

    Energy Technology Data Exchange (ETDEWEB)

    Waggoner, Charles A.; Parsons, Michael S.; Giffin, Paxton K. [Mississippi State University, Institute for Clean Energy Technology, 205 Research Blvd, Starkville, MS (United States)

    2013-07-01

    Processing liquid wastes frequently generates off gas streams with high humidity and liquid aerosols. Droplet laden air streams can be produced from tank mixing or sparging and processes such as reforming or evaporative volume reduction. Unfortunately these wet air streams represent a genuine threat to HEPA filters. High efficiency mist eliminators (HEME) are one option for removal of liquid aerosols with high dissolved or suspended solids content. HEMEs have been used extensively in industrial applications, however they have not seen widespread use in the nuclear industry. Filtering efficiency data along with loading curves are not readily available for these units and data that exist are not easily translated to operational parameters in liquid waste treatment plants. A specialized test stand has been developed to evaluate the performance of HEME elements under use conditions of a US DOE facility. HEME elements were tested at three volumetric flow rates using aerosols produced from an iron-rich waste surrogate. The challenge aerosol included submicron particles produced from Laskin nozzles and super micron particles produced from a hollow cone spray nozzle. Test conditions included ambient temperature and relative humidities greater than 95%. Data collected during testing HEME elements from three different manufacturers included volumetric flow rate, differential temperature across the filter housing, downstream relative humidity, and differential pressure (dP) across the filter element. Filter challenge was discontinued at three intermediate dPs and the filter to allow determining filter efficiency using dioctyl phthalate and then with dry surrogate aerosols. Filtering efficiencies of the clean HEME, the clean HEME loaded with water, and the HEME at maximum dP were also collected using the two test aerosols. Results of the testing included differential pressure vs. time loading curves for the nine elements tested along with the mass of moisture and solid

  11. Method of eliminating gaseous hydrogen isotopes

    International Nuclear Information System (INIS)

    Nagakura, Masaaki; Imaizumi, Hideki; Suemori, Nobuo; Aizawa, Takashi; Naito, Taisei.

    1983-01-01

    Purpose: To prevent external diffusion of gaseous hydrogen isotopes such as tritium or the like upon occurrence of tritium leakage accident in a thermonuclear reactor by recovering to eliminate the isotopes rapidly and with safety. Method: Gases at the region of a reactor container where hydrogen isotopes might leak are sucked by a recycing pump, dehumidified in a dehumidifier and then recycled from a preheater through a catalytic oxidation reactor to a water absorption tower. In this structure, the dehumidifier is disposed at the upstream of the catalytic oxidation reactor to reduce the water content of the gases to be processed, whereby the eliminating efficiency for the gases to be processed can be maintained well even when the oxidation reactor is operated at a low temperature condition near the ambient temperature. This method is based on the fact that the oxidating reactivity of the catalyst can be improved significantly by eliminating the water content in the gases to be processed. (Yoshino, Y.)

  12. Counting SET-free sets

    OpenAIRE

    Harman, Nate

    2016-01-01

    We consider the following counting problem related to the card game SET: How many $k$-element SET-free sets are there in an $n$-dimensional SET deck? Through a series of algebraic reformulations and reinterpretations, we show the answer to this question satisfies two polynomiality conditions.

  13. Attacking the mosquito on multiple fronts: Insights from the Vector Control Optimization Model (VCOM for malaria elimination.

    Directory of Open Access Journals (Sweden)

    Samson S Kiware

    Full Text Available Despite great achievements by insecticide-treated nets (ITNs and indoor residual spraying (IRS in reducing malaria transmission, it is unlikely these tools will be sufficient to eliminate malaria transmission on their own in many settings today. Fortunately, field experiments indicate that there are many promising vector control interventions that can be used to complement ITNs and/or IRS by targeting a wide range of biological and environmental mosquito resources. The majority of these experiments were performed to test a single vector control intervention in isolation; however, there is growing evidence and consensus that effective vector control with the goal of malaria elimination will require a combination of interventions.We have developed a model of mosquito population dynamic to describe the mosquito life and feeding cycles and to optimize the impact of vector control intervention combinations at suppressing mosquito populations. The model simulations were performed for the main three malaria vectors in sub-Saharan Africa, Anopheles gambiae s.s, An. arabiensis and An. funestus. We considered areas having low, moderate and high malaria transmission, corresponding to entomological inoculation rates of 10, 50 and 100 infective bites per person per year, respectively. In all settings, we considered baseline ITN coverage of 50% or 80% in addition to a range of other vector control tools to interrupt malaria transmission. The model was used to sweep through parameters space to select the best optimal intervention packages. Sample model simulations indicate that, starting with ITNs at a coverage of 50% (An. gambiae s.s. and An. funestus or 80% (An. arabiensis and adding interventions that do not require human participation (e.g. larviciding at 80% coverage, endectocide treated cattle at 50% coverage and attractive toxic sugar baits at 50% coverage may be sufficient to suppress all the three species to an extent required to achieve local malaria

  14. Ten years left to eliminate blinding trachoma

    Directory of Open Access Journals (Sweden)

    Haddad D.

    2010-09-01

    Full Text Available n 1997, the World Health Organization formed the Global Alliance to Eliminate Blinding Trachoma by 2020 (GET 2020, a coalition of governmental, non-governmental, research, and pharmaceutical partners. In 1998, the World Health Assembly urged member states to map blinding trachoma in endemic areas, implement the SAFE strategy (which stands for surgery for trichiasis, antibiotics, facial-cleanliness and environmental change, such as clean water and latrines and collaborate with the global alliance in its work to eliminate blinding trachoma.

  15. Recognizing, Confronting, and Eliminating Workplace Bullying.

    Science.gov (United States)

    Berry, Peggy Ann; Gillespie, Gordon L; Fisher, Bonnie S; Gormley, Denise K

    2016-07-01

    Workplace bullying (WPB) behaviors negatively affect nurse productivity, satisfaction, and retention, and hinder safe patient care. The purpose of this article is to define WPB, differentiate between incivility and WPB, and recommend actions to prevent WPB behaviors. Informed occupational and environmental health nurses and nurse leaders must recognize, confront, and eliminate WPB in their facilities and organizations. Recognizing, confronting, and eliminating WPB behaviors in health care is a crucial first step toward sustained improvements in patient care quality and the health and safety of health care employees. © 2016 The Author(s).

  16. Duplicate Record Elimination in Large Data Files.

    Science.gov (United States)

    1981-08-01

    UNCLASSIFIJED CSTR -445 NL LmEE~hhE - I1.0 . 111112----5 1.~4 __112 ___IL25_ 1.4 111111.6 EI24 COMPUTER SCIENCES DEPARTMENT oUniversity of Wisconsin...we propose a combinatorial model for the use in the analysis of algorithms for duplicate elimination. We contend that this model can serve as a...duplicates in a multiset of records, knowing the size of the multiset and the number of distinct records in it. 3. Algorithms for Duplicate Elimination

  17. Evidence-Based Psychosocial Treatments for Pediatric Elimination Disorders.

    Science.gov (United States)

    Shepard, Jaclyn A; Poler, Joseph E; Grabman, Jesse H

    2017-01-01

    Pediatric elimination disorders are common in childhood, yet psychosocial correlates are generally unclear. Given the physiological concomitants of both enuresis and encopresis, and the fact that many children with elimination disorders are initially brought to their primary care physician for treatment, medical evaluation and management are crucial and may serve as the first-line treatment approach. Scientific investigation on psychological and behavioral interventions has progressed over the past couple of decades, resulting in the identification of effective treatments for enuresis and encopresis. However, the body of literature has inherent challenges, particularly given the multicomponent nature of many of the treatment packages. This review identified 25 intervention studies-18 for nocturnal enuresis and 7 for encopresis-over the past 15 years and classified them according to the guidelines set forth by the Task Force on the Promotion and Dissemination of Psychological Procedures. For nocturnal enuresis, the urine alarm and dry-bed training were identified as well-established treatments, Full Spectrum Home Therapy was probably efficacious, lifting was possibly efficacious, and hypnotherapy and retention control training were classified as treatments of questionable efficacy. For encopresis, only two probably efficacious treatments were identified: biofeedback and enhanced toilet training (ETT). Best practice recommendations and suggestions for future research are provided to address existing limitations, including heterogeneity and the multicomponent nature of many of the interventions for pediatric elimination disorders.

  18. Discovering highly informative feature set over high dimensions

    KAUST Repository

    Zhang, Chongsheng; Masseglia, Florent; Zhang, Xiangliang

    2012-01-01

    For many textual collections, the number of features is often overly large. These features can be very redundant, it is therefore desirable to have a small, succinct, yet highly informative collection of features that describes the key characteristics of a dataset. Information theory is one such tool for us to obtain this feature collection. With this paper, we mainly contribute to the improvement of efficiency for the process of selecting the most informative feature set over high-dimensional unlabeled data. We propose a heuristic theory for informative feature set selection from high dimensional data. Moreover, we design data structures that enable us to compute the entropies of the candidate feature sets efficiently. We also develop a simple pruning strategy that eliminates the hopeless candidates at each forward selection step. We test our method through experiments on real-world data sets, showing that our proposal is very efficient. © 2012 IEEE.

  19. Discovering highly informative feature set over high dimensions

    KAUST Repository

    Zhang, Chongsheng

    2012-11-01

    For many textual collections, the number of features is often overly large. These features can be very redundant, it is therefore desirable to have a small, succinct, yet highly informative collection of features that describes the key characteristics of a dataset. Information theory is one such tool for us to obtain this feature collection. With this paper, we mainly contribute to the improvement of efficiency for the process of selecting the most informative feature set over high-dimensional unlabeled data. We propose a heuristic theory for informative feature set selection from high dimensional data. Moreover, we design data structures that enable us to compute the entropies of the candidate feature sets efficiently. We also develop a simple pruning strategy that eliminates the hopeless candidates at each forward selection step. We test our method through experiments on real-world data sets, showing that our proposal is very efficient. © 2012 IEEE.

  20. Typhoid intestinal perforations at a University teaching hospital in Northwestern Tanzania: A surgical experience of 104 cases in a resource-limited setting

    Directory of Open Access Journals (Sweden)

    Chalya Phillipo L

    2012-03-01

    Full Text Available Abstract Background Typhoid intestinal perforation is still prevalent in many developing countries. Despite the advances in the management, the outcome in these patients in resource limited countries is still very poor. This study was to review our experiences on the surgical management of typhoid intestinal perforation and to determine the prognostic factors for mortality in our local setting. Methods This was a combined retrospective and prospective study of patients who were operated for typhoid intestinal perforation at Bugando Medical Centre between August 2006 and September 2011. Data collected were analyzed using SPSS computer software version 15. Results A total of 104 patients were studied representing 8.7% of typhoid fever cases. Males were affected twice more than the females (2.6:1. Their ages ranged from 8 to 76 years with a median age of 18.5 years. The peak age incidence was in the 11-20 years age group. Fever and abdominal pain were the most common presenting symptoms and majority of the patients (80.8% perforated between within 14 days of illness. Chest and abdominal radiographs revealed pneumoperitonium in 74.7% of cases. Ultrasound showed free peritoneal collection in 85.7% of cases. Nine (10.2% patients were HIV positive with a median CD4+ count of 261 cells/μl. The perforation-surgery interval was more than 72 hours in 90(86.5% patients. The majority of patients (84.6% had single perforations and ileum was the most common part of the bowel affected occurring in 86.2% of cases. Simple closure of the perforations was the most commonly performed procedure accounting for 78.8% of cases. Postoperative complication rate was 39.4% and surgical site infection was the most frequent complication in 55.5% of cases. Mortality rate was 23.1% and it was statistically significantly associated with delayed presentation, inadequate antibiotic treatment prior to admission, shock on admission, HIV positivity, low CD4 count (P Conclusion

  1. Eliminating malaria in Malaysia: the role of partnerships between the public and commercial sectors in Sabah

    OpenAIRE

    Sanders, Kelly C; Rundi, Christina; Jelip, Jenarun; Rashman, Yusof; Smith Gueye, Cara; Gosling, Roly D

    2014-01-01

    Background Countries in the Asia Pacific region have made great progress in the fight against malaria; several are rapidly approaching elimination. However, malaria control programmes operating in elimination settings face substantial challenges, particularly around mobile migrant populations, access to remote areas and the diversity of vectors with varying biting and breeding behaviours. These challenges can be addressed through subnational collaborations with commercial partners, such as mi...

  2. Elimination of Dog-Mediated Human Rabies Deaths by 2030: Needs Assessment and Alternatives for Progress Based on Dog Vaccination

    OpenAIRE

    Wallace, Ryan M.; Undurraga, Eduardo A.; Blanton, Jesse D.; Cleaton, Julie; Franka, Richard

    2017-01-01

    Background Rabies imposes a substantial burden to about half of the world population. The World Health Organization (WHO), World Organization for Animal Health, and the Food and Agriculture Organization have set the goal of eliminating dog-mediated human rabies deaths by 2030. This could be achieved largely by massive administration of post-exposure prophylaxis—in perpetuity—, through elimination of dog rabies, or combining both. Here, we focused on the resources needed for the elimination...

  3. Taking Centrioles to the Elimination Round.

    Science.gov (United States)

    Schoborg, Todd A; Rusan, Nasser M

    2016-07-11

    Two recent papers published in The Journal of Cell Biology (Borrego-Pinto et al., 2016) and Science (Pimenta-Marques et al., 2016) have begun to shed light on the mechanism of centriole elimination during female oogenesis, highlighting a protective role for Polo kinase and the pericentriolar material. Published by Elsevier Inc.

  4. Elimination Problems in Infants and Children

    Science.gov (United States)

    ... inability to digest wheat (CELIAC DISEASE) or milk (LACTOSE INTOLERANCE) can cause these symptoms. Self CareEliminate foods that ... be an appropriate substitute for infants who have lactose intolerance. Start OverDiagnosisPain from HEMORRHOIDS or an ANAL FISSURE ...

  5. Eliminating Problems Caused by Multicollinearity: A Warning.

    Science.gov (United States)

    Kennedy, Peter E.

    1982-01-01

    Explains why an econometric practice introduced by J.C. Soper cannot eliminate the problems caused by multicollinearity. The author suggests that it can be a useful technique in that it forces researchers to pay more attention to the specifications of their models. (AM)

  6. Double elimination voltammetry of short oligonucleotides

    Czech Academy of Sciences Publication Activity Database

    Mikelová, R.; Trnková, L.; Jelen, František

    2007-01-01

    Roč. 19, č. 17 (2007), s. 1807-1814 ISSN 1040-0397 R&D Projects: GA AV ČR(CZ) IAA100040602 Institutional research plan: CEZ:AV0Z50040507; CEZ:AV0Z50040702 Keywords : adsorptive stripping voltammetry * elimination voltammetry * oligodeoxynucleotide Subject RIV: BO - Biophysics Impact factor: 2.949, year: 2007

  7. Strategy elimination in games with interaction structures

    NARCIS (Netherlands)

    Witzel, A.; Apt, K.R.; Zvesper, J.A.

    2009-01-01

    We study games in the presence of an interaction structure, which allows players to communicate their preferences, assuming that each player initially only knows his own preferences. We study the outcomes of iterated elimination of strictly dominated strategies (IESDS) that can be obtained in any

  8. [Application of thermosetting plastics to eliminate undercuts].

    Science.gov (United States)

    Bielawski, T

    1989-01-01

    The author proposes to utilize the properties of thermosetting plastics used in other fields to use them in prosthetics in order to eliminate undercuts. Application of extra equipment in claspograph in the form of studs of three dimension makes formation of undercuts' blockade easier improving the result of work at the same time.

  9. Challenges for malaria elimination in Brazil.

    Science.gov (United States)

    Ferreira, Marcelo U; Castro, Marcia C

    2016-05-20

    Brazil currently contributes 42 % of all malaria cases reported in the Latin America and the Caribbean, a region where major progress towards malaria elimination has been achieved in recent years. In 2014, malaria burden in Brazil (143,910 microscopically confirmed cases and 41 malaria-related deaths) has reached its lowest levels in 35 years, Plasmodium falciparum is highly focal, and the geographic boundary of transmission has considerably shrunk. Transmission in Brazil remains entrenched in the Amazon Basin, which accounts for 99.5 % of the country's malaria burden. This paper reviews major lessons learned from past and current malaria control policies in Brazil. A comprehensive discussion of the scientific and logistic challenges that may impact malaria elimination efforts in the country is presented in light of the launching of the Plan for Elimination of Malaria in Brazil in November 2015. Challenges for malaria elimination addressed include the high prevalence of symptomless and submicroscopic infections, emerging anti-malarial drug resistance in P. falciparum and Plasmodium vivax and the lack of safe anti-relapse drugs, the largely neglected burden of malaria in pregnancy, the need for better vector control strategies where Anopheles mosquitoes present a highly variable biting behaviour, human movement, the need for effective surveillance and tools to identify foci of infection in areas with low transmission, and the effects of environmental changes and climatic variability in transmission. Control actions launched in Brazil and results to come are likely to influence control programs in other countries in the Americas.

  10. Eliminating transducer distortion in acoustic measurements

    DEFF Research Database (Denmark)

    Agerkvist, Finn T.; Torras Rosell, Antoni; McWalter, Richard Ian

    2014-01-01

    This paper investigates the in uence of nonlinear components that contaminate the linear response of acoustic transducer, and presents a method for eliminating the in uence of nonlinearities in acoustic measurements. The method is evaluated on simulated as well as experimental data, and is shown...

  11. Ten-year clinical experience of humanitarian cardiothoracic surgery in Rwanda: Building a platform for ultimate sustainability in a resource-limited setting.

    Science.gov (United States)

    Swain, JaBaris D; Sinnott, Colleen; Breakey, Suellen; Hasson Charles, Rian; Mody, Gita; Nyirimanzi, Napthal; Patton-Bolman, Ceeya; Come, Patricia; Ganza, Gapira; Rusingiza, Emmanuel; Ruhamya, Nathan; Mucumbitsi, Joseph; Borges, Jorge; Zammert, Martin; Muehlschlegel, Jochen D; Oakes, Robert; Leavitt, Bruce; Bolman, R Morton

    2018-06-01

    Despite its near complete eradication in resource-rich countries, rheumatic heart disease remains the most common acquired cardiovascular disease in sub-Saharan Africa. With a ratio of physicians/population of 1 per 10,500, including only 4 cardiologists for a population of 11.4 million, Rwanda represents a resource-limited setting lacking the local capacity to detect and treat early cases of strep throat and perform lifesaving operations for advanced rheumatic heart disease. Humanitarian surgical outreach in this region can improve the delivery of cardiovascular care by providing sustainability through mentorship, medical expertise, training, and knowledge transfer, and ultimately the creation of a cardiac center. We describe the experience of consecutive annual visits to Rwanda since 2008 and report the outcomes of a collaborative approach to enable sustainable cardiac surgery in the region. The Ferrans and Powers Quality of Life Index tool's Cardiac Version (http://www.uic.edu/orgs/qli/) was administered to assess the postoperative quality of life. Ten visits have been completed, performing 149 open procedures, including 200 valve implantations, New York Heart Association class III or IV, with 4.7% 30-day mortality. All procedures were performed with the participation of local Rwandan personnel, expatriate physicians, nurses, residents, and support staff. Early complications included cerebrovascular accident (n = 4), hemorrhage requiring reoperation (n = 6), and death (n = 7). Quality of life was assessed to further understand challenges encountered after cardiac surgery in this resource-limited setting. Four major domains were considered: health and functioning, social and economic, psychologic/spiritual, and family. The mean total quality of life index was 20.79 ± 4.07 on a scale from 0 to 30, for which higher scores indicated higher quality of life. Women had significantly lower "social and economic" subscores (16.81 ± 4.17) than men (18.64 ± 4

  12. OZONE DEPLETING SUBSTANCES ELIMINATION MANAGEMENT: THE SUCCESS STORY OF MACEDONIA

    Directory of Open Access Journals (Sweden)

    Margarita Matlievska

    2013-04-01

    Full Text Available Man, with its activities, produces and uses substances that have negative impact on the environment and the human health, and can cause an economic damage. Consequently, they have a great impact on quality of life. Among the most harmful chemicals are Ozone Depleting Substances that are subject of regulation with international conventions. This Paper supports the fact that each country has to undertake national efforts for ozone depleting substances reduction and elimination. In that respect, the general objective of the Paper is to present the Macedonian unique experience regarding its efforts to reduce or eliminate these substances. The following two aspects were subject to the research: national legislation which regulates the Ozone Depleting Substances import and export as well as the implementation of the projects that resulted with the elimination of Ozone Depleting Substances quantities in the period 1995 – 2010. The research outcomes confirm the starting research hypothesis i.e. that with adequately created and implemented national action, the amount of Ozone Depleting Substances consumption can dramatically fall.

  13. Mercury bioaccumulation and elimination by Xenomelanires brasiliensis - radioactive tracers technique

    International Nuclear Information System (INIS)

    Malagrino, Waldir; Mesquita, Carlos Henrique de; Sousa, Eduinetty Ceci P.M. de

    2002-01-01

    The present work has as main objective to emphasized the importance of using radioactive tracers as well as to establish a methodology for the utilization of 203 Hg in the bioaccumulation study of mercury by X enomelanires brasiliensis. The exposure time was 168 hours. The bioaccumulation of mercury from the water as well as the elimination of the metal previously absorbed were determined by measuring the activity of 203 Hg, which was added to the water in the beginning of the experiments. The technique chosen is suitable to study the behavior of the stable mercury since the radioisotope used is an isotope of the same element and therefore presents the same chemical properties. The results obtained show that the absorption and elimination of mercury by Xenomelanires brasiliensis is slow, 168 hours being necessary for the elimination of 38 % of the previously absorbed mercury. The results are of main concern if it is considered that the literature about bioaccumulation of mercury by the Brazilian ichthyofauna is scarce. Furthermore the species Xenomelanires brasiliensis is part of the food chain and the results can be used in the evaluation of the potential risk of the mercury bioaccumulation by fishes of higher trophic levels and by men who are the final link of the food chain. (author)

  14. Particle physics contribution to the elimination of nuclear waste

    CERN Document Server

    Revol, Jean Pierre Charles

    2000-01-01

    Progress in particle accelerator technology makes it possible to use a proton accelerator to eliminate nuclear waste efficiently. The Energy Amplifier (EA) proposed by C. Rubbia and his group is a subcritical system driven by a proton accelerator. It is particularly attractive for destroying, through fission, transuranic elements produced by present nuclear reactors. The EA could also transform efficiently and at minimal cost long-lived fission fragments using the concept of Adiabatic Resonance Crossing (ARC) recently tested at CERN with the TARC experiment. The ARC concept can be extended to several other application domains (radioactive isotopes production for medicine and industry, neutron research applications, etc.).

  15. Interdisciplinary study of atmospheric processes and constituents of the mid-Atlantic coastal region. Attachment 3: Data set for Craney Island oil refinery installation experiment. [air pollution monitoring

    Science.gov (United States)

    Kindle, E. C.; Bandy, A.; Copeland, G.; Blais, R.; Levy, G.; Sonenshine, D.; Adams, D.; Maier, G.

    1975-01-01

    Data tables and maps are presented which include background information and experimental data on the Craney Island oil refinery installation experiment. The experiment was to investigate air pollution effects.

  16. Automatic sets and Delone sets

    International Nuclear Information System (INIS)

    Barbe, A; Haeseler, F von

    2004-01-01

    Automatic sets D part of Z m are characterized by having a finite number of decimations. They are equivalently generated by fixed points of certain substitution systems, or by certain finite automata. As examples, two-dimensional versions of the Thue-Morse, Baum-Sweet, Rudin-Shapiro and paperfolding sequences are presented. We give a necessary and sufficient condition for an automatic set D part of Z m to be a Delone set in R m . The result is then extended to automatic sets that are defined as fixed points of certain substitutions. The morphology of automatic sets is discussed by means of examples

  17. A Decision Logic Approach to Mill’s Eliminative Induction

    Directory of Open Access Journals (Sweden)

    Piętka Dariusz

    2015-09-01

    Full Text Available The subject of the paper is a contemporary interpretation of J.S. Mill’s elimination method using selected concepts of Zdzisław Pawlak’s decision logic. The aim of the interpretation is to reformulate the original rules (canons of Mill’s induction so that they correspond more precisely to his concept of cause as a complex sufficient condition. In the first part of the paper, we turn to Mill’s writings and justify the thesis that in his understanding the cause is an aggregation of circumstances, and not a single circumstance; next, we point out that Mill’s original canons (for example the canon of agreement and the canon of difference do not allow causes-aggregations to be singled out from empirical data. In the second part of this paper, we present such aspects of Z. Pawlak’s decision logic that serve as the basis for the formalisation of the method of eliminative induction. We describe exhaustively the schema of induction that involves a gradual - divided into three stages - simplification of a set of implications corresponding to the observed dependencies [system of potential causes, effect]. The simplification is deductive because it maintains consistency within the set of implications. We show that such schema is ideal for isolating complex causes (aggregations of circumstances, ultimately described using complex conditional formulas of decision logic.

  18. Techniques to eliminate nuclear weapons testing infrastructure at former Semipalatinsk test site

    International Nuclear Information System (INIS)

    Erofeev, I.E.; Kovalev, V.V.

    2003-01-01

    It was at the former Semipalatinsk Test Site where for the first time in the world the nuclear weapons testing infrastructure elimination was put into practice. Fundamentally new procedures for blasting operations have been developed by specialists of the Kazakh State Research and Production Center of Blasting Operations (KSCBO), National Nuclear Center of the Republic of Kazakhstan (NNC) and Degelen Enterprise to enhance reliability and provide safety during elimination of various objects and performance of large-scale experiments. (author)

  19. Global elimination of leprosy by 2020: are we on track?

    Science.gov (United States)

    Blok, David J; De Vlas, Sake J; Richardus, Jan Hendrik

    2015-10-22

    Every year more than 200,000 new leprosy cases are registered globally. This number has been fairly stable over the past 8 years. WHO has set a target to interrupt the transmission of leprosy globally by 2020. The aim of this study is to investigate whether this target, interpreted as global elimination, is feasible given the current control strategy. We focus on the three most important endemic countries, India, Brazil and Indonesia, which together account for more than 80 % of all newly registered leprosy cases. We used the existing individual-based model SIMCOLEP to predict future trends of leprosy incidence given the current control strategy in each country. SIMCOLEP simulates the spread of M. leprae in a population that is structured in households. Current control consists of passive and active case detection, and multidrug therapy (MDT). Predictions of leprosy incidence were made for each country as well as for one high-endemic region within each country: Chhattisgarh (India), Pará State (Brazil) and Madura (Indonesia). Data for model quantification came from: National Leprosy Elimination Program (India), SINAN database (Brazil), and Netherlands Leprosy Relief (Indonesia). Our projections of future leprosy incidence all show a downward trend. In 2020, the country-level leprosy incidence has decreased to 6.2, 6.1 and 3.3 per 100,000 in India, Brazil and Indonesia, respectively, meeting the elimination target of less than 10 per 100,000. However, elimination may not be achieved in time for the high-endemic regions. The leprosy incidence in 2020 is predicted to be 16.2, 21.1 and 19.3 per 100,000 in Chhattisgarh, Pará and Madura, respectively, and the target may only be achieved in another 5 to 10 years. Our predictions show that although country-level elimination is reached by 2020, leprosy is likely to remain a problem in the high-endemic regions (i.e. states, districts and provinces with multimillion populations), which account for most of the cases in a

  20. Possibilities of Sulphate Elimination from Mine Water

    Directory of Open Access Journals (Sweden)

    Heviánková Silvie

    2004-12-01

    Full Text Available The issue of „acid water“ (or AMD is well known in the world for some centuries. In the Eastern Slovakia, the most acid surface water occurs in the area of old mine Smolník, which is closed and submerged for 15 years. The submitted contribution deals with the sulphate-elimination from this locality. Recently, several methods of sulphate-elimination from the mine water are applied. The best-known methods are biological, physical-chemical and chemical precipitation. The method described in this contribution consists of chemical precipitation by sodium aluminate and calcium hydrate. Under application of this method very interesting results were obtained. The amount of SO42- anions decreased to almost zero-value, using optimal doses of the chemical reagents.

  1. McGuire snubber elimination program

    International Nuclear Information System (INIS)

    Cloud, R.L.; Leung, J.S.M.; Taylor, W.H.; Morgan, R.L. Jr.

    1993-01-01

    An engineering program has been initiated at McGuire Nuclear Stations 1 and 2 to eliminate all existing snubbers. The elimination is achieved by replacing existing snubbers with limit stop pipe supports. The program establishes plant-wide modification procedures for one-to-one substitution under the 10 CFR 50.59 requirement. Nuclear Regulatory Commission (NRC) acceptance is based on the results of both comparison analyses and the hardware implementation of sample piping systems at McGuire nuclear stations. Experimental results obtained on shake table testing and from the NRC sponsored HDR research program are also used to formulate the technical basis and design procedures for plant-wide implementation of the snubber replacement effort. The overall program plan is for nearly 3,000 snubbers to be replaced in phases consistent with the plant scheduled outages. Duke Power estimates the program, when completed, will maintain ALARA, improve reliability, and reduce plant operating costs

  2. Elimination of salmonella from animal glandular products.

    Science.gov (United States)

    De Fiebre, C W; Burck, K T; Feldman, D

    1969-03-01

    Methods for the elimination of salmonellae from selected powdered pharmaceuticals of animal glandular origin were studied. Terminal heat treatment under carefully controlled conditions was effective for pancreatin-a powder containing proteolytic, amylolytic, and lipolytic enzymes prepared from hog pancreas glands. Use of this method resulted in a significant reduction in the number of salmonella-positive batches and also reduced the testing procedures required to confirm the absence of viable salmonellae among the majority of samples tested. Powders such as stomach substance and thyroid, in which the biological activity is not enzyme in nature, were treated successfully with acidified organic solvents. Other methods were investigated but were not suitable because of a deleterious effect on the biological activity or physical properties of the product or an inability to effect salmonella elimination.

  3. Elimination of Salmonellae from Animal Glandular Products

    Science.gov (United States)

    De Fiebre, Conrad W.; Burck, Kenneth T.; Feldman, David

    1969-01-01

    Methods for the elimination of salmonellae from selected powdered pharmaceuticals of animal glandular origin were studied. Terminal heat treatment under carefully controlled conditions was effective for pancreatin—a powder containing proteolytic, amylolytic, and lipolytic enzymes prepared from hog pancreas glands. Use of this method resulted in a significant reduction in the number of salmonella-positive batches and also reduced the testing procedures required to confirm the absence of viable salmonellae among the majority of samples tested. Powders such as stomach substance and thyroid, in which the biological activity is not enzyme in nature, were treated successfully with acidified organic solvents. Other methods were investigated but were not suitable because of a deleterious effect on the biological activity or physical properties of the product or an inability to effect salmonella elimination. PMID:5780395

  4. Eliminative behaviour of dairy cows at pasture

    DEFF Research Database (Denmark)

    Whistance, Lindsay Kay; Sinclair, Liam A.; Arney, David Richard

    2011-01-01

    Walking whilst defaecating was most likely to occur when cows were simultaneously engaged in an ‘active’ state, such as going to drink or catching up with the herd. Overall, standing to defaecate and moving forward...... behaviour of 40 Holstein-Friesian cows was observed at pasture for6 heach day between morning and afternoon milking for a total of24 h. Lying (l), standing (s) and walking (w) behaviours were recorded pre, during and post-elimination. Sequences of 3–6 changes in these behaviours were recorded if expressed...... within 30 s of an eliminative event. Intentional, incidental or no avoidance of faeces was also recorded for each event. Activity, characterised as static (lying, grazing or loafing), or active (moving to a different area of field, going to drink and catching up with herd) was also recorded. Of the 437...

  5. Elimination of Plasmodium falciparum malaria in Tajikistan.

    Science.gov (United States)

    Kondrashin, Anatoly V; Sharipov, Azizullo S; Kadamov, Dilshod S; Karimov, Saifuddin S; Gasimov, Elkhan; Baranova, Alla M; Morozova, Lola F; Stepanova, Ekaterina V; Turbabina, Natalia A; Maksimova, Maria S; Morozov, Evgeny N

    2017-05-30

    Malaria was eliminated in Tajikistan by the beginning of the 1960s. However, sporadic introduced cases of malaria occurred subsequently probably as a result of transmission from infected mosquito Anopheles flying over river the Punj from the border areas of Afghanistan. During the 1970s and 1980s local outbreaks of malaria were reported in the southern districts bordering Afghanistan. The malaria situation dramatically changed during the 1990s following armed conflict and civil unrest in the newly independent Tajikistan, which paralyzed health services including the malaria control activities and a large-scale malaria epidemic occurred with more than 400,000 malaria cases. The malaria epidemic was contained by 1999 as a result of considerable financial input from the Government and the international community. Although Plasmodium falciparum constituted only about 5% of total malaria cases, reduction of its incidence was slower than that of Plasmodium vivax. To prevent increase in P. falciparum malaria both in terms of incidence and territory, a P. falciparum elimination programme in the Republic was launched in 200, jointly supported by the Government and the Global Fund for control of AIDS, tuberculosis and malaria. The main activities included the use of pyrethroids for the IRS with determined periodicity, deployment of mosquito nets, impregnated with insecticides, use of larvivorous fishes as a biological larvicide, implementation of small-scale environmental management, and use of personal protection methods by population under malaria risk. The malaria surveillance system was strengthened by the use of ACD, PCD, RCD and selective use of mass blood surveys. All detected cases were timely epidemiologically investigated and treated based on the results of laboratory diagnosis. As a result, by 2009, P. falciparum malaria was eliminated from all of Tajikistan, one year ahead of the originally targeted date. Elimination of P. falciparum also contributed towards

  6. An Elimination of Resonance in Electric Drives

    Directory of Open Access Journals (Sweden)

    Michal Malek

    2011-01-01

    Full Text Available Flexible couplings together with resonance phenomenon are present mainly in the field of servodrives where high accuracy and dynamic requirements are crucial. When dynamics doesn’t correlate with mechanical system design, unwanted frequencies in the system are exited. Sometimes we haven’t conditions (whether material or space to design mechanical system with resonant frequencies too high to be exited. In that case we must choose compensating methods which can eliminate these phenomenons. This paper is dedicated to them.

  7. Planning of elimination of emergency consequences

    Directory of Open Access Journals (Sweden)

    S. Kovalenko

    2015-05-01

    Full Text Available Introduction. The volume of useful information in the planning of elimination of emergency consequences process is reasonable to assess with calculatory problems and mathematical models. Materials and methods. The expert survey method is used to calculate quantitative values of probability and to determine the optimal solution before the information in condition is received. Results. It is determined that the quality of the solution of elimination emergency consequences depends primarily on the number of factors that are taken into account in particular circumstances of the situation; on the level of information readiness of control bodies to take decision to eliminate emergency consequences as soon as possible and to consider several options for achieving reasonableness and concreteness of a particular decision. The ratio between volume of useful information collected and processed during operation planning which is required for identifying optimal solution is calculated. This ratio allows to construct a graph of probability of identifying a solution in existing environment and probability value of identifying optimal solution before information in P*condition is obtained. This graph also shows the ratio volume of useful information collected and processed during operation planning and necessary volume of information for identifying optimal solution. Conclusion. The results of this research can be used for improving control bodies decisions to ensure safe working conditions for employees of food industry.

  8. Immune Interventions to Eliminate the HIV Reservoir.

    Science.gov (United States)

    Hsu, Denise C; Ananworanich, Jintanat

    2017-10-26

    Inducing HIV remission is a monumental challenge. A potential strategy is the "kick and kill" approach where latently infected cells are first activated to express viral proteins and then eliminated through cytopathic effects of HIV or immune-mediated killing. However, pre-existing immune responses to HIV cannot eradicate HIV infection due to the presence of escape variants, inadequate magnitude, and breadth of responses as well as immune exhaustion. The two major approaches to boost immune-mediated elimination of infected cells include enhancing cytotoxic T lymphocyte mediated killing and harnessing antibodies to eliminate HIV. Specific strategies include increasing the magnitude and breadth of T cell responses through therapeutic vaccinations, reversing the effects of T cell exhaustion using immune checkpoint inhibition, employing bispecific T cell targeting immunomodulatory proteins or dual-affinity re-targeting molecules to direct cytotoxic T lymphocytes to virus-expressing cells and broadly neutralizing antibody infusions. Methods to steer immune responses to tissue sites where latently infected cells are located need to be further explored. Ultimately, strategies to induce HIV remission must be tolerable, safe, and scalable in order to make a global impact.

  9. Comparing materials used in mist eliminators

    Energy Technology Data Exchange (ETDEWEB)

    Looney, B.; Baleno, B.; Boles, G.L.; Telow, J. [Solvay Advanced Polyers (United States)

    2007-11-15

    Wet flue gas desulfurization (FGD) systems, or wet scrubbers, are notoriously capital - and maintenance-intensive. Mist eliminators are an integral part of most wet FGD systems. These are available in a variety of materials - polypropylene, fiberglass reinforced polymer (FRP), polysulfone and stainless steel. The article discusses the material properties, performance attributes and relative cost differences associated with each of these four materials. It describes the common problems with mist eliminators - fouling and corrosion. These can be minimised by routine cleaning and use of chemical additives to prevent deposition. An analysis was carried out to compare the four materials at APS Cholla power plant. As a result the facility is retrofitting its remaining wet scrubber towers in Unit 2 with mist eliminators constructed from polysulfone as each of the current ones of the existing polypropylene needs replacing. Polysulfone is cheaper to clean and components require replacing less frequently than polypropylene. Switching from stainless steel to polypropylene has proved advantageous on 22 wet scrubbers operated by PPL Montana. 5 figs. 2 tabs.

  10. The Ilocos Norte Communities against Rabies Exposure Elimination Project in the Philippines: Epidemiological and Economic Aspects

    Directory of Open Access Journals (Sweden)

    Anna Charinna B. Amparo

    2017-04-01

    Full Text Available As canine rabies control in Africa and Asia transitions from research-led proof-of-concept studies to government-led programs for elimination, experience and evidence of their impact and costs must be shared for the benefit of future programs. The Ilocos Norte Communities against Rabies Exposure project was implemented in April 2012 by the provincial veterinary and health offices and supported by many other partners. It delivered a comprehensive dog vaccination program and increased awareness of the need for postexposure prophylaxis (PEP, aiming to eliminate human and animal rabies cases from Ilocos Norte by 2015. Prior to the intervention, confirmed rabies cases in dogs were between 19 and 50 per year (2008–2011. The primary outcome of the project was a reduction in rabies cases in both dogs and humans to 0 in 2014 and 2015, which has subsequently been maintained. Animal bite consultations increased significantly during the project. Economic data for the dog vaccination and PEP components of the project were collated for two sites: Laoag City (an urban setting and Dingras Municipality (a rural setting between 2012 and 2014. The average programmatic cost of vaccinating each dog was $4.54 in Laoag City and $8.65 in Dingras, and costs fell as the project reached more dogs. The average costs of providing PEP were $69.72 per patient and $49.02 per patient for the two sites, respectively, again falling as the project reached more people. External donor contributions contributed less than 20% of dog vaccination costs and less than 1% of PEP costs. The project demonstrated that rabies elimination can be achieved in a short period of time, with concerted effort across multiple sectors. A lack of clear dog population estimates hampered interpretation of some aspects of the programme. From 2016, the provincial government has assumed complete responsibility for the programme and must now continue the vaccination and surveillance efforts. Although

  11. Heterogeneity in the spread and control of infectious disease: consequences for the elimination of canine rabies

    Science.gov (United States)

    Ferguson, Elaine A.; Hampson, Katie; Cleaveland, Sarah; Consunji, Ramona; Deray, Raffy; Friar, John; Haydon, Daniel T.; Jimenez, Joji; Pancipane, Marlon; Townsend, Sunny E.

    2015-12-01

    Understanding the factors influencing vaccination campaign effectiveness is vital in designing efficient disease elimination programmes. We investigated the importance of spatial heterogeneity in vaccination coverage and human-mediated dog movements for the elimination of endemic canine rabies by mass dog vaccination in Region VI of the Philippines (Western Visayas). Household survey data was used to parameterise a spatially-explicit rabies transmission model with realistic dog movement and vaccination coverage scenarios, assuming a basic reproduction number for rabies drawn from the literature. This showed that heterogeneous vaccination reduces elimination prospects relative to homogeneous vaccination at the same overall level. Had the three vaccination campaigns completed in Region VI in 2010-2012 been homogeneous, they would have eliminated rabies with high probability. However, given the observed heterogeneity, three further campaigns may be required to achieve elimination with probability 0.95. We recommend that heterogeneity be reduced in future campaigns through targeted efforts in low coverage areas, even at the expense of reduced coverage in previously high coverage areas. Reported human-mediated dog movements did not reduce elimination probability, so expending limited resources on restricting dog movements is unnecessary in this endemic setting. Enhanced surveillance will be necessary post-elimination, however, given the reintroduction risk from long-distance dog movements.

  12. Eliminating Space Debris: Applied Technology and Policy Prescriptions, Fall 2007 - Project 07-02

    Science.gov (United States)

    2008-01-01

    Selfish maximization of the profit from property rights will lead to a socially efficient outcome. The negative externalities will be eliminated.52...Experiment (MSX)” MSX Celestial Backgrounds. 27 Dec. 2007 <http://www.ipac.caltech.edu/ipac/msx/msx.html> 155 Heyler, Gene “MSX Midcourse Space Experiment

  13. malERA: An updated research agenda for malaria elimination and eradication.

    Science.gov (United States)

    Rabinovich, Regina N; Drakeley, Chris; Djimde, Abdoulaye A; Hall, B Fenton; Hay, Simon I; Hemingway, Janet; Kaslow, David C; Noor, Abdisalan; Okumu, Fredros; Steketee, Richard; Tanner, Marcel; Wells, Timothy N C; Whittaker, Maxine A; Winzeler, Elizabeth A; Wirth, Dyann F; Whitfield, Kate; Alonso, Pedro L

    2017-11-01

    Achieving a malaria-free world presents exciting scientific challenges as well as overwhelming health, equity, and economic benefits. WHO and countries are setting ambitious goals for reducing the burden and eliminating malaria through the "Global Technical Strategy" and 21 countries are aiming to eliminate malaria by 2020. The commitment to achieve these targets should be celebrated. However, the need for innovation to achieve these goals, sustain elimination, and free the world of malaria is greater than ever. Over 180 experts across multiple disciplines are engaged in the Malaria Eradication Research Agenda (malERA) Refresh process to address problems that need to be solved. The result is a research and development agenda to accelerate malaria elimination and, in the longer term, transform the malaria community's ability to eradicate it globally.

  14. malERA: An updated research agenda for malaria elimination and eradication.

    Directory of Open Access Journals (Sweden)

    Regina N Rabinovich

    2017-11-01

    Full Text Available Achieving a malaria-free world presents exciting scientific challenges as well as overwhelming health, equity, and economic benefits. WHO and countries are setting ambitious goals for reducing the burden and eliminating malaria through the "Global Technical Strategy" and 21 countries are aiming to eliminate malaria by 2020. The commitment to achieve these targets should be celebrated. However, the need for innovation to achieve these goals, sustain elimination, and free the world of malaria is greater than ever. Over 180 experts across multiple disciplines are engaged in the Malaria Eradication Research Agenda (malERA Refresh process to address problems that need to be solved. The result is a research and development agenda to accelerate malaria elimination and, in the longer term, transform the malaria community's ability to eradicate it globally.

  15. Adrenalectomy eliminates the extinction spike in autoshaping with rats.

    Science.gov (United States)

    Thomas, B L; Papini, M R

    2001-03-01

    Experiment 1, using rats, investigated the effect of adrenalectomy (ADX) on the invigoration of lever-contact performance that occurs in the autoshaping situation after a shift from acquisition to extinction (called the extinction spike). Groups of rats with ADX or sham operations were trained under spaced and massed conditions [average intertrial intervals (ITI) of either 15 or 90 s] for 10 sessions and then shifted to extinction. ADX did not affect acquisition training but it eliminated the extinction spike. Plasma corticosterone levels during acquisition were shown in Experiment 2 to be similar in rats trained under spaced or massed conditions. Adrenal participation in the emotional arousal induced by conditions of surprising nonreward (e.g., extinction) is discussed.

  16. Economic communication model set

    Science.gov (United States)

    Zvereva, Olga M.; Berg, Dmitry B.

    2017-06-01

    This paper details findings from the research work targeted at economic communications investigation with agent-based models usage. The agent-based model set was engineered to simulate economic communications. Money in the form of internal and external currencies was introduced into the models to support exchanges in communications. Every model, being based on the general concept, has its own peculiarities in algorithm and input data set since it was engineered to solve the specific problem. Several and different origin data sets were used in experiments: theoretic sets were estimated on the basis of static Leontief's equilibrium equation and the real set was constructed on the basis of statistical data. While simulation experiments, communication process was observed in dynamics, and system macroparameters were estimated. This research approved that combination of an agent-based and mathematical model can cause a synergetic effect.

  17. "Why are you pregnant? What were you thinking?": How women navigate experiences of HIV-related stigma in medical settings during pregnancy and birth.

    Science.gov (United States)

    Greene, Saara; Ion, Allyson; Kwaramba, Gladys; Smith, Stephanie; Loutfy, Mona R

    2016-01-01

    Having children is a growing reality for women living with HIV in Canada. It is imperative to understand and respond to women's unique experiences and psychosocial challenges during pregnancy and as mothers including HIV-related stigma. This qualitative study used a narrative methodological approach to understand women's experiences of HIV-related stigma as they navigate health services in pregnancy (n = 66) and early postpartum (n = 64). Narratives of women living with HIV expose the spaces where stigmatizing practices emerge as women seek perinatal care and support, as well as highlight the relationship between HIV-related stigma and disclosure, and the impact this has on women's pregnancy and birthing experiences.

  18. The global cost of eliminating avoidable blindness

    Directory of Open Access Journals (Sweden)

    Kirsten L Armstrong

    2012-01-01

    Full Text Available Aims : To complete an initial estimate of the global cost of eliminating avoidable blindness, including the investment required to build ongoing primary and secondary health care systems, as well as to eliminate the ′backlog′ of avoidable blindness. This analysis also seeks to understand and articulate where key data limitations lie. Materials and Methods : Data were collected in line with a global estimation approach, including separate costing frameworks for the primary and secondary care sectors, and the treatment of backlog. Results : The global direct health cost to eliminate avoidable blindness over a 10-year period from 2011 to 2020 is estimated at $632 billion per year (2009 US$. As countries already spend $592 billion per annum on eye health, this represents additional investment of $397.8 billion over 10 years, which is $40 billion per year or $5.80 per person for each year between 2010 and 2020. This is concentrated in high-income nations, which require 68% of the investment but comprise 16% of the world′s inhabitants. For all other regions, the additional investment required is $127 billion. Conclusions : This costing estimate has identified that low- and middle-income countries require less than half the additional investment compared with high-income nations. Low- and middle-income countries comprise the greater investment proportion in secondary care whereas high-income countries require the majority of investment into the primary sector. However, there is a need to improve sector data. Investment in better data will have positive flow-on effects for the eye health sector.

  19. Redundancy Elimination in DTN via ACK Mechanism

    Directory of Open Access Journals (Sweden)

    Xiqing Zhang

    2015-08-01

    Full Text Available The traditional routing protocols for delay tolerant networks (DTN usually take the strategy of spreading multiple copies of one message to the networks. When one copy reaches destination, the transmission of other copies not only waste the bandwidth but also deprive other messages of the opportunities for transmission. This paper brings up a mechanism to eliminate the redundant copies. By adding an acknowledge field to the packet header to delete redundant copies, it can degrade the network overhead while improve the delivery ratio. Simulation results confirm that the proposed method can improve the performance of epidemic and Spray and Wait routing protocol.

  20. Ghost marker detection and elimination in marker-based optical tracking systems for real-time tracking in stereotactic body radiotherapy

    International Nuclear Information System (INIS)

    Yan, Guanghua; Li, Jonathan; Huang, Yin; Mittauer, Kathryn; Lu, Bo; Liu, Chihray

    2014-01-01

    Purpose: To propose a simple model to explain the origin of ghost markers in marker-based optical tracking systems (OTS) and to develop retrospective strategies to detect and eliminate ghost markers. Methods: In marker-based OTS, ghost markers are virtual markers created due to the cross-talk between the two camera sensors, which can lead to system execution failure or inaccuracy in patient tracking. As a result, the users have to limit the number of markers and avoid certain marker configurations to reduce the chances of ghost markers. In this work, the authors propose retrospective strategies to detect and eliminate ghost markers. The two camera sensors were treated as mathematical points in space. The authors identified the coplanar within limit (CWL) condition as the necessary condition for ghost marker occurrence. A simple ghost marker detection method was proposed based on the model. Ghost marker elimination was achieved through pattern matching: a ghost marker-free reference set was matched with the optical marker set observed by the OTS; unmatched optical markers were eliminated as either ghost markers or misplaced markers. The pattern matching problem was formulated as a constraint satisfaction problem (using pairwise distances as constraints) and solved with an iterative backtracking algorithm. Wildcard markers were introduced to address missing or misplaced markers. An experiment was designed to measure the sensor positions and the limit for the CWL condition. The ghost marker detection and elimination algorithms were verified with samples collected from a five-marker jig and a nine-marker anthropomorphic phantom, rotated with the treatment couch from −60° to +60°. The accuracy of the pattern matching algorithm was further validated with marker patterns from 40 patients who underwent stereotactic body radiotherapy (SBRT). For this purpose, a synthetic optical marker pattern was created for each patient by introducing ghost markers, marker position

  1. Ghost marker detection and elimination in marker-based optical tracking systems for real-time tracking in stereotactic body radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Guanghua, E-mail: yan@ufl.edu; Li, Jonathan; Huang, Yin; Mittauer, Kathryn; Lu, Bo; Liu, Chihray [Department of Radiation Oncology, University of Florida, Gainesville, Florida 32610 (United States)

    2014-10-15

    Purpose: To propose a simple model to explain the origin of ghost markers in marker-based optical tracking systems (OTS) and to develop retrospective strategies to detect and eliminate ghost markers. Methods: In marker-based OTS, ghost markers are virtual markers created due to the cross-talk between the two camera sensors, which can lead to system execution failure or inaccuracy in patient tracking. As a result, the users have to limit the number of markers and avoid certain marker configurations to reduce the chances of ghost markers. In this work, the authors propose retrospective strategies to detect and eliminate ghost markers. The two camera sensors were treated as mathematical points in space. The authors identified the coplanar within limit (CWL) condition as the necessary condition for ghost marker occurrence. A simple ghost marker detection method was proposed based on the model. Ghost marker elimination was achieved through pattern matching: a ghost marker-free reference set was matched with the optical marker set observed by the OTS; unmatched optical markers were eliminated as either ghost markers or misplaced markers. The pattern matching problem was formulated as a constraint satisfaction problem (using pairwise distances as constraints) and solved with an iterative backtracking algorithm. Wildcard markers were introduced to address missing or misplaced markers. An experiment was designed to measure the sensor positions and the limit for the CWL condition. The ghost marker detection and elimination algorithms were verified with samples collected from a five-marker jig and a nine-marker anthropomorphic phantom, rotated with the treatment couch from −60° to +60°. The accuracy of the pattern matching algorithm was further validated with marker patterns from 40 patients who underwent stereotactic body radiotherapy (SBRT). For this purpose, a synthetic optical marker pattern was created for each patient by introducing ghost markers, marker position

  2. Unimolecular H2 elimination during the liquid phase radiolysis and photolysis of alkane - alkane mixtures

    International Nuclear Information System (INIS)

    Wojnarovits, L.; Foeldiak, G.

    1980-01-01

    Unimolecular H 2 elimination from alkanes was investigated in cyclopentane-cyclohexane, n-hexane-cyclohexane and cyclohexane-cyclooctane mixtures during fluradiolysis and 7.6 eV photolysis. During the radiolysis of all systems, and when the fluorescence shift law allowed it, during the photolysis as well, inhibited H 2 detachment was observed from the first component and sensitized hydrogen molecule elimination from the second. It has been concluded that the same excited state (the lowest singlet, S 1 ) is responsible for the H 2 elimination during radiolysis and photolysis and this is that one that gives rise to fluorescence in the experiments of other authors. The H 2 and H elimination from alkanes generally have different excited precursors. The direct population of S 1 by γ-irradiation is of limited importance and this intermediate is mainly produced in ''charge neutralization'' processes. (author)

  3. Deviance and resistance: Malaria elimination in the greater Mekong subregion.

    Science.gov (United States)

    Lyttleton, Chris

    2016-02-01

    Malaria elimination rather than control is increasingly globally endorsed, requiring new approaches wherein success is not measured by timely treatment of presenting cases but eradicating all presence of infection. This shift has gained urgency as resistance to artemisinin-combination therapies spreads in the Greater Mekong Sub-region (GMS) posing a threat to global health security. In the GMS, endemic malaria persists in forested border areas and elimination will require calibrated approaches to remove remaining pockets of residual infection. A new public health strategy called 'positive deviance' is being used to improve health promotion and community outreach in some of these zones. However, outbreaks sparked by alternative understandings of appropriate behaviour expose the unpredictable nature of 'border malaria' and difficulties eradication faces. Using a recent spike in infections allegedly linked to luxury timber trade in Thai borderlands, this article suggests that opportunities for market engagement can cause people to see 'deviance' as a means to material advancement in ways that increase disease vulnerability. A malaria outbreak in Ubon Ratchathani was investigated during two-week field-visit in November 2014 as part of longer project researching border malaria in Thai provinces. Qualitative data were collected in four villages in Ubon's three most-affected districts. Discussions with villagers focused primarily on changing livelihoods, experience with malaria, and rosewood cutting. Informants included ten men and two women who had recently overnighted in the nearby forest. Data from health officials and villagers are used to frame Ubon's rise in malaria transmission within moral and behavioural responses to expanding commodity supply-chains. The article argues that elimination strategies in the GMS must contend with volatile outbreaks among border populations wherein 'infectiousness' and 'resistance' are not simply pathogen characteristics but also

  4. The experiences of chronically ill patients and registered nurses when they negotiate patient care in hospital settings: a feminist poststructural approach: A qualitative study that explores negotiation of patient care between patients and chronically ill patients in hospital settings.

    Science.gov (United States)

    Griscti, Odette; Aston, Megan; Martin-Misener, Ruth; Mcleod, Deborah; Warner, Grace

    2016-07-01

    The aim of this study was to understand the experiences of chronically ill patients and registered nurse in negotiating patient care in hospital. Specifically, we explored how social and institutional discourses shaped power relations and negotiation of patient care. Current literature indicates that although nurses embrace this notion, such partnerships are not easily implemented. Most existing studies focus on the role of the nurse as the leader of the partnership with little attention paid to how social and institutional values, beliefs and practices shape nurse/patient power relations; or how these relationships are negotiated between nurses and patients. The theoretical and methodological approaches used in this study are based on the precepts of Foucault and feminist poststructural theorists. In depth interviews were conducted with eight chronically ill patients and 10 registered nurses. Both nurses and patients commented about the relationships that develop between nurses and chronically ill patients and how these relationships facilitate negotiation of patient care. Both parties described challenging moments and how institutional discourses may hinder positive negotiations of care. In this paper we highlight three themes that emerged: getting to know each other, they are not the sickest patients and finding time to listen. This study offers an innovative way of unpacking negotiation of care between chronically ill patients and registered nurses. It exposes how social and institutional discourses play a pivotal role in shaping negotiations between nurses and chronically ill patients. Negotiating care with chronically ill patients is not as asymmetric as portrayed in some of the literature and tends to be based on mutual agreements between nurses and patients. Nurses make it a point to listen to patients' needs and resist institutional discourses that preclude them from spending time with patients. © 2016 John Wiley & Sons Ltd.

  5. Neonatal tetanus elimination in Pakistan: progress and challenges.

    Science.gov (United States)

    Lambo, Jonathan A; Nagulesapillai, Tharsiya

    2012-12-01

    Pakistan is one of the 34 countries that have not achieved the neonatal tetanus (NT) global elimination target set by the World Health Organization (WHO). NT, caused by Clostridium tetani, is a highly fatal infection of the neonatal period. It is one of the most underreported diseases and remains a major but preventable cause of neonatal and infant mortality in many developing countries. In 1989, the World Health Assembly called for the elimination of NT by 1995, and since then considerable progress has been made using the following strategies: clean delivery practices, routine tetanus toxoid (TT) immunization of pregnant women, and immunization of all women of childbearing age with three doses of TT vaccine in high-risk areas during supplementary immunization campaigns. This review presents the activities, progress, and challenges in achieving NT elimination in Pakistan. A review of the literature found TT vaccination coverage in Pakistan ranged from 60% to 74% over the last decade. Low vaccination coverage, the main driver for NT in Pakistan, is due to many factors, including demand failure for TT vaccine resulting from inadequate knowledge of TT vaccine among reproductive age females and inadequate information about the benefits of TT provided by health care workers and the media. Other factors linked to low vaccination coverage include residing in rural areas, lack of formal education, poor knowledge about place and time to get vaccinated, and lack of awareness about the importance of vaccination. A disparity exists in TT vaccination coverage and antenatal care between urban and rural areas due to access and utilization of health care services. NT reporting is incomplete, as cases from the private sector and rural areas are underreported. To successfully eliminate NT, women of reproductive age must be made aware of the benefits of TT vaccine, not only to themselves, but also to their families. Effective communication strategies for TT vaccine delivery and

  6. Apparatus for eliminating electrodeposition of radioactive nuclide

    International Nuclear Information System (INIS)

    Inomata, Ichiro; Ishibe, Tadao; Matsunaga, Masaaki; Konuki, Ryoichi; Suzuki, Kazunori; Watanabe, Minoru; Tomoshige, Shozo; Kondo, Kozo.

    1990-01-01

    In a conventional device for eliminating by radioactive nuclides electrodeposition, a liquid containing radioactive nuclides is electrolyzed under a presence of non-radioactive heavy metals and removing radioactive nuclides by electrodepositing them together with the heavy metals. Two anode plates are opposed in an electrolysis vessel of this device. A plurality (4 to 6) of cathode plates are arranged between the anodes in parallel with them and the cathode surfaces opposed to the anodes are insulated. Further, such a plurality of cathode plates are grouped into respective units. Alternatively, the anode plate is made of platinum-plated titanium material and the cathode plate is made of stainless steel. In the thus constituted electrodeposition eliminating device, since the cathode surface directed to the anodes on both ends are insulated, all of electric current from the anode reach the core cathode after flowing around the cathodes at both ends. As a result, there is no substantial difference in the flowing length of the electrolyzing current to each of the cathodes and these is neither difference in the electrodeposition amount. The electrodeposited products are adhered uniformly and densely to the electrodes and, simultaneously, Co-60 and Mn-54, etc. are also electrodeposited. (I.S.)

  7. Processes and problems of ammonia elimination

    Energy Technology Data Exchange (ETDEWEB)

    Tippmer, K

    1974-01-01

    In many cases a conversion of ammonia in coke oven gases to ammonium sulfate (fertilizer) is not useful. It must then be eliminated by oxidation to nitrogen and water or catalytically to N2 and hydrogen. Several processes are available for this which are combined with the simultaneous removal of hydrogen sulfide. The absorption of NH3 with NH3 incineration with and without heat utilization, the NH3 absorption with catalytic cracking of NH3, H2S and NH3 scrubbing with NH3 incineration and production of sulfuric acid (78 or 96 percent), as well as H2S and NH3 scrubbing with catalytic cracking of NH3 and production of pure sulfur are discussed in great detail. A cost comparison of these methods is provided. Lowest investments are required for an NH3 scrubbing process with elimination of NH3 but without desulfurization. Expenditures for an NH3 scrubber with desulfurization of the coke oven gas to about 1.5 g H2S/cu m and NH3 incineration with production of 78 percent H2SO4 are lower than those for the production of 96 percent H2SO4. For the latter there is more demand, however. Desulfurization to about 0.7 g H2S/cu m is only slightly more expensive. The process producing sulfur in combination with an H2S oxidation method requires somewhat lower investment costs.

  8. Elimination of frequency noise from groundwater measurements

    International Nuclear Information System (INIS)

    Chien, Y.M.; Bryce, R.W.; Strait, S.R.; Yeatman, R.A.

    1986-04-01

    Groundwater response to atmospheric fluctuation can be effectively removed from downhole-pressure records using the systematic approach. The technique is not as successful for removal of earth tides, due to a probable discrepancy between the actual earth tide and the theoretical earth tide. The advantage of the systematic technique is that a causative relationship is established for each component of the pressure response removed. This concept of data reduction is easily understood and well accepted. The disadvantage is that a record of the stress causing the pressure fluctuation must be obtained. This may be done by monitoring or synthesizing the stress. Frequency analysis offers a simpler way to eliminate the undesirable hydrologic fluctuations from the downhole pressure. Frequency analysis may prove to be impractical if the fluctuations being removed have broadband characteristics. A combination of the two techniques, such as eliminating the atmospheric effect with the systematic method and the earth-tide fluctuations with the frequency method, is the most effective and efficient approach

  9. Elastic and inelastic electrons in the double-slit experiment: A variant of Feynman's which-way set-up

    Energy Technology Data Exchange (ETDEWEB)

    Frabboni, Stefano [Department FIM, University of Modena and Reggio Emilia, Via G. Campi 213/a, 41125 Modena (Italy); CNR-Institute of Nanoscience-S3, Via G. Campi 213/a, 41125 Modena (Italy); Gazzadi, Gian Carlo [CNR-Institute of Nanoscience-S3, Via G. Campi 213/a, 41125 Modena (Italy); Grillo, Vincenzo [CNR-Institute of Nanoscience-S3, Via G. Campi 213/a, 41125 Modena (Italy); CNR-IMEM, Parco delle Scienze 37a, 43100 Parma (Italy); Pozzi, Giulio [Department of Physics and Astronomy, University of Bologna, Viale B. Pichat 6/2, 40127 Bologna (Italy)

    2015-07-15

    Modern nanotechnology tools allowed us to prepare slits of 90 nm width and 450 nm spacing in a screen almost completely opaque to 200 keV electrons. Then by covering both slits with a layer of amorphous material and carrying out the experiment in a conventional transmission electron microscope equipped with an energy filter we can demonstrate that the diffraction pattern, taken by selecting the elastically scattered electrons, shows the presence of interference fringes, but with a bimodal envelope which can be accounted for by taking into account the non-constant thickness of the deposited layer. However, the intensity of the inelastically scattered electrons in the diffraction plane is very broad and at the limit of detectability. Therefore the experiment was repeated using an aluminum film and a microscope also equipped with a Schottky field emission gun. It was thus possible to observe also the image due to the inelastically scattered electron, which does not show interference phenomena both in the Fraunhofer or Fresnel regimes. If we assume that inelastic scattering through the thin layer covering the slits provides the dissipative process of interaction responsible for the localization mechanism, then these experiments can be considered a variant of the Feynman which-way thought experiment. - Highlights: • Fabrication by focused ion beam and electron beam induced deposition of two slits covered by electron transparent materials. • Two slits interference experiment with elastic and inelastic electrons. • Analysis of Fraunhofer and Fresnel images of the two slits formed with elastic and inelastic (plasmon loss) electrons.

  10. Optimized set of two-dimensional experiments for fast sequential assignment, secondary structure determination, and backbone fold validation of 13C/15N-labelled proteins

    International Nuclear Information System (INIS)

    Bersch, Beate; Rossy, Emmanuel; Coves, Jacques; Brutscher, Bernhard

    2003-01-01

    NMR experiments are presented which allow backbone resonance assignment, secondary structure identification, and in favorable cases also molecular fold topology determination from a series of two-dimensional 1 H- 15 N HSQC-like spectra. The 1 H- 15 N correlation peaks are frequency shifted by an amount ± ω X along the 15 N dimension, where ω X is the C α , C β , or H α frequency of the same or the preceding residue. Because of the low dimensionality (2D) of the experiments, high-resolution spectra are obtained in a short overall experimental time. The whole series of seven experiments can be performed in typically less than one day. This approach significantly reduces experimental time when compared to the standard 3D-based methods. The here presented methodology is thus especially appealing in the context of high-throughput NMR studies of protein structure, dynamics or molecular interfaces

  11. Cut Elimination, Identity Elimination, and Interpolation in Super-Belnap Logics

    Czech Academy of Sciences Publication Activity Database

    Přenosil, Adam

    2017-01-01

    Roč. 105, č. 6 (2017), s. 1255-1289 ISSN 0039-3215 R&D Projects: GA ČR GBP202/12/G061 EU Projects: European Commission(XE) 689176 - SYSMICS Institutional support: RVO:67985807 Keywords : Super-Belnap logic s * Dunn–Belnap logic * Logic of Paradox * Strong Kleene logic * Exactly True Logic * Gentzen calculus * Cut elimination * Identity elimination * Interpolation Subject RIV: BA - General Mathematics OBOR OECD: Computer sciences, information science, bioinformathics (hardware development to be 2.2, social aspect to be 5.8) Impact factor: 0.589, year: 2016

  12. Do action learning sets facilitate collaborative, deliberative learning?: A focus group evaluation of Graduate Entry Pre-registration Nursing (GEN) students' experience.

    Science.gov (United States)

    Maddison, Charlotte; Strang, Gus

    2018-01-01

    The aim of this study was to investigate if by participating in action learning sets, Graduate Entry Pre-registration Nursing (GEN) students were able to engage in collaborative and deliberative learning. A single focus group interview involving eleven participants was used to collect data. Data analysis identified five themes; collaborative learning; reflection; learning through case study and problem-solving; communication, and rejection of codified learning. The themes are discussed and further analysed in the context of collaborative and deliberative learning. The evidence from this small scale study suggests that action learning sets do provide an environment where collaborative and deliberative learning can occur. However, students perceived some of them, particularly during year one, to be too 'teacher lead', which stifled learning. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Analysis of Regional Timelines To Set Up a Global Phase III Clinical Trial in Breast Cancer: the Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization Experience

    OpenAIRE

    Metzger-Filho, Otto; Azambuja, Evandro de; Bradbury, Ian; Saini, Kamal S.; Bines, Jose; Simon, Sergio D. [UNIFESP; Van Dooren, Veerle; Aktan, Gursel; Pritchard, Kathleen I.; Wolff, Antonio C.; Smith, Ian; Jackisch, Christian; Lang, Istvan; Untch, Michael; Boyle, Frances

    2013-01-01

    Purpose. This study measured the time taken for setting up the different facets of Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization (ALTTO), an international phase III study being conducted in 44 participating countries.Methods. Time to regulatory authority (RA) approval, time to ethics committee/institutional review board (EC/IRB) approval, time from study approval by EC/IRB to first randomized patient, and time from first to last randomized patient were prospectively collected i...

  14. Goal setting using telemedicine in rural underserved older adults with diabetes: experiences from the informatics for diabetes education and telemedicine project.

    Science.gov (United States)

    West, Susan P; Lagua, Carina; Trief, Paula M; Izquierdo, Roberto; Weinstock, Ruth S

    2010-05-01

    To describe the use of telemedicine for setting goals for behavior change and examine the success in achieving these goals in rural underserved older adults with diabetes. Medicare beneficiaries with diabetes living in rural upstate New York who were enrolled in the telemedicine intervention of the Informatics for Diabetes Education and Telemedicine (IDEATel) project (n = 610) participated in home televisits with nurse and dietitian educators every 4-6 weeks for 2-6 years. Behavior change goals related to nutrition, physical activity, monitoring, diabetes health maintenance, and/or use of the home telemedicine unit were established at the conclusion of each televisit and assessed at the next visit. Collaborative goal setting was employed during 18,355 televisits (mean of 33 goal-setting televisits/participant). The most common goals were related to monitoring, followed by diabetes health maintenance, nutrition, exercise, and use of the telemedicine equipment. Overall, 68% of behavioral goals were rated as "improved" or "met." The greatest success was achieved for goals related to proper insulin injection technique and daily foot care. These elderly participants had the most difficulty achieving goals related to use of the computer. No gender differences in goal achievement were observed. Televisits can be successfully used to collaboratively establish behavior change goals to help improve diabetes self-management in underserved elderly rural adults.

  15. An Implementation Strategy to Improve the Guideline Adherence of Insurance Physicians: A Process Evaluation Alongside an Experiment in a Controlled Setting

    Science.gov (United States)

    Zwerver, Feico; Bonefaas-Groenewoud, Karin; Schellart, Antonius J. M.; Anema, Johannes R.; van der Beek, Allard J.

    2013-01-01

    Background: We developed an implementation strategy for the insurance medicine guidelines for depression, which we implemented via a post-graduate course for insurance physicians (IPs). In this study we evaluate the physicians' experiences of the implementation strategy by measuring the following aspects: recruitment and reach, dose delivered and…

  16. 'Just gripping my heart and squeezing': Naming and explaining the emotional experience of receiving bad news in the paediatric oncology setting.

    Science.gov (United States)

    Nelson, Mia; Kelly, Daniel; McAndrew, Rachel; Smith, Pam

    2017-09-01

    To explore recipients' perspectives on the range and origins of their emotional experiences during their 'bad news' consultations. Participants were four bereaved families of children who had changed from active treatment to palliative care in paediatric oncology. Data was collected using emotional touchpoint storytelling. The names (descriptors) given to the emotional experiences were linguistically classified. Explanations of their perceived origins were examined using applied thematic analysis. 26 descriptors were given, relating to bodily sensations, affective states, evaluations and cognitive conditions. Three themes were identified in the origins of these experiences - 'becoming aware', 'the changes' and 'being in this situation'. Parents described strong emotional displays during the consultation including physical collapse. These related to the internal process of 'becoming aware'. Three descriptors were given as originating from the clinicians and their delivery of the news - 'supported', 'included', 'trusting'. Recipients perceive their emotional experiences as mainly originating from the news itself, and perceived consequences of it, rather than its delivery. Strong emotional reactions during the interaction are not necessarily an indicator of ineffectual delivery. Findings offer a thematic framing that may support and deepen practitioners understanding of recipients' emotional reactions during bad news consultations. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  17. Calculation methodology validation. Pt. 2/01-R. Calculation of the multiplication factor for eight experiments with a critical set of nineteen VVER-440 fuel assemblies

    International Nuclear Information System (INIS)

    Kyncl, J.

    2001-04-01

    Comparison calculations were performed for 8 experiments accomplished in 2000 on the LR-0 reactor. The MCNP4a code was applied using effective cross section data in the continuous representation as per the ENDF/B-VI library. (P.A.)

  18. Preventing Radicalisation: A Systematic Review of Literature Considering the Lived Experiences of the UK's Prevent Strategy in Educational Settings

    Science.gov (United States)

    Taylor, Laura; Soni, Anita

    2017-01-01

    This article surveys relevant literature on experiences of the Prevent Strategy in the UK in order to explore the role of schools in preventing radicalisation. The first section explores the concept of radicalisation and how this is positioned within UK policy and legislation followed by a review and critical appraisal of seven relevant articles.…

  19. Feasibility of establishing a biosafety level 3 tuberculosis culture laboratory of acceptable quality standards in a resource-limited setting: an experience from Uganda

    NARCIS (Netherlands)

    Ssengooba, Willy; Gelderbloem, Sebastian J.; Mboowa, Gerald; Wajja, Anne; Namaganda, Carolyn; Musoke, Philippa; Mayanja-Kizza, Harriet; Joloba, Moses Lutaakome

    2015-01-01

    Background: Despite the recent innovations in tuberculosis (TB) and multi-drug resistant TB (MDR-TB) diagnosis, culture remains vital for difficult-to-diagnose patients, baseline and end-point determination for novel vaccines and drug trials. Herein, we share our experience of establishing a BSL-3

  20. The Experiences of and Attitudes toward Non-Pharmacological Interventions for Attention-Deficit/hyperactivity Disorder Used in School Settings: A Systematic Review and Synthesis of Qualitative Research

    Science.gov (United States)

    Moore, Darren A.; Gwernan-Jones, Ruth; Richardson, Michelle; Racey, Daniel; Rogers, Morwenna; Stein, Ken; Thompson-Coon, Jo; Ford, Tamsin J.; Garside, Ruth

    2016-01-01

    School-based non-pharmacological interventions are an important part of the treatment of attention-deficit/hyperactivity disorder (ADHD). We aimed to systematically review qualitative literature relating to the experience of and attitudes towards school-based non-pharmacological interventions for ADHD. Systematic searches of 20 electronic…

  1. Subject-specific cardiovascular system model-based identification and diagnosis of septic shock with a minimally invasive data set: animal experiments and proof of concept

    International Nuclear Information System (INIS)

    Geoffrey Chase, J; Starfinger, Christina; Hann, Christopher E; Lambermont, Bernard; Ghuysen, Alexandre; Kolh, Philippe; Dauby, Pierre C; Desaive, Thomas; Shaw, Geoffrey M

    2011-01-01

    A cardiovascular system (CVS) model and parameter identification method have previously been validated for identifying different cardiac and circulatory dysfunctions in simulation and using porcine models of pulmonary embolism, hypovolemia with PEEP titrations and induced endotoxic shock. However, these studies required both left and right heart catheters to collect the data required for subject-specific monitoring and diagnosis—a maximally invasive data set in a critical care setting although it does occur in practice. Hence, use of this model-based diagnostic would require significant additional invasive sensors for some subjects, which is unacceptable in some, if not all, cases. The main goal of this study is to prove the concept of using only measurements from one side of the heart (right) in a 'minimal' data set to identify an effective patient-specific model that can capture key clinical trends in endotoxic shock. This research extends existing methods to a reduced and minimal data set requiring only a single catheter and reducing the risk of infection and other complications—a very common, typical situation in critical care patients, particularly after cardiac surgery. The extended methods and assumptions that found it are developed and presented in a case study for the patient-specific parameter identification of pig-specific parameters in an animal model of induced endotoxic shock. This case study is used to define the impact of this minimal data set on the quality and accuracy of the model application for monitoring, detecting and diagnosing septic shock. Six anesthetized healthy pigs weighing 20–30 kg received a 0.5 mg kg −1 endotoxin infusion over a period of 30 min from T0 to T30. For this research, only right heart measurements were obtained. Errors for the identified model are within 8% when the model is identified from data, re-simulated and then compared to the experimentally measured data, including measurements not used in the

  2. For a convention for nuclear weapon elimination

    International Nuclear Information System (INIS)

    2008-03-01

    This document contains two texts linked with the project of an international convention for the elimination of nuclear weapons (the text of this project has been sent to the UN General Secretary and is part of an international campaign to abolish nuclear weapons, ICAN). These two texts are contributions presented in London at the Global Summit for a Nuclear Weapon-free World. The first one calls into question the deterrence principle and the idea of a nuclear weapon-based security. It calls for different forms of action to promote a nuclear weapon-free world. The second text stresses the role and the responsibility of states with nuclear weapons in nuclear disarmament and in the reinforcement of the nuclear non proliferation treaty (NPT)

  3. Lean for Government: Eliminating the Seven Wastes

    Science.gov (United States)

    Shepherd, Christena C.

    2012-01-01

    With shrinking budgets and a slow economy, it is becoming increasingly important for all government agencies to become more efficient. Citizens expect and deserve efficient and effective services from federal, state and local government agencies. One of the best methods to improve efficiency and eliminate waste is to institute the business process improvement methodologies known collectively as Lean; however, with reduced budgets, it may not be possible to train everyone in Lean or to engage the services of a trained consultant. It is possible, however, to raise awareness of the "Seven Wastes" of Lean in each employee, and encourage them to identify areas for improvement. Management commitment is vital to the success of these initiatives, and it is also important to develop the right metrics that will track the success of these changes.

  4. Adaptive elimination of synchronization in coupled oscillator

    Science.gov (United States)

    Zhou, Shijie; Ji, Peng; Zhou, Qing; Feng, Jianfeng; Kurths, Jürgen; Lin, Wei

    2017-08-01

    We present here an adaptive control scheme with a feedback delay to achieve elimination of synchronization in a large population of coupled and synchronized oscillators. We validate the feasibility of this scheme not only in the coupled Kuramoto’s oscillators with a unimodal or bimodal distribution of natural frequency, but also in two representative models of neuronal networks, namely, the FitzHugh-Nagumo spiking oscillators and the Hindmarsh-Rose bursting oscillators. More significantly, we analytically illustrate the feasibility of the proposed scheme with a feedback delay and reveal how the exact topological form of the bimodal natural frequency distribution influences the scheme performance. We anticipate that our developed scheme will deepen the understanding and refinement of those controllers, e.g. techniques of deep brain stimulation, which have been implemented in remedying some synchronization-induced mental disorders including Parkinson disease and epilepsy.

  5. Gaussian elimination is not optimal, revisited

    DEFF Research Database (Denmark)

    Macedo, Hugo Daniel

    2016-01-01

    We refactor the universal law for the tensor product to express matrix multiplication as the product . MN of two matrices . M and . N thus making possible to use such matrix product to encode and transform algorithms performing matrix multiplication using techniques from linear algebra. We explore...... the end results are equations involving matrix products, our exposition builds upon previous works on the category of matrices (and the related category of finite vector spaces) which we extend by showing: why the direct sum . (⊕,0) monoid is not closed, a biproduct encoding of Gaussian elimination...... such possibility and show two stepwise refinements transforming the composition . MN into the Naïve and Strassen's matrix multiplication algorithms. The inspection of the stepwise transformation of the composition of matrices . MN into the Naïve matrix multiplication algorithm evidences that the steps...

  6. RESULTS of the "ELIMINATING NOISE" campaign

    CERN Multimedia

    SC Unit

    2008-01-01

    From 4 to 6 August, CERN’s nurses conducted a screening campaign entitled "Eliminating noise". This campaign was especially aimed at young people exposed to noise during their leisure hours (playing in a band, listening to MP3 players, attending concerts, etc.). In all, 166 people attended the Infirmary, where they were able to receive personalised advice, documentation and, above all, a hearing test (audiogram). While the high attendance of people in the younger age category (18-30) was a success, their audiogram data were a cause for concern, with 24.5% showing abnormal results, hearing deficiencies which, we should remind you, are irreversible. It should be noted that such conditions are almost exclusively caused by noise exposure in a non-professional environment (leisure activities, music, etc.). This latest campaign confirms the harmful effects of noise on people’s hearing due to the absence or insufficiency of protective equipment during music-related activities; this further unde...

  7. RESULTS of the "ELIMINATING NOISE" campaign

    CERN Multimedia

    SC Unit

    2008-01-01

    From 4 to 6 August, CERN’s nurses conducted a screening campaign entitled "Eliminating noise". This campaign was especially aimed at young people exposed to noise during their leisure hours (playing in a band, listening to MP3 players, attending concerts, etc.). In all, 166 people attended the infirmary, where they were able to receive personalised advice, documentation and, above all, a hearing test (audiogram). While the high attendance of people in the younger age category (18-30) was a success, their audiogram data were a cause for concern, with 24.5% showing abnormal results, hearing deficiencies which, we should remind you, are irreversible. It should be noted that such conditions are almost exclusively caused by noise exposure in a non-professional environment (leisure activities, music, etc.). This latest campaign confirms the harmful effects of noise on people’s hearing due to the absence or insufficiency of protective equipment during music-related activities; this further unde...

  8. Adaptive elimination of synchronization in coupled oscillator

    International Nuclear Information System (INIS)

    Zhou, Shijie; Lin, Wei; Ji, Peng; Feng, Jianfeng; Zhou, Qing; Kurths, Jürgen

    2017-01-01

    We present here an adaptive control scheme with a feedback delay to achieve elimination of synchronization in a large population of coupled and synchronized oscillators. We validate the feasibility of this scheme not only in the coupled Kuramoto’s oscillators with a unimodal or bimodal distribution of natural frequency, but also in two representative models of neuronal networks, namely, the FitzHugh–Nagumo spiking oscillators and the Hindmarsh–Rose bursting oscillators. More significantly, we analytically illustrate the feasibility of the proposed scheme with a feedback delay and reveal how the exact topological form of the bimodal natural frequency distribution influences the scheme performance. We anticipate that our developed scheme will deepen the understanding and refinement of those controllers, e.g. techniques of deep brain stimulation, which have been implemented in remedying some synchronization-induced mental disorders including Parkinson disease and epilepsy. (paper)

  9. Technique to eliminate helium induced weld cracking in stainless steels

    International Nuclear Information System (INIS)

    Chin-An Wang; Chin, B.A.

    1992-01-01

    Experiments have shown that Type 316 stainless steel is susceptible to heat-affected-zone (HAZ) cracking upon cooling when welded using the gas tungsten arc (GTA) process under lateral constraint. The cracking has been hypothesized to be caused by stress-assisted helium bubble growth and rupture at grain boundaries. This study utilized an experimental welding setup which enabled different compressive stresses to be applied to the plates during welding. Autogenous GTA welds were produced in Type 316 stainless steel doped with 256 appm helium. The application of a compressive stress, 55 Mpa, during welding suppressed the previously observed catastrophic cracking. Detailed examinations conducted after welding showed a dramatic change in helium bubble morphology. Grain boundary bubble growth along directions parallel to the weld was suppressed. Results suggest that stress-modified welding techniques may be used to suppress or eliminate helium-induced cracking during joining of irradiated materials

  10. 76 FR 24802 - Eliminating the Decision Review Board

    Science.gov (United States)

    2011-05-03

    ... 0960-AG80 Eliminating the Decision Review Board AGENCY: Social Security Administration. ACTION: Final rules. SUMMARY: We are eliminating the Decision Review Board (DRB) portions of part 405 of our rules...-level process. DSI also eliminated review by the Appeals Council, the final step in our administrative...

  11. 77 FR 30871 - Implementing the Prison Rape Elimination Act

    Science.gov (United States)

    2012-05-23

    ...--Implementing the Prison Rape Elimination Act Proclamation 8823--Armed Forces Day, 2012 #0; #0; #0; Presidential... Prison Rape Elimination Act Memorandum for the Heads of Executive Departments and Agencies Sexual... Rape Elimination Act of 2003 (PREA) was enacted with bipartisan support and established a ``zero...

  12. Emotional and psychosocial aspects of menstrual poverty in resource-poor settings: a qualitative study of the experiences of adolescent girls in an informal settlement in Nairobi.

    Science.gov (United States)

    Crichton, Joanna; Okal, Jerry; Kabiru, Caroline W; Zulu, Eliya Msiyaphazi

    2013-10-01

    We introduce the concept of "menstrual poverty" to categorize the multiple deprivations relating to menstruation in resource-poor settings across the Global South, and we examine how this affects the psychological well-being of adolescent girls in an urban informal settlement in Kenya. We use qualitative data collected through 34 in-depth interviews and 18 focus group discussions with girls, women, and key informants. Menstrual poverty involved practical and psychosocial challenges affecting girls at home and at school. Its emotional impacts included anxiety, embarrassment, fear of stigma, and low mood. Further research is needed on how menstrual poverty affects girls' psychological and educational outcomes.

  13. Sign language interpreting in legal settings in Flanders : An exploratory study into the experiences of Flemish Deaf people in their contact with the justice system

    OpenAIRE

    Doggen, Carolien

    2016-01-01

    This study is part of the European project Justisigns. The aim of this study is to ascertain experiences of Deaf people when contact was made with the justice system in Flanders. The literature review consists of explanation of the Conventions of United Nations (UN) and the European Union (EU) and the two Directives of the EU concerning the demand for interpreters in police interviews. Furthermore, an overview of the background in relation to accessibility, sign language and Deaf people in Fl...

  14. Refining the Results of a Classical SELEX Experiment by Expanding the Sequence Data Set of an Aptamer Pool Selected for Protein A

    OpenAIRE

    Regina Stoltenburg; Beate Strehlitz

    2018-01-01

    New, as yet undiscovered aptamers for Protein A were identified by applying next generation sequencing (NGS) to a previously selected aptamer pool. This pool was obtained in a classical SELEX (Systematic Evolution of Ligands by EXponential enrichment) experiment using the FluMag-SELEX procedure followed by cloning and Sanger sequencing. PA#2/8 was identified as the only Protein A-binding aptamer from the Sanger sequence pool, and was shown to be able to bind intact cells of Staphylococcus aur...

  15. Simple messages help set the record straight about scientific agreement on human-caused climate change: the results of two experiments.

    Directory of Open Access Journals (Sweden)

    Teresa A Myers

    Full Text Available Human-caused climate change is happening; nearly all climate scientists are convinced of this basic fact according to surveys of experts and reviews of the peer-reviewed literature. Yet, among the American public, there is widespread misunderstanding of this scientific consensus. In this paper, we report results from two experiments, conducted with national samples of American adults, that tested messages designed to convey the high level of agreement in the climate science community about human-caused climate change. The first experiment tested hypotheses about providing numeric versus non-numeric assertions concerning the level of scientific agreement. We found that numeric statements resulted in higher estimates of the scientific agreement. The second experiment tested the effect of eliciting respondents' estimates of scientific agreement prior to presenting them with a statement about the level of scientific agreement. Participants who estimated the level of agreement prior to being shown the corrective statement gave higher estimates of the scientific consensus than respondents who were not asked to estimate in advance, indicating that incorporating an "estimation and reveal" technique into public communication about scientific consensus may be effective. The interaction of messages with political ideology was also tested, and demonstrated that messages were approximately equally effective among liberals and conservatives. Implications for theory and practice are discussed.

  16. Fine Needle Aspiration of Thyroid Nodules Using the Bethesda System for Reporting Thyroid Cytopathology: An Institutional Experience in a Rural Setting

    Directory of Open Access Journals (Sweden)

    Aili Guo

    2017-01-01

    Full Text Available Background. Fine needle aspiration (FNA remains the first-line diagnostic in management of thyroid nodules and reduces unnecessary surgeries. However, it is still challenging since cytological results are not always straightforward. This study aimed to examine the results of thyroid FNA using the Bethesda system for reporting thyroid cytopathology (TBSRTC to establish the level of accuracy of FNA procedures in a rural practice setting. Method. A retrospective chart review was conducted on existing thyroid FNA performed in a referral endocrine center between December 2011 and November 2015. Results. A total of 159 patients (18–88 years old and 236 nodule aspirations were performed and submitted for evaluation. 79% were benign, 3% atypia/follicular lesion of unknown significance (AUS/FLUS, 5% follicular neoplasm/suspicious for follicular neoplasm (FN/SFN, 4% suspicious for malignancy (one case was indeed an atypical parathyroid neoplasm by surgical pathology, 2% malignant, and 7% nondiagnostic. Two cases also had advanced molecular analysis on FNA specimens before thyroidectomy. Conclusion. The diagnostic yield of FNA cytology from our practice in a rural setting suggests that accuracy and specificity are comparable to results from larger centers.

  17. The implementation and evaluation of therapeutic touch in burn patients: an instructive experience of conducting a scientific study within a non-academic nursing setting.

    Science.gov (United States)

    Busch, Martine; Visser, Adriaan; Eybrechts, Maggie; van Komen, Rob; Oen, Irma; Olff, Miranda; Dokter, Jan; Boxma, Han

    2012-12-01

    Evaluation of therapeutic touch (TT) in the nursing of burn patients; post hoc evaluation of the research process in a non-academic nursing setting. 38 burn patients received either TT or nursing presence. On admission, days 2, 5 and 10 of hospitalization, data were collected on anxiety for pain, salivary cortisol, and pain medication. Interviews with nurses were held concerning research in a non-academic setting. Anxiety for pain was more reduced on day 10 in the TT-group. The TT-group was prescribed less morphine on day 1 and 2. On day 2 cortisol level before dressing changes was higher in the TT-group. The situational challenges of this study led to inconsistencies in data collection and a high patient attrition rate, weakening its statistical power. Conducting an effect study within daily nursing practice should not be done with a nursing staff inexperienced in research. Analysis of the remaining data justifies further research on TT for burn patients with pain, anxiety for pain, and cortisol levels as outcomes. Administering and evaluating TT during daily care requires nurses experienced both in TT and research, thus leading to less attrition and missing data, increasing the power of future studies. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. 'I'm not an outsider, I'm his mother!' A phenomenological enquiry into carer experiences of exclusion from acute psychiatric settings.

    Science.gov (United States)

    Wilkinson, Claire; McAndrew, Sue

    2008-12-01

    Contemporary standards and policies advocate carer involvement in planning, implementing, and evaluating mental health services. Critics have questioned why such standards and policies fail to move from rhetoric to reality, this particularly being applicable to carer involvement within acute psychiatric settings. As there is only limited UK research on this topic, this interpretive phenomenological study was undertaken to explore the perceived level of involvement from the perspective of carers of service users who were admitted to acute inpatient settings within the previous 2 years. Interviews were conducted with four individuals who cared for a loved one with a mental illness. The interview analysis was influenced by Van Manen, whose interpretive approach seeks to generate a deeper understanding of the phenomenon under study. Four main themes emerged: powerlessness, feeling isolated, needing to be recognized and valued, and a desire for partnership. The findings reflect the views expressed by carers in other studies, identifying that while carers seek to work in partnership with health-care professionals, at a clinical level they often feel excluded. The study concludes by discussing ways of improving and promoting carer involvement and advocating a partnership in care approach within acute psychiatry.

  19. Implementing universal HIV treatment in a high HIV prevalence and rural South African setting - Field experiences and recommendations of health care providers.

    Directory of Open Access Journals (Sweden)

    Melanie Plazy

    Full Text Available We aimed to describe the field experiences and recommendations of clinic-based health care providers (HCP regarding the implementation of universal antiretroviral therapy (ART in rural KwaZulu-Natal, South Africa.In Hlabisa sub-district, the local HIV programme of the Department of Health (DoH is decentralized in 18 clinics, where ART was offered at a CD4 count ≤500 cells/μL from January 2015 to September 2016. Within the ANRS 12249 TasP trial, implemented in part of the sub-district, universal ART (no eligibility criteria was offered in 11 mobile clinics between March 2012 and June 2016. A cross-sectional qualitative survey was conducted in April-July 2016 among clinic-based nurses and counsellors providing HIV care in the DoH and TasP trial clinics. In total, 13 individual interviews and two focus groups discussions (including 6 and 7 participants were conducted, audio-recorded, transcribed, and thematically analyzed.All HCPs reported an overall good experience of delivering ART early in the course of HIV infection, with most patients willing to initiate ART before being symptomatic. Yet, HCPs underlined that not feeling sick could challenge early ART initiation and adherence, and thus highlighted the need to take time for counselling as an important component to achieve universal ART. HCPs also foresaw logistical challenges of universal ART, and were especially concerned about increasing workload and ART shortage. HCPs finally recommended the need to strengthen the existing model of care to facilitate access to ART, e.g., community-based and integrated HIV services.The provision of universal ART is feasible and acceptable according to HCPs in this rural South-African area. However their experiences suggest that universal ART, and more generally the 90-90-90 UNAIDS targets, will be difficult to achieve without the implementation of new models of health service delivery.

  20. Implementing universal HIV treatment in a high HIV prevalence and rural South African setting – Field experiences and recommendations of health care providers

    Science.gov (United States)

    Gumede, Dumile; Boyer, Sylvie; Pillay, Deenan; Dabis, François; Seeley, Janet; Orne-Gliemann, Joanna

    2017-01-01

    Background We aimed to describe the field experiences and recommendations of clinic-based health care providers (HCP) regarding the implementation of universal antiretroviral therapy (ART) in rural KwaZulu-Natal, South Africa. Methods In Hlabisa sub-district, the local HIV programme of the Department of Health (DoH) is decentralized in 18 clinics, where ART was offered at a CD4 count ≤500 cells/μL from January 2015 to September 2016. Within the ANRS 12249 TasP trial, implemented in part of the sub-district, universal ART (no eligibility criteria) was offered in 11 mobile clinics between March 2012 and June 2016. A cross-sectional qualitative survey was conducted in April–July 2016 among clinic-based nurses and counsellors providing HIV care in the DoH and TasP trial clinics. In total, 13 individual interviews and two focus groups discussions (including 6 and 7 participants) were conducted, audio-recorded, transcribed, and thematically analyzed. Results All HCPs reported an overall good experience of delivering ART early in the course of HIV infection, with most patients willing to initiate ART before being symptomatic. Yet, HCPs underlined that not feeling sick could challenge early ART initiation and adherence, and thus highlighted the need to take time for counselling as an important component to achieve universal ART. HCPs also foresaw logistical challenges of universal ART, and were especially concerned about increasing workload and ART shortage. HCPs finally recommended the need to strengthen the existing model of care to facilitate access to ART, e.g., community-based and integrated HIV services. Conclusions The provision of universal ART is feasible and acceptable according to HCPs in this rural South-African area. However their experiences suggest that universal ART, and more generally the 90-90-90 UNAIDS targets, will be difficult to achieve without the implementation of new models of health service delivery. PMID:29155832

  1. Mental Health Priorities: Stigma Elimination and Community Advocacy in College Settings

    Science.gov (United States)

    Michaels, Patrick J.; Corrigan, Patrick W.; Kanodia, Nupur; Buchholz, Blythe; Abelson, Sara

    2015-01-01

    Low rates of psychological help-seeking among college students have been attributed to a lack of awareness about on-campus resources and to mental illness stigma. One mental health advocacy organization, Active Minds, collaborates with its university-recognized student-run on-campus chapters to promote service use and psychological healthy…

  2. On the Importance of Elimination Heuristics in Lazy Propagation

    DEFF Research Database (Denmark)

    Madsen, Anders Læsø; Butz, Cory J.

    2012-01-01

    elimination orders on-line. This paper considers the importance of elimination heuristics in LP when using Variable Elimination (VE) as the message and single marginal computation algorithm. It considers well-known cost measures for selecting the next variable to eliminate and a new cost measure....... The empirical evaluation examines dierent heuristics as well as sequences of cost measures, and was conducted on real-world and randomly generated Bayesian networks. The results show that for most cases performance is robust relative to the cost measure used and in some cases the elimination heuristic can have...

  3. Nature works best when allowed to run its course. The experience of midwives promoting normal births in a home birth setting.

    Science.gov (United States)

    Aune, Ingvild; Hoston, Mari A; Kolshus, Nora J; Larsen, Christel E G

    2017-07-01

    to gain a deeper understanding of how midwives promote a normal birth in a home birth setting in Norway. a qualitative approach was chosen for data collection. In-depth interviews were conducted with nine midwives working in a home birth setting in different areas in Norway. The transcribed interviews were analysed with the help of systematic text condensation. the analysis generated two main themes: «The midwife's fundamental beliefs» and «Working in line with one's ideology». The midwives had a fundamental belief that childbirth is a normal event that women are able to manage. It is important that this attitude is transferred to the woman in order for her to believe in her own ability to give birth. The midwives in the study were able to work according to their ideology when promoting a normal birth at home. To avoid disturbing the natural birth process was described as an important factor. Also crucial was to approach the work in a patient manner. Staying at home in a safe environment and establishing a close relationship with the midwife also contributed positively to a normal birth. the midwife's attitude is important when trying to promote a normal birth. Patience was seen as essential to avoid interventions. Being in a safe environment with a familiar midwife provides a good foundation for a normal birth. The attitude of the midwives towards normal childbirth ought to be more emphasised, also in the context of maternity wards. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Financial incentives to influence maternal mortality in a low-income setting: making available 'money to transport' - experiences from Amarpatan, India.

    Science.gov (United States)

    De Costa, Ayesha; Patil, Rajkumar; Kushwah, Surgiv Singh; Diwan, Vinod Kumar

    2009-03-18

    Only 40.7% women in India deliver in an institution; leaving many vulnerable to maternal morbidity and mortality (India has 22% of global maternal deaths). While limited accessibility to functioning institutions may account in part, a common reason why women deliver at home is poverty. A lack of readily available financial resources for families to draw upon at the time of labor to transport the mother to an institution, is often observed. This paper reports a yearlong collaborative intervention (between the University and Department of Health) to study if providing readily available and easily accessible funds for emergency transportation would reduce maternal deaths in a rural, low income, and high maternal mortality setting in central India. It aimed to obviate a deterrent to emergency obstetric care; the non-availability of resources with mothers when most needed. Issues in implementation are also discussed. Maternal deaths were actively identified in block Amarpatan (0.2 million population) over a 2-year period. The project, with participation from local government and other groups, trained 482 local health care providers (public and private) to provide antenatal care. Emergency transport money (in cash) was placed with one provider in each village. Maternal mortality in the adjacent block (Maihar) was followed (as a 'control' block). Maternal deaths in Amarpatan decreased during the project year relative to the previous year, or in the control block the same year. Issues in implementation of the cash incentive scheme are discussed. Although the intervention reduced maternal deaths in this low-income setting, chronic poverty and malnutrition are underlying structural problems that need to be addressed.

  5. Monte Carlo analyses of TRX slightly enriched uranium-H2O critical experiments with ENDF/B-IV and related data sets (AWBA Development Program)

    International Nuclear Information System (INIS)

    Hardy, J. Jr.

    1977-12-01

    Four H 2 O-moderated, slightly-enriched-uranium critical experiments were analyzed by Monte Carlo methods with ENDF/B-IV data. These were simple metal-rod lattices comprising Cross Section Evaluation Working Group thermal reactor benchmarks TRX-1 through TRX-4. Generally good agreement with experiment was obtained for calculated integral parameters: the epi-thermal/thermal ratio of U238 capture (rho 28 ) and of U235 fission (delta 25 ), the ratio of U238 capture to U235 fission (CR*), and the ratio of U238 fission to U235 fission (delta 28 ). Full-core Monte Carlo calculations for two lattices showed good agreement with cell Monte Carlo-plus-multigroup P/sub l/ leakage corrections. Newly measured parameters for the low energy resonances of U238 significantly improved rho 28 . In comparison with other CSEWG analyses, the strong correlation between K/sub eff/ and rho 28 suggests that U238 resonance capture is the major problem encountered in analyzing these lattices

  6. Elimination of onchocerciasis from Colombia: first proof of concept of river blindness elimination in the world.

    Science.gov (United States)

    Nicholls, Rubén Santiago; Duque, Sofía; Olaya, Luz Adriana; López, Myriam Consuelo; Sánchez, Sol Beatriz; Morales, Alba Lucía; Palma, Gloria Inés

    2018-04-11

    Onchocerciasis is a chronic parasitic infection originally endemic in 13 discrete regional foci distributed among six countries of Latin America (Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela). In Colombia, this disease was discovered in 1965 in the Pacific Coast of the country. The National Onchocerciasis Elimination Program was established in 1993 with the aim of eliminating disease morbidity and infection transmission. In 2013, the World Health Organization (WHO) verified Colombia as free of onchocerciasis, becoming the first country in the world to reach such a goal. This report provides the empirical evidence of the elimination of Onchocerca volvulus transmission by Simulium exiguum (s.l.) after 12 years of 6-monthly mass drug administration of Mectizan® (ivermectin) to all the eligible residents living in this endemic area. From 1996 onwards, a biannual community-based mass ivermectin administration programme was implemented, complemented by health education and community participation. In-depth parasitological, serological and entomological surveys were conducted periodically between 1998 and 2007 to evaluate the impact of ivermectin treatment according to the 2001 WHO guidelines. When the interruption of parasite transmission was demonstrated, the drug distribution ceased and a three-year post-treatment surveillance (PTS) period (2008-2010) was initiated. After 23 rounds of treatment, parasitological and ophthalmological assessments showed absence of microfilariae in skin and anterior chamber of the eyes. Serological tests proved lack of antibodies against O. volvulus in children under 10 years-old. A total of 10,500 S. exiguum flies tested by PCR had no L3 infection (infectivity rate = 0.0095%; 95% CI: 0.0029-0.049) during 2004, indicating interruption of parasite transmission. However, biannual ivermectin treatments continued until 2007 followed by a 3-year PTS period at the end of which 13,481 flies were analyzed and no infective flies were

  7. Therapists in Oncology Settings

    Science.gov (United States)

    Hendrick, Susan S.

    2013-01-01

    This article describes the author's experiences of working with cancer patients/survivors both individually and in support groups for many years, across several settings. It also documents current best-practice guidelines for the psychosocial treatment of cancer patients/survivors and their families. The author's view of the important qualities…

  8. Gas-chromatographic quantitative determination of argon in air samples, by elimination of oxigen

    International Nuclear Information System (INIS)

    Sofronie, E.

    1982-08-01

    A method of gas-chromatographic quantitative determination of argon in air samples, by elimination of oxygen, is presented. Experiments were carried out in a static system. Conditions for the application of the method in dynamic systems are specified. Sensibility of the method: 5 10 -4 cm 3 Ar per cm 3 of air. (author)

  9. Using an Electronic Highlighter to Eliminate the Negative Effects of Pre-Existing, Inappropriate Highlighting

    Science.gov (United States)

    Gier, Vicki; Kreiner, David; Hudnell, Jason; Montoya, Jodi; Herring, Daniel

    2011-01-01

    The purpose of the present experiment was to determine whether using an active learning technique, electronic highlighting, can eliminate the negative effects of pre-existing, poor highlighting on reading comprehension. Participants read passages containing no highlighting, appropriate highlighting, or inappropriate highlighting. We hypothesized…

  10. Elimination of viruses, bacteria and protozoan oocysts by slow sand filtration

    NARCIS (Netherlands)

    Hijnen, W.A.M.; Visser, Ate; Schijven, J.F.; Bonné, P.; Medema, Gerriet Jan

    2004-01-01

    The decimal elimination capacity (DEC) of slow sand filters (SSF) for viruses, bacteria and oocysts of Cryptosporidium has been assessed from full-scale data and pilot plant and laboratory experiments. DEC for viruses calculated from experimental data with MS2-bacteriophages in the pilot plant

  11. Chasing zero: the drive to eliminate surgical site infections.

    Science.gov (United States)

    Thompson, Kristine M; Oldenburg, W Andrew; Deschamps, Claude; Rupp, William C; Smith, C Daniel

    2011-09-01

    It is estimated that healthcare associated infections (HAI) account for 1.7 million infections and 99,000 associated deaths each year, with annual direct medical costs of up to $45 billion. Surgical Site Infections (SSI) account for 17% of HAIs, an estimated annual cost of $3.5 to 10 billion for our country alone. This project was designed to pursue elimination of SSIs and document results. Starting in 2009 a program to eliminate SSIs was undertaken at a nationally recognized academic health center. Interventions already outlined by CMS and IHI were utilized, along with additional interventions based on literature showing relationships with SSI reduction and best practices. Rapid deployment of multiple interventions (SSI Bundle) was undertaken. Tactics included standardized order sets, a centralized preoperative evaluation (POE) clinic, high compliance with intraoperative interventions, and widespread monthly reporting of compliance and results. Data from 2008 to 2010 were collected and analyzed. Between May 1, 2008 and June 30, 2010, all patients with Class I and Class II wounds were tracked for SSIs. Baseline data (May-June 2008) was obtained showing a Class I surgical site infection rate of 1.78%, Class II of 2.82% (total surgical volume: 4160 cases). As of the second quarter 2010, those rates have dropped to 0.51% and 1.44%, respectively (P cost savings of nearly $1 million during the study period. Committed leadership, aggressive assurance of high compliance with multiple known interventions (SSI Bundle), transparency to achieve high levels of staff engagement, and centralization of critical surgical activities result in significant declines in SSIs with resulting substantial cost savings.

  12. Mobile surgical services in primary care in a rural and remote setting: Experience and evidence from Yala, Cross River State, Nigeria

    Directory of Open Access Journals (Sweden)

    Emmanuel Monjok

    2009-07-01

    Full Text Available Surgical conditions account for 11 to 15% of the global burden of disease. Yet, surgical services are very scarce in the rural areas of Nigeria where approximately 60 to 80% of the population resides. Among other basic contributing factors is the shortage of surgical workforce, since Nigeria’s few surgeons practise in the urban centre of the major cities. One way to respond to this acute shortage of surgeons is the training of generalist medical doctors to undertake surgery in rural areas. The introduction of mobile surgical services in rural populations as part of the existing primary health care activities in the Local Government Areas (districts can reduce surgical morbidity and mortality in Nigeria. This can be done by the generalist physician with training and experience in surgery using local health staff and simple surgical equipment. A number of recommendations are made.

  13. A mechanistic study on the simultaneous elimination of soot and nitric oxide from engine exhaust

    KAUST Repository

    Raj, Abhijeet; Zainuddin, Zakwan; Sander, Markus; Kraft, Markus

    2011-01-01

    The non-catalytic interaction between soot and nitric oxide (NO) resulting in their simultaneous elimination was studied on different types of reactive site present on soot. The reaction mechanism proposed previously was extended by including seven new reaction pathways for which the reaction energetics and kinetics were studied using density functional theory and transition state theory. This has led to the calculation of a new rate for the removal of carbon monoxide (CO) from soot. The new pathways have been added to our polycyclic aromatic hydrocarbon (PAH) growth model and used to simulate the NO-soot interaction to form CO, N2 and N2O. The simulation results show satisfactory agreement with experiment for the new CO removal rate. The NO-soot reaction was found to depend strongly on the soot site type and temperature. For a set of temperatures, computed PAH structures were analysed to determine the functional groups responsible for the decrease in the reactivity of soot with NO with increasing reaction time. In isothermal conditions, it was found that as temperature is increased, the number of oxygen atoms remaining on the soot surface decreases, while the number of nitrogen atoms increases for a given reaction time. © 2010 Elsevier Ltd. All rights reserved.

  14. A mechanistic study on the simultaneous elimination of soot and nitric oxide from engine exhaust

    KAUST Repository

    Raj, Abhijeet

    2011-04-01

    The non-catalytic interaction between soot and nitric oxide (NO) resulting in their simultaneous elimination was studied on different types of reactive site present on soot. The reaction mechanism proposed previously was extended by including seven new reaction pathways for which the reaction energetics and kinetics were studied using density functional theory and transition state theory. This has led to the calculation of a new rate for the removal of carbon monoxide (CO) from soot. The new pathways have been added to our polycyclic aromatic hydrocarbon (PAH) growth model and used to simulate the NO-soot interaction to form CO, N2 and N2O. The simulation results show satisfactory agreement with experiment for the new CO removal rate. The NO-soot reaction was found to depend strongly on the soot site type and temperature. For a set of temperatures, computed PAH structures were analysed to determine the functional groups responsible for the decrease in the reactivity of soot with NO with increasing reaction time. In isothermal conditions, it was found that as temperature is increased, the number of oxygen atoms remaining on the soot surface decreases, while the number of nitrogen atoms increases for a given reaction time. © 2010 Elsevier Ltd. All rights reserved.

  15. Supercritical Water Oxidation: A Solution for the Elimination of Back-End Organic Reprocessing Wastes

    International Nuclear Information System (INIS)

    Leybros, A.; Roubaud, A.; Turc, H.A.; Fournel, B.

    2008-01-01

    Supercritical water oxidation (SCWO) is a very efficient technique for total elimination of organic wastes from reprocessing activities on the way of 'zero wastes' facilities. This technology uses the properties of supercritical water (P > 221 bars and T > 647 K) to obtain a good mixing between oxygen (the oxidant) and the organic waste. Thereby, the oxidation reaction is fast and complete. Using the SCWO process, contamination contained in organic materials like spent solvents can be confined in a closed space, like a reactor in a glovebox. A new application is tested for the treatment of solid organic wastes like ion exchange resins (IER). Experiments are made with suspensions of IER in water and isopropyl-alcohol. A nuclear version of the process with the double shell reactor has been constructed and is being tested. The aim of this work is to obtain a treatment capacity of 1 kg/h for the nuclear version with the same global set-up, concept of process and security as well as contamination management as for a 200 g/h pilot. (authors)

  16. Supercritical Water Oxidation: A Solution for the Elimination of Back-End Organic Reprocessing Wastes

    Energy Technology Data Exchange (ETDEWEB)

    Leybros, A.; Roubaud, A.; Turc, H.A.; Fournel, B. [Supercritical fluids and membranes Laboratory, CEA Valrho, BP 17171, 30207 Bagnols/Ceze Cedex (France)

    2008-07-01

    Supercritical water oxidation (SCWO) is a very efficient technique for total elimination of organic wastes from reprocessing activities on the way of 'zero wastes' facilities. This technology uses the properties of supercritical water (P > 221 bars and T > 647 K) to obtain a good mixing between oxygen (the oxidant) and the organic waste. Thereby, the oxidation reaction is fast and complete. Using the SCWO process, contamination contained in organic materials like spent solvents can be confined in a closed space, like a reactor in a glovebox. A new application is tested for the treatment of solid organic wastes like ion exchange resins (IER). Experiments are made with suspensions of IER in water and isopropyl-alcohol. A nuclear version of the process with the double shell reactor has been constructed and is being tested. The aim of this work is to obtain a treatment capacity of 1 kg/h for the nuclear version with the same global set-up, concept of process and security as well as contamination management as for a 200 g/h pilot. (authors)

  17. Delivering HIV care in challenging operating environments: the MSF experience towards differentiated models of care for settings with multiple basic health care needs.

    Science.gov (United States)

    Ssonko, Charles; Gonzalez, Lucia; Mesic, Anita; da Fonseca, Marcio Silveira; Achar, Jay; Safar, Nadia; Martin, Beatriz; Wong, Sidney; Casas, Esther C

    2017-07-21

    Countries in the West and Central African regions struggle to offer quality HIV care at scale, despite HIV prevalence being relatively low. In these challenging operating environments, basic health care needs are multiple, systems are highly fragile and conflict disrupts health care. Médecins Sans Frontières (MSF) has been working to integrate HIV care in basic health services in such settings since 2000. We review the implementation of differentiated HIV care and treatment approaches in MSF-supported programmes in South Sudan (RoSS), Central African Republic (CAR) and Democratic Republic of Congo (DRC). A descriptive analysis from CAR, DRC and RoSS programmes reviewing methodology and strategies of HIV care integration between 2010 and 2015 was performed. We describe HIV care models integrated within the provision of general health care and highlight best practices and challenges. Services included provision of general health care, with out-patient care (range between countries 43,343 and 287,163 consultations/year in 2015) and in-patient care (range 1076-16,595 in 2015). By the end of 2015 antiretroviral therapy (ART) initiations reached 12-255 patients/year. A total of 1101 and 1053 patients were on ART in CAR and DRC, respectively. In RoSS 186 patients were on ART when conflict recommenced late in 2013. While ART initiation and monitoring were mostly clinically driven in the early phase of the programmes, DRC implemented CD4 monitoring and progressively HIV viral load (VL) monitoring during study period. Attacks to health care facilities in CAR and RoSS disrupted service provision temporarily. Programmatic challenges include: competing health priorities influencing HIV care and need to integrate within general health services. Differentiated care approaches that support continuity of care in these programmes include simplification of medical protocols, multi-month ART prescriptions, and community strategies such as ART delivery groups, contingency plans and

  18. A chart review of morbidity patterns among adult patients attending primary care setting in urban Odisha, India: An International Classification of Primary Care experience

    Directory of Open Access Journals (Sweden)

    Subhashisa Swain

    2017-01-01

    Full Text Available Introduction: Disease burden estimations based on sound epidemiological research provide the foundation for designing health services. Patients visiting a primary care often present with symptoms and signs. Understanding the burden is crucial for developing countries including India. The project aimed to record the reasons for encounter (RFE at primary care settings for estimating the burden at the health-care facility. Methodology: This cross-sectional study was undertaken at four urban health dispensaries of Bhubaneswar, Odisha, with the aim to explore the prevailing patterns of diseases among patients attending these facilities. Data collection spanned from May to October 2012. At each center, patients' information on age, sex, religion, and presenting illness was extracted from the outpatient records over these time period. Data were entered and analyzed in SPSS version 20, and the International Classification of Primary Care-2 was used for coding the illnesses. Results: In total, 2249 patient's records were extracted over 12 weeks. Out of them, 1241 (55.2% were male with mean age of 41.8 (±15.8 years vis-à -vis 38.2 (±14.1 years for females. Around 151 (6.7% had 2 or more symptoms or conditions. Overall, the most common categories were general and unspecified followed by digestive-related symptoms in both sexes. The most common symptoms among males were fever (11.4%, heart burn (8.1%, and vertigo or dizziness (3.6%. Similar pattern was seen among females. Respiratory (17.0% and cardiovascular (10.2% problems were the most common RFEs among males and females. The most common RFEs for acute care among males and females were fever, allergic rhinitis, upper respiratory tract infection, and acute bronchitis. Leading RFEs for chronic care among males were hypertension uncomplicated, heart burn, low back pain, whereas among females, hypertension and heartburn were mostly seen. Conclusion: Primary care settings are experiencing both communicable

  19. Reward eliminates retrieval-induced forgetting.

    Science.gov (United States)

    Imai, Hisato; Kim, Dongho; Sasaki, Yuka; Watanabe, Takeo

    2014-12-02

    Although it is well known that reward enhances learning and memory, how extensively such enhancement occurs remains unclear. To address this question, we examined how reward influences retrieval-induced forgetting (RIF) in which the retrieval of a nonpracticed item under the same category as a practiced item is worse than the retrieval of a nonpracticed item outside the category. Subjects were asked to try to encode category-exemplar pairs (e.g., FISH-salmon). Then, they were presented with a category name and a two-letter word stem (e.g., FISH-sa) and were asked to complete an encoded word (retrieval practice). For a correct response, apple juice was given as a reward in the reward condition and a beeping sound was presented in the no-reward condition. Finally, subjects were asked to report whether each exemplar had been presented in the first phase. RIF was replicated in the no-reward condition. However, in the reward condition, RIF was eliminated. These results suggest that reward enhances processing of retrieval of unpracticed members by mechanisms such as spreading activation within the same category, irrespective of whether items were practiced or not.

  20. Eliminating Residents Increases the Cost of Care.

    Science.gov (United States)

    DeMarco, Deborah M; Forster, Richard; Gakis, Thomas; Finberg, Robert W

    2017-08-01

    Academic health centers are facing a potential reduction in Medicare financing for graduate medical education (GME). Both the Medicare Payment Advisory Commission and the National Commission on Fiscal Responsibility and Reform (Deficit Commission) have suggested cutting approximately half the funding that teaching hospitals receive for indirect medical education. Because of the effort that goes into teaching trainees, who are only transient employees, hospital executives often see teaching programs as a drain on resources. In light of the possibility of a Medicare cut to GME programs, we undertook an analysis to assess the financial risk of training programs to our institution and the possibility of saving money by reducing resident positions. The chief administrative officer, in collaboration with the hospital chief financial officer, performed a financial analysis to examine the possibility of decreasing costs by reducing residency programs at the University of Massachusetts Memorial Medical Center. Despite the real costs of our training programs, the analysis demonstrated that GME programs have a positive impact on hospital finances. Reducing or eliminating GME programs would have a negative impact on our hospital's bottom line.

  1. Seasonal blood shortages can be eliminated.

    Science.gov (United States)

    Gilcher, Ronald O; McCombs, Suzanne

    2005-11-01

    This review is designed to help readers understand seasonal blood shortages and provide solutions through the use of technology that can increase the number of red blood cell units collected and the use of recruitment and marketing initiatives that appeal to the increasingly diverse donor base. Seasonal shortages are, in reality, mostly shortages of group O red blood cells and occur most commonly during midsummer and early winter. The shortages occur primarily from increased use of group O red blood cells at times of decreased donor availability. While reducing the disproportionate use of red cells will help, blood centers can more quickly reduce the seasonal deficits by using automated red cell technology to collect double red blood cell units; targeted marketing programs to provide effective messages; seasonal advertising campaigns; and recognition, benefits, and incentives to enhance the donor motivation donation threshold. A multi-level approach to increasing blood donations at difficult times of the year can ensure that donations are increased at a time when regular donor availability is decreased. Seasonal blood shortages can be eliminated by understanding the nature of the shortages, why and when they occur, and using more sophisticated recruitment and marketing strategies as well as automated collection technologies to enhance the blood supply.

  2. Elimination of Sitophilus oryzae (L.) by irradiation

    International Nuclear Information System (INIS)

    Castro, Fernanda Peixoto

    2005-01-01

    Food treatment by exposure to ionizing radiation, known as food irradiation, presents several attractive features such as: leaving no residues, posing no threat to consumer health, usually causing no damage to sensory or nutritional properties and acting uniformly throughout the volume of the products. This work investigated the efficiency of irradiation for eliminating Sitophilus oryzae (L.), also known as 'the rice weevil', a small beetle frequently found in infested grains. A total of 444 individuals of Sitophilus oryzae (L.) found in corn meal and noodles supplies were irradiated with gamma ray doses of 0, 0.6, 0.9, 1.0, 1.2, 1.5 and 2.0 kGy and then visually monitored for 4 days in order to determine the number of insects still alive. The least-squares fitting method was used to determine the survival curves as functions of post-irradiation time and dose. The living fraction of the irradiated population was found to decrease exponentially with time. The results indicated that doses of 2.0, 1.5 and 0.6 kGy cause immediate death, instantaneous immobility and death of the species within one week, respectively. The findings suggest that disinfestation of Sitophilus oryzae (L.) by irradiation is an interesting option to the dangerous use of toxic chemicals. (author)

  3. Minimizing or eliminating refueling of nuclear reactor

    Science.gov (United States)

    Doncals, Richard A.; Paik, Nam-Chin; Andre, Sandra V.; Porter, Charles A.; Rathbun, Roy W.; Schwallie, Ambrose L.; Petras, Diane S.

    1989-01-01

    Demand for refueling of a liquid metal fast nuclear reactor having a life of 30 years is eliminated or reduced to intervals of at least 10 years by operating the reactor at a low linear-power density, typically 2.5 kw/ft of fuel rod, rather than 7.5 or 15 kw/ft, which is the prior art practice. So that power of the same magnitude as for prior art reactors is produced, the volume of the core is increased. In addition, the height of the core and it diameter are dimensioned so that the ratio of the height to the diameter approximates 1 to the extent practicable considering the requirement of control and that the pressure drop in the coolant shall not be excessive. The surface area of a cylinder of given volume is a minimum if the ratio of the height to the diameter is 1. By minimizing the surface area, the leakage of neutrons is reduced. By reducing the linear-power density, increasing core volume, reducing fissile enrichment and optimizing core geometry, internal-core breeding of fissionable fuel is substantially enhanced. As a result, core operational life, limited by control worth requirements and fuel burnup capability, is extended up to 30 years of continuous power operation.

  4. Elimination of mercury in health care facilities.

    Science.gov (United States)

    2000-03-01

    Mercury is a persistent, bioaccumulative toxin that has been linked to numerous health effects in humans and wildlife. It is a potent neurotoxin that may also harm the brain, kidneys, and lungs. Unborn children and young infants are at particular risk for brain damage from mercury exposure. Hospitals' use of mercury in chemical solutions, thermometers, blood pressure gauges, batteries, and fluorescent lamps makes these facilities large contributors to the overall emission of mercury into the environment. Most hospitals recognize the dangers of mercury. In a recent survey, four out of five hospitals stated that they have policies in place to eliminate the use of mercury-containing products. Sixty-two percent of them require vendors to disclose the presence of mercury in chemicals that the hospitals purchase. Only 12 percent distribute mercury-containing thermometers to new parents. Ninety-two percent teach their employees about the health and environmental effects of mercury, and 46 percent teach all employees how to clean up mercury spills. However, the same study showed that many hospitals have not implemented their policies. Forty-two percent were not aware whether they still purchased items containing mercury. In addition, 49 percent still purchase mercury thermometers, 44 percent purchase mercury gastrointestinal diagnostic equipment, and 64 percent still purchase mercury lab thermometers.

  5. Elimination device for decontaminated surface layers

    International Nuclear Information System (INIS)

    Yoshikawa, Kozo.

    1983-01-01

    Purpose: To conduct efficient decontamination injecting solid carbon dioxide particles at a high speed by using a simple and compact device. Constitution: Liquid carbon dioxide is injected from a first vessel containing liquid carbon dioxide by way of a carbon dioxide supply tube to a solid carbon dioxide particle jetting device. The liquid carbon dioxide is partially converted into fine solid carbon dioxide particles due to the temperature reduction caused by adiabatic expansion of the gaseous carbon dioxide in an expansion space for the gaseous carbon dioxide formed in the jetting device and arrives at a solid carbon dioxide injection nozzle in communication with the expansion space. Then, the fine solid carbon dioxide particles are further cooled and accelerated by the nitrogen gas jetted out from a nitrogen gas nozzle at the top of a nitrogen gas supply tube in communication with a second vessel containing liquid nitrogen disposed within the nozzle, and jetted out from the solid carbon dioxide injection nozzle to collide against the surface to be decontaminated and eliminate the surface contamination. (Seki, T.)

  6. Elimination of Sitophilus oryzae (L.) by irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Fernanda Peixoto [Exercito Brasileiro, Brasilia, DF (Brazil). Diretoria de Suprimento. Dept. Logistico]. E-mail: peixotocastro@dlog.eb.mil.br; Vital, Helio de Carvalho [Centro Tecnologico do Exercito (CTEx), Rio de Janeiro, RJ (brazil)]. E-mail: vital@ctex.eb.br

    2005-07-01

    Food treatment by exposure to ionizing radiation, known as food irradiation, presents several attractive features such as: leaving no residues, posing no threat to consumer health, usually causing no damage to sensory or nutritional properties and acting uniformly throughout the volume of the products. This work investigated the efficiency of irradiation for eliminating Sitophilus oryzae (L.), also known as 'the rice weevil', a small beetle frequently found in infested grains. A total of 444 individuals of Sitophilus oryzae (L.) found in corn meal and noodles supplies were irradiated with gamma ray doses of 0, 0.6, 0.9, 1.0, 1.2, 1.5 and 2.0 kGy and then visually monitored for 4 days in order to determine the number of insects still alive. The least-squares fitting method was used to determine the survival curves as functions of post-irradiation time and dose. The living fraction of the irradiated population was found to decrease exponentially with time. The results indicated that doses of 2.0, 1.5 and 0.6 kGy cause immediate death, instantaneous immobility and death of the species within one week, respectively. The findings suggest that disinfestation of Sitophilus oryzae (L.) by irradiation is an interesting option to the dangerous use of toxic chemicals. (author)

  7. Elimination of excess molybdenum by cattle

    Energy Technology Data Exchange (ETDEWEB)

    Toelgyesi, G.; Elmoty, I.A.

    1967-01-01

    It was found that cattle would ingest spontaneously 5-15 g of molybdenum on one occasion. The uptake of this quantity caused but moderate loss of appetite and mild enteritis, both normalizing in one week. The occurrence of a severe acute molybdenum poisoning can be practically excluded, owing to refusal of the poisoned feed. Spontaneously ingested molybdenum caused on the first day a 30-100 fold rise of ruminal Mo-level, decreasing to the order of the normal value in about one week. But in the urine and faeces, Mo-level was at least 10 fold, in the blood and milk about 4 fold of the normal one, even one or two weeks after ingestion. During this period at least 90% of ingested Mo was eliminated with the faeces, urine and milk. One week after the ingestion of molybdenum, the rumen content showed no evidence on poisoning and no trace of molybdenum. Oral administration of ammonium molybdenate in an amount equivalent to 40 g molybdenum caused no fatality. In fact, cattle would never ingest spontaneously such a large dose.

  8. The role of emergency medicine clerkship e-Portfolio to monitor the learning experience of students in different settings: a prospective cohort study.

    Science.gov (United States)

    Cevik, Arif Alper; Shaban, Sami; El Zubeir, Margret; Abu-Zidan, Fikri M

    2018-04-12

    Although emergency departments provide acute care learning opportunities for medical students, student exposure to recommended curriculum presentations and procedures are limited. In this perspective, clinical environments providing learning opportunities for students should be monitored as part of an ongoing quality improvement process. This study aims to analyze student exposures and their involvement levels in two different hospitals (Tawam and Al Ain) so as to improve the teaching and learning activities. This is a prospective study on all 76 final year medical students' electronic logbooks (e-Portfolio) of the academic year 2016/2017. Students recorded 5087 chief complaints and 3721 procedures. The average patient and procedure exposure in a shift per student in Al Ain Hospital compared with Tawam Hospital were 7.2 vs 6.4 and 5.8 vs 4.3, respectively. The highest full involvement with presentations was seen in the pediatric unit (67.1%, P portfolio has proven to be a very useful tool in defining the learning activities of final year medical students during their emergency medicine clerkship and in comparing activities in two different clinical settings. Data collected and analyzed using this e-Portfolio has the potential to help medical educators and curriculum designers improve emergency medicine teaching and learning activities.

  9. Is the psychological refractory period effect for ideomotor compatible tasks eliminated by speed-stress instructions?

    Science.gov (United States)

    Shin, Yun Kyoung; Cho, Yang Seok; Lien, Mei-Ching; Proctor, Robert W

    2007-09-01

    It has been argued that the psychological refractory period (PRP) effect is eliminated with two ideomotor compatible tasks when instructions stress fast and simultaneous responding. Three experiments were conducted to test this hypothesis. In all experiments, Task 1 required spatially compatible manual responses (left or right) to the direction of an arrow, and Task 2 required saying the name of the auditory letter A or B. In Experiments 1 and 3, the manual responses were keypresses made with the left and right hands, whereas in Experiment 2 they were left-right toggle-switch movements made with the dominant hand. Instructions that stressed response speed reduced reaction time and increased error rate compared to standard instructions to respond fast and accurately, but did not eliminate the PRP effect on Task 2 reaction time. These results imply that, even when response speed is emphasized, ideomotor compatible tasks do not bypass response selection.

  10. Eliminating traditional reference services in an academic health sciences library: a case study

    Science.gov (United States)

    Schulte, Stephanie J

    2011-01-01

    Question: How were traditional librarian reference desk services successfully eliminated at one health sciences library? Setting: The analysis was done at an academic health sciences library at a major research university. Method: A gap analysis was performed, evaluating changes in the first eleven months through analysis of reference transaction and instructional session data. Main Results: Substantial increases were seen in the overall number of specialized reference transactions and those conducted by librarians lasting more than thirty minutes. The number of reference transactions overall increased after implementing the new model. Several new small-scale instructional initiatives began, though perhaps not directly related to the new model. Conclusion: Traditional reference desk services were eliminated at one academic health sciences library without negative impact on reference and instructional statistics. Eliminating ties to the confines of the physical library due to staffing reference desk hours removed one significant barrier to a more proactive liaison program. PMID:22022221

  11. Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali.

    Science.gov (United States)

    Kulane, Asli; Owuor, John O A; Sematimba, Douglas; Abdulahi, Sacdia Abdisamad; Yusuf, Hamdi Moalim; Mohamed, Lul M

    2017-07-05

    Human Immunodeficiency Virus (HIV) continues to take a heavy toll on the lives of many people, with the worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region are often unexpressed. This pilot qualitative study sought to explore the experiences of people diagnosed with HIV living in Mogadishu, and their resilience in access to care and social support. Participants were recruited through drug dispensers at the HIV clinic in Banadir Hospital. Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving antiretroviral therapy (ART) from the HIV clinic in Mogadishu. These were tape-recorded, transcribed, and translated for content analysis. Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouses or through health care contamination. They were very knowledgeable about the realities of HIV, how the medication works, nutritional requirements, and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However, the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organizations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainty of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants' coping mechanisms included living together and starting their own NGO for support with very strong optimism about their prognosis. The people diagnosed with HIV living in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with a diagnosed HIV infection, and the efficacy of HIV treatment. Our small sample

  12. Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

    Science.gov (United States)

    Kulane, Asli; Owuor, John O. A.; Abdulahi, Sacdia Abdisamad; Yusuf, Hamdi Moalim; Mohamed, Lul M.

    2017-01-01

    Background: Human Immunodeficiency Virus (HIV) continues to take a heavy toll on the lives of many people, with the worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region are often unexpressed. This pilot qualitative study sought to explore the experiences of people diagnosed with HIV living in Mogadishu, and their resilience in access to care and social support. Methods: Participants were recruited through drug dispensers at the HIV clinic in Banadir Hospital. Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving antiretroviral therapy (ART) from the HIV clinic in Mogadishu. These were tape-recorded, transcribed, and translated for content analysis. Results: Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouses or through health care contamination. They were very knowledgeable about the realities of HIV, how the medication works, nutritional requirements, and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However, the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organizations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainty of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants’ coping mechanisms included living together and starting their own NGO for support with very strong optimism about their prognosis. Conclusions: The people diagnosed with HIV living in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with a diagnosed HIV infection, and the

  13. Elimination of heavy metals from leachates by membrane electrolysis

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, R. [Technische Universitaet Dresden, Institut fuer Siedlungs- und Industriewasserwirtschaft, Mommsenstrasse 13, 01062 Dresden (Germany); Seidel, H. [UFZ-Umweltforschungszentrum Leipzig-Halle GmbH, Department Bioremediation, Permoserstrasse 15, D-04318 Leipzig (Germany); Rahner, D. [Technische Universitaet Dresden, Institut fuer Physikalische Chemie und Eektrochemie, Mommsenstrasse 13, D-01062 Dresden (Germany); Morgenstern, P. [UFZ-Umweltforschungszentrum Leipzig-Halle GmbH, Department Analytik, Permoserstrasse 15, D-04318 Leipzig (Germany); Loeser, C. [Technische Universitaet Dresden, Institut fuer Lebensmittel- und Bioverfahrenstechnik, Bergstrasse 120, D-01062 Dresden (Germany)

    2004-10-01

    The elimination of heavy metals from bioleaching process waters (leachates) by electrolysis was studied in the anode and cathode region of a membrane electrolysis cell at current densities of 5-20 mA/cm{sup 2} using various electrode materials. The leaching waters containing a wide range of dissolved heavy metals, were high in sulfate, and had pH values of approx. 3. In preliminary tests using a rotating disc electrode the current density-potential curve (CPK) was recorded at a rotation velocity of 0, 1000 and 2000 rpm and a scan rate of 10 mV/s in order to collect information on the influence of transport processes on the electrochemical processes taking place at the electrodes. The electrochemical deposition-dissolution processes at the cathode are strongly dependent on the hydrodynamics. Detailed examination of the anodic oxidation of dissolved Mn(II) indicated that the manganese dioxide which formed adhered well to the electrode surface but in the cathodic return run it was again reduced. Electrode pairs of high-grade steel, lead and coal as well as material combinations were used to investigate heavy metal elimination in a membrane electrolysis cell. Using high-grade steel, lead and carbon electrode pairs, the reduction and deposition of Cu, Zn, Cr, Ni and some Cd in metallic or hydroxide form were observed in an order of 10-40 % in the cathode chamber. The dominant process in the anode chamber was the precipitation of manganese dioxide owing to the oxidation of dissolved Mn(II). Large amounts of heavy metals were co-precipitated by adsorption onto the insoluble MnO{sub 2}. High-grade steel and to some extent lead anodes were dissolved and hence were proven unsuitable as an anode material. These findings were largely confirmed by experiments using combination electrodes of coal and platinized titanium as an anode material and steel as a cathode material.The results indicate that electrochemical metal separation in the membrane electrolysis cell can represent a

  14. Analysis of regional timelines to set up a global phase III clinical trial in breast cancer: the adjuvant lapatinib and/or trastuzumab treatment optimization experience.

    Science.gov (United States)

    Metzger-Filho, Otto; de Azambuja, Evandro; Bradbury, Ian; Saini, Kamal S; Bines, José; Simon, Sergio D; Dooren, Veerle Van; Aktan, Gursel; Pritchard, Kathleen I; Wolff, Antonio C; Smith, Ian; Jackisch, Christian; Lang, Istvan; Untch, Michael; Boyle, Frances; Xu, Binghe; Baselga, Jose; Perez, Edith A; Piccart-Gebhart, Martine

    2013-01-01

    This study measured the time taken for setting up the different facets of adjuvant lapatinib and/or trastuzumab treatment optimization (ALTTO), an nternational phase III study being conducted in 44 participating countries. Time to regulatory authority (RA) approval, time to ethics committee/institutional review board (EC/IRB) approval, time from study approval by EC/IRB to first randomized patient, and time from first to last randomized patient were prospectively collected in the ALTTO study. Analyses were conducted by grouping countries into either geographic regions or economic classes as per the World Bank's criteria. South America had a significantly longer time to RA approval (median: 236 days, range: 21-257 days) than Europe (median: 52 days, range: 0-151 days), North America (median: 26 days, range: 22-30 days), and Asia-Pacific (median: 62 days, range: 37-75 days). Upper-middle economies had longer times to RA approval (median: 123 days, range: 21-257 days) than high-income (median: 47 days, range: 0-112 days) and lower-middle income economies (median: 57 days, range: 37-62 days). No significant difference was observed for time to EC/IRB approval across the studied regions (median: 59 days, range 0-174 days). Overall, the median time from EC/IRB approval to first recruited patient was 169 days (range: 26-412 days). This study highlights the long time intervals required to activate a global phase III trial. Collaborative research groups, pharmaceutical industry sponsors, and regulatory authorities should analyze the current system and enter into dialogue for optimizing local policies. This would enable faster access of patients to innovative therapies and enhance the efficiency of clinical research.

  15. Set up of a method for the adjustment of resonance parameters on integral experiments; Mise au point d`une methode d`ajustement des parametres de resonance sur des experiences integrales

    Energy Technology Data Exchange (ETDEWEB)

    Blaise, P.

    1996-12-18

    Resonance parameters for actinides play a significant role in the neutronic characteristics of all reactor types. All the major integral parameters strongly depend on the nuclear data of the isotopes in the resonance-energy regions.The author sets up a method for the adjustment of resonance parameters taking into account the self-shielding effects and restricting the cross section deconvolution problem to a limited energy region. (N.T.).

  16. Acrylic microspheres in vivo. X. Elimination of circulating cells by active targeting using specific monoclonal antibodies bound to microparticles

    International Nuclear Information System (INIS)

    Laakso, T.; Andersson, J.; Artursson, P.; Edman, P.; Sjoeholm, I.

    1986-01-01

    The elimination from the blood of 51 Cr-labelled mouse erythrocytes modified with trinitrophenyl (TNP) groups was followed in mice. After 24 hours, when a stable concentration of the labelled erythrocytes has been attained, monoclonal anti-TNP-antibodies were given intravenously, either in free, soluble form, or bound to microparticles containing immobilized protein A. The anti-TNP-antibodies induced a rapid elimination of the TNP- and 51 Cr-labelled erythrocytes. Over the 8-hours time period studied, the elimination rate was significantly faster when the antibodies were administered bound to the particles. After the elimination of the target cells, the radioactivity was found in the liver, spleen and bone marrow. These results and relevant control experiments indicate that a solid carrier (1) can be directed to a specific target cell with a specific antibody and (2) can induce a rapid elimination of the target cell from the circulation. 31 references, 1 figure, 2 tables

  17. Distributed iterated elimination of strictly dominated strategies

    NARCIS (Netherlands)

    Witzel, S.A.; Apt, K.R.; Zvesper, J.A.

    2012-01-01

    We characterize epistemic consequences of truthful communication among rational agents in a game-theoretic setting. To this end we introduce normal-form games equipped with an interaction structure, which specifies which groups of players can communicate their preferences with each other. We then

  18. Tracking development assistance and government health expenditures for 35 malaria-eliminating countries: 1990-2017.

    Science.gov (United States)

    Shretta, Rima; Zelman, Brittany; Birger, Maxwell L; Haakenstad, Annie; Singh, Lavanya; Liu, Yingying; Dieleman, Joseph

    2017-07-14

    Donor financing for malaria has declined since 2010 and this trend is projected to continue for the foreseeable future. These reductions have a significant impact on lower burden countries actively pursuing elimination, which are usually a lesser priority for donors. While domestic spending on malaria has been growing, it varies substantially in speed and magnitude across countries. A clear understanding of spending patterns and trends in donor and domestic financing is needed to uncover critical investment gaps and opportunities. Building on the Institute for Health Metrics and Evaluation's annual Financing Global Health research, data were collected from organizations that channel development assistance for health to the 35 countries actively pursuing malaria elimination. Where possible, development assistance for health (DAH) was categorized by spend on malaria intervention. A diverse set of data points were used to estimate government health budgets expenditure on malaria, including World Malaria Reports and government reports when available. Projections were done using regression analyses taking recipient country averages and earmarked funding into account. Since 2010, DAH for malaria has been declining for the 35 countries actively pursuing malaria elimination (from $176 million in 2010 to $62 million in 2013). The Global Fund is the largest external financier for malaria, providing 96% of the total external funding for malaria in 2013, with vector control interventions being the highest cost driver in all regions. Government expenditure on malaria, while increasing, has not kept pace with diminishing DAH or rising national GDP rates, leading to a potential gap in service delivery needed to attain elimination. Despite past gains, total financing available for malaria in elimination settings is declining. Health financing trends suggest that substantive policy interventions will be needed to ensure that malaria elimination is adequately financed and that

  19. Elimination of radioactivity after intratracheal instillation of tritiated 3, 4-benzopyrene in hamsters

    Energy Technology Data Exchange (ETDEWEB)

    Pylev, L N; Roe, F J.C.; Warwick, G P

    1969-01-01

    Injection and recovery experiments of tritiated 3,4-benzopyrene (BaP) injected alone or with particulate carriers into hamsters were performed. After 21 days, asbestos or carbon black carriers had significantly increased the retention of BaP in the lung. Elimination was rapid at first (2 weeks: and little influenced by carrier; slower rate of elimination was noted after that. Carriers increased recoverable macrophages but decreased the amount of radioactivity per macrophage. Radioactivity was similar in all groups for kidney, liver, blood, feces, and urine.

  20. Challenges and strategies for implementing genomic services in diverse settings: experiences from the Implementing GeNomics In pracTicE (IGNITE) network.

    Science.gov (United States)

    Sperber, Nina R; Carpenter, Janet S; Cavallari, Larisa H; J Damschroder, Laura; Cooper-DeHoff, Rhonda M; Denny, Joshua C; Ginsburg, Geoffrey S; Guan, Yue; Horowitz, Carol R; Levy, Kenneth D; Levy, Mia A; Madden, Ebony B; Matheny, Michael E; Pollin, Toni I; Pratt, Victoria M; Rosenman, Marc; Voils, Corrine I; W Weitzel, Kristen; Wilke, Russell A; Ryanne Wu, R; Orlando, Lori A

    2017-05-22

    To realize potential public health benefits from genetic and genomic innovations, understanding how best to implement the innovations into clinical care is important. The objective of this study was to synthesize data on challenges identified by six diverse projects that are part of a National Human Genome Research Institute (NHGRI)-funded network focused on implementing genomics into practice and strategies to overcome these challenges. We used a multiple-case study approach with each project considered as a case and qualitative methods to elicit and describe themes related to implementation challenges and strategies. We describe challenges and strategies in an implementation framework and typology to enable consistent definitions and cross-case comparisons. Strategies were linked to challenges based on expert review and shared themes. Three challenges were identified by all six projects, and strategies to address these challenges varied across the projects. One common challenge was to increase the relative priority of integrating genomics within the health system electronic health record (EHR). Four projects used data warehousing techniques to accomplish the integration. The second common challenge was to strengthen clinicians' knowledge and beliefs about genomic medicine. To overcome this challenge, all projects developed educational materials and conducted meetings and outreach focused on genomic education for clinicians. The third challenge was engaging patients in the genomic medicine projects. Strategies to overcome this challenge included use of mass media to spread the word, actively involving patients in implementation (e.g., a patient advisory board), and preparing patients to be active participants in their healthcare decisions. This is the first collaborative evaluation focusing on the description of genomic medicine innovations implemented in multiple real-world clinical settings. Findings suggest that strategies to facilitate integration of genomic

  1. The safety and efficacy of the Angio-Seal closure device in diagnostic and interventional neuroangiography setting: a single-center experience with 1,443 closures

    Energy Technology Data Exchange (ETDEWEB)

    Geyik, Serdar; Yavuz, Kivilcim; Akgoz, Ayca; Koc, Osman; Peynircioglu, Bora; Cil, Barbaros; Cekirge, Saruhan; Saatci, Isil [Hacettepe University Hospitals, Radiology Department, Ankara (Turkey)

    2007-09-15

    We evaluated the safety and efficacy of the Angio-Seal closure device used to close arterial puncture sites in patients who had undergone diagnostic cerebral angiography and neurointerventional procedures. A total of 1,443 Angio-Seal devices were placed in 1,099 patients in the Interventional Neuroradiology Unit between May 2005 and August 2006. Of these, 670 were interventional and 745 were diagnostic cerebral angiographic procedures. In 28 patients bilateral puncture of the femoral arteries was performed for endovascular treatment. In 167 patients 286 repeat diagnostic procedures were performed and 30 interventional procedures were followed by re-closure with an Angio-Seal device at the time of repeat puncture. The procedural success rate for antegrade closures was 99.7% for all procedures. The device failed in 5 of 745 diagnostic procedures (0.7%). Major complication occurred in one patient only (0.13%) in the diagnostic group. No minor complications were observed in this group. In the interventional group, the major complication rate was 1.4% (10 of 698 closures) and the minor complication rate was 2.4% (17 of 698 closures). However, in the subgroup of patients with cerebral aneurysms who received heparin in combination with antiplatelet agents after the procedure, the major complication rate was 5.3%, but in the carotid/vertebral stenting group it was 0.8%. Our experience in a relatively large series of patients shows that the use of the Angio-Seal STS vascular closure device is safe and effective in patients undergoing cerebral diagnostic angiography and neurointerventional procedures with an acceptable rate of complications, although the complication rate was higher in the group of patients who received heparin and/or antiplatelet medication. (orig.)

  2. Refining the Results of a Classical SELEX Experiment by Expanding the Sequence Data Set of an Aptamer Pool Selected for Protein A

    Directory of Open Access Journals (Sweden)

    Regina Stoltenburg

    2018-02-01

    Full Text Available New, as yet undiscovered aptamers for Protein A were identified by applying next generation sequencing (NGS to a previously selected aptamer pool. This pool was obtained in a classical SELEX (Systematic Evolution of Ligands by EXponential enrichment experiment using the FluMag-SELEX procedure followed by cloning and Sanger sequencing. PA#2/8 was identified as the only Protein A-binding aptamer from the Sanger sequence pool, and was shown to be able to bind intact cells of Staphylococcus aureus. In this study, we show the extension of the SELEX results by re-sequencing of the same aptamer pool using a medium throughput NGS approach and data analysis. Both data pools were compared. They confirm the selection of a highly complex and heterogeneous oligonucleotide pool and show consistently a high content of orphans as well as a similar relative frequency of certain sequence groups. But in contrast to the Sanger data pool, the NGS pool was clearly dominated by one sequence group containing the known Protein A-binding aptamer PA#2/8 as the most frequent sequence in this group. In addition, we found two new sequence groups in the NGS pool represented by PA-C10 and PA-C8, respectively, which also have high specificity for Protein A. Comparative affinity studies reveal differences between the aptamers and confirm that PA#2/8 remains the most potent sequence within the selected aptamer pool reaching affinities in the low nanomolar range of KD = 20 ± 1 nM.

  3. Refining the Results of a Classical SELEX Experiment by Expanding the Sequence Data Set of an Aptamer Pool Selected for Protein A.

    Science.gov (United States)

    Stoltenburg, Regina; Strehlitz, Beate

    2018-02-24

    New, as yet undiscovered aptamers for Protein A were identified by applying next generation sequencing (NGS) to a previously selected aptamer pool. This pool was obtained in a classical SELEX (Systematic Evolution of Ligands by EXponential enrichment) experiment using the FluMag-SELEX procedure followed by cloning and Sanger sequencing. PA#2/8 was identified as the only Protein A-binding aptamer from the Sanger sequence pool, and was shown to be able to bind intact cells of Staphylococcus aureus . In this study, we show the extension of the SELEX results by re-sequencing of the same aptamer pool using a medium throughput NGS approach and data analysis. Both data pools were compared. They confirm the selection of a highly complex and heterogeneous oligonucleotide pool and show consistently a high content of orphans as well as a similar relative frequency of certain sequence groups. But in contrast to the Sanger data pool, the NGS pool was clearly dominated by one sequence group containing the known Protein A-binding aptamer PA#2/8 as the most frequent sequence in this group. In addition, we found two new sequence groups in the NGS pool represented by PA-C10 and PA-C8, respectively, which also have high specificity for Protein A. Comparative affinity studies reveal differences between the aptamers and confirm that PA#2/8 remains the most potent sequence within the selected aptamer pool reaching affinities in the low nanomolar range of K D = 20 ± 1 nM.

  4. Particle physics contribution to the elimination of nuclear waste

    International Nuclear Information System (INIS)

    Revol, Jean-Pierre

    2001-01-01

    My introduction on fundamental research and innovation will explain how CERN, a laboratory which is a priori entirely dedicated to fundamental research, came to contribute to a major challenge of society: the energy problem. I will describe the motivation behind the original experimental effort carried out at CERN (FEAT and TARC experiments) and discuss some of the main elements of the energy problem. Progress in particle accelerator technology makes it possible nowadays to use a proton accelerator to produce energy and eliminate nuclear waste efficiently. The Energy Amplifier proposed by Carlo Rubbia and his group is a subcritical fast neutron system driven by a proton accelerator. It is particularly attractive as it could destroy, through fission, transuranic elements produced by present nuclear reactors. The Energy Amplifier could also efficiently transform long lived fission fragments at minimal cost using the concept of Adiabatic Resonance Crossing (ARC) recently tested at CERN with the TARC experiment. The ARC concept can be extended to several other domains of application (production of radioactive isotopes for medicine and industry, neutron research applications, etc.)

  5. Recruiting and consenting into a peripartum trial in an emergency setting: a qualitative study of the experiences and views of women and healthcare professionals.

    Science.gov (United States)

    Lawton, Julia; Snowdon, Claire; Morrow, Susan; Norman, Jane E; Denison, Fiona C; Hallowell, Nina

    2016-04-11

    Recruiting and consenting women to peripartum trials can be challenging as the women concerned may be anxious, in pain, and exhausted; there may also be limited time for discussion and decision-making to occur. To address these potential difficulties, we undertook a qualitative evaluation of the internal pilot of a trial (Got-it) involving women who had a retained placenta (RP). We explored the experiences and views of women and staff about the information and consent pathway used within the pilot, in order to provide recommendations for use in future peripartum trials involving recruitment in emergency situations. In-depth interviews were undertaken with staff (n = 27) and participating women (n = 22). Interviews were analysed thematically. The accounts of women and staff were compared to identify differences and similarities in their views about recruitment and consent procedures. Women and staff regarded recruitment as having been straightforward and facilitated by the use of simplified (verbal and written) summaries of trial information. Both parties, however, conveyed discordant views about whether fully informed consent had been obtained. These differences in perspectives appeared to arise from the different factors and considerations impinging on women and staff at the time of recruitment. While staff placed emphasis on promoting understanding in the emergency situation of RP by imparting information in clear and succinct ways, women highlighted the experiential realities of their pre- and post-birthing situations, and how these had led to quick decisions being made without full engagement with the potential risks of trial participation. To facilitate informed consent, women suggested that trial information should be given during the antenatal period, and, in doing so, articulated a rights-based discourse. Staff, however, voiced opposition to this approach by emphasising a duty of care to all pregnant women, and raising concerns about causing undue

  6. Gauss Elimination: Workhorse of Linear Algebra.

    Science.gov (United States)

    1995-08-05

    linear algebra computation for solving systems, computing determinants and determining the rank of matrix. All of these are discussed in varying contexts. These include different arithmetic or algebraic setting such as integer arithmetic or polynomial rings as well as conventional real (floating-point) arithmetic. These have effects on both accuracy and complexity analyses of the algorithm. These, too, are covered here. The impact of modern parallel computer architecture on GE is also

  7. Albert Sabin and the Coalition to Eliminate Polio from the Americas.

    Science.gov (United States)

    Hampton, Lee

    2009-01-01

    Albert B. Sabin, MD, developer of the oral polio vaccine, was also a major proponent of its use in annual vaccination campaigns aimed at the elimination of polio. Sabin argued that administering his vaccine simultaneously to every child in a country would break polio's chains of transmission. Although he was already promoting mass vaccination by the 1960s, Sabin's efforts expanded considerably when he became an adviser to groups fighting polio in the Americas in the 1980s. Sabin's experiences provide a window into both the formation of the coalition that eliminated poliomyelitis from the Western Hemisphere and what can happen when biomedical researchers become public health policy advisers. Although the polio elimination coalition succeeded in part because member groups often accommodated each other's priorities, Sabin was often limited by his indifference to the interests of those he was advising and to the shortcomings of his vaccine.

  8. Accumulation and Elimination of 137Cs Radionuclide by gold fish (Cyprinus Carpio)

    International Nuclear Information System (INIS)

    Hiswara, E; Tjahaya, I P; Wahyudi

    1996-01-01

    A study to estimate accumulation and elimination of 137Cs radionuclide by gold fish (Cyprinus Carpio) has been carried out. The experiment used aquarium as a cultivating media. Gold fish was placed into aquarium filled with 70 liter of water and 137Cs concentration of 10 Bq/ml. From the observing time of 40 days it was found that activity concentration in fish became saturated in 30th day. Saturation after the 30th day was confined by additional observation using 137Cs concentration of 5 and 15 Bq/ml. Saturated concentration fish was then transfered to inactive aquarium to determine is elimination rate. Transfer factor, i.e. the ratio of 137Cs concentration in fish to that in water, was found to be (12.99+0.28) ml/g, whereas the elimination rate of 137Cs was found to be 0.046 day, which correspond to a biological half life of 15 days

  9. EPA Enforcement and Compliance History Online: Water Discharge Monitoring Report Data Sets for FY2010

    Data.gov (United States)

    U.S. Environmental Protection Agency — Integrated Compliance Information System (ICIS) National Pollutant Discharge Elimination System (NPDES) Discharge Monitoring Report (DMR) data sets for Clean Water...

  10. EPA Enforcement and Compliance History Online: Water Discharge Monitoring Report Data Sets for FY2015

    Data.gov (United States)

    U.S. Environmental Protection Agency — Integrated Compliance Information System (ICIS) National Pollutant Discharge Elimination System (NPDES) Discharge Monitoring Report (DMR) data sets for Clean Water...

  11. EPA Enforcement and Compliance History Online: Water Discharge Monitoring Report Data Sets for FY2014

    Data.gov (United States)

    U.S. Environmental Protection Agency — Integrated Compliance Information System (ICIS) National Pollutant Discharge Elimination System (NPDES) Discharge Monitoring Report (DMR) data sets for Clean Water...

  12. EPA Enforcement and Compliance History Online: Water Discharge Monitoring Report Data Sets for FY2009

    Data.gov (United States)

    U.S. Environmental Protection Agency — Integrated Compliance Information System (ICIS) National Pollutant Discharge Elimination System (NPDES) Discharge Monitoring Report (DMR) data sets for Clean Water...

  13. EPA Enforcement and Compliance History Online: Water Discharge Monitoring Report Data Sets for FY2016

    Data.gov (United States)

    U.S. Environmental Protection Agency — Integrated Compliance Information System (ICIS) National Pollutant Discharge Elimination System (NPDES) Discharge Monitoring Report (DMR) data sets for Clean Water...