WorldWideScience

Sample records for enhanced protein-energy provision

  1. Protein energy malnutrition.

    Science.gov (United States)

    Grover, Zubin; Ee, Looi C

    2009-10-01

    Protein energy malnutrition (PEM) is a common problem worldwide and occurs in both developing and industrialized nations. In the developing world, it is frequently a result of socioeconomic, political, or environmental factors. In contrast, protein energy malnutrition in the developed world usually occurs in the context of chronic disease. There remains much variation in the criteria used to define malnutrition, with each method having its own limitations. Early recognition, prompt management, and robust follow up are critical for best outcomes in preventing and treating PEM.

  2. evolution of hiv training for enhanced care provision in kenya

    African Journals Online (AJOL)

    in pre-service and in-service HIV training to ensure sustainability. INTRODUCTION. Over the .... workers to ensure provision of quality service delivery. (1). HIV service delivery ... (internal migration) as well as 'brain drain' to wealthier countries ...

  3. Spirituality and Older Adults: Ethical Guidelines to Enhance Service Provision

    Directory of Open Access Journals (Sweden)

    David R. Hodge

    2010-03-01

    Full Text Available Spirituality plays an important role in the lives of many older adults. Consequently, it is not surprising that gerontological social workers frequently engage spirituality in practice settings. The paucity of training gerontological workers have received on this topic, however, is a cause for concern. To help equip workers, three ethical principles are proposed to guide interactions in the area of spirituality. These principles can be summarized as: 1 client autonomy, 2 spiritual competence, and 3 professional competence. The application of these principles in practice settings will enhance the ability of gerontological social workers to interact with older adults’ spirituality in a professional and ethical manner.

  4. Albumin synthesis in protein energy malnutrition

    International Nuclear Information System (INIS)

    Duggan, C.; Hardy, S.; Kleinman, R.E.; Lembcke, J.; Young, V.E.

    1994-01-01

    The dietary treatment of protein-energy malnutrition (PEM) has been designed on an empirical basis, with outcomes for successful management including body weight gain and resolution of apathy. We propose using the measurements of protein synthesis as a more objective measure of renourishment. We will therefore randomize a group of malnourished children (weigh-for-height Z score 13 C-leucine and serial measurements of 13 C-enrichment of albumin. Isotope infusions will be performed on days one and three, following a standard three hour fast. Since albumin synthesis is reduced under the influence of cytokines which mediate the inflammatory response, results will be stratified according to the presence or absence of clinically apparent infections. We hypothesize that the provision of added dietary protein will optimize albumin synthesis rates in PEM as well as attenuate the reduction in albumin synthesis seen in the presence of infections. (author). 20 refs

  5. Performance Enhancements of UMTS networks using end-to-end QoS provisioning

    DEFF Research Database (Denmark)

    Wang, Haibo; Prasad, Devendra; Teyeb, Oumer

    2005-01-01

    This paper investigates the end-to-end(E2E) quality of service(QoS) provisioning approaches for UMTS networks together with DiffServ IP network. The effort was put on QoS classes mapping from DiffServ to UMTS, Access Control(AC), buffering and scheduling optimization. The DiffServ Code Point (DSCP......) was utilized in the whole UMTS QoS provisioning to differentiate different type of traffics. The overall algorithm was optimized to guarantee the E2E QoS parameters of each service class, especially for realtime applications, as well as to improve the bandwidth utilization. Simulation shows that the enhanced...

  6. Albumin synthesis in protein energy malnutrition

    Energy Technology Data Exchange (ETDEWEB)

    Duggan, C; Hardy, S; Kleinman, R E [Harvard Medical School, Boston, MA (United States); Lembcke, J [Instituto de Investigacion Nutricional, La Molina, Lima (Peru); Young, V E [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States). Lab. of Human Nutrition

    1994-12-31

    The dietary treatment of protein-energy malnutrition (PEM) has been designed on an empirical basis, with outcomes for successful management including body weight gain and resolution of apathy. We propose using the measurements of protein synthesis as a more objective measure of renourishment. We will therefore randomize a group of malnourished children (weigh-for-height Z score <-2.0) to receive either a standard (10% of calories as protein) or increased (15%) amount of dietary protein early in their recovery phase. We will calculate albumin synthesis rates via the flooding dose technique, using {sup 13}C-leucine and serial measurements of {sup 13}C-enrichment of albumin. Isotope infusions will be performed on days one and three, following a standard three hour fast. Since albumin synthesis is reduced under the influence of cytokines which mediate the inflammatory response, results will be stratified according to the presence or absence of clinically apparent infections. We hypothesize that the provision of added dietary protein will optimize albumin synthesis rates in PEM as well as attenuate the reduction in albumin synthesis seen in the presence of infections. (author). 20 refs.

  7. [Protein-energy malnutrition in clinical practice].

    Science.gov (United States)

    Necheva, G I; Druk, I V; Lialiukova, E A

    2013-01-01

    The analysis of the reasons and mechanisms of development of an protein-energy malnutrition, communication of fetal pathology and development of an protein-energy malnutrition at mature age is submitted. Systemic character of a syndrome is marked out. Importance of a problem of an protein-energy malnutrition at patients with a dysplasia of a connecting tissue is bound to high prevalence of a syndrome at this pathology.

  8. An Energy-Efficient Approach to Enhance Virtual Sensors Provisioning in Sensor Clouds Environments.

    Science.gov (United States)

    Lemos, Marcus Vinícius de S; Filho, Raimir Holanda; Rabêlo, Ricardo de Andrade L; de Carvalho, Carlos Giovanni N; Mendes, Douglas Lopes de S; Costa, Valney da Gama

    2018-02-26

    Virtual sensors provisioning is a central issue for sensors cloud middleware since it is responsible for selecting physical nodes, usually from Wireless Sensor Networks (WSN) of different owners, to handle user's queries or applications. Recent works perform provisioning by clustering sensor nodes based on the correlation measurements and then selecting as few nodes as possible to preserve WSN energy. However, such works consider only homogeneous nodes (same set of sensors). Therefore, those works are not entirely appropriate for sensor clouds, which in most cases comprises heterogeneous sensor nodes. In this paper, we propose ACxSIMv2, an approach to enhance the provisioning task by considering heterogeneous environments. Two main algorithms form ACxSIMv2. The first one, ACASIMv1, creates multi-dimensional clusters of sensor nodes, taking into account the measurements correlations instead of the physical distance between nodes like most works on literature. Then, the second algorithm, ACOSIMv2, based on an Ant Colony Optimization system, selects an optimal set of sensors nodes from to respond user's queries while attending all parameters and preserving the overall energy consumption. Results from initial experiments show that the approach reduces significantly the sensor cloud energy consumption compared to traditional works, providing a solution to be considered in sensor cloud scenarios.

  9. Quality and the academic library reviewing, assessing and enhancing service provision

    CERN Document Server

    2016-01-01

    Quality and the Academic Library: Reviewing, Assessing and Enhancing Service Provision provides an in-depth review and analysis of quality management and service quality in academic libraries. All aspects of quality are considered in the book, including quality assessment, quality review, and quality enhancement. An overview of quality management and service quality concepts, principles, and methods leads to a detailed consideration of how they have been applied in universities and their libraries. A case study approach is used with different perspectives provided from the different stakeholders involved in the quality processes. All contributors adopt a critical reflection approach, reflecting on the implications, impact, and significance of the activities undertaken and the conclusions that can be drawn for future developments. The book concludes with an overall reflection on quality management and service quality in academic libraries with a final analysis of priorities for the future.

  10. Computed tomography in severe protein energy malnutrition.

    OpenAIRE

    Househam, K C; de Villiers, J F

    1987-01-01

    Computed tomography of the brain was performed on eight children aged 1 to 4 years with severe protein energy malnutrition. Clinical features typical of kwashiorkor were present in all the children studied. Severe cerebral atrophy or brain shrinkage according to standard radiological criteria was present in every case. The findings of this study suggest considerable cerebral insult associated with severe protein energy malnutrition.

  11. Challenges for tree officers to enhance the provision of regulating ecosystem services from urban forests.

    Science.gov (United States)

    Davies, Helen J; Doick, Kieron J; Hudson, Malcolm D; Schreckenberg, Kate

    2017-07-01

    Urbanisation and a changing climate are leading to more frequent and severe flood, heat and air pollution episodes in Britain's cities. Interest in nature-based solutions to these urban problems is growing, with urban forests potentially able to provide a range of regulating ecosystem services such as stormwater attenuation, heat amelioration and air purification. The extent to which these benefits are realized is largely dependent on urban forest management objectives, the availability of funding, and the understanding of ecosystem service concepts within local governments, the primary delivery agents of urban forests. This study aims to establish the extent to which British local authorities actively manage their urban forests for regulating ecosystem services, and identify which resources local authorities most need in order to enhance provision of ecosystem services by Britain's urban forests. Interviews were carried out with staff responsible for tree management decisions in fifteen major local authorities from across Britain, selected on the basis of their urban nature and high population density. Local authorities have a reactive approach to urban forest management, driven by human health and safety concerns and complaints about tree disservices. There is relatively little focus on ensuring provision of regulating ecosystem services, despite awareness by tree officers of the key role that urban forests can play in alleviating chronic air pollution, flood risk and urban heat anomalies. However, this is expected to become a greater focus in future provided that existing constraints - lack of understanding of ecosystem services amongst key stakeholders, limited political support, funding constraints - can be overcome. Our findings suggest that the adoption of a proactive urban forest strategy, underpinned by quantified and valued urban forest-based ecosystem services provision data, and innovative private sector funding mechanisms, can facilitate a change to a

  12. Non-conventional provisions in regional trade agreements : do they enhance international trade?

    OpenAIRE

    Hayakawa, Kazunobu; Kimura, Fukunari; Nabeshima, Kaoru

    2011-01-01

    The scope of recent regional trade agreements (RTAs) is becoming much wider in terms of including several provisions such as competition policy or intellectual property. This paper empirically examines how far advanced, non-conventional provisions in RTAs increase trade values among RTA member countries, by estimating the gravity equation with more disaggregated indicators for RTAs. As a result, we find that the provision on competition policy has the largest impacts on trade values, followin...

  13. Reverse triiodothyronine in protein energy malnutrition

    Energy Technology Data Exchange (ETDEWEB)

    Hafiez, A A; Abdel-Salam, E; Abbas, E Z; Halawa, F A; El-Hefnawy, N [Cairo Univ. (Egypt)

    1984-08-01

    Serum levels of thyroxine (T/sub 4/), triiodothyronine (T/sub 3/), reverse triiodothyronine (rT/sub 3/) and thyrotropin (TSH) were determined in cases of kwashiorkor and marasmus. Decreased levels of T/sub 4/ and T/sub 3/, and increased levels of rT/sub 3/ with no change in TSH were obtained. Thus in infants suffering from protein energy malnutrition there is a state of thyroid dysfunction as well as a shift in the peripheral T/sub 4/ metabolism being converted to the inert rT/sub 3/ rather than to the physiologically active T/sub 3/.

  14. Reverse triiodothyronine in protein energy malnutrition

    International Nuclear Information System (INIS)

    Hafiez, A.A.; Abdel-Salam, E.; Abbas, E.Z.; Halawa, F.A.; El-Hefnawy, N.

    1984-01-01

    Serum levels of thyroxine (T 4 ), triiodothyronine (T 3 ), reverse triiodothyronine (rT 3 ) and thyrotropin (TSH) were determined in cases of kwashiorkor and marasmus. Decreased levels of T 4 and T 3 , and increased levels of rT 3 with no change in TSH were obtained. Thus in infants suffering from protein energy malnutrition there is a state of thyroid dysfunction as well as a shift in the peripheral T 4 metabolism being converted to the inert rT 3 rather than to the physiologically active T 3 . (author)

  15. Nutrition and protein energy homeostasis in elderly.

    Science.gov (United States)

    Boirie, Yves; Morio, Béatrice; Caumon, Elodie; Cano, Noël J

    2014-01-01

    Protein-energy homeostasis is a major determinant of healthy aging. Inadequate nutritional intakes and physical activity, together with endocrine disturbances are associated with of sarcopenia and frailty. Guidelines from scientific societies mainly address the quantitative aspects of protein and energy nutrition in elderly. Besides these quantitative aspects of protein load, perspective strategies to promote muscle protein synthesis and prevent sarcopenia include pulse feeding, the use of fast proteins and the addition of leucine or citrulline to dietary protein. An integrated management of sarcopenia, taking into account the determinants of muscle wasting, i.e. nutrition, physical activity, anabolic factors such as androgens, vitamin D and n-3 polyunsaturated fatty acids status, needs to be tested in the prevention and treatment of sarcopenia. The importance of physical activity, specifically resistance training, is emphasized, not only in order to facilitate muscle protein anabolism but also to increase appetite and food intake in elderly people at risk of malnutrition. According to present data, healthy nutrition in elderly should respect the guidelines for protein and energy requirement, privilege a Mediterranean way of alimentation, and be associated with a regular physical activity. Further issues relate to the identification of the genetics determinants of protein energy wasting in elderly. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Enhancing resource availability in agro-ecosystems for beneficial arthropods through floral provisioning

    Science.gov (United States)

    There has been a decline in beneficial arthropods (insects and spiders) including pollinators because of habitat destruction and intense management practices. Enhancing landscapes with additional floral and other non-crop habitats has the potential to attract pollinators, and predatory arthropods wh...

  17. 78 FR 39233 - Data Practices, Computer III Further Remand: BOC Provision of Enhanced Services

    Science.gov (United States)

    2013-07-01

    ... comparably efficient interconnection (CEI) and open network architecture (ONA) services; proposes eliminating... Further Notice of Proposed Rulemaking, is available for public inspection during regular business hours in... BOCs use for their own enhanced services offerings. The BOCs' ONA plans, based on the architecture of...

  18. Protein-enhanced soups: a consumer-accepted food for increasing dietary protein provision among older adults.

    Science.gov (United States)

    Donahue, Elizabeth; Crowe, Kristi Michele; Lawrence, Jeannine

    2015-02-01

    Protein-enhanced soups (PES) may improve protein intake among older adults. This study examined sensory attributes (aroma, texture, taste, and overall acceptability) and preferences of PES (chicken noodle and cheddar broccoli) compared with flavor-matched control soups (FCS) among older adults (≥65 years) and evaluated dietary profile changes of a standard menu based on the substitution of one PES serving/d for a standard soup. Modified paired preference tests and 5-point facial hedonic scales were administered to participants (n = 44). No significant differences in sensory attributes between either PES compared with FCS were identified, but significant gender- and age-related differences (p preferred protein-enhanced chicken noodle soup while only 38% preferred protein-enhanced cheddar broccoli soup to their respective FCS. Substituting one PES serving for one non-fortified soup serving per day resulted in significantly higher (p < 0.001) protein profile. Results suggest that all attributes of PES were consistent with sensory expectations and PES substitution could improve protein provision.

  19. Evidence acquisition and evaluation for evidence summit on enhancing provision and use of maternal health services through financial incentives.

    Science.gov (United States)

    Higgs, Elizabeth S; Stammer, Emily; Roth, Rebecca; Balster, Robert L

    2013-12-01

    Recognizing the need for evidence to inform US Government and governments of the low- and middle-income countries on efficient, effective maternal health policies, strategies, and programmes, the US Government convened the Evidence Summit on Enhancing Provision and Use of Maternal Health Services through Financial Incentives in April 2012 in Washington, DC, USA. This paper summarizes the background and methods for the acquisition and evaluation of the evidence used for achieving the goals of the Summit. The goal of the Summit was to obtain multidisciplinary expert review of literature to inform both US Government and governments of the low- and middle-income countries on evidence-informed practice, policies, and strategies for financial incentives. Several steps were undertaken to define the tasks for the Summit and identify the appropriate evidence for review. The process began by identifying focal questions intended to inform governments of the low-and middle-income countries and the US Government about the efficacy of supply- and demand-side financial incentives for enhanced provision and use of quality maternal health services. Experts were selected representing the research and programme communities, academia, relevant non-governmental organizations, and government agencies and were assembled into Evidence Review Teams. This was followed by a systematic process to gather relevant peer-reviewed literature that would inform the focal questions. Members of the Evidence Review Teams were invited to add relevant papers not identified in the initial literature review to complete the bibliography. The Evidence Review Teams were asked to comply with a specific evaluation framework for recommendations on practice and policy based on both expert opinion and the quality of the data. Details of the search processes and methods used for screening and quality reviews are described.

  20. Provision of enhanced ancillary services from wind power plants - Examples and challenges

    DEFF Research Database (Denmark)

    Hansen, Anca Daniela; Altin, Müfit; Iov, Florin

    2016-01-01

    Emphasis in this article is on the power system impact of wind power plants capability to provide enhanced ancillary services, i.e. temporary frequency response (TFR) and power oscillation damping (POD). The main objective of the article is to analyze and justify the challenges in the use of TFR...... and POD from wind power plants (WPPs). The study is conducted with an aggregated wind power plant model which is integrated into a generic power system model, specifically designed to assess the targeted ancillary services in a relatively simple, but still relevant environment. Various case studies...... with different wind power penetration levels are considered. The study shows that WPPs can provide additional control features such as TFR and POD to enhance the stability of power systems with large share of wind power. Nevertheless, the results illustrate that the power system stability can be potentially...

  1. Enhancing Evacuation Plans with a Situation Awareness System Based on End-User Knowledge Provision

    Directory of Open Access Journals (Sweden)

    Augusto Morales

    2014-06-01

    Full Text Available Recent disasters have shown that having clearly defined preventive procedures and decisions is a critical component that minimizes evacuation hazards and ensures a rapid and successful evolution of evacuation plans. In this context, we present our Situation-Aware System for enhancing Evacuation Plans (SASEP system, which allows creating end-user business rules that technically support the specific events, conditions and actions related to evacuation plans. An experimental validation was carried out where 32 people faced a simulated emergency situation, 16 of them using SASEP and the other 16 using a legacy system based on static signs. From the results obtained, we compare both techniques and discuss in which situations SASEP offers a better evacuation route option, confirming that it is highly valuable when there is a threat in the evacuation route. In addition, a study about user satisfaction using both systems is presented showing in which cases the systems are assessed as satisfactory, relevant and not frustrating.

  2. Albumin synthesis in protein energy malnutrition

    International Nuclear Information System (INIS)

    Duggan, C.; Hardy, S.; Kleinman, R.E.; Harvard Medical School, Children's Hospital, Boston, MA; Lembcke, J.; Young, V.R.

    1996-01-01

    Assessment of protein nutritional status during re-feeding children with protein energy malnutrition (PEM) can be difficult. We hypothesized that the fractional synthesis rate (FSR) of albumin, as measured by stable isotope technology, would serve as an objective measure of changes in protein status, and that increased amounts of dietary protein (15% of calories vs 10%) would lead to higher FSR. Eight (5 M, 3 F) Peruvian children (mean age 15.5 months) with PEM (mean wt/ht Z score = -2.47) were studied twice during the first week of admission by the flooding dose technique. An intravenous dose of 13 C-leucine (57 mg/kg, 99 atom%) was given and serial blood samples were drawn in intervals up to 90 minutes in order to measure isotopic enrichment of serum albumin. Mean FSR for the day one infusion was 6.11% (range 3.07 - 15.37%) (n = 8). Mean FSR for the follow-up infusion was 7.67% (range 3.63 - 12.37%) (n = 5), and FSR was no different between the two dietary groups. FSR on day one was inversely related to age (r = -0.62), and one patient with Shigella dysentery had the highest FSR (15.9%). We conclude that FSR of albumin can be measured successfully in children with PEM using the flooding dose technique, and that assessment of albumin FSR holds promise to help determine protein requirements and status during recovery from PEM. (author). 14 refs, 6 figs, 3 tabs

  3. Albumin synthesis in protein energy malnutrition

    Energy Technology Data Exchange (ETDEWEB)

    Duggan, C; Hardy, S; Kleinman, R E [Massachusetts General Hospital, Boston, MA (United States); [Harvard Medical School, Children` s Hospital, Boston, MA (United States). Combined Program in Pediatric GI and Nutrition; Lembcke, J [Av. La Universidad S/N - La Molina, Lima (Peru). Inst. de Investigacion Nutricional; Young, V R [Massachussetts Inst. of Technology, Cambridge, MA (United States). Lab. of Human Nutrition

    1997-12-31

    Assessment of protein nutritional status during re-feeding children with protein energy malnutrition (PEM) can be difficult. We hypothesized that the fractional synthesis rate (FSR) of albumin, as measured by stable isotope technology, would serve as an objective measure of changes in protein status, and that increased amounts of dietary protein (15% of calories vs 10%) would lead to higher FSR. Eight (5 M, 3 F) Peruvian children (mean age 15.5 months) with PEM (mean wt/ht Z score = -2.47) were studied twice during the first week of admission by the flooding dose technique. An intravenous dose of {sup 13}C-leucine (57 mg/kg, 99 atom%) was given and serial blood samples were drawn in intervals up to 90 minutes in order to measure isotopic enrichment of serum albumin. Mean FSR for the day one infusion was 6.11% (range 3.07 - 15.37%) (n = 8). Mean FSR for the follow-up infusion was 7.67% (range 3.63 - 12.37%) (n = 5), and FSR was no different between the two dietary groups. FSR on day one was inversely related to age (r = -0.62), and one patient with Shigella dysentery had the highest FSR (15.9%). We conclude that FSR of albumin can be measured successfully in children with PEM using the flooding dose technique, and that assessment of albumin FSR holds promise to help determine protein requirements and status during recovery from PEM. (author). 14 refs, 6 figs, 3 tabs.

  4. Liver Function Status in some Nigerian Children with Protein Energy ...

    African Journals Online (AJOL)

    Objective: To ascertain functional status of the liver in Nigeria Children with Protein energy malnutrition. Materials and Methods: Liver function tests were performed on a total of 88 children with protein energy malnutrition (PEM). These were compared with 22 apparently well-nourished children who served as controls.

  5. Protein energy malnutrition: analysis of admission and outcome ...

    African Journals Online (AJOL)

    Background: Protein energy malnutrition (PEM) is a common condition in our environment. The morbidity and mortality is still high. Method: A retrospective study of 136 children with PEM, aimed at evaluating the outcome of management of children with severe protein energy malnutrition in Ahmadu Bello University ...

  6. Protein, energy and phosphorus supplementation of cattle fed low ...

    African Journals Online (AJOL)

    The effect of protein, energy and phosphorus supplements, fed ..... The results of this experiment confirm the basic concepts that ... article. The lack of response or even negative reaction to energy supplements under these conditions can be ...

  7. potential for quality protein maize for reducing protein- energy

    African Journals Online (AJOL)

    ACSS

    social systems hampering QPM promotion and adoption and to identify ... affects growth and development. Protein- energy ... to purchase QPM seed leading to PEU reduction. Education ..... decision support framework “targetCSA”. Agricultural ...

  8. Children with protein energy malnutrition: management and out ...

    African Journals Online (AJOL)

    Children with protein energy malnutrition: management and out-come in a ... Sahel Medical Journal ... Demographic data, predisposing factors, clinical types of PEM, outcome of management and time of discharge or death were also extracted ...

  9. Everyone Playing in Class: A Group Play Provision for Enhancing the Emotional Well-Being of Children in School

    Science.gov (United States)

    Woolf, Alison

    2011-01-01

    "Everyone Playing in Class" is an unstructured free play based provision for small classes or groups. The intervention involves training staff in attachment theory, presenting up-to-date research findings on the role of play in emotional well-being and relationship building, as well as teaching reflective communication skills. In this…

  10. Protein energy malnutrition increases arginase activity in monocytes and macrophages.

    Science.gov (United States)

    Corware, Karina; Yardley, Vanessa; Mack, Christopher; Schuster, Steffen; Al-Hassi, Hafid; Herath, Shanthi; Bergin, Philip; Modolell, Manuel; Munder, Markus; Müller, Ingrid; Kropf, Pascale

    2014-01-01

    Protein energy malnutrition is commonly associated with immune dysfunctions and is a major factor in susceptibility to infectious diseases. In this study, we evaluated the impact of protein energy malnutrition on the capacity of monocytes and macrophages to upregulate arginase, an enzyme associated with immunosuppression and increased pathogen replication. Our results show that monocytes and macrophages are significantly increased in the bone marrow and blood of mice fed on a protein low diet. No alteration in the capacity of bone marrow derived macrophages isolated from malnourished mice to phagocytose particles, to produce the microbicidal molecule nitric oxide and to kill intracellular Leishmania parasites was detected. However, macrophages and monocytes from malnourished mice express significantly more arginase both in vitro and in vivo. Using an experimental model of visceral leishmaniasis, we show that following protein energy malnutrition, the increased parasite burden measured in the spleen of these mice coincided with increased arginase activity and that macrophages provide a more permissive environment for parasite growth. Taken together, these results identify a novel mechanism in protein energy malnutrition that might contributes to increased susceptibility to infectious diseases by upregulating arginase activity in myeloid cells.

  11. Possible Biochemical Markers in Protein-Energy Malnutrition and ...

    African Journals Online (AJOL)

    This study was carried out to determine possible biochemical markers in children suffering from Plasmodium falciparum malaria and Protein-Energy Malnutrition in a Hospital setting in Western Kenya. Spectrophotometric assays of selected biochemical parameters namely, albumin, total proteins, glucose, glutamate ...

  12. Leucine supplementation in the management of protein energy ...

    African Journals Online (AJOL)

    Objective: To establish if leucine could be used as a therapeutic agent in the treatment of protein energy malnutrition. Study selection: Based on defined key words a search was carried out on Pubmed to retrieve all publications on leucine supplementation and muscle protein synthesis. Only studies that met the search ...

  13. Bone marrow and chelatable iron in patients with protein energy ...

    African Journals Online (AJOL)

    Objectives: To examine the iron status of malnourished children by comparing bone marrow iron deposits in children with protein energy malnutrition with those in well-nourished controls, and measuring chelatable urinary iron excretion in children with kwashiorkor. Design: Bone marrow iron was assessed histologicaHy in ...

  14. Reduction of erythroid progenitors in protein-energy malnutrition.

    Science.gov (United States)

    Borelli, Primavera; Blatt, Solange; Pereira, Juliana; de Maurino, Beatriz Beutler; Tsujita, Maristela; de Souza, Ana Cristina; Xavier, José Guilherme; Fock, Ricardo Ambrósio

    2007-02-01

    Protein-energy malnutrition is a syndrome in which anaemia together with multivitamin and mineral deficiency may be present. The pathophysiological mechanisms involved have not, however, yet been completely elucidated. The aim of the present study was to evaluate the pathophysiological processes that occur in this anaemia in animals that were submitted to protein-energy malnutrition, in particular with respect to Fe concentration and the proliferative activity of haemopoietic cells. For this, histological, histochemical, cell culture and immunophenotyping techniques were used. Two-month-old male Swiss mice were submitted to protein-energy malnutrition with a low-protein diet (20 g/kg) compared with control diet (400 g/kg). When the experimental group had attained a 20 % loss of their original body weight, the animals from both groups received, intravenously, 20 IU erythropoietin every other day for 14 d. Malnourished animals showed a decrease in red blood cells, Hb concentration and reticulocytopenia, as well as severe bone marrow and splenic atrophy. The results for serum Fe, total Fe-binding capacity, transferrin and erythropoietin in malnourished animals were no different from those of the control animals. Fe reserves in the spleen, liver and bone marrow were found to be greater in the malnourished animals. The mixed colony-forming unit assays revealed a smaller production of granulocyte-macrophage colony-forming units, erythroid burst-forming units, erythroid colony-forming units and CD45, CD117, CD119 and CD71 expression in the bone marrow and spleen cells of malnourished animals. These findings suggest that, in this protein-energy malnutrition model, anaemia is not caused by Fe deficiency or erythropoietin deficiency, but is a result of ineffective erythropoiesis.

  15. Protein energy malnutrition predicts complications in liver cirrhosis.

    Science.gov (United States)

    Huisman, Ellen J; Trip, Evelien J; Siersema, Peter D; van Hoek, Bart; van Erpecum, Karel J

    2011-11-01

    Protein energy malnutrition frequently occurs in liver cirrhosis. Hand-grip strength according to Jamar is most reliable to predict protein energy malnutrition. We aimed to determine whether protein energy malnutrition affects complication risk. In 84 cirrhotics, baseline nutritional state was determined and subsequent complications prospectively assessed. Influence of potentially relevant factors including malnutrition (by Jamar hand-grip strength) on complication rates were evaluated with univariate analysis. Effect of malnutrition was subsequently evaluated by multivariate logistic regression with adjustment for possible confounders. Underlying causes of cirrhosis were viral hepatitis in 31%, alcohol in 26%, and other in 43%. Baseline Child-Pugh (CP) class was A, B, or C in 58, 35, and 7%, respectively. Energy and protein intake decreased significantly with increasing CP class, with shift from proteins to carbohydrates. At baseline, according to Jamar hand-grip strength, malnutrition occurred in 67% (n=56). Malnutrition was associated with older age and higher CP class (CP class A 57%, B 79%, C 100%) but not with underlying disease or comorbidity. Complications occurred in 18 and 48% in well-nourished and malnourished patients, respectively, (P=0.007) during 13 ± 6 months follow-up. In multivariate analysis, malnutrition was an independent predictor of complications, after correcting for comorbidity, age, and CP score (adjusted odds ratio 4.230; 95% confidence interval 1.090-16.422; P=0.037). In univariate analysis, mortality (4 vs. 18%; P=0.1) tended to be worse in malnourished patients, but this trend was lost in multivariate analysis. Malnutrition is an independent predictor of complications in cirrhosis.

  16. Drug disposition in obesity and protein-energy malnutrition.

    Science.gov (United States)

    Boullata, Joseph I

    2010-11-01

    Clinical response to medication can differ between patients. Among the known sources of variability is an individual's nutrition status. This review defines some pharmacokinetic terms, provides relevant body size metrics and describes the physiologic influences of protein-energy malnutrition and obesity on drug disposition. Weight-based drug dosing, which presumes a healthy BMI, can be problematic in the protein-energy malnourished or obese patient. The use of total body weight, lean body weight, or an adjusted body weight depends on the drug and how it is differently handled in malnutrition or obesity. Most of the recognized influences are seen in drug distribution and drug elimination as a result of altered body composition and function. Distribution characteristics of each drug are determined by several drug-related factors (e.g. tissue affinity) in combination with body-related factors (e.g. composition). Drug elimination occurs through metabolic and excretory pathways that can also vary with body composition. The current data are limited to select drugs that have been reported in small studies or case reports. In the meantime, a rational approach to evaluate the potential influences of malnutrition and obesity can be used clinically based on available information. Antimicrobials are discussed as a useful example of this approach. Further advancement in this field would require collaboration between experts in body composition and those in drug disposition. Until more data are available, routine monitoring by the clinician of the protein-energy malnourished or obese patient receiving weight-based drug regimens is necessary.

  17. STUDY OF ANEMIA AMONG PROTEIN ENERGY MALNOURISHED CHILDREN IN MYSORE

    Directory of Open Access Journals (Sweden)

    Nayana

    2015-02-01

    Full Text Available INTRODUCTION AND OBJECTIVES : Anemia in Protein energy malnutrition (PEM is common and its pathogenesis is multifactorial. Since the clinico - pathological patterns are reflected by their underlying etiopathogenic factors, it is important to study the associated morbidity and mortalit y and to establish their causes for an effective management. The purpose of the present study is to determine the prevalence, patterns, clinico - pathological and morphological types of anemia in protein energy malnutrition children. The objectives of the st udy are: (1 To study the clinico - pathological and morphological patterns of anemia in PEM children of age group 6 month – 5 years. (2 To assess the resultant morbidity and mortality. (3 To determine the ideal parameter for iron deficiency anemia. METHOD S: This study was conducted on 75 clinically diagnosed Protein energy malnutrition patients of age group 6 months to 5 years. Detailed clinical history elicitation and thorough clinical examination was performed. Peripheral smears of these patients were ex amined. The complete hemogram including reticulocyte count was done. The special investigations like bone marrow study, Hb electrophoresis, iron studies and stool examination were done whenever required. RESULTS: In our study, anemia in PEM affected female population more than the males of age 36 - 47 months. Most of children had Grade III PEM and Microcytic hypochromic anemia was most prevalent. Most of the children had Iron deficiency anemia. This study also indicated that Serum iron assay and TIBC are the better indicators of iron deficiency anemia in patients with PEM and it is the investigation of choice when compared to serum ferritin as it gets falsely elevated in these patients with infections confirmed by elevated CRP level. INTERPRETATION AND CONCLUS ION: Malnutrition, Infection and Anemia show a synergistic relationship. So it necessitates prompt screening and early diagnosis through proper

  18. [Protein-energy malnutrition in patients with connective tissue dysplasia].

    Science.gov (United States)

    Lialiukova, E A

    2013-01-01

    In the conditions of the specialized Center of a dysplasia of a connecting tissue the assessment of an protein--energy malnutrition at 121 patients with signs of a dysplasia of a connecting tissue is carried out. High frequency of an oligotrophy at patients with a dysplasia of a connecting tissue is registered. The I degree of a gipotorofiya is taped at 26.21% of the patients, II degree--at 18.44%, the III degree--at 3.88% of patients.

  19. ENHANCED PROVISIONING ALGORITHM FOR VIRTUAL PRIVATE NETWORK IN HOSE MODEL WITH QUALITY OF SERVICE SUPPORT USING WAXMAN MODEL

    Directory of Open Access Journals (Sweden)

    R. Ravi

    2011-03-01

    Full Text Available As Internet usage grows exponentially, network security issues become increasingly important. Network security measures are needed to protect data during transmission. Various security controls are used to prevent the access of hackers in networks. They are firewall, virtual private networks and encryption algorithms. Out of these, the virtual private network plays a vital role in preventing hackers from accessing the networks. A Virtual Private Network (VPN provides end users with a way to privately access information on their network over a public network infrastructure such as the internet. Using a technique called “Tunneling”, data packets are transmitted across a public routed network, such as the internet that simulates a point-to-point connection. Virtual private networks provide customers with a secure and low-cost communication environment. The basic structure of the virtual circuit is to create a logical path from the source port to the destination port. This path may incorporate many hops between routers for the formation of the circuit. The final, logical path or virtual circuit acts in the same way as a direct connection between the two ports. The K-Cost Optimized Delay Satisfied Virtual Private Networks Tree Provisioning Algorithm connects VPN nodes using a tree structure and attempts to optimize the total bandwidth reserved on the edges of the VPN tree that satisfies the delay requirement. It also allows sharing the bandwidth on the links to improve the performance. The proposed KCDVT algorithm computes the optimal VPN Tree. The performance analysis of the proposed algorithm is carried out in terms of cost, the number of nodes, and the number of VPN nodes, delay, asymmetric ratio and delay with constraints with Breadth First Search Algorithm. The KCDVT performs better than the Breadth First Search Algorithm.

  20. Provisions distributed

    NARCIS (Netherlands)

    Martin Olsthoorn; Evert Pommer; Michiel Ras; Ab van der Torre; Jean Marie Wildeboer Schut

    2017-01-01

    Original title: Voorzieningen verdeeld Citizens ‘profit’ from the government when they receive income support because they are unable to generate an income themselves. They also profit when they make use of provisions such as care, support, education, public transport, sport, culture

  1. Language skills and intelligence quotient of protein energy malnutrition survivors.

    Science.gov (United States)

    Nassar, May F; Shaaban, Sanaa Y; Nassar, Jilan F; Younis, Neveen T; Abdel-Mobdy, Ahmad E

    2012-06-01

    The study was conducted on 33 children aged 3-6 years who suffered from protein energy malnutrition (PEM) during infancy in comparison to 30 matching children to assess the long-term deficits in cognition and language skills. The patients' files were revised to record their admission and follow-up data and history, clinical examination, intelligence quotient and language assessment were done. The study revealed that 2-5 years from the acute attack the PEM patients were still shorter than the controls and their cognitive abilities were poorer. Their mental ages and language skills were mostly determined by their height and the duration of follow-up during their acute illness. Additionally their diet after the 3-5 years is still defective and does not meet their recommended daily allowance. These observations urge us to continue following these patients for longer durations to make sure no permanent damage occurs due to the PEM insult to the growing brain.

  2. Cognitive development in children with chronic protein energy malnutrition

    Directory of Open Access Journals (Sweden)

    Chandramouli B A

    2008-07-01

    Full Text Available Abstract Background Malnutrition is associated with both structural and functional pathology of the brain. A wide range of cognitive deficits has been reported in malnourished children. Effect of chronic protein energy malnutrition (PEM causing stunting and wasting in children could also affect the ongoing development of higher cognitive processes during childhood (>5 years of age. The present study examined the effect of stunted growth on the rate of development of cognitive processes using neuropsychological measures. Methods Twenty children identified as malnourished and twenty as adequately nourished in the age groups of 5–7 years and 8–10 years were examined. NIMHANS neuropsychological battery for children sensitive to the effects of brain dysfunction and age related improvement was employed. The battery consisted of tests of motor speed, attention, visuospatial ability, executive functions, comprehension and learning and memory Results Development of cognitive processes appeared to be governed by both age and nutritional status. Malnourished children performed poor on tests of attention, working memory, learning and memory and visuospatial ability except on the test of motor speed and coordination. Age related improvement was not observed on tests of design fluency, working memory, visual construction, learning and memory in malnourished children. However, age related improvement was observed on tests of attention, visual perception, and verbal comprehension in malnourished children even though the performance was deficient as compared to the performance level of adequately nourished children. Conclusion Chronic protein energy malnutrition (stunting affects the ongoing development of higher cognitive processes during childhood years rather than merely showing a generalized cognitive impairment. Stunting could result in slowing in the age related improvement in certain and not all higher order cognitive processes and may also result in

  3. Protein-Energy Wasting and Mortality in Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Ezio Gianetta

    2011-05-01

    Full Text Available Protein-energy wasting (PEW is common in patients with chronic kidney disease (CKD and is associated with an increased death risk from cardiovascular diseases. However, while even minor renal dysfunction is an independent predictor of adverse cardiovascular prognosis, PEW becomes clinically manifest at an advanced stage, early before or during the dialytic stage. Mechanisms causing loss of muscle protein and fat are complex and not always associated with anorexia, but are linked to several abnormalities that stimulate protein degradation and/or decrease protein synthesis. In addition, data from experimental CKD indicate that uremia specifically blunts the regenerative potential in skeletal muscle, by acting on muscle stem cells. In this discussion recent findings regarding the mechanisms responsible for malnutrition and the increase in cardiovascular risk in CKD patients are discussed. During the course of CKD, the loss of kidney excretory and metabolic functions proceed together with the activation of pathways of endothelial damage, inflammation, acidosis, alterations in insulin signaling and anorexia which are likely to orchestrate net protein catabolism and the PEW syndrome.

  4. Serum transferrin levels in children with protein-energy malnutrition

    Directory of Open Access Journals (Sweden)

    Selime Aydoğdu

    2013-03-01

    Full Text Available Objective: Although the diagnosis of patients with severemalnutrition is easy, it is very difficult to recognize patientswith mild and moderate malnutrition. A variety of methodsattempts to develop for early diagnosis of these cases.In this study, we evaluated the serum transferrin and albuminlevels in children with mild, moderate and severeprotein-energy malnutrition (PEM.Materials and methods: Children admitted to our policlinic,aged between 3 and 25 months, 45 subjects withPEM and 39 healthy subjects (control group were evaluated.According to the Gomez, Waterlow and Kanawatisubjects with PEM were divided in 3 subgroups mild,moderate and severe PEM. Anthropometric measurementsand biochemical results of 4 groups were compared.Results: For albumin levels in mild to moderate PEMgroups, 37.7% sensitivity, and 28.5% specificity, positivepredictive value 54%; negative predictive value 16.6%was found. For severe PEM sensitivity, specificity, positivepredictive value and negative predictive value were71%, 62.5%, 45%, and 83.3% respectively.With respect to the levels of transferrin, a significant differencewas found between mild PEM-control and moderatePEM-control groups (p0.05.Conclusion: Our study results showed that albumin isa weak indicator in mild-moderate PEM. In these cases,serum transferrin level reduces before decreasing of albuminlevel, thus it may be an early sensitive finding thatcan be used as a sensitive parameter in the diagnosis ofearly stages of malnutrition.Key words: Protein energy malnutrition, children, albumin,transferrin

  5. Protein-energy malnutrition: a risk factor for various ailments.

    Science.gov (United States)

    Batool, Rizwana; Butt, Masood Sadiq; Sultan, Muhammad Tauseef; Saeed, Farhan; Naz, Rabia

    2015-01-01

    The wheel of industrialization that spun throughout the last century resulted in urbanization coupled with modifications in lifestyles and dietary habits. However, the communities living in developing economies are facing many problems related to their diet and health. Amongst, the prevalence of nutritional problems especially protein-energy malnutrition (PEM) and micronutrients deficiencies are the rising issues. Moreover, the immunity or susceptibility to infect-parasitic diseases is also directly linked with the nutritional status of the host. Likewise, disease-related malnutrition that includes an inflammatory component is commonly observed in clinical practice thus affecting the quality of life. The PEM is treatable but early detection is a key for its appropriate management. However, controlling the menace of PEM requires an aggressive partnership between the physician and the dietitian. This review mainly attempts to describe the pathophysiology, prevalence and consequences of PEM and aims to highlight the importance of this clinical syndrome and the recent growth in our understanding of the processes behind its development. Some management strategies/remedies to overcome PEM are also the limelight of the article. In the nutshell, early recognition, prompt management, and robust follow up are critical for best outcomes in preventing and treating PEM.

  6. Insulin resistance and protein energy metabolism in patients with advanced chronic kidney disease.

    Science.gov (United States)

    Siew, Edward D; Ikizler, Talat Alp

    2010-01-01

    Insulin resistance (IR), the reciprocal of insulin sensitivity is a known complication of advanced chronic kidney disease (CKD) and is associated with a number of metabolic derangements. The complex metabolic abnormalities observed in CKD such as vitamin D deficiency, obesity, metabolic acidosis, inflammation, and accumulation of "uremic toxins" are believed to contribute to the etiology of IR and acquired defects in the insulin-receptor signaling pathway in this patient population. Only a few investigations have explored the validity of commonly used assessment methods in comparison to gold standard hyperinsulinemic hyperglycemic clamp technique in CKD patients. An important consequence of insulin resistance is its role in the pathogenesis of protein energy wasting, a state of metabolic derangement characterized by loss of somatic and visceral protein stores not entirely accounted for by inadequate nutrient intake. In the general population, insulin resistance has been associated with accelerated protein catabolism. Among end-stage renal disease (ESRD) patients, enhanced muscle protein breakdown has been observed in patients with Type II diabetes compared to ESRD patients without diabetes. In the absence of diabetes mellitus (DM) or severe obesity, insulin resistance is detectable in dialysis patients and strongly associated with increased muscle protein breakdown, primarily mediated by the ubiquitin-proteasome pathway. Recent epidemiological data indicate a survival advantage and better nutritional status in insulin-free Type II DM patients treated with insulin sensitizer thiazolidinediones. Given the high prevalence of protein energy wasting in ESRD and its unequivocal association with adverse clinical outcomes, insulin resistance may represent an important modifiable target for intervention in the ESRD population.

  7. Free Radicals and Antioxidant Status in Protein Energy Malnutrition

    Directory of Open Access Journals (Sweden)

    M. Khare

    2014-01-01

    Full Text Available Background/Objectives. The aim of this study was to evaluate oxidant and antioxidant status in children with different grades of Protein Energy Malnutrition (PEM. Subjects/Methods. A total of two hundred fifty (250 children (age range: 6 months to 5 years living in eastern UP, India, were recruited. One hundred and ninety-three (193 of these children had different grades of PEM (sixty-five (65 children belong to mild, sixty (60 to moderate, and sixty-eight (68 to severe group. Grading in group was done after standardization in weight and height measurements. Fifty-seven (57 children who are age and and sex matched, healthy, and well-nourished were recruited from the local community and used as controls after checking their protein status (clinical nutritional status with height and weight standardization. Redox homeostasis was assessed using spectrophotometric/colorimetric methods. Results. In our study, erythrocyte glutathione (GSH, plasma Cu, Zn-superoxide dismutase (Cu,Zn-SOD,EC 1.15.1.1, ceruloplasmin (Cp, and ascorbic acid were significantly (P<0.001 more decreased in children with malnutrition than controls. Plasma malondialdehyde (MDA, and protein carbonyl (PC were significantly (P<0.001 raised in cases as compared to controls. Conclusion. Stress is created as a result of PEM which is responsible for the overproduction of reactive oxygen species (ROSs. These ROSs will lead to membrane oxidation and thus an increase in lipid peroxidation byproducts such as MDA and protein oxidation byproducts such as PC mainly. Decrease in level of antioxidants suggests an increased defense against oxidant damage. Changes in oxidant and antioxidant levels may be responsible for grading in PEM.

  8. Porcine placenta mitigates protein-energy malnutrition-induced fatigue.

    Science.gov (United States)

    Han, Na-Ra; Kim, Kyu-Yeop; Kim, Myong-Jo; Kim, Min-Ho; Kim, Hyung-Min; Jeong, Hyun-Ja

    2013-01-01

    Fatigue can be caused by a deficiency of nutrition or immune function. The goal of this study was to identify the effects of porcine placenta extract (PPE) and its constituents, amino acids (glutamic acid, glycine, arginine, and proline), on protein-energy malnutrition (PEM)-induced fatigue. Mice were administered a PEM diet and came to immunodeficient status. Simultaneously, the mice were administered PPE or amino acids and a forced swimming test (FST) was performed. We analyzed the levels of fatigue-related factors in serum, splenocytes, and muscles. In the FST, PPE or amino acids significantly decreased immobility times compared with the PEM diet. PPE or amino acids also significantly decreased the serum levels of fatigue-related factors after the FST. Additionally, PPE significantly decreased the levels of fatigue-related muscle parameters after the FST. In this in vitro study, PPE increased the mRNA and protein expression of Ki-67 and promoted the proliferation of splenocytes. PPE or amino acids significantly increased the levels of intracellular calcium and the translocation into the nucleus of nuclear factor of activated T-cells cytoplasmic in stimulated splenocytes. PPE or amino acids significantly decreased the production of fatigue-related inflammatory cytokines in the stimulated splenocytes. Additionally, the translocated levels of nuclear factor-κB in the nucleus and the degradation of the inhibitory protein, IκBα, in the cytosol were inhibited by PPE or amino acids. These results demonstrate that PPE and its constituents regulate PEM-induced fatigue through improving levels of immunity and decreasing fatigue-related factors. PPE may be a potential agent for a recovery from fatigue. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Use of Bee Honey as Alternative Medicine in Protein Energy Deficiency

    OpenAIRE

    Prasetyo, R. Heru; Sandhika, Willy; Susanto, Djoni

    2013-01-01

    The protein energy deficiency cause intestinal villus atrophy and epithel mucous damage. The effect of bee honey on histostructure of intestine was studied in the experimental mice as model of proteinenergy deficiency. The use bee honey in protein-energy deficiency shown to improve intestinal villus atrophy and epithel damage. In conclusion that bee honey can use as alternative medicine in protein energydeficiency

  10. The Influence of Early Protein Energy Malnutrition on Subsequent Behavior and Intellectual Performance.

    Science.gov (United States)

    Gupta, Sarita

    1990-01-01

    Protein-energy malnutrition in early childhood, as seen in many developing countries, influences subsequent behavior and intellectual performance. These impairments are associated with further reduction in fine motor skills and academic performance. (Author)

  11. Fast Flux Test Facility (FFTF) maintenance provisions

    International Nuclear Information System (INIS)

    Marshall, J.L.

    1981-05-01

    The Fast Flux Test Facility (FFTF) was designed with maintainability as a primary parameter, and facilities and provisions were designed into the plant to accommodate the maintenance function. This paper describes the FFTF and its systems. Special maintenance equipment and facilities for performing maintenance on radioactive components are discussed. Maintenance provisions designed into the plant to enhance maintainability are also described

  12. Irisin is Associated with Urotensin II and Protein Energy Wasting in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Wan-Yu He

    2016-02-01

    Full Text Available Aims/Introduction: Irisin is a newly identified myokine which can promote energy expenditure. Urotensin II (UII is identified as the most potent mammalian vasoconstrictor to date. Previous studies showed that UII can aggravate insulin resistance while irisin alleviate insulin resistance. Through this study, it is our aim to elucidate if UII can induce insulin resistance and also have an association with the irisin level in hemodialysis (HD patients. Materials and Methods: One hundred and twenty-eight patients on maintenance hemodialysis treatment and forty healthy subjects were enrolled in this study. Blood irisin concentrations and UII concentrations were measured by ELISA and RIA respectively. The body composition was analyzed by bioelectrical impedance. Results: The serum irisin levels and UII levels were both significantly lower in HD patients in comparison to that of the healthy subjects. The serum irisin levels were lower in HD patients with protein energy wasting than those of the patients without protein energy wasting. The independent determinants of circulating Ln (irisin (the natural logarithm of irisin were UII lean body mass and patients with protein energy wasting. Conclusions: Our results are the first to provide the clinical evidence of the association among irisin, UII, and protein energy wasting. Our results hint that UII and protein energy wasting might inhibit the release or synthesis of irisin from skeletal muscles in HD patients.

  13. Social Housing Provision in Copenhagen

    DEFF Research Database (Denmark)

    Tsenkova, Sasha; Vestergaard, Hedvig

    -profit housing providers, and a wide range of fiscal and regulatory instruments enhancing the competitive performance of the social housing sector. The research analyses recent housing policy measures and their impact on new social housing provision in Copenhagen. The emphasis is on the mix of housing policy......The paper provides an overview of trends and processes of change affecting new social housing provision in Denmark with a focus on Copenhagen. The local responses are reviewed within the context of changes to the unitary national housing system that functions with a robust range of private and non...... instruments implemented in three major policy domains-fiscal, financial and regulatory-to promote the production of new social housing. The system of new social housing provision is examined as a dynamic process of interaction between public and private institutions defining housing policy outcomes...

  14. Protein-energy malnutrition and intellectual abilities : a study of teen-age Ugandan children

    NARCIS (Netherlands)

    Hoorweg, J.C.

    1976-01-01

    This study is concerned with the relation between protein-energy malnutrition and the intellectual abilities of children in Uganda. The findings are based on the investigation of a group of 60 Ugandan boys and girls who became severely malnourished during the first 27 months of their life, resulting

  15. Serum proteinase inhibitors and other serum proteins in protein-energy malnutrition

    NARCIS (Netherlands)

    Schelp, F.P.; Migasena, P.; Pongpaew, P.; SCHREURS W.H.P

    1977-01-01

    1. The concentrations of serum protein albumin, prealbumin and transferrin were determined in twenty-eight cases of protein-energy malnutrition (PEM) with infection, together with the levels of serum proteinase inhibitors (PI), alpha1-antitrypsin (AT), alpha1-antichymotrypsin (Ach),

  16. Practical dietary management of protein energy malnutrition in young children with cow's milk protein allergy.

    Science.gov (United States)

    Meyer, Rosan; Venter, Carina; Fox, Adam T; Shah, Neil

    2012-06-01

    Cow's milk protein allergy (CMPA) affects between 1.9 and 4.9% of infants and young children. This food allergy requires the complete elimination of cow's milk and its derivatives, impacting on nutritional status. The risk of having protein energy malnutrition (PEM) in children with CMPA has been well documented. In 2007, the World Health Organisation published guidelines on the dietary management of PEM, which has impacted on the recommendations and composition on specialist feeds for many chronic diseases, but not on CMPA. The main change in management of the child with PEM is the protein energy ratio and energy requirements. The ideal protein energy ratio lies between 8.9 and 11.5%, which would ensure a deposition of about 70% lean and 30% fat mass. In addition, for optimal catch-up growth between 5 and 10 g/kg/day, energy requirements should be between 105 and 126 kcal/kg/day. Although most current hypoallergenic formulas fall well within the recommendation for protein, there is a problem in achieving energy requirements. As a result, modular additions are often made, disturbing the protein energy ratio or feeds are concentrated, which impacts on osmolality. We therefore aimed to review current guidelines on PEM and how these can be applied in the management of the malnourished child with CMPA. © 2012 John Wiley & Sons A/S.

  17. Protein-energy nutritional status and kidney disease-specific quality of life in hemodialysis patients

    NARCIS (Netherlands)

    Mazairac, A.H.A.; de Wit, G.A.; Penne, E.L.; van der Weerd, N.C.; Grooteman, M.P.C.; van den Dorpel, M.A.; Nube, M.J.; Buskens, E.; Levesque, R.; ter Wee, P.M.; Bots, M.L.; Blankestijn, P.J.

    Objective: Health-related quality of life (HRQOL) is an important outcome in dialysis care. Previous research has related protein-energy nutritional status to generic HRQOL domains, but it is still not clear as to how it relates to HRQOL domains that are unique to hemodialysis patients. Therefore,

  18. Design provisions for safety

    International Nuclear Information System (INIS)

    Birkhofer, A.

    1983-01-01

    Design provisions for safety of nuclear power plants are based on a well balanced concept: the public is protected against a release of radioactive material by multiple barriers. These barriers are protected according to a 'defence-in-depth' principle. The reactor safety concept is primarily aimed at the prevention of accidents, especially fuel damage. Additionally, measures for consequence limitation are provided in order to prevent a severe release of radioactivity to the environment. However, it is difficult to judge the overall effectiveness of such devices. In a comprehensive safety analysis it has to be shown that the protection systems and safeguards work with sufficient reliability in the event of an accident. For the reliability assessment deterministic criteria (single failure, redundancy, fail-safe, demand for diversity) play an important role. Increasing efforts have been made to assess reliability quantitatively by means of probabilistic methods. It is now usual to perform reliability analyses of essential systems of nuclear power plants in the course of licensing procedures. As an additional level of emergency measures for a further reduction of hazards a reasonable amount of accident information has to be transferred. Operational experience may be considered as an important feedback to the design of plant safety features. Operator training has to include, besides skill in performing of operating procedures, the training of a flexible response to different accident situations. Experience has shown that the design provisions for safety could prevent dangerous release of the radioactive material to the environment after an accident has occurred. For future developments of reactor safety, extensive analyses of operating experience are of great importance. The main goal should be to enhance the reliability of measures for accident prevention, which prevent the core from meltdown or other damages

  19. Effect of balanced protein energy supplementation during pregnancy on birth outcomes

    Directory of Open Access Journals (Sweden)

    Bhutta Zulfiqar A

    2011-04-01

    Full Text Available Abstract Background The nutritional status of the mother prior to and during pregnancy plays a vital role in fetal growth and development, and maternal undernourishment may lead to adverse perinatal outcomes including intrauterine growth restriction (IUGR. Several macronutrient interventions had been proposed for adequate protein and energy supplementation during pregnancy. The objective of this paper was to review the effect of balanced protein energy supplementation during pregnancy on birth outcomes. This paper is a part of a series of reviews undertaken for getting estimates of effectiveness of an intervention for input to Lives Saved Tool (LiST model. Methods A literature search was conducted on PubMed, Cochrane Library and WHO regional data bases to identify randomized trials (RCTs and quasi RCTs that evaluated the impact of balanced protein energy supplementation in pregnancy. Balanced protein energy supplementation was defined as nutritional supplementation during pregnancy in which proteins provided less than 25% of the total energy content. Those studies were excluded in which the main intervention was dietary advice to pregnant women for increase in protein energy intake, high protein supplementation (i.e. supplementation in which protein provides at least 25% of total energy content, isocaloric protein supplementation (where protein replaces an equal quantity of non-protein energy content, or low energy diet to pregnant women who are either overweight or who exhibit high weight gain earlier in gestation. The primary outcomes were incidence of small for gestational age (SGA birth, mean birth weight and neonatal mortality. Quality of evidence was evaluated according to the Child Health Epidemiology Reference group (CHERG adaptation of Grading of Recommendations Assessment, Development and Evaluation (GRADE criteria. Results The final number of studies included in our review was eleven comprising of both RCTs and quasi-RCTs. Our meta

  20. Relationship between protein energy malnutrition and social maturity in children aged 1-2 years

    OpenAIRE

    Nurhayati Nurhayati; Soetjiningsih Soetjiningsih; I Ketut G. Suandi

    2006-01-01

    Background Protein energy malnutrition (PEM) affects physical, psychological, and social development. Objective To investigate the relationship between PEM and social maturity in children aged 1-2 years. Methods We carried out a cross-sectional study at Child Health Outpatient Clinic, Sanglah Hospital, betweenApril-September 2000. We included children living with their parents, with no handicap or chronically ill condition. Data were collected by using structured questionnaires. Nutri...

  1. Protein energy malnutrition decreases immunity and increases susceptibility to influenza infection in mice.

    Science.gov (United States)

    Taylor, Andrew K; Cao, Weiping; Vora, Keyur P; De La Cruz, Juan; Shieh, Wun-Ju; Zaki, Sherif R; Katz, Jacqueline M; Sambhara, Suryaprakash; Gangappa, Shivaprakash

    2013-02-01

    Protein energy malnutrition (PEM), a common cause of secondary immune deficiency in children, is associated with an increased risk of infections. Very few studies have addressed the relevance of PEM as a risk factor for influenza. We investigated the influence of PEM on susceptibility to, and immune responses following, influenza virus infection using isocaloric diets providing either adequate protein (AP; 18%) or very low protein (VLP; 2%) in a mouse model. We found that mice maintained on the VLP diet, when compared to mice fed with the AP diet, exhibited more severe disease following influenza infection based on virus persistence, trafficking of inflammatory cell types to the lung tissue, and virus-induced mortality. Furthermore, groups of mice maintained on the VLP diet showed significantly lower virus-specific antibody response and a reduction in influenza nuclear protein-specific CD8(+) T cells compared with mice fed on the AP diet. Importantly, switching diets for the group maintained on the VLP diet to the AP diet improved virus clearance, as well as protective immunity to viral challenge. Our results highlight the impact of protein energy on immunity to influenza infection and suggest that balanced protein energy replenishment may be one strategy to boost immunity against influenza viral infections.

  2. Infant feeding practices and its impact on the prevalence of protein energy malnutrition infant feeding practices and its impact on the prevalence of protein energy malnutrition

    Directory of Open Access Journals (Sweden)

    S Nanda

    1995-09-01

    Full Text Available Protein-Energy-Malnulrition is an important Public Hea Ith Problem among infants and young children. Though poverty is known to be the major fac­tor but faulty feeding habits arising out of ignorance often lead to inadequate intake of essential nutrients by the infant. In order to find out the actual prevailing feeding practices and its impact on the nutritional status of infants this study conducted in one urban andtivo rural units of Varanasi district by adopting appropriate sampling procedure. In a II mothers of360 infants (120 in each study un it were interviewed regarding breastfeeding practices, dilution and nature of top milk, age of introducing supplementaryfeeding etc. It was observed that the o verall prevalence of PEM was sig­nificantly higher in bottle fed group (72.73% than spoonfed group (40.11%. Similarly the prevalence of PEM was 67.86% in late weaned group as compared to 48.38% in optimum weaned group.

  3. Cloud-based Collaborative Business Services Provision

    NARCIS (Netherlands)

    Camarinha-Matos, L.M.; Afsarmanesh, H.; Oliveira, A.I.; Ferrada, F.; Hammoudi, S.; Cordeiro, J.; Maciaszek, L.A.; Filipe, J.

    2014-01-01

    The notion of service-enhanced product, representing the association of services to manufactured products, offers an important mechanism for value creation and product differentiation. This is particularly relevant in the case of complex, highly customized and long-life products. Provision of

  4. Seroprevalence rate of Poliovirus antibodies among the Healthy and Protein Energy Malnutrition children.

    Science.gov (United States)

    Yousuf, Aliya; Syed Shah, Skindar Ali; Syed Jaffery, Imtiaz Ahmed; Ahmed, Syed Azher; Khan, M A Basit; Aslam, Mohammad

    2015-01-01

    To study the association between Protein energy malnutrition and polio-specific immunoglobulin G antibodies production among children in Gadap Town Karachi, Pakistan. Comparative cross sectional survey conducted at fixed EPI center and Pediatric OPD of a tertiary care hospital Karachi. Children were selected by convenient sampling method during the period from 17 March to 17 May 2013. It was ensured that they must have received more than seven oral polio vaccine doses as eligibility criteria for the study. A total of 170 blood samples were collected and tested for the presence of polio-specific IgG antibodies using Poliomyelitis IgG ELISA Test Kit produced. Statistically significant relation was found between PEM and IgG antibodies production OR (P = 0.000). Overall Seroprevalence rate among the study population was 98.8%, PEM group 97.6% and healthy group 100%. The study demonstrated that there is a need to focus on the protein energy malnutrition among the children as an immunization strategy for the 100% seroprevalence rate in all population against polio in Pakistan.

  5. Protein energy malnutrition impairs homeostatic proliferation of memory CD8 T cells.

    Science.gov (United States)

    Iyer, Smita S; Chatraw, Janel Hart; Tan, Wendy G; Wherry, E John; Becker, Todd C; Ahmed, Rafi; Kapasi, Zoher F

    2012-01-01

    Nutrition is a critical but poorly understood determinant of immunity. There is abundant epidemiological evidence linking protein malnutrition to impaired vaccine efficacy and increased susceptibility to infections; yet, the role of dietary protein in immune memory homeostasis remains poorly understood. In this study, we show that protein-energy malnutrition induced in mice by low-protein (LP) feeding has a detrimental impact on CD8 memory. Relative to adequate protein (AP)-fed controls, LP feeding in lymphocytic choriomeningitis virus (LCMV)-immune mice resulted in a 2-fold decrease in LCMV-specific CD8 memory T cells. Adoptive transfer of memory cells, labeled with a division tracking dye, from AP mice into naive LP or AP mice demonstrated that protein-energy malnutrition caused profound defects in homeostatic proliferation. Remarkably, this defect occurred despite the lymphopenic environment in LP hosts. Whereas Ag-specific memory cells in LP and AP hosts were phenotypically similar, memory cells in LP hosts were markedly less responsive to polyinosinic-polycytidylic acid-induced acute proliferative signals. Furthermore, upon recall, memory cells in LP hosts displayed reduced proliferation and protection from challenge with LCMV-clone 13, resulting in impaired viral clearance in the liver. The findings show a metabolic requirement of dietary protein in sustaining functional CD8 memory and suggest that interventions to optimize dietary protein intake may improve vaccine efficacy in malnourished individuals.

  6. Determinants of protein-energy malnutrition in community-dwelling older adults: a systematic review of observational studies.

    Science.gov (United States)

    van der Pols-Vijlbrief, Rachel; Wijnhoven, Hanneke A H; Schaap, Laura A; Terwee, Caroline B; Visser, Marjolein

    2014-11-01

    Protein-energy malnutrition is associated with numerous poor health outcomes, including high health care costs, mortality rates and poor physical functioning in older adults. This systematic literature review aims to identify and provide an evidence based overview of potential determinants of protein-energy malnutrition in community-dwelling older adults. A systematic search was conducted in PUBMED, EMBASE, CINAHL and COCHRANE from the earliest possible date through January 2013. Observational studies that examined determinants of protein-energy malnutrition were selected and a best evidence synthesis was performed to summarize the results. In total 28 studies were included in this review from which 122 unique potential determinants were derived. Thirty-seven determinants were examined in sufficient number of studies and were included in a best evidence synthesis. The best evidence score comprised design (cross-sectional, longitudinal) and quality of the study (high, moderate) to grade the evidence level. Strong evidence for an association with protein-energy malnutrition was found for poor appetite, and moderate evidence for edentulousness, having no diabetes, hospitalization and poor self-reported health. Strong evidence for no association was found for anxiety, chewing difficulty, few friends, living alone, feeling lonely, death of spouse, high number of diseases, heart failure and coronary failure, stroke (CVA) and the use of anti-inflammatory medications. This review shows that protein-energy malnutrition is a multifactorial problem and that different domains likely play a role in the pathway of developing protein-energy malnutrition. These results provide important knowledge for the development of targeted, multifactorial interventions that aim to prevent the development of protein-energy malnutrition in community-dwelling older adults. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. The effect of folic acid, protein energy and multiple micronutrient supplements in pregnancy on stillbirths

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    Bhutta Zulfiqar A

    2011-04-01

    Full Text Available Abstract Background Pregnancy is a state of increased requirement of macro- and micronutrients, and malnourishment or inadequate dietary intake before and during pregnancy, can lead to adverse perinatal outcomes including stillbirths. Many nutritional interventions have been proposed during pregnancy according to the nutritional status of the mother and baseline risk factors for different gestational disorders. In this paper, we have reviewed three nutritional interventions including peri-conceptional folic acid supplementation, balanced protein energy supplementation and multiple micronutrients supplementation during pregnancy. This paper is a part of a series to estimate the effect of interventions on stillbirths for input to Live Saved Tool (LiST model. Methods We systematically reviewed all published literature to identify studies evaluating effectiveness of peri-conceptional folic acid supplementation in reducing neural tube defects (NTD, related stillbirths and balanced protein energy and multiple micronutrients supplementation during pregnancy in reducing all-cause stillbirths. The primary outcome was stillbirths. Meta-analyses were generated where data were available from more than one study. Recommendations were made for the Lives Saved Tool (LiST model based on rules developed by the Child Health Epidemiology Reference Group (CHERG. Results There were 18 studies that addressed peri-conceptional folic acid supplementation for prevention of neural tube defects (NTDs. Out of these, 7 studies addressed folic acid supplementation while 11 studies evaluated effect of folic acid fortification. Pooled results from 11 fortification studies showed that it reduces primary incidence of NTDs by 41 % [Relative risk (RR 0.59; 95 % confidence interval (CI 0.52-0.68]. This estimate has been recommended for inclusion in the LiST as proxy for reduction in stillbirths. Pooled results from three studies considered to be of low quality and suggest that

  8. A narrative review of recent progress in understanding the relationship between tuberculosis and protein energy malnutrition.

    Science.gov (United States)

    Hood, M L H

    2013-11-01

    Protein energy malnutrition (PEM) and tuberculosis (TB) are the major public health issues, particularly in the developing country setting. Malnutrition is an underlying cause of many deaths and when left untreated devastates normal physical and cognitive development. TB continues to gather momentum as a serious infectious killer. They have both rightly been highlighted as important global health issues by their inclusion in the Millennium Development Goals. But what is known of their relationship with one another? It is historically accepted that PEM and TB have a synergistic relationship adversely having an impact on one another. However, researchers have sought to apply this understanding in an examination of the relationship between TB and PEM with often inconclusive results. This narrative review of recently published research and current knowledge may help delineate the association between PEM and TB mortality. Such results will assist future research in this important area of health--an area lacking evidence-based guidance.

  9. Protein-energy malnutrition is frequent and precocious in children with cri du chat syndrome.

    Science.gov (United States)

    Lefranc, Violaine; de Luca, Arnaud; Hankard, Régis

    2016-05-01

    Protein-energy malnutrition (PEM) is poorly reported in cri du chat syndrome (CDCS) (OMIM #123450), a genetic disease that causes developmental delay and global growth retardation. The objective was to determine the nutritional status at different ages in children with CDCS and factors associated with PEM. A questionnaire focused on growth and nutritional care was sent to 190 families. Among 36 analyzable questionnaires, growth and nutritional indices compatible with PEM occurred in 47% of patients: 19% before 6 months of age, 24% between 6-12 months and 34% after 12 months. Eight patients received enteral feeding. Speech therapy for swallowing education was performed more often in malnourished children (63% vs. 22%, P < 0.02). PEM is frequent and occurs early in this disease, requiring closed nutritional monitoring. © 2016 Wiley Periodicals, Inc.

  10. Using megestrol acetate to ameliorate protein-energy wasting in chronic kidney disease.

    Science.gov (United States)

    Smith, Christine Skouberdis; Logomarsino, John V

    2016-03-01

    Various populations are affected by chronic kidney disease (CKD), and a low dose appetite stimulant megestrol acetate (MA) is sometimes recommended in patients with CKD to ameliorate protein-energy wasting (PEW). Patients with CKD are at greater risk of developing PEW since the progression of their disease can cause decreased nutrient intake, catabolic effects, systemic inflammation and metabolic changes. Providers can detect PEW in CKD by identifying low serum levels ≤3.8 g/dl of albumin, protein and energy intake increases from 27% to 42%. There are potential adverse effects of using MA in CKD. After reviewing the available literature, the benefits of using MA should be evaluated against the potential side effects. For further examination of MA's potential benefits, long-term, prospective, large clinical trials should be carried out. © 2015 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  11. The effect of protein-energy levels dietary on Kacang goats performances

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    MuchJi Martawidjaja

    1999-10-01

    Full Text Available An experiment was done to evaluate the protein-energy requirement for growing Kacang goats. Twelve males and 18 female goats, seven to eight months old were used in this study and randomized into three treatment groups, with four and six animals each, and were kept in individual pens. The treatments used were: R1= Elephant grass (E.G. + concentrate C1 (21% CP; 3.9 Mcal GE/kg, R2 = E.G. + concentrate C2 (17% CP; 3.7 Mcal GE/kg, and R3 = E.G. + concentrate C3 (12% CP; 3.5 Mcal GE/kg, respectively. Fresh Elephant grass was offered in restricted, and concentrate was offered at 3% of body weight. The experiment was carried out for 12 weeks. Data were analysed by using factorial completely randomized design 2x3 (3 rations and 2 sexes. Parameters measured were: feed intake; average daily gain and feed conversion. The results indicated that among treatments there was no significant difference on dry matter (DM and gross energy (GE intake (P>0.05, but crude protein (CP intake of R1 was 23,6% higher than treatment R2; treatment R2 was 38.1% higher than R3 (P0.05, but treatment R1 was 36.9% and significantly higher than R3 (P0.05, but ration R1 was more efficient than R3 (P0.05. It was concluded that protein intake and average daily gain were increased, and feed conversion was more efficient as the crude protein-energy levels increased in the ration. Feed intake and average daily gain of male goats were higher and feed conversion was more efficient than the female goats.

  12. Protein-energy supplementation for lambs: feed intake, ingestive behavior, rumen parameters and nutrient digestibility

    Directory of Open Access Journals (Sweden)

    Pâmila Carolini Gonçalves da Silva

    2017-08-01

    Full Text Available The study evaluated the effects of dietary protein-energy supplementation on feed intake, ingestive behavior, rumen parameters and nutrient digestibility in lambs. Four castrated lambs with 31.9 kg mean body weight and fistulated rumen were tested. distributed into latin square design (4x4, four treatments were tested over four periods of time: no supplementation (control or with supplementation at 8, 16 and 24 g kg-1 body weight. The supplement (soybean meal, soybean hulls, ground corn and minerals was provided with roughage (Tifton Bermudagrass, Cynodon spp., hay, which was offered ad libitum once a day, at 8h00. In treatments receiving 0 (control, 8, 16 and 24 g kg-1 supplementation, dry matter intake was 685.26, 742.86, 842.51 and 1013.33 g day-1, crude protein intake was 80.18, 95.98, 118.64, 150.14 g day-1 and metabolizable energy intake 1.55, 1.91, 2.31 and 2.98 g day-1, respectively. Treatments receiving the highest supplementation levels spent less time with rumination and feeding and rested for longer (P < 0.05. Protein-energy supplementation level did not affect rumen parameters. Average rumen pH was 6.3 and rumen ammonia nitrogen 165 mg dL-1; both were affected by sampling time. Supplementation levels until 24 g kg-1 BW improves feed intake and nutrient digestibility linearly and changes ingestive behavior, lowering rumination time without affecting rumen parameters.

  13. Protein-Energy Malnutrition Exacerbates Stroke-Induced Forelimb Abnormalities and Dampens Neuroinflammation.

    Science.gov (United States)

    Alaverdashvili, Mariam; Caine, Sally; Li, Xue; Hackett, Mark J; Bradley, Michael P; Nichol, Helen; Paterson, Phyllis G

    2018-02-03

    Protein-energy malnutrition (PEM) pre-existing at stroke onset is believed to worsen functional outcome, yet the underlying mechanisms are not fully understood. Since brain inflammation is an important modulator of neurological recovery after stroke, we explored the impact of PEM on neuroinflammation in the acute period in relation to stroke-initiated sensori-motor abnormalities. Adult rats were fed a low-protein (LP) or normal protein (NP) diet for 28 days before inducing photothrombotic stroke (St) in the forelimb region of the motor cortex or sham surgery; the diets continued for 3 days after the stroke. Protein-energy status was assessed by a combination of body weight, food intake, serum acute phase proteins and corticosterone, and liver lipid content. Deficits in motor function were evaluated in the horizontal ladder walking and cylinder tasks at 3 days after stroke. The glial response and brain elemental signature were investigated by immunohistochemistry and micro-X-ray fluorescence imaging, respectively. The LP-fed rats reduced food intake, resulting in PEM. Pre-existing PEM augmented stroke-induced abnormalities in forelimb placement accuracy on the ladder; LP-St rats made more errors (29 ± 8%) than the NP-St rats (15 ± 3%; P < 0.05). This was accompanied by attenuated astrogliosis in the peri-infarct area by 18% and reduced microglia activation by up to 41 and 21% in the peri-infarct area and the infarct rim, respectively (P < 0.05). The LP diet altered the cortical Zn, Ca, and Cl signatures (P < 0.05). Our data suggest that proactive treatment of pre-existing PEM could be essential for optimal post-stroke recovery.

  14. [Height and weight growth delay and protein-energy malnutrition in children with chronic dialysis].

    Science.gov (United States)

    Perţea, L; Diaconeasa, Lavinia; Burlea, M; Munteanu, Mihaela; Brumariu, O

    2010-01-01

    Growth retardation is an important problem in children with chronic renal disease, and malnutrition is a determinative factor. The study intends to assess the relationship between protein-energy malnutrition and stature-weight retardation in children enrolled in chronic dialysis program. The study group was composed of 16 children (5 boys and 11 girls--sex ratio of 2.2) hospitalized in the IVth Nephrology Clinic at Clinical Emergency Hospital "St. Maria" Iaşi, 13 rural and 3 urban, aged between 9 and 17 years, with chronic dialysis program. This was a follow-up study during a period of 4 years (2006-2009), resulting in correlations between anthropometric paremeters, biochemical, BIA and DEXA data. The stature-weight deficiency of the 16 patients was as follows: after an average period of 61.7 months of HD and 32.7 months of PD, in children older than 12 years (mean age 15.27 years), 7 of 10 had stature-weight deficits higher than (-3DS) or (-4DS). The group with less than (-2DS) stature-weight deficits showed the same mean age of 15.2 years, the protein energy-malnutrition was present in 2 cases (33%) and was attributed to a dialysis period shorter than 13.8 months. The late diagnosis of the disease (at an average age of 13 years), the long period of chronic dialysis program (over 39.5 months on average) and the early debut of malnutrition are favoring or worsening factors of stature-weight retardation. After correlating ESG with biochemical, BIA and DEXA data, in our group were identified 4 cases of moderate malnutrition and 9 cases of severe malnutrition.

  15. A review of some metabolic changes in protein-energy malnutrition.

    Science.gov (United States)

    Akuyam, S A

    2007-06-01

    Protein-energy malnutrition (PEM) is a major public health problem in the tropical and subtropical regions of the world and often arises during protein and / or energy deficit due to nutritional inadequacy, infections and poor socio-economic and environmental conditions. It is the most common nutritional disorder affecting children in developing countries and the third most common disease of childhood in such countries. PEM has a lasting effect on immune functions, growth and development of children, learning ability, social adjustment, work efficiency and productivity of labour. It seems that many deaths from PEM occur as a result of outdated clinical practices and that improving these practices reduces the rate of morbidity and mortality. This paper reviews various metabolic changes in protein-energy malnutrition (PEM). It gives an overview of the theoretical basis for the understanding of the biochemical derangements in PEM. It aims at stimulating the paediatricians and clinical chemists to read more on the recent advances in this broad subject with the view to improving the understanding of the current laboratory investigation of PEM. This review demonstrates that the metabolic changes in PEM include water and electrolytes imbalance, amino acids and proteins deficiencies, carbohydrates and energy deficiencies, hypolipidaemias, hypolipoproteinaemias, hormonal imbalance, deficiency of anti-oxidant vitamins and enzymes, depression of cell-mediated immune complexes and decrease in amino acids and trace elements in skin and hair. The review therefore suggests that assessment of these conditions in PEM patients could improve the management of this group of patients and hence reduce the rate of morbidity and mortality from PEM.

  16. Enhanced

    Directory of Open Access Journals (Sweden)

    Martin I. Bayala

    2014-06-01

    Full Text Available Land Surface Temperature (LST is a key parameter in the energy balance model. However, the spatial resolution of the retrieved LST from sensors with high temporal resolution is not accurate enough to be used in local-scale studies. To explore the LST–Normalised Difference Vegetation Index relationship potential and obtain thermal images with high spatial resolution, six enhanced image sharpening techniques were assessed: the disaggregation procedure for radiometric surface temperatures (TsHARP, the Dry Edge Quadratic Function, the Difference of Edges (Ts∗DL and three models supported by the relationship of surface temperature and water stress of vegetation (Normalised Difference Water Index, Normalised Difference Infrared Index and Soil wetness index. Energy Balance Station data and in situ measurements were used to validate the enhanced LST images over a mixed agricultural landscape in the sub-humid Pampean Region of Argentina (PRA, during 2006–2010. Landsat Thematic Mapper (TM and Moderate Resolution Imaging Spectroradiometer (EOS-MODIS thermal datasets were assessed for different spatial resolutions (e.g., 960, 720 and 240 m and the performances were compared with global and local TsHARP procedures. Results suggest that the Ts∗DL technique is the most adequate for simulating LST to high spatial resolution over the heterogeneous landscape of a sub-humid region, showing an average root mean square error of less than 1 K.

  17. Leucine supplementation improves acquired growth hormone resistance in rats with protein-energy malnutrition.

    Science.gov (United States)

    Gao, Xuejin; Tian, Feng; Wang, Xinying; Zhao, Jie; Wan, Xiao; Zhang, Li; Wu, Chao; Li, Ning; Li, Jieshou

    2015-01-01

    Protein-energy malnutrition (PEM) can lead to growth hormone (GH) resistance. Leucine supplementation diets have been shown to increase protein synthesis in muscles. Our study aimed at investigating if long-term leucine supplementation could modulate GH-insulin-like growth factor (IGF)-1 system function and mammalian target of rapamycin (mTOR)-related signal transduction in skeletal muscles in a rat model of severe malnutrition. Male Sprague-Dawley rats (n = 50; weight, 302 ± 5 g) were divided into 5 treatment groups, including 2 control groups (a normal control group that was fed chow and ad libitum water [CON, n = 10] and a malnourished control group [MC, n = 10] that was fed a 50% chow diet). After undergoing a weight loss stage for 4 weeks, rats received either the chow diet (MC-CON, n = 10), the chow diet supplemented with low-dose leucine (MC-L, n = 10), or the chow diet supplemented with high-dose leucine (MC-H, n = 10) for 2 weeks. The muscle masses of the gastrocnemius, soleus, and extensor digitorum longus were significantly reduced in the MC group. Re-feeding increased muscle mass, especially in the MC-L and MC-H groups. In the MC group, serum IGF-1, IGF-binding protein (IGFBP)-3, and hepatic growth hormone receptor (GHR) levels were significantly decreased and phosphorylation of the downstream anabolic signaling effectors protein kinase B (Akt), mTOR, and ribosomal protein S6 kinase 1 (S6K1) were significantly lower than in other groups. However, serum IGF-1 and IGF binding protein (IGFBP)-3 concentrations and hepatic growth hormone receptor (GHR) levels were significantly higher in the MC-L and MC-H groups than in the MC-CON group, and serum IGFBP-1 levels was significantly reduced in the MC-L and MC-H groups. These changes were consistent with those observed for hepatic mRNA expression levels. Phosphorylation of the downstream anabolic signaling effectors Akt, mTOR, and S6K1 were also significantly higher in the MC-L and MC-H groups than in the MC

  18. Protein energy malnutrition during vaccination has limited influence on vaccine efficacy but abolishes immunity if administered during Mycobacterium tuberculosis infection

    DEFF Research Database (Denmark)

    Hoang, Truc; Agger, Else Marie; Cassidy, Joseph P

    2015-01-01

    Protein energy malnutrition (PEM) increases susceptibility to infectious diseases, including tuberculosis (TB), but it is not clear how PEM influences vaccine-promoted immunity to TB. We demonstrate that PEM during low-level steady-state TB infection in a mouse model results in rapid relapse...

  19. Nutritional geometry: gorillas prioritize non-protein energy while consuming surplus protein.

    Science.gov (United States)

    Rothman, Jessica M; Raubenheimer, David; Chapman, Colin A

    2011-12-23

    It is widely assumed that terrestrial food webs are built on a nitrogen-limited base and consequently herbivores must compensate through selection of high-protein foods and efficient nitrogen retention. Like many folivorous primates, gorillas' diet selection supports this assumption, as they apparently prefer protein-rich foods. Our study of mountain gorillas (Gorilla beringei) in Uganda revealed that, in some periods, carbohydrate-rich fruits displace a large portion of protein-rich leaves in their diet. We show that non-protein energy (NPE) intake was invariant throughout the year, whereas protein intake was substantially higher when leaves were the major portion of the diet. This pattern of macronutrient intake suggests that gorillas prioritize NPE and, to achieve this when leaves are the major dietary item, they over-eat protein. The concentrations of protein consumed in relation to energy when leaves were the major portion of the diet were close to the maximum recommended for humans and similar to high-protein human weight-loss diets. By contrast, the concentrations of protein in relation to energy when gorillas ate fruit-dominated diets were similar to those recommended for humans. Our results question the generality of nitrogen limitation in terrestrial herbivores and provide a fascinating contrast with human macronutrient intake.

  20. Membrane Protein Stability Analyses by Means of Protein Energy Profiles in Case of Nephrogenic Diabetes Insipidus

    Directory of Open Access Journals (Sweden)

    Florian Heinke

    2012-01-01

    Full Text Available Diabetes insipidus (DI is a rare endocrine, inheritable disorder with low incidences in an estimated one per 25,000–30,000 live births. This disease is characterized by polyuria and compensatory polydypsia. The diverse underlying causes of DI can be central defects, in which no functional arginine vasopressin (AVP is released from the pituitary or can be a result of defects in the kidney (nephrogenic DI, NDI. NDI is a disorder in which patients are unable to concentrate their urine despite the presence of AVP. This antidiuretic hormone regulates the process of water reabsorption from the prourine that is formed in the kidney. It binds to its type-2 receptor (V2R in the kidney induces a cAMP-driven cascade, which leads to the insertion of aquaporin-2 water channels into the apical membrane. Mutations in the genes of V2R and aquaporin-2 often lead to NDI. We investigated a structure model of V2R in its bound and unbound state regarding protein stability using a novel protein energy profile approach. Furthermore, these techniques were applied to the wild-type and selected mutations of aquaporin-2. We show that our results correspond well to experimental water ux analysis, which confirms the applicability of our theoretical approach to equivalent problems.

  1. The influence of childhood protein energy malnutrition on serum ghrelin and leptin levels

    International Nuclear Information System (INIS)

    Mostafa, A.M.

    2007-01-01

    Protein-energy malnutrition (PEM) is a clinical problem caused by inadequate intake of one or more nutritional elements and remains as one of the most important health problems in developing countries. The aim of this study is to investigate the influence of PEM on ghrelin and leptin levels and to determine the relationships of ghrelin and leptin concentrations with anthropometric measurements in malnourished children. The study group consisted of 24 infants diagnosed as PEM. They were classified into marasmic group (10), kwashiorkor group (8) and marasmic kwashiorkor group (b). Ten healthy infants were enrolled as the control group. Serum ghrelin was evaluated by enzyme linked immuno absorbent assay (ELISA) while serum leptin was determined by radioimmunoassay (RIA). Patients with PEM established a significantly lower midarm circumference, skin fold thickness, (W/A) Z, (W/H) Z, BMI, total proteins, serum albumin, cholesterol and triglycerides compared with the age-matched control group. Markedly elevated mean serum ghrelin levels (448.7± 185.82, 293.83±155.02 and 354.1±90.1 vs 20.97± 8.61 pg/ml, p

  2. Infant Feeding Practices And Its Impact On The Prevalence Of Protein Energy- Malnutrition

    Directory of Open Access Journals (Sweden)

    S Nanda

    1995-09-01

    Full Text Available Protein-Energy-Malnulrition is an important Public Hea Ith Problem among infants and young children. Though poverty is known to be the major fac­tor but faulty feeding habits arising out of ignorance often lead to inadequate intake of essential nutrients by the infant. In order to find out the actual prevailing feeding practices and its impact on the nutritional status of infants this study conducted in one urban andtivo rural units of Varanasi district by adopting appropriate sampling procedure. In a II mothers of360 infants (120 in each study un it were interviewed regarding breastfeeding practices, dilution and nature of top milk, age of introducing supplementaryfeeding etc. It was observed that the o verall prevalence of PEM was sig­nificantly higher in bottle fed group (72.73% than spoonfed group (40.11%. Similarly the prevalence of PEM was 67.86% in late weaned group as compared to 48.38% in optimum weaned group.

  3. Nutritional geometry: gorillas prioritize non-protein energy while consuming surplus protein

    Science.gov (United States)

    Rothman, Jessica M.; Raubenheimer, David; Chapman, Colin A.

    2011-01-01

    It is widely assumed that terrestrial food webs are built on a nitrogen-limited base and consequently herbivores must compensate through selection of high-protein foods and efficient nitrogen retention. Like many folivorous primates, gorillas' diet selection supports this assumption, as they apparently prefer protein-rich foods. Our study of mountain gorillas (Gorilla beringei) in Uganda revealed that, in some periods, carbohydrate-rich fruits displace a large portion of protein-rich leaves in their diet. We show that non-protein energy (NPE) intake was invariant throughout the year, whereas protein intake was substantially higher when leaves were the major portion of the diet. This pattern of macronutrient intake suggests that gorillas prioritize NPE and, to achieve this when leaves are the major dietary item, they over-eat protein. The concentrations of protein consumed in relation to energy when leaves were the major portion of the diet were close to the maximum recommended for humans and similar to high-protein human weight-loss diets. By contrast, the concentrations of protein in relation to energy when gorillas ate fruit-dominated diets were similar to those recommended for humans. Our results question the generality of nitrogen limitation in terrestrial herbivores and provide a fascinating contrast with human macronutrient intake. PMID:21632622

  4. Pathophysiological changes that affect drug disposition in protein-energy malnourished children

    Directory of Open Access Journals (Sweden)

    Oshikoya Kazeem A

    2009-12-01

    Full Text Available Abstract Protein-energy malnutrition (PEM is a major public health problem affecting a high proportion of infants and older children world-wide and accounts for a high childhood morbidity and mortality in the developing countries. The epidemiology of PEM has been extensively studied globally and management guidelines formulated by the World Health Organization (WHO. A wide spectrum of infections such as measles, malaria, acute respiratory tract infection, intestinal parasitosis, tuberculosis and HIV/AIDS may complicate PEM with two or more infections co-existing. Thus, numerous drugs may be required to treat the patients. In-spite of abundant literature on the epidemiology and management of PEM, focus on metabolism and therapeutic drug monitoring is lacking. A sound knowledge of pathophysiology of PEM and pharmacology of the drugs frequently used for their treatment is required for safe and rational treatment. In this review, we discuss the pathophysiological changes in children with PEM that may affect the disposition of drugs frequently used for their treatment. This review has established abnormal disposition of drugs in children with PEM that may require dosage modification. However, the relevance of these abnormalities to the clinical management of PEM remains inconclusive. At present, there are no good indications for drug dosage modification in PEM; but for drug safety purposes, further studies are required to accurately determine dosages of drugs frequently used for children with PEM.

  5. Relationship between protein energy malnutrition and social maturity in children aged 1-2 years

    Directory of Open Access Journals (Sweden)

    Nurhayati Nurhayati

    2006-12-01

    Full Text Available Background Protein energy malnutrition (PEM affects physical, psychological, and social development. Objective To investigate the relationship between PEM and social maturity in children aged 1-2 years. Methods We carried out a cross-sectional study at Child Health Outpatient Clinic, Sanglah Hospital, betweenApril-September 2000. We included children living with their parents, with no handicap or chronically ill condition. Data were collected by using structured questionnaires. Nutritional status was determined based on WHO-NCHS standard, while social maturity was measured by Vineland social maturity scale. Results Of the 200 subjects analyzed, the mean age was 16.9 months (SD 3.8, body weight 10.2 kg (SD 1.7 and social quotient (SQ score 94.3(SD 10.6. There was a significant correlation between SQ and PEM (B-7.5, CI 95%-10.6;-4.3, p<0.001 parents' occupation (B4.9, CI 95% 2.2-7.7, P<0.001 and mothers' education (B4.2,CI 95% 1.0-7.4, P<0.001. Conclusion This study revealed that the more severe the PEM, the lower the SQ, while the better the education and occupation, the higher the SQ was.

  6. 1Protein Energy Malnutrition Impairs Homeostatic Proliferation of Memory CD8 T cells

    Science.gov (United States)

    Iyer, Smita S.; Chatraw, Janel Hart; Tan, Wendy G.; Wherry, E. John; Becker, Todd C.; Ahmed, Rafi; Kapasi, Zoher F.

    2011-01-01

    Nutrition is a critical but poorly understood determinant of immunity. There is abundant epidemiological evidence linking protein malnutrition to impaired vaccine efficacy and increased susceptibility to infections; yet, the role of dietary protein in immune memory homeostasis remains poorly understood. Here we show that protein energy malnutrition (PEM) induced in mice by low-protein (LP) feeding has a detrimental impact on CD8 memory. Relative to adequate-protein (AP) fed controls, LP feeding in lymphocytic choriomeningitis virus (LCMV) immune mice resulted in a 2-fold decrease in LCMV-specific CD8 memory T cells. Adoptive transfer of memory cells, labeled with a division tracking dye, from AP mice into naive LP or AP mice demonstrated that PEM caused profound defects in homeostatic proliferation. Remarkably, this defect occurred despite the lymphopenic environment in LP hosts. While antigen-specific memory cells in LP and AP hosts were phenotypically similar, memory cells in LP hosts were markedly less-responsive to poly(I:C)-induced acute proliferative signals. Furthermore, upon recall, memory cells in LP hosts displayed reduced proliferation and protection from challenge with LCMV-clone 13 resulting in impaired viral clearance in the liver. The findings show a metabolic requirement of dietary protein in sustaining functional CD8 memory and suggest that interventions to optimize dietary protein intake may improve vaccine efficacy in malnourished individuals. PMID:22116826

  7. Rutin (quercetin rutinoside) induced protein-energy malnutrition in chronic kidney disease, but quercetin acted beneficially.

    Science.gov (United States)

    Hsieh, Chiu-Lan; Peng, Chiung-Chi; Chen, Kuan-Chou; Peng, Robert Y

    2013-07-31

    Nutraceutically, much of the literature has indicated that an aglycon and its related glycoside would act similarly. However, controversial reports are accumulating. We hypothesize that rutin (RT) and quercetin (QT) pharmacodynamically could act differently. To confirm this, doxorubicin (DR) (8.5 mg/kg) was used to induce rat chronic kidney disease (CKD) and then treated with QT and RT (each 70 mg/kg body weight per day) for 13 weeks. QT exhibited better body weight gaining effect (420 ± 45) vs RT, 350 ± 57 g/rat (p protein-energy malnutrition". RT stimulated serum creatinine (sCr) production to reach 6.0 ± 0.9 mg/dL (p < 0.001). QT did not alter the sCr level. RT but not QT induced uremia and hypercreatininemia. DR significantly downregulated Bcl-2, but highly upregulated Bax, Bad, and cleaved caspase-3, implicating the intrinsic mitochondrial pathway. DR damaged DNA, but QT completely rescued such an effect and recovered renal amyloidosis and collagen deposition. Conclusively, RT and QT act differently, and RT is inferior to QT with respect to treating CKD.

  8. Protein-energy malnutrition alters thermoregulatory homeostasis and the response to brain ischemia.

    Science.gov (United States)

    Smith, Shari E; Prosser-Loose, Erin J; Colbourne, Frederick; Paterson, Phyllis G

    2011-02-01

    Co-existing protein-energy malnutrition (PEM), characterized by deficits in both protein and energy status, impairs functional outcome following global ischemia and has been associated with increased reactive gliosis. Since temperature is a key determinant of brain damage following an ischemic insult, the objective was to investigate whether alterations in post-ischemic temperature regulation contribute to PEM-induced reactive gliosis following ischemia. Male Sprague-Dawley rats (190-280 g) were assigned to either control diet (18% protein) or PEM induced by feeding a low protein diet (2% protein) for 7 days prior to either global ischemia or sham surgery. There was a rapid disruption in thermoregulatory function in rats fed the low protein diet as assessed by continuous recording of core temperature with bio-electrical sensor transmitters. Both daily temperature fluctuation and mean temperature increased within the first 24 hours, and these remained significantly elevated throughout the 7 day pre-ischemic period (p protein diet rapidly impairs the ability to maintain thermoregulatory homeostasis, and the resultant PEM also diminishes the ability to thermoregulate in response to a challenge. Since temperature regulation is a key determinant of brain injury following ischemia, these findings suggest that the pathophysiology of brain injury could be altered in stroke victims with coexisting PEM.

  9. Hepatoprotective and nephroprotective effects of Cnidoscolus aconitifolius in protein energy malnutrition induced liver and kidney damage.

    Science.gov (United States)

    Oyagbemi, Ademola A; Odetola, Adebimpe A

    2013-10-01

    This study was designed to evaluate the ameliorative and hypocholesterolemic effects of dietary supplementation of Cnidoscolus aconitifolius leaf meal (CALM) on hepatic injury and kidney injury associated with protein energy malnutrition (PEM). In this study, PEM was induced in weaning male Wistar albino rats by feeding them with low protein diet for 2 weeks. The effects of several recovery diets containing 20% soya protein or 20% C. aconitifolius in place of soya protein or 10% soya proteins with 10% C. aconitifolius or commercial rat feed were assessed in PEM rats. Plasma biochemical parameters were assessed as well. After the induction of PEM, results obtained showed significant increase in alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total proteins (T.P), total bilirubin (T.Bil), triglycerides, total cholesterol, low density lipoproteins (LDL), blood urea nitrogen (BUN), and creatinine with significant reduction in plasma high density lipoproteins (HDL), albumin, sodium (Na(+)), potassium (K(+)), chloride (Cl(-)), bicarbonate (HC03(-)), and phosphate (P04(2-)) in PEM rats. Upon introduction of recovery diets containing 20% soya protein or 20% C. aconitifolius in place of soya protein or 10% soya proteins with 10% C. aconitifolius or commercial rat feed for 4 weeks caused significant (P protein deficient diets has a protective role against hepatic injury and renal damage associated with PEM.

  10. Protein-Energy Malnutrition Causes Deficits in Motor Function in Adult Male Rats.

    Science.gov (United States)

    Alaverdashvili, Mariam; Li, Xue; Paterson, Phyllis G

    2015-11-01

    Adult protein-energy malnutrition (PEM) often occurs in combination with neurological disorders affecting hand use and walking ability. The independent effects of PEM on motor function are not well characterized and may be obscured by these comorbidities. Our goal was to undertake a comprehensive evaluation of sensorimotor function with the onset and progression of PEM in an adult male rat model. In Expt. 1 and Expt. 2, male Sprague-Dawley rats (14-15 wk old) were assigned ad libitum access for 4 wk to normal-protein (NP) or low-protein (LP) diets containing 12.5% and 0.5% protein, respectively. Expt. 1 assessed muscle strength, balance, and skilled walking ability on days 2, 8, and 27 by bar-holding, cylinder, and horizontal ladder walking tasks, respectively. In addition to food intake and body weight, nutritional status was determined on days 3, 9, and 28 by serum acute-phase reactant and corticosterone concentrations and liver lipids. Expt. 2 addressed the effect of an LP diet on hindlimb muscle size. PEM evolved over time in rats consuming the LP diet. Total food intake decreased by 24% compared with the NP group. On day 28, body weight and serum albumin decreased by 31% and 26%, respectively, and serum α2-macroglobulin increased by 445% (P malnutrition. This model can be used in combination with disease models of sensorimotor deficits to examine the interactions between nutritional status, other treatments, and disease progression. © 2015 American Society for Nutrition.

  11. Protein energy malnutrition associates with different types of hearing impairments in toddlers: Anemia increases cochlear dysfunction.

    Science.gov (United States)

    Kamel, Terez Boshra; Deraz, Tharwat Ezzat; Elkabarity, Rasha H; Ahmed, Rasha K

    2016-06-01

    This work aimed to highlight a challenging asymptomatic problem which is early detection of hearing impairment in toddlers with protein energy malnutrition (PEM) as a neuro-cognitive effect of PEM on developing brain in relation to hemoglobin level. 100 toddlers, aged 6-24 months, fifty with moderate/severe PEM and fifty healthy children, were included in study. Both TEOAEs and ABR testing were used to assess auditory function. Study reported an association between malnutrition and hearing impairment, 26% of cases had conductive deafness secondary to otitis media with effusion using tympanometry; 84.6% showed type B and 15.4% type C which may suggest developing or resolving otitis media. Their ABR showed 46% mild and 53% moderate impairment. 32% of PEM cases had sensory neural hearing loss and with type (A) tympanometry. Those were assessed using ABR; 58% had mild, 34% moderate and 8% profound impairment. 10% of PEM cases had mixed hearing loss with 50% type B and 50% type C tympanometry and their ABR showed moderate to profound impairment. TEOAEs latencies at different frequencies correlate negatively with hemoglobin level. Toddlers with moderate/severe PEM had hearing impairments of different types and degrees. Neuro-physiological methods could be early and safe detectors of auditory disorders especially in high-risk toddlers. Anemia increases risk for auditory dysfunction. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Protein energy malnutrition alters mucosal IgA responses and reduces mucosal vaccine efficacy in mice.

    Science.gov (United States)

    Rho, Semi; Kim, Heejoo; Shim, Seung Hyun; Lee, Seung Young; Kim, Min Jung; Yang, Bo-Gie; Jang, Myoung Ho; Han, Byung Woo; Song, Man Ki; Czerkinsky, Cecil; Kim, Jae-Ouk

    2017-10-01

    Oral vaccine responsiveness is often lower in children from less developed countries. Childhood malnutrition may be associated with poor immune response to oral vaccines. The present study was designed to investigate whether protein energy malnutrition (PEM) impairs B cell immunity and ultimately reduces oral vaccine efficacy in a mouse model. Purified isocaloric diets containing low protein (1/10 the protein of the control diet) were used to determine the effect of PEM. PEM increased both nonspecific total IgA and oral antigen-specific IgA in serum without alteration of gut permeability. However, PEM decreased oral antigen-specific IgA in feces, which is consistent with decreased expression of polymeric Immunoglobulin receptor (pIgR) in the small intestine. Of note, polymeric IgA was predominant in serum under PEM. In addition, PEM altered B cell development status in the bone marrow and increased the frequency of IgA-secreting B cells, as well as IgA secretion by long-lived plasma cells in the small intestinal lamina propria. Moreover, PEM reduced the protective efficacy of the mucosally administered cholera vaccine and recombinant attenuated Salmonella enterica serovar Typhimurium vaccine in a mouse model. Our results suggest that PEM can impair mucosal immunity where IgA plays an important role in host protection and may partly explain the reduced efficacy of oral vaccines in malnourished subjects. Copyright © 2017 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

  13. Serum adiponectin and protein-energy wasting in predialysis chronic kidney disease.

    Science.gov (United States)

    Hyun, Young Youl; Lee, Kyu-Beck; Oh, Kook-Hwan; Ahn, Curie; Park, Sue Kyung; Chae, Dong Wan; Yoo, Tae-Hyun; Cho, Kyu Hun; Kim, Yong-Soo; Hwang, Young-Hwan

    2017-01-01

    Adiponectin (ADPN) has antiatherogenic, anti-inflammatory, and insulin-sensitizing effects. Serum ADPN levels are increased in patients with chronic kidney diseases (CKD), and higher ADPN is paradoxically a predictor of mortality in these patients. The aim of this study was to determine the association between serum ADPN levels and protein-energy wasting (PEW) in predialysis CKD. We examined serum ADPN concentrations and PEW in 1303 patients from the KNOW-CKD (KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease) study. PEW was defined as the presence of three or more of the following four indicators: serum albumin protein intake patients, 72 (5.5%) had PEW. In multivariate logistic regression analysis, higher ADPN level was associated with PEW (odds ratio, 1.04; 95% confidence interval [CI], 1.01-1.08 by 1 μg/mL ADPN). The highest ADPN quartile was associated with PEW in comparison with the lowest quartile (odds ratio, 10.54; 95% CI, 1.28-86.74). In multiple linear regression with PEW indicators, ADPN was more strongly associated with UCE (β = -2.21; 95% CI, -4.13 to -0.28; R 2  = 0.67). High ADPN is independently associated with PEW. Among PEW indicators, serum ADPN is closely associated with UCE as an indirect measure of muscle mass. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Parallel changes in cortical neuron biochemistry and motor function in protein-energy malnourished adult rats.

    Science.gov (United States)

    Alaverdashvili, Mariam; Hackett, Mark J; Caine, Sally; Paterson, Phyllis G

    2017-04-01

    While protein-energy malnutrition in the adult has been reported to induce motor abnormalities and exaggerate motor deficits caused by stroke, it is not known if alterations in mature cortical neurons contribute to the functional deficits. Therefore, we explored if PEM in adult rats provoked changes in the biochemical profile of neurons in the forelimb and hindlimb regions of the motor cortex. Fourier transform infrared spectroscopic imaging using a synchrotron generated light source revealed for the first time altered lipid composition in neurons and subcellular domains (cytosol and nuclei) in a cortical layer and region-specific manner. This change measured by the area under the curve of the δ(CH 2 ) band may indicate modifications in membrane fluidity. These PEM-induced biochemical changes were associated with the development of abnormalities in forelimb use and posture. The findings of this study provide a mechanism by which PEM, if not treated, could exacerbate the course of various neurological disorders and diminish treatment efficacy. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Studies on the Predisposing Factors of Protein Energy Malnutrition Among Pregnant Women in a Nigerian Community

    Directory of Open Access Journals (Sweden)

    Okwu GN

    2008-01-01

    Full Text Available Protein Energy Malnutrition (PEM continues to be a major public health problem in developing countries and affects mostly infants, young children, pregnant and lactating mothers. This study was carried on some of the factors that predispose pregnant women to PEM and hence identify groups at greater risk. A total of 1387 pregnant women (910 in the urban area and 477 in the rural areas were recruited for the study. Anthropometric indices of weight, height and Body Mass Index (BMI of the pregnant women were measured and semi structured questionnaires were used to elicit information on possible predisposing factors such as age, level of education, parity, child spacing etc. Results obtained showed that the mean weight and height of the rural pregnant women, were significantly (p<0.0001 lower than those of the urban pregnant women. The mean BMI of the rural subjects, was also significantly (p< 0.0027 lower than that of the urban subjects. Analysis of the effect of age showed that the younger age category (24 years and below had significantly (p<0.0001 lower mean BMI and higher prevalence of PEM while the effect of level of education showed significantly (p<0006 lower mean BMI and higher PEM prevalence among the less educated (no formal and primary education. Those with parity of two, one and primipara showed significantly (p<0.0175 lower mean BMI while child spacing did not have any significant effect on both mean BMI and prevalence of PEM. The implications of these findings are discussed and recommendations made on how to tackle the problem.

  16. Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

    Energy Technology Data Exchange (ETDEWEB)

    Pasquini, T.A.S. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Neder, H.D. [Instituto de Economia, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Araújo-Junqueira, L. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); De-Souza, D.A. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Departamento de Clínica Médica e Curso de Nutrição, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil)

    2012-12-17

    Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant.

  17. Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

    International Nuclear Information System (INIS)

    Pasquini, T.A.S.; Neder, H.D.; Araújo-Junqueira, L.; De-Souza, D.A.

    2012-01-01

    Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant

  18. Energy requirements, protein-energy metabolism and balance, and carbohydrates in preterm infants.

    Science.gov (United States)

    Hay, William W; Brown, Laura D; Denne, Scott C

    2014-01-01

    Energy is necessary for all vital functions of the body at molecular, cellular, organ, and systemic levels. Preterm infants have minimum energy requirements for basal metabolism and growth, but also have requirements for unique physiology and metabolism that influence energy expenditure. These include body size, postnatal age, physical activity, dietary intake, environmental temperatures, energy losses in the stool and urine, and clinical conditions and diseases, as well as changes in body composition. Both energy and protein are necessary to produce normal rates of growth. Carbohydrates (primarily glucose) are principle sources of energy for the brain and heart until lipid oxidation develops over several days to weeks after birth. A higher protein/energy ratio is necessary in most preterm infants to approximate normal intrauterine growth rates. Lean tissue is predominantly produced during early gestation, which continues through to term. During later gestation, fat accretion in adipose tissue adds increasingly large caloric requirements to the lean tissue growth. Once protein intake is sufficient to promote net lean body accretion, additional energy primarily produces more body fat, which increases almost linearly at energy intakes >80-90 kcal/kg/day in normal, healthy preterm infants. Rapid gains in adiposity have the potential to produce later life obesity, an increasingly recognized risk of excessive energy intake. In addition to fundamental requirements for glucose, protein, and fat, a variety of non-glucose carbohydrates found in human milk may have important roles in promoting growth and development, as well as production of a gut microbiome that could protect against necrotizing enterocolitis. © 2014 S. Karger AG, Basel.

  19. Effect of early childhood protein-energy malnutrition on permanent dentition dental caries.

    Science.gov (United States)

    Reyes-Perez, Elisandra; Borrell, Luisa N; Katz, Ralph V; Gebrian, Bette J; Prophete, Samuel; Psoter, Walter J

    2014-01-01

    The objective of this study is to determine the effect of early childhood protein-energy malnutrition (ECPEM) on decayed, missing, filled tooth (DMFT) scores in the permanent dentition of rural Haitian adolescents aged 11-19 years (n = 1,006). We used data from a retrospective cohort that was developed from the Haitian Health Foundation database and merged records on weight-for-age covering the birth through 5-year-old period for all enrolled participants. Dental examinations and interviewer-administered structured questionnaires on demographic and socioeconomic status, and relative sugar consumption were completed in 1,058 participants aged 11-19 years. The ECPEM was defined based on weight-for-age of the subjects during their first 5 years of life that were converted to Z-scores based on the National Center for Health Statistics referent database. Descriptive statistics were calculated. DMFT was regressed on ECPEM adjusting for age, sex, current body mass index Z-score, socioeconomic status, relative sugar consumption, and number of permanent teeth present assuming a Poisson distribution. Questionable malnutrition [rate ratio (RR) = 0.72; 95 percent confidence interval (CI), 0.61-0.86] and malnutrition (RR = 0.58; 95 percent CI, 0.49-0.69) were associated with a statistically significant lower DMFT in Haitian adolescents. ECPEM status is inversely associated with DMFT in Haitian participants. Further follow-up of these same participants will be recommended to evaluate the potential caries catch-up effect. © 2013 American Association of Public Health Dentistry.

  20. Protein energy-malnutrition: does the in vitro zinc sulfate supplementation improve chromosomal damage repair?

    Science.gov (United States)

    Padula, Gisel; González, Horacio F; Varea, Ana; Seoane, Analía I

    2014-12-01

    Protein-energy malnutrition (PEM) is originated by a cellular imbalance between nutrient/energy supply and body's demand. Induction of genetic damage by PEM was reported. The purpose of this study was to determine the genetic effect of the in vitro zinc sulfate (ZnSO4) supplementation of cultured peripheral blood lymphocytes from children with PEM. Twenty-four samples from 12 children were analyzed. Anthropometric and biochemical diagnosis was made. For the anthropometric assessment, height-for-age index, weight-for-age index, and weight-for-height index were calculated (WHO, 2005). Micronutrient status was evaluated. A survey for assessed previous exposure to potentially genotoxic agents was applied. Results were statistically evaluated using paired sample t test and χ (2) test. Each sample was fractionated and cultured in two separate flasks to performed two treatments. One was added with 180 μg/dl of ZnSO4 (PEMs/ZnSO4) and the other remains non-supplemented (PEMs). Cytotoxic effects and chromosomal damage were assessed using the cytokinesis-block micronucleus assay (CBMN). All participants have at least one type of malnutrition and none have anemia, nor iron, folate, vitamin A, and zinc deficiency. All PEMs/ZnSO4 samples have a significant reduction in the micronucleus (MNi) frequency compared with PEMs (t = 6.25685; p < 0.001). Nuclear division index (NDI) increase in PEMs/ZnSO4 (t = -17.4226; p < 0.001). Nucleoplasmic bridge (NPBs) frequency was four times smaller in PEMs/ZnSO4 (χ (2) = 40.82; p < 0.001). No nuclear buds (NBuds) were observed. Cytotoxic effects and chromosomal damage observed in children suffering from PEM can be repaired in vitro with zinc sulfate supplementation.

  1. Prognostic significance of low skeletal muscle mass compared with protein-energy malnutrition in liver cirrhosis.

    Science.gov (United States)

    Nishikawa, Hiroki; Enomoto, Hirayuki; Ishii, Akio; Iwata, Yoshinori; Miyamoto, Yuho; Ishii, Noriko; Yuri, Yukihisa; Takata, Ryo; Hasegawa, Kunihiro; Nakano, Chikage; Nishimura, Takashi; Yoh, Kazunori; Aizawa, Nobuhiro; Sakai, Yoshiyuki; Ikeda, Naoto; Takashima, Tomoyuki; Iijima, Hiroko; Nishiguchi, Shuhei

    2017-09-01

    To investigate the impact of low skeletal muscle mass (LSMM) on survival as compared with protein-energy malnutrition (PEM) in patients with liver cirrhosis (LC). A total of 206 individuals with LC were analyzed. We retrospectively examined the impact of LSMM, as defined by psoas muscle mass at the third lumber on computed tomography, on survival as compared with PEM. In terms of comparison of the effects of LSMM and PEM on survival, we used time-dependent receiver operating characteristics (ROC) analysis. Our study cohort included 115 men and 91 women with a median age of 67 years. There were 140 patients with Child-Pugh A, 62 with Child-Pugh B, and 4 with Child-Pugh C. A total of 117 patients (56.8%) had LSMM and 52 patients (25.2%) had PEM. The proportion of PEM in patients with LSMM (31.62%, 37/117) was significantly higher than in patients without LSMM (16.85%, 15/89) (P = 0.0229). In the multivariate analysis for the entire cohort, the presence of hepatocellular carcinoma, lower body mass index, presence of LSMM, lower triglyceride value, poorer renal function, and higher des-γ-carboxy prothrombin value were found to be significant adverse predictors linked to overall survival, while presence of PEM tended to be significant. In the time-dependent ROC analysis, all area under the ROCs for survival in LSMM at each time point were higher than those in PEM except for Child-Pugh B patients. In this comparison of LSMM and PEM on clinical outcomes in LC patients, it was shown that LSMM may have stronger prognostic impact than PEM. © 2016 The Japan Society of Hepatology.

  2. Convergence of a diabetes mellitus, protein energy malnutrition, and TB epidemic: the neglected elderly population.

    Science.gov (United States)

    Menon, Sonia; Rossi, Rodolfo; Nshimyumukiza, Leon; Wusiman, Aibibula; Zdraveska, Natasha; Eldin, Manal Shams

    2016-07-26

    On a global scale, nearly two billion persons are infected with Mycobacterium tuberculosis. From this vast reservoir of latent tuberculosis (TB) infection, a substantial number will develop active TB during their lifetime, with some being able to transmit TB or Multi-drug- resistant (MDR) TB to others. There is clinical evidence pointing to a higher prevalence of infectious diseases including TB among individuals with Diabetes Mellitus (DM). Furthermore, ageing and diabetes mellitus may further aggravate protein-energy malnutrition (PEM), which in turn impairs T-lymphocyte mediated immunologic defenses, thereby increasing the risk of developing active TB and compromising TB treatment. This article aims to a) highlight synergistic mechanisms associated with immunosenescence, DM and PEM in relation to the development of active TB and b) identify nutritional, clinical and epidemiological research gaps. To explore the synergistic relationship between ageing, DM, tuberculosis and PEM, a comprehensive review was undertaken. The MEDLINE and the Google Scholar databases were searched for articles published from 1990 to March 2015, using different MESH keywords in various combinations. Ageing and DM act synergistically to reduce levels of interferon gamma (IFN- γ), thereby increasing susceptibility to TB, for which cell mediated immunity (CMI) plays an instrumental role. These processes can set in motion a vicious nutritional cycle which can predispose to PEM, further impairing the CMI and consequently limiting host defenses. This ultimately transforms the latent TB infection into active disease. A clinical diagnostic algorithm and clinical guidelines need to be established for this population. Given the increase in ageing population with DM and PEM, especially in resource-poor settings, these synergistic tripartite interactions must be examined if a burgeoning TB epidemic is to be averted. Implementation of a comprehensive, all-encompassing approach to curb transmission

  3. Hematologic and bone marrow changes in children with protein-energy malnutrition.

    Science.gov (United States)

    Özkale, Murat; Sipahi, Tansu

    2014-05-01

    All systems in an organism are affected by protein-energy malnutrition (PEM), but one of the worst affected is the hematopoietic system. Today PEM remains a very serious problem in developing countries. We examined the relationships between clinical features, hematological, and bone marrow changes with severe PEM from Turkey. We evaluated 34 (11 females and 23 males) consecutive cases of severe PEM, with no underlying diseases aged 3-20 months. The clinical nutritional conditions of the patients were determined using the Wellcome-Trust PEM classification. Ten of the patients were in the Marasmic-Kwashiorkor (M-K) group, 10 were in the Kwashiorkor (KW) group, and 14 were in the Marasmic (M) group. Full blood count, protein, albumin, serum iron (SI), iron-binding capacity (TIBC), ferritin, vitamin B12, folic acid, complement-3 (C3), complement-4 (C4), and bone marrow were investigated in all groups. Anemia was detected in 97% of patients. We determined serum iron levels were low in 67.6% of the patients, TS levels were low in 76.4% of the patients and ferritin levels were low in 20.5%. The level of vitamin B12 was normal in all patients. Bone marrow analysis showed erythroid series hypoplasia in 28.5% of patients in the M group, 50% in the KW group, and 30% in the M-K group. Marrow iron was absent in 58.8% of patients. The most common hematologic change in the children with PEM was anemia and major cause of anemia was iron deficiency in this study. Patients with severe PEM have normal Vit B12 and serum folate levels. Most of the patients with severe PEM had normal cellularity with megaloblastic and dysplastic changes in bone marrow due to the inadequate and imbalanced intake of protein and energy.

  4. Effects of protein-energy malnutrition on NF-kappaB signalling in murine peritoneal macrophages.

    Science.gov (United States)

    Fock, Ricardo Ambrósio; Rogero, Marcelo Macedo; Vinolo, Marco Aurélio Ramirez; Curi, Rui; Borges, Maria Carolina; Borelli, Primavera

    2010-04-01

    Protein-energy malnutrition (PEM) is an important public health problem affecting millions of people worldwide. PEM decreases resistance to infection, impairing a number of physiological processes. In unstimulated cells, NF-kappaB is kept from binding to its consensus sequence by the inhibitor I kappaB alpha, which retains NF-kappaB in the cytoplasm. Upon various signals, such as lipopolysaccharide (LPS), I kappaB alpha is rapidly degraded and NF-kappaB is induced to translocate into the nucleus, where it activates expression of various genes that participate in the inflammatory response, including those involved in the synthesis of TNF-alpha. TRAF-6 is a cytoplasmic adapter protein that links the stimulatory signal from Toll like receptor-4 to NF-kappaB. The aim of this study was to evaluate the effect of malnutrition on induction of TNF-alpha by LPS in murine peritoneal macrophages. We evaluated peritoneal cellularity, the expression of MyD88, TRAF-6, IKK, I kappaB alpha and NF-kappaB, NF-kappaB activation and TNF-alpha mRNA and protein synthesis in macrophages. Two-month-old male BALB/C mice were submitted to PEM with a low-protein diet that contained 2% protein, compared to 12% protein in the control diet. When the experimental group had lost about 20% of the original body weight, it was used in the subsequent experiments. Malnourished animals presented anemia, leucopenia and severe reduction in peritoneal cavity cellularity. TNF-alpha mRNA and protein levels of macrophages stimulated with LPS were significantly lower in malnourished animals. PEM also decreased TRAF-6 expression and NF-kappaB activation after LPS stimulation. These results led us to conclude that PEM changes NF-kB signalling pathway in macrophages to LPS stimulus.

  5. Associations of Dietary Protein and Energy Intakes With Protein-Energy Wasting Syndrome in Hemodialysis Patients.

    Science.gov (United States)

    Beddhu, Srinivasan; Wei, Guo; Chen, Xiaorui; Boucher, Robert; Kiani, Rabia; Raj, Dominic; Chonchol, Michel; Greene, Tom; Murtaugh, Maureen A

    2017-09-01

    The associations of dietary protein and/or energy intakes with protein or energy wasting in patients on maintenance hemodialysis are controversial. We examined these in the Hemodialysis (HEMO) Study. In 1487 participants in the HEMO Study, baseline dietary protein intake (grams per kilogram per day) and dietary energy intake (kilocalories per kilograms per day) were related to the presence of the protein-energy wasting (PEW) syndrome at month 12 (defined as the presence of at least 1 criteria in 2 of the 3 categories of low serum chemistry, low body mass, and low muscle mass) in logistic regression models. In additional separate models, protein intake estimated from equilibrated normalized protein catabolic rate (enPCR) was also related to the PEW syndrome. Compared with the lowest quartile, the highest quartile of baseline dietary protein intake was paradoxically associated with increased risk of the PEW syndrome at month 12 (odds ratio [OR]: 4.11; 95% confidence interval [CI]: 2.79-6.05). This relationship was completely attenuated (OR: 1.35; 95% CI: 0.88-2.06) with adjustment for baseline body weight, which suggested mathematical coupling. Results were similar for dietary energy intake. Compared with the lowest quartile of baseline enPCR, the highest quartile was not associated with the PEW syndrome at 12 months (OR: 0.78; 95% CI: 0.54-1.12). These data do not support the use of dietary protein intake or dietary energy intake criteria in the definition of the PEW syndrome in patients on maintenance hemodialysis.

  6. Protein-energy wasting syndrome in advanced chronic kidney disease: prevalence and specific clinical characteristics.

    Science.gov (United States)

    Pérez-Torres, Almudena; González Garcia, M Elena; San José-Valiente, Belén; Bajo Rubio, M Auxiliadora; Celadilla Diez, Olga; López-Sobaler, Ana M; Selgas, Rafael

    Protein-energy wasting (PEW) is associated with increased mortality and differs depending on the chronic kidney disease (CKD) stage and the dialysis technique. The prevalence in non-dialysis patients is understudied and ranges from 0 to 40.8%. To evaluate the nutritional status of a group of Spanish advanced CKD patients by PEW criteria and subjective global assessment (SGA). Cross-sectional study of 186 patients (101 men) with a mean age of 66.1±16 years. The nutritional assessment consisted of: SGA, PEW criteria, 3-day dietary records, anthropometric parameters and bioelectrical impedance vector analysis. The prevalence of PEW was 30.1%, with significant differences between men and women (22.8 vs. 33.8%, p intake. Women had higher levels of total cholesterol, HDL and a higher body fat percentage. The characteristics of patients with PEW were low albumin levels and a low total lymphocyte count, high proteinuria, low fat and muscle mass and a high Na/K ratio. The multivariate analysis found PEW to be associated with: proteinuria (OR: 1.257; 95% CI: 1.084-1.457, p=0.002), percentage of fat intake (OR: 0.903; 95% CI: 0.893-0.983, p=0.008), total lymphocyte count (OR: 0.999; 95% CI: 0.998-0.999, p=0.001) and cell mass index (OR: 0.995; 95% CI: 0.992-0.998). Malnutrition was identified in Spanish advanced CKD patients measured by different tools. We consider it appropriate to adapt new diagnostic elements to PEW criteria. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Serum hyaluronic acid predicts protein-energy malnutrition in chronic hepatitis C.

    Science.gov (United States)

    Nishikawa, Hiroki; Enomoto, Hirayuki; Yoh, Kazunori; Iwata, Yoshinori; Hasegawa, Kunihiro; Nakano, Chikage; Takata, Ryo; Kishino, Kyohei; Shimono, Yoshihiro; Sakai, Yoshiyuki; Nishimura, Takashi; Aizawa, Nobuhiro; Ikeda, Naoto; Takashima, Tomoyuki; Ishii, Akio; Iijima, Hiroko; Nishiguchi, Shuhei

    2016-06-01

    Serum hyaluronic acid (HA) is a well-established marker of fibrosis in patients with chronic liver disease (CLD). However, the relationship between serum HA level and protein-energy malnutrition (PEM) in patients with CLD is an unknown. We aimed to examine the relationship between serum HA level and PEM in patients with chronic hepatitis C (CHC) compared with the relationships of other serum markers of fibrosis. A total of 298 CHC subjects were analyzed. We defined patients with serum albumin level of ≤3.5 g/dL and nonprotein respiratory quotient <0.85 using indirect calorimetry as having PEM. We investigated the effect of serum HA level on the presence of PEM. Receiver operating characteristic curve (ROC) analysis was performed for calculating the area under the ROC (AUROC) for serum HA level, platelet count, aspartate aminotransferase (AST) to platelet ratio index, FIB-4 index, AST to alanine aminotransferase ratio, and Forns index for the presence of PEM. The median serum HA level in this study was 148.0 ng/mL (range: 9.0-6340.0 ng/mL). In terms of the degree of liver function (chronic hepatitis, Child-Pugh A, B, and C), the analyzed patients were well stratified according to serum HA level (overall significance, P < 0.0001). The median value (range) of serum HA level in patients with PEM (n = 61) was 389.0 ng/mL (43.6-6340.0 ng/mL) and that in patients without PEM (n = 237) was 103.0 ng/mL (9.0-783.0 ng/mL) (P < 0.0001). Among 6 fibrosis markers, serum HA level yielded the highest AUROC with a level of 0.849 at an optimal cut-off value of 151.0 ng/mL (sensitivity 93.4%; specificity 62.0%; P < 0.0001). In the multivariate analysis, serum HA level was found to be a significant prognostic factor related to the presence of PEM (P = 0.0001).In conclusion, serum HA level can be a useful predictor of PEM in patients with CHC.

  8. Factors Associated With Protein-energy Malnutrition in Chronic Liver Disease: Analysis Using Indirect Calorimetry.

    Science.gov (United States)

    Nishikawa, Hiroki; Yoh, Kazunori; Enomoto, Hirayuki; Iwata, Yoshinori; Kishino, Kyohei; Shimono, Yoshihiro; Hasegawa, Kunihiro; Nakano, Chikage; Takata, Ryo; Nishimura, Takashi; Aizawa, Nobuhiro; Sakai, Yoshiyuki; Ikeda, Naoto; Takashima, Tomoyuki; Ishii, Akio; Iijima, Hiroko; Nishiguchi, Shuhei

    2016-01-01

    We aimed to elucidate the incidence of protein-energy malnutrition (PEM) in patients with chronic liver disease and to identify factors linked to the presence of PEM.A total of 432 patients with chronic liver disease were analyzed in the current analysis. We defined patients with serum albumin level of ≤3.5 g/dL and nonprotein respiratory quotient (npRQ) value using indirect calorimetry less than 0.85 as those with PEM. We compared between patients with PEM and those without PEM in baseline characteristics and examined factors linked to the presence of PEM using univariate and multivariate analyses.There are 216 patients with chronic hepatitis, 123 with Child-Pugh A, 80 with Child-Pugh B, and 13 with Child-Pugh C. Six patients (2.8%) had PEM in patients with chronic hepatitis, 17 (13.8%) in patients with Child-Pugh A, 42 (52.5%) in patients with Child-Pugh B, and 10 (76.9%) in patients with Child-Pugh C (P < 0.001). Multivariate analysis revealed that Child-Pugh classification (P < 0.001), age ≥64 years (P = 0.0428), aspartate aminotransferase (AST) ≥40 IU/L (P = 0.0023), and branched-chain amino acid to tyrosine ratio (BTR) ≤5.2 (P = 0.0328) were independent predictors linked to the presence of PEM. On the basis of numbers of above risk factors (age, AST, and BTR), the proportions of patients with PEM were well stratified especially in patients with early chronic hepatitis or Child-Pugh A (n = 339, P < 0.0001), while the proportions of patients with PEM tended to be well stratified in patients with Child-Pugh B or C (n = 93, P = 0.0673).Age, AST, and BTR can be useful markers for identifying PEM especially in patients with early stage of chronic liver disease.

  9. Hybrid resource provisioning for clouds

    International Nuclear Information System (INIS)

    Rahman, Mahfuzur; Graham, Peter

    2012-01-01

    Flexible resource provisioning, the assignment of virtual machines (VMs) to physical machine, is a key requirement for cloud computing. To achieve 'provisioning elasticity', the cloud needs to manage its available resources on demand. A-priori, static, VM provisioning introduces no runtime overhead but fails to deal with unanticipated changes in resource demands. Dynamic provisioning addresses this problem but introduces runtime overhead. To reduce VM management overhead so more useful work can be done and to also avoid sub-optimal provisioning we propose a hybrid approach that combines static and dynamic provisioning. The idea is to adapt a good initial static placement of VMs in response to evolving load characteristics, using live migration, as long as the overhead of doing so is low and the effectiveness is high. When this is no longer so, we trigger a revised static placement. (Thus, we are essentially applying local multi-objective optimization to tune a global optimization with reduced overhead.) This approach requires a complicated migration decision algorithm based on current and predicted:future workloads, power consumptions and memory usage in the host machines as well as network burst characteristics for the various possible VM multiplexings (combinations of VMs on a host). A further challenge is to identify those characteristics of the dynamic provisioning that should trigger static re-provisioning.

  10. Collaborative Business Services Provision

    NARCIS (Netherlands)

    Camarinha-Matos, L.M.; Afsarmanesh, H.; Oliveira, A.I.; Ferrada, F.; Hammoudi, S.; Maciaszek, L.A.; Cordeiro, J.; Dietz, J.L.G.

    2013-01-01

    The association of services to manufactured products, leading to service-enhanced products, is an important mechanism for value creation and differentiation. This is particularly relevant in the case of complex, highly customized and long-life products. Suitable servicing in this context typically

  11. 50 CFR 71.12 - General provisions.

    Science.gov (United States)

    2010-10-01

    ....12 General provisions. The following provisions shall apply to public sport fishing on a national... fish hatchery area. (e) Each person shall comply with the provisions of any special notices governing...

  12. Serum vitamin D status in children with protein-energy malnutrition admitted to a national referral hospital in Uganda.

    Science.gov (United States)

    Nabeta, Henry W; Kasolo, Josephine; Kiggundu, Reuben K; Kiragga, Agnes N; Kiguli, Sarah

    2015-09-07

    Vitamin D deficiency is a world-wide epidemic with recent estimates indicating that greater than 50% of the global population is at risk. In Uganda, 80% of healthy community children in a survey were found to be vitamin D insufficient. Protein-energy malnutrition is likely to be associated with vitamin D intake deficiency. The aim of this study was to determine the prevalence of vitamin D deficiency and the associated factors among children admitted with protein-energy malnutrition to the pediatrics wards of Mulago hospital in Kampala, Uganda. Consecutive sampling was done with 158 children, aged 6-24 months, enrolled in a cross sectional study. One hundred and seventeen malnourished and 41 non malnourished children were enrolled from the Acute Care unit, pediatrics in-patient wards, outpatient and immunization clinics, following informed consent obtained from the children's parents/guardians. Children with protein energy malnutrition were categorized based on anthropometric measurements of weight-for-height and weight for length compared with the recommended WHO reference Z-score. Serum 25-hydroxyvitamin D, calcium and phosphate were assayed. One hundred seventeen malnourished and 41 non malnourished children were enrolled. The majority of study participants were male, 91 (57.6%). The mean serum vitamin D levels among the malnourished was 32.5 mmol/L (±12.0 SD) and 32.2 mmol/L (10.9 SD) among the malnourished, p = 0.868. Fifteen (36.6%) of the non malnourished children and 51 (43.6%) of the malnourished had suboptimal levels, p = 0.689. Malnourished children admitted with meningitis and cerebral palsy had lower serum vitamin D levels than those with other infections. There was no statistically significant difference in vitamin D values between the malnourished and non malnourished children. Clinicians should actively screen for children for serum vitamin D levels regardless of nutritional status.

  13. [Dietary prevention of protein-energy malnutrition during early postoperative period in elderly patients with gastroduodenal diseases].

    Science.gov (United States)

    Baranovskiĭ, A Iu; Protopopova, O B

    2012-01-01

    The modified diet of postoperative rehabilitation program in elderly patients with gastroduodenal ulcers and prognosis of development of protein-energy malnutrition (PEM) is presented. It is shown that early initiated special diet in postoperative period, blocks mechanisms of malnutrition and can significantly improve the functional status of the small intestine and activate, thus, membrane digestion, which leads to normalization of all types of metabolism in elderly patients. In comparison with control group, where 72% of patients in postoperative period had malnutrition, malnutrition in the study group revealed a mild degree in only 17.3% of patients.

  14. Protein-energy wasting syndrome in advanced chronic kidney disease: Prevalence and specific clinical characteristics

    Directory of Open Access Journals (Sweden)

    Almudena Pérez-Torres

    2018-03-01

    Full Text Available Introduction: Protein-energy wasting (PEW is associated with increased mortality and differs depending on the chronic kidney disease (CKD stage and the dialysis technique. The prevalence in non-dialysis patients is understudied and ranges from 0 to 40.8%. Objective: To evaluate the nutritional status of a group of Spanish advanced CKD patients by PEW criteria and subjective global assessment (SGA. Patients and methods: Cross-sectional study of 186 patients (101 men with a mean age of 66.1 ± 16 years. The nutritional assessment consisted of: SGA, PEW criteria, 3-day dietary records, anthropometric parameters and bioelectrical impedance vector analysis. Results: The prevalence of PEW was 30.1%, with significant differences between men and women (22.8 vs. 33.8%, p < 0.005, while 27.9% of SGA values were within the range of malnutrition. No differences were found between the 2 methods. Men had higher proteinuria, percentage of muscle mass and nutrient intake. Women had higher levels of total cholesterol, HDL and a higher body fat percentage. The characteristics of patients with PEW were low albumin levels and a low total lymphocyte count, high proteinuria, low fat and muscle mass and a high Na/K ratio.The multivariate analysis found PEW to be associated with: proteinuria (OR: 1.257; 95% CI: 1.084–1.457, p = 0.002, percentage of fat intake (OR: 0.903; 95% CI: 0.893–0.983, p = 0.008, total lymphocyte count (OR: 0.999; 95% CI: 0.998–0.999, p = 0.001 and cell mass index (OR: 0.995; 95% CI: 0.992–0.998. Conclusion: Malnutrition was identified in Spanish advanced CKD patients measured by different tools. We consider it appropriate to adapt new diagnostic elements to PEW criteria. Resumen: Introducción: El desgaste proteico energético (DPE se asocia a mayor mortalidad y difiere dependiendo del estadio de la enfermedad renal y de la técnica de diálisis. Su prevalencia en pacientes sin di

  15. Comparative evaluation of the sperm characteristics and morphology of adult Wistar rats fed either low or normal protein-energy diets and orally dosed with aqueous Cuscuta australis extracts.

    Science.gov (United States)

    Omirinde, J O; Ozegbe, P C; Oyeyemi, M O

    2014-06-19

    Cuscuta australis (C. australis) seed and stem are commonly used as dietary supplements in a maize-meal, "Ogi", by the local population for the management of male and female reproductive dysfunctions. This study, as a part of on-going efforts, therefore, evaluated and compared the effects of Low Protein-energy (LP) and Normal Protein-energy (NP) diets on the sperm morphology and characteristics of adult Wistar rats orally dosed aqueous extracts of C. australis seed (LPSE and NPSE) and stem (LPST and NPST), 300 mg of extract/kg body weight of rat/day, for seven days. The control groups (LPWA and NPWA) received vehicle, water. Live-dead ratio and percentage of sperms with curved tail were significantly decreased (p<0.01) in the NPST relative to the NPWA, LPWA, LPST, NPSE and LPSE. Total abnormal sperm counts, acephalic sperms and tailless head sperms were significantly decreased (p<0.001, p<0.05 and p<0.001, respectively) in the LPST and NPST relative to LPSE, NPSE, LPWA and NPWA. The LPSE, LPST and NPST showed significantly decreased (p<0.05) percentages of sperms with either bent mid-piece or curved mid-piece relative to the LPWA. Significantly decreased (p<0.05) percentage of sperms with curved mid-piece was also observed in the NPSE relative to LPWA. Protein-energy diet significantly influenced (at least p<0.05) the effect of each extract on sperm motility and percentage of sperms with curved tail. Stem extract significantly decreased (p<0.01) the percentages of acephalic sperms and tailless head sperms. Diet-stem extract interaction significantly influenced (p<0.05) live-dead ratio. Our data suggest that orally administered aqueous extracts of C. australis generally enhanced the sperm morphology and characteristics of the male Wistar rat and that the stem extract maintained sperm morphology better than the seed extract. It also showed that the stem extract decreased live-dead ratio and that the efficacy of orally administered aqueous C. australis stem extract

  16. Assessment of utilization of maternal health care provisions in ...

    African Journals Online (AJOL)

    Assessment of utilization of maternal health care provisions in Orumba North Local Government Area of Anambra State, Nigeria. ... care facilities (52%). This study therefore, recommends equipping modern health care facilities with both human and material resources to enhance their performance. Also, periodic training of ...

  17. Models of Public Service Provision

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Kristensen, Nicolai; Pedersen, Lene Holm

    2013-01-01

    This article extends the framework of Le Grand (2003, 2010) to encompass responsiveness, and the main argument is that the combination of employee motivation, user capacity, and models of public service provision potentially has serious implications for responsiveness across service areas. Although...... research on employee motivation thrives, especially in the public service motivation (PSM) literature, few studies have investigated user capacity empirically, and we know little about the combination of PSM, user capacity and models of service provision. Analyzing four central service areas (day care......, schools, hospitals, and universities), we find variations in both user capacity and PSM. Taking this variation as a point of departure we discuss what implications different combinations of employee motivation, user capacity, and models of public service provision may have for responsiveness....

  18. Dynamic provisioning for community services

    CERN Document Server

    Qi, Li

    2013-01-01

    Dynamic Provisioning for Community Services outlines a dynamic provisioning and maintenance mechanism in a running distributed system, e.g. the grid, which can be used to maximize the utilization of computing resources and user demands. The book includes a complete and reliable maintenance system solution for the large-scale distributed system and an interoperation mechanism for the grid middleware deployed in the United States, Europe, and China. The experiments and evaluations have all been practically implemented for ChinaGrid, and the best practices established can help readers to construc

  19. Optimal Provision of Public Goods

    DEFF Research Database (Denmark)

    Kreiner, Claus Thustrup; Verdelin, Nicolaj

    2009-01-01

    There currently exist two competing approaches in the literature on the optimal provision of public goods. The standard approach highlights the importance of distortionary taxation and distributional concerns. The new approach neutralizes distributional concerns by adjusting the non-linear income...... for the optimal level of a public good without imposing strong assumptions on preferences. This formula shows that distortionary taxation may have a role to play as in the standard approach. However, the main determinants of optimal provision are completely different and the traditional formula with its emphasis...

  20. 75 FR 15777 - Common Crop Insurance Regulations, Basic Provisions; and Various Crop Insurance Provisions

    Science.gov (United States)

    2010-03-30

    ... (protection for production losses only) within one Basic Provisions and the applicable Crop Provisions to..., Macadamia Nut Crop Insurance Provisions, Onion Crop Insurance Provisions, Dry Pea Crop Insurance Provisions... (protection for production losses only) and revenue protection (protection against loss of revenue caused by...

  1. Clinical practice guidelines from the French Health High Authority: nutritional support strategy in protein-energy malnutrition in the elderly.

    Science.gov (United States)

    Raynaud-Simon, Agathe; Revel-Delhom, Christine; Hébuterne, Xavier

    2011-06-01

    These guidelines were produced at the request of the General Directorate of Health within the scope of the French Nutrition and Health Program (PNNS). They concern the management of malnutrition in elderly persons living at home, in institutional care, or in hospital. They belong to a recent series of studies published by ANAES(1) or HAS. Preceding studies concerned the "Diagnostic assessment of protein-energy malnutrition in hospitalized adults" (ANAES, September 2003) and the work conducted by the Committee for the Assessment of Devices and Health Technologies (CEPP) on "Reimbursement procedures for dietary foods for special medical purposes for nutritional supplementation and home enteral nutrition" (HAS, September 2006). The objective of these guidelines is to develop a tool for identifying and managing elderly subjects who are malnourished or at risk of malnutrition. Copyright © 2010. Published by Elsevier Ltd.

  2. Bereavement Care Provision in Europe

    DEFF Research Database (Denmark)

    Guldin, Mai-Britt; Murphy, Irene; Keegan, Orla

    2015-01-01

    The Bereavement Care Taskforce of the EAPC has conducted a survey on bereavement care service provision in Europe. Mai-Britt Guldin, Irene Murphy, Orla Keegan, Barbara Monroe, Maria Antonia Lacasta Reverte and Inger Benkel report on the results. One of the key findings is that not all palliative...

  3. Protein-energy wasting and uremic failure to thrive in children with chronic kidney disease: they are not small adults.

    Science.gov (United States)

    Nourbakhsh, Noureddin; Rhee, Connie M; Kalantar-Zadeh, Kamyar

    2014-12-01

    Protein-energy wasting (PEW), a condition of decreased body protein and fat mass, is highly prevalent in patients with chronic kidney disease (CKD) and a potent predictor of mortality in this population. In adults with CKD, PEW has typically been defined on the basis of (1) deranged biochemical parameters, (2) reduced body mass, (3) reduced muscle mass, and (4) decreased dietary protein intake. Emerging data suggest that PEW may also commonly afflict children with CKD and have a negative impact on growth and development ("uremic failure to thrive"), yet it remains comparatively understudied and less well characterized in these patients. Given the challenges of applying adult-defined PEW criteria to the pediatric population, the authors of a recent study entitled "Protein energy wasting in children with chronic kidney disease" [Abraham et al. (2014) Pediatr Nephrol 29:1231-1238] have sought to develop a scoring system and three alterative definitions for this condition using a combination of biochemical markers, clinical measurements, and subjective reporting in children in the CKiD cohort: (1) minimal PEW definition (≥2 adult-defined PEW criteria); (2) standard PEW definition (≥3 adult-defined PEW criteria); (3) modified PEW definition (≥3 adult-defined PEW criteria, plus short stature or poor growth). These authors observed that meeting the modified PEW definition was associated with a significantly increased risk of hospitalization in unadjusted analyses, i.e., a 2.2-fold higher risk, and trended towards increased risk in multivariable adjusted analyses, i.e., 2.0-fold higher risk. At the present time, future studies validating these findings and developing further refined definitions and/or scoring systems for the detection and management of PEW in children and uremic failure to thrive are urgently needed.

  4. Protein-energy wasting and nutritional supplementation in patients with end-stage renal disease on hemodialysis.

    Science.gov (United States)

    Sabatino, A; Regolisti, G; Karupaiah, T; Sahathevan, S; Sadu Singh, B K; Khor, B H; Salhab, N; Karavetian, M; Cupisti, A; Fiaccadori, E

    2017-06-01

    Protein-Energy Wasting (PEW) is the depletion of protein/energy stores observed in the most advanced stages of Chronic Kidney Disease (CKD). PEW is highly prevalent among patients on chronic dialysis, and is associated with adverse clinical outcomes, high morbidity/mortality rates and increased healthcare costs. This narrative review was aimed at exploring the pathophysiology of PEW in end-stage renal disease (ESRD) on hemodialysis. The main aspects of nutritional status evaluation, intervention and monitoring in this clinical setting were described, as well as the current approaches for the prevention and treatment of ESRD-related PEW. An exhaustive literature search was performed, in order to identify the relevant studies describing the epidemiology, pathogenesis, nutritional intervention and outcome of PEW in ESRD on hemodialysis. The pathogenesis of PEW is multifactorial. Loss of appetite, reduced intake of nutrients and altered lean body mass anabolism/catabolism play a key role. Nutritional approach to PEW should be based on a careful and periodic assessment of nutritional status and on timely dietary counseling. When protein and energy intakes are reduced, nutritional supplementation by means of specific oral formulations administered during the hemodialysis session may be the first-step intervention, and represents a valid nutritional approach to PEW prevention and treatment since it is easy, effective and safe. Omega-3 fatty acids and fibers, now included in commercially available preparations for renal patients, could lend relevant added value to macronutrient supplementation. When oral supplementation fails, intradialytic parenteral nutrition can be implemented in selected patients. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  5. Provision of enabling technology in professional sports.

    Science.gov (United States)

    McBride, D K

    2000-06-01

    Multiple-round golf tournaments are designed intentionally to separate individuals' scores as play proceeds. Variance analyses and consideration of individual differences (vs group mean effects) for a sample of professional events confirm that 3-, 4-, and 5-round tournaments show significantly increased variability (though stable means) from first to last rounds. It is argued here that the dispersion of scores increases as play proceeds because the more physically or mentally fit players emerge and continue to perform best. Furthermore, a marginal income analysis indicates that the average gain in earnings from a one-shot improvement in score is approximately $8,000. An interpretation based on fatigue, competition, and stress supports the Professional Golf Association's claim that provision of enabling devices, like a golf cart for disabled players, is also an enhancement and is thus unfair.

  6. Comparative morphophysiological evaluation of the testis of adult Wistar rats fed low protein-energy diet and dosed with aqueous extracts of Cuscuta australis.

    Science.gov (United States)

    Ozegbe, P C; Omirinde, J O

    2012-12-18

    Cuscuta australis (C. australis) seed and stem are historically used by the local population as dietary supplement for the management of infertility. This study, therefore, evaluated the effect of orally administered aqueous extracts of C. australis seed and stem, 300 mg/kg body weight/day for seven days, on the testis of the adult Wistar rat fed either low or normal protein-energy diets. The control group received water. The relative weight of the testis was non-significantly increased (p>0.05) in the Low Protein-energy diet-Water-treated (LPWA), Low Protein-energy diet-Seed-treated (LPSE) and Normal Protein-energy diet-Seed-treated (NPSE) groups relative to the Normal Protein-energy diet-Water-treated (NPWA). The weight of the testis was also non-significantly increased (p˃0.05) in the Low Protein-energy diet-Stem-treated (LPST), but decreased in the Normal Protein-energy diet-Stem-treated (NPST), relative to LPWA and NPWA. Heights of germinal epithelium were significantly decreased (p<0.05) in the LPWA, LPSE and LPST relative to the NPWA, NPSE and NPST. Diet significantly influenced (p<0.001) the effect of stem extract on the height of germinal epithelium. The NPSE, LPSE, NPST, LPST and LPWA showed significantly decreased (p<0.001) plasma levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) relative to NPWA. The LPWA, LPSE and NPST also showed significantly decreased (p<0.001) levels of testosterone relative to NPWA and LPST. Diet significantly influenced (p<0.001) the effect of seed on the level of LH. Seed-diet interactions significantly affected the levels of FSH (p<0.001) and LH (p<0.05), but not testosterone. Diet significantly influenced (p<0.001) the effects of stem extract on the levels of FSH, LH and testosterone. Stem-diet interactions significantly affected (p<0.001) the levels of FSH, LH and testosterone. Our data suggest that the aqueous extract of C. australis stem is more potent than the seed extract and that dietary protein-energy

  7. 24 CFR 201.16 - Default provision.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Default provision. 201.16 Section... PROPERTY IMPROVEMENT AND MANUFACTURED HOME LOANS Loan and Note Provisions § 201.16 Default provision. The... default by the borrower. ...

  8. gRINN: a tool for calculation of residue interaction energies and protein energy network analysis of molecular dynamics simulations.

    Science.gov (United States)

    Serçinoglu, Onur; Ozbek, Pemra

    2018-05-25

    Atomistic molecular dynamics (MD) simulations generate a wealth of information related to the dynamics of proteins. If properly analyzed, this information can lead to new insights regarding protein function and assist wet-lab experiments. Aiming to identify interactions between individual amino acid residues and the role played by each in the context of MD simulations, we present a stand-alone software called gRINN (get Residue Interaction eNergies and Networks). gRINN features graphical user interfaces (GUIs) and a command-line interface for generating and analyzing pairwise residue interaction energies and energy correlations from protein MD simulation trajectories. gRINN utilizes the features of NAMD or GROMACS MD simulation packages and automatizes the steps necessary to extract residue-residue interaction energies from user-supplied simulation trajectories, greatly simplifying the analysis for the end-user. A GUI, including an embedded molecular viewer, is provided for visualization of interaction energy time-series, distributions, an interaction energy matrix, interaction energy correlations and a residue correlation matrix. gRINN additionally offers construction and analysis of Protein Energy Networks, providing residue-based metrics such as degrees, betweenness-centralities, closeness centralities as well as shortest path analysis. gRINN is free and open to all users without login requirement at http://grinn.readthedocs.io.

  9. From Extraction of Local Structures of Protein Energy Landscapes to Improved Decoy Selection in Template-Free Protein Structure Prediction.

    Science.gov (United States)

    Akhter, Nasrin; Shehu, Amarda

    2018-01-19

    Due to the essential role that the three-dimensional conformation of a protein plays in regulating interactions with molecular partners, wet and dry laboratories seek biologically-active conformations of a protein to decode its function. Computational approaches are gaining prominence due to the labor and cost demands of wet laboratory investigations. Template-free methods can now compute thousands of conformations known as decoys, but selecting native conformations from the generated decoys remains challenging. Repeatedly, research has shown that the protein energy functions whose minima are sought in the generation of decoys are unreliable indicators of nativeness. The prevalent approach ignores energy altogether and clusters decoys by conformational similarity. Complementary recent efforts design protein-specific scoring functions or train machine learning models on labeled decoys. In this paper, we show that an informative consideration of energy can be carried out under the energy landscape view. Specifically, we leverage local structures known as basins in the energy landscape probed by a template-free method. We propose and compare various strategies of basin-based decoy selection that we demonstrate are superior to clustering-based strategies. The presented results point to further directions of research for improving decoy selection, including the ability to properly consider the multiplicity of native conformations of proteins.

  10. Prevalence of protein-energy malnutrition in hospital patients over 75 years of age admitted for hip fracture.

    Science.gov (United States)

    Drevet, S; Bioteau, C; Mazière, S; Couturier, P; Merloz, P; Tonetti, J; Gavazzi, G

    2014-10-01

    One percent of falls in over-75 years old cause hip fracture (HF). Protein-energy malnutrition (PEM) is associated with falls and fracture. PEM screening and perioperative nutritional management are recommended by the European Society of Parenteral and Enteral Nutrition, yet data on nutritional status in elderly HF patients are sparse. The Mini Nutritional Assessment (MNA) score is presently the most effective screening tool for PEM in over-75 years old. The principal objective of the present study was to determine the prevalence on MNA of PEM in patients aged over 75 years admitted for HF. Secondary objectives were to identify factors associated with PEM and its role as a factor of evolution. A prospective observational epidemiological study included 50 patients aged over 75 years admitted for HF in an 8-bed orthopedic surgery department with a geriatric follow-up unit. PEM was defined by MNApatients was 86.1 years (range, 77-94 years). Prevalence of PEM was 28%; a further 58% of patients were at risk for PEM. PEM was associated with elevated CIRS-G (Ppatients aged over 75 years, supporting longer hospital stay. MNA is a diagnostic gold standard, not to be replaced by albuminemia or body-mass index in this perioperative clinical situation. Given the present economic stakes relating to geriatric trauma patients' hospital stay, it is essential to prevent, diagnose and treat PEM in elderly subjects. Level IV; prospective cohort study. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  11. Honey can repairing damage of liver tissue due to protein energy malnutrition through induction of endogenous stem cells

    Directory of Open Access Journals (Sweden)

    R. Heru Prasetyo

    2017-06-01

    Full Text Available Aim: This study was to evaluate effect of honey in repairing damage of liver tissue due to energy protein malnutrition and in mobilization of endogenous stem cells. Materials and Methods: Male mice model of degenerative liver was obtained through food fasting but still have drinking water for 5 days. It caused energy protein malnutrition and damage of liver tissue. The administration of 50% (v/v honey was performed for 10 consecutive days, while the positive control group was fasted and not given honey and the negative control not fasted and without honey. Observations of regeneration the liver tissue based on histologically examination, observation of Hsp70 expression, and homing signal based on vascular endothelial growth factor-1 (VEGF-1 expression using immunohistochemistry technique. Observation on expression of CD34 and CD45 as the marker of auto mobilization of hematopoietic stem cells using flow cytometry technique. Results: There is regeneration of the liver tissue due to protein energy malnutrition, decrease of Hsp70 expression, increase of VEGF-1 expression, and high expression of CD34 and CD45. Conclusion: Honey can improve the liver tissue based on: (1 Mobilization of endogenous stem cells (CD34 and CD45; (2 Hsp70 and VEGF-1 expressions as regeneration marker of improvement, and (3 regeneration histologically of liver tissue.

  12. Protein energy wasting in chronic kidney disease: An update with focus on nutritional interventions to improve outcomes

    Directory of Open Access Journals (Sweden)

    Yashpal P Jadeja

    2012-01-01

    Full Text Available Protein-energy wasting (PEW is common in patients with chronic kidney disease (CKD. PEW is one of the strongest predictors of mortality in patients with CKD. The International Society of Renal Nutrition and Metabolism (ISRNM expert panel has defined PEW as a, "state of decreased body stores of protein and energy fuels (body protein and fat masses". The ISRNM panel has also proposed diagnostic criteria of PEW with four categories. Cachexia is a severe form of PEW. The proposed causes of PEW are multi-factorial and include nutritional and non-nutritional mechanisms. The literature indicates that PEW can be mitigated or corrected with an appropriate diet and enteral nutritional support that targets dietary protein intake. Dietary requirements and enteral nutritional support must also be considered in patients with CKD and diabetes mellitus and in children with CKD, in addition to dialysis patients. Features of ideal dietary supplement have also been discussed. Dietary interventions such as enteral feeding with high-protein meals or supplements might improve the nutritional status and outcomes in dialysis patients.

  13. Honey can repairing damage of liver tissue due to protein energy malnutrition through induction of endogenous stem cells.

    Science.gov (United States)

    Prasetyo, R Heru; Hestianah, Eka Pramyrtha

    2017-06-01

    This study was to evaluate effect of honey in repairing damage of liver tissue due to energy protein malnutrition and in mobilization of endogenous stem cells. Male mice model of degenerative liver was obtained through food fasting but still have drinking water for 5 days. It caused energy protein malnutrition and damage of liver tissue. The administration of 50% (v/v) honey was performed for 10 consecutive days, while the positive control group was fasted and not given honey and the negative control not fasted and without honey. Observations of regeneration the liver tissue based on histologically examination, observation of Hsp70 expression, and homing signal based on vascular endothelial growth factor-1 (VEGF-1) expression using immunohistochemistry technique. Observation on expression of CD34 and CD45 as the marker of auto mobilization of hematopoietic stem cells using flow cytometry technique. There is regeneration of the liver tissue due to protein energy malnutrition, decrease of Hsp70 expression, increase of VEGF-1 expression, and high expression of CD34 and CD45. Honey can improve the liver tissue based on: (1) Mobilization of endogenous stem cells (CD34 and CD45); (2) Hsp70 and VEGF-1 expressions as regeneration marker of improvement, and (3) regeneration histologically of liver tissue.

  14. The effect of serum magnesium levels and serum endothelin-1 levels on bone mineral density in protein energy malnutrition.

    Science.gov (United States)

    Ozturk, C F; Karakelleoglu, C; Orbak, Z; Yildiz, L

    2012-06-01

    An inadequate and imbalanced intake of protein and energy results in protein-energy malnutrition (PEM). It is known that bone mineral density and serum magnesium levels are low in malnourished children. However, the roles of serum magnesium and endothelin-1 (ET-1) levels in the pathophysiology of bone mineralization are obscure. Thus, the relationships between serum magnesium and ET-1 levels and the changes in bone mineral density were investigated in this study. There was a total of 32 subjects, 25 of them had PEM and seven were controls. While mean serum ET-1 levels of the children with kwashiorkor and marasmus showed no statistically significant difference, mean serum ET-1 levels of both groups were significantly higher than that of the control group. Serum magnesium levels were lower than normal value in 9 (36%) of 25 malnourished children. Malnourished children included in this study were divided into two subgroups according to their serum magnesium levels. While mean serum ET-1 levels in the group with low magnesium levels were significantly higher than that of the group with normal magnesium levels (p malnutrition. Our study suggested that lower magnesium levels and higher ET-1 levels might be important factors in changes of bone mineral density in malnutrition. We recommend that the malnourished patients, especially with hypomagnesaemia, should be treated with magnesium early.

  15. Dialysis Malnutrition and Malnutrition Inflammation Scores: screening tools for prediction of dialysis-related protein-energy wasting in Malaysia.

    Science.gov (United States)

    Harvinder, Gilcharan Singh; Swee, Winnie Chee Siew; Karupaiah, Tilakavati; Sahathevan, Sharmela; Chinna, Karuthan; Ahmad, Ghazali; Bavanandan, Sunita; Goh, Bak Leong

    2016-01-01

    Malnutrition is highly prevalent in Malaysian dialysis patients and there is a need for a valid screening tool for early identification and management. This cross-sectional study aims to examine the sensitivity of the Dialysis Malnutrition Score (DMS) and Malnutrition Inflammation Score (MIS) tools in predicting protein-energy wasting (PEW) among Malaysian dialysis patients. A total of 155 haemodialysis (HD) and 90 peritoneal dialysis (PD) patients were screened for risk of malnutrition using DMS and MIS and comparisons were made with established guidelines by International Society of Renal Nutrition and Metabolism (ISRNM) for PEW. MIS cut-off score of >=5 indicated presence of malnutrition in all patients. A total of 59% of HD and 83% of PD patients had PEW by ISRNM criteria. Based on DMS, 73% of HD and 71% of PD patients exhibited moderate malnutrition, whilst using MIS, 88% and 90%, respectively were malnourished. DMS and MIS correlated significantly in HD (r2=0.552, pmalnutrition classification were established (score >=5) for use amongst Malaysian dialysis patients. Both DMS and MIS are valid tools to be used for nutrition screening of dialysis patients especially those undergoing peritoneal dialysis. The DMS may be a more practical and simpler tool to be utilized in the Malaysian dialysis settings as it does not require laboratory markers.

  16. Protein-energy malnutrition induces an aberrant acute-phase response and modifies the circadian rhythm of core temperature.

    Science.gov (United States)

    Smith, Shari E; Ramos, Rafaela Andrade; Refinetti, Roberto; Farthing, Jonathan P; Paterson, Phyllis G

    2013-08-01

    Protein-energy malnutrition (PEM), present in 12%-19% of stroke patients upon hospital admission, appears to be a detrimental comorbidity factor that impairs functional outcome, but the mechanisms are not fully elucidated. Because ischemic brain injury is highly temperature-sensitive, the objectives of this study were to investigate whether PEM causes sustained changes in temperature that are associated with an inflammatory response. Activity levels were recorded as a possible explanation for the immediate elevation in temperature upon introduction to a low protein diet. Male, Sprague-Dawley rats (7 weeks old) were fed a control diet (18% protein) or a low protein diet (PEM, 2% protein) for either 7 or 28 days. Continuous core temperature recordings from bioelectrical sensor transmitters demonstrated a rapid increase in temperature amplitude, sustained over 28 days, in response to a low protein diet. Daily mean temperature rose transiently by day 2 (p = 0.01), falling to normal by day 4 (p = 0.08), after which mean temperature continually declined as malnutrition progressed. There were no alterations in activity mean (p = 0.3) or amplitude (p = 0.2) that were associated with the early rise in mean temperature. Increased serum alpha-2-macroglobulin (p protein diet had no effect on the signaling pathway of the pro-inflammatory transcription factor, NFκB, in the hippocampus. In conclusion, PEM induces an aberrant and sustained acute-phase response coupled with long-lasting effects on body temperature.

  17. Protein blend ingestion before allogeneic stem cell transplantation improves protein-energy malnutrition in patients with leukemia.

    Science.gov (United States)

    Ren, Guangxu; Zhang, Jianping; Li, Minghua; Yi, Suqin; Xie, Jin; Zhang, Hongru; Wang, Jing

    2017-10-01

    Severe protein-energy malnutrition (PEM) and skeletal muscle wasting are commonly observed in patients with acute leukemia. Recently, the ingestion of a soy-whey protein blend has been shown to promote muscle protein synthesis (MPS). Thus, we tested the hypothesis that the ingestion of a soy-whey blended protein (BP) may improve the PEM status and muscle mass in acute leukemia patients. In total, 24 patients from the same treatment group were randomly assigned to the natural diet plus soy-whey blended protein (BP) group and the natural diet only (ND) group. Our data showed that protein and energy intake decreased significantly (P protein) were observed in the majority (>50%) of the patients. However, 66% of the patients who ingested the BP before transplantation showed obvious increases in arm muscle area. The gripping power value (△ post-pre or △ post-baseline ) was significantly higher in the BP group than in the ND group (P protein to different extents. Notably, the average time to stem cell engraftment was significantly shorter for patients in the BP group (12.2 ± 2.0 days) than for patients in the ND group (15.1 ± 2.9 days). Collectively, our data supported that soy-whey protein can improve PEM status and muscle mass in leukemia patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. From Extraction of Local Structures of Protein Energy Landscapes to Improved Decoy Selection in Template-Free Protein Structure Prediction

    Directory of Open Access Journals (Sweden)

    Nasrin Akhter

    2018-01-01

    Full Text Available Due to the essential role that the three-dimensional conformation of a protein plays in regulating interactions with molecular partners, wet and dry laboratories seek biologically-active conformations of a protein to decode its function. Computational approaches are gaining prominence due to the labor and cost demands of wet laboratory investigations. Template-free methods can now compute thousands of conformations known as decoys, but selecting native conformations from the generated decoys remains challenging. Repeatedly, research has shown that the protein energy functions whose minima are sought in the generation of decoys are unreliable indicators of nativeness. The prevalent approach ignores energy altogether and clusters decoys by conformational similarity. Complementary recent efforts design protein-specific scoring functions or train machine learning models on labeled decoys. In this paper, we show that an informative consideration of energy can be carried out under the energy landscape view. Specifically, we leverage local structures known as basins in the energy landscape probed by a template-free method. We propose and compare various strategies of basin-based decoy selection that we demonstrate are superior to clustering-based strategies. The presented results point to further directions of research for improving decoy selection, including the ability to properly consider the multiplicity of native conformations of proteins.

  19. Nutritional Status of Maintenance Dialysis Patients: Low Lean Body Mass Index and Obesity Are Common, Protein-Energy Wasting Is Uncommon.

    Directory of Open Access Journals (Sweden)

    Mette Koefoed

    Full Text Available Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean body mass index and obesity in maintenance dialysis patients, and compared different methods of nutritional assessment.In a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip circumferences, and determined plasma albumin and normalized protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients.Seventy-nine eligible maintenance dialysis patients participated. The prevalence of protein-energy wasted patients was 4% (95% CI: 2-12 as assessed by the coexistence of low lean body mass index and low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22-44. Obesity prevalence as assessed from fat mass index was 43% (95% CI: 32-55. Coexistence of low lean body mass index and obesity was seen in 10% (95% CI: 5-19. The prevalence of protein-energy wasting and obesity varied considerably, depending on nutritional assessment methodology.Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in the future. In order to clearly distinguish between shortage, sufficiency and abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest the simple measurements of lean body mass index and fat mass index.

  20. Nutritional Status of Maintenance Dialysis Patients: Low Lean Body Mass Index and Obesity Are Common, Protein-Energy Wasting Is Uncommon.

    Science.gov (United States)

    Koefoed, Mette; Kromann, Charles Boy; Juliussen, Sophie Ryberg; Hvidtfeldt, Danni; Ekelund, Bo; Frandsen, Niels Erik; Marckmann, Peter

    2016-01-01

    Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean body mass index and obesity in maintenance dialysis patients, and compared different methods of nutritional assessment. In a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip circumferences), and determined plasma albumin and normalized protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients. Seventy-nine eligible maintenance dialysis patients participated. The prevalence of protein-energy wasted patients was 4% (95% CI: 2-12) as assessed by the coexistence of low lean body mass index and low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22-44). Obesity prevalence as assessed from fat mass index was 43% (95% CI: 32-55). Coexistence of low lean body mass index and obesity was seen in 10% (95% CI: 5-19). The prevalence of protein-energy wasting and obesity varied considerably, depending on nutritional assessment methodology. Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in the future. In order to clearly distinguish between shortage, sufficiency and abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest the simple measurements of lean body mass index and fat mass index.

  1. Optimal Provision of Public Goods

    DEFF Research Database (Denmark)

    Kreiner, Claus Thustrup; Verdelin, Nicolaj

    2012-01-01

    The standard approach to the optimal provision of public goods highlights the importance of distortionary taxation and distributional concerns. A new approach neutralizes distributional concerns by adjusting the income tax schedule. We demonstrate that both approaches are derived from the same...... basic formula. We also take the new approach further by deriving an intuitive formula for the optimal level of public goods, without imposing strong assumptions on preferences. This formula shows that distortionary taxation has a role to play, as in the standard approach. However, the main determinants...

  2. Optimal Provision of Public Goods

    DEFF Research Database (Denmark)

    Kreiner, Claus Thustrup; Verdelin, Nicolaj

    There currently exist two competing approaches in the literature on the optimal provision of public goods. The standard approach highlights the importance of distortionary taxation and distributional concerns. The new approach neutralizes distributional concerns by adjusting the non-linear income...... tax, and finds that this reinvigorates the simple Samuelson rule when preferences are separable in goods and leisure. We provide a synthesis by demonstrating that both approaches derive from the same basic formula. We further develop the new approach by deriving a general, intuitive formula...

  3. Under-five protein energy malnutrition admitted at the University of Nigeria Teaching Hospital, Enugu: a 10 year retrospective review.

    Science.gov (United States)

    Ubesie, Agozie C; Ibeziako, Ngozi S; Ndiokwelu, Chika I; Uzoka, Chinyeaka M; Nwafor, Chinelo A

    2012-06-14

    To determine the prevalence, risk factors, co-morbidities and case fatality rates of Protein Energy Malnutrition (PEM) admissions at the paediatric ward of the University of Nigeria Teaching Hospital Enugu, South-east Nigeria over a 10 year period. A retrospective study using case Notes, admission and mortality registers retrieved from the Hospital's Medical Records Department. All children aged 0 to 59 months admitted into the hospital on account of PEM between 1996 and 2005. A total of 212 children with PEM were admitted during the period under review comprising of 127 (59.9%) males and 85 (40.1%) females. The most common age groups with PEM were 6 to 12 months (55.7%) and 13 to 24 months (36.8%). Marasmus (34.9%) was the most common form of PEM noted in this review. Diarrhea and malaria were the most common associated co-morbidities. Majority (64.9%) of the patients were from the lower socio-economic class. The overall case fatality rate was 40.1% which was slightly higher among males (50.9%). Mortality in those with marasmic-kwashiokor and in the unclassified group was 53.3% and 54.5% respectively. Most of the admissions and case fatality were noted in those aged 6 to 24 months which coincides with the weaning period. Marasmic-kwashiokor is associated with higher case fatality rate than other forms of PEM. We suggest strengthening of the infant feeding practices by promoting exclusive breastfeeding for the first six months of life, followed by appropriate weaning with continued breast feeding. Under-five children should be screened for PEM at the community level for early diagnosis and prompt management as a way of reducing the high mortality associated with admitted severe cases.

  4. Missed opportunities in the diagnosis and management of protein energy malnutrition among children under 5 years in Wakiso district, Uganda.

    Science.gov (United States)

    Akugizibwe, Roselyne; Kasolo, Josephine; Makubuya, Duncan B; Damani, Ali M

    2013-11-30

    Protein energy malnutrition (PEM) is one of the leading causes of death among children below 5 years in Uganda. It develops after acute childhood illnesses despite children having received treatment from health facilities. This study assessed knowledge and practices of health workers in the diagnosis and management of PEM, which was used to establish missed opportunities to prevent severe acute malnutrition (SAM) in its management. This was a cross sectional descriptive study that used questionnaires and observation of health workers at Health Center IV (HCIV) in Wakiso district, Uganda. The clinical nutrition diagnosis of the children was then obtained. There were 44 health workers that assessed 225 children. Most of the health workers 32 (72.7%) had education in PEM management and over 60% of them knew the forms of PEM, clinical signs of kwashiorkor and marasmus and the factors that predispose to PEM. Health workers did not weigh 56 (24.9%) of the children, 193 (86%) children had no height taken and only 32 (14.2%) had mid upper arm circumference measured. The weight for height of 223 (99.2%) and weight for age of 109 (93%) children was not calculated. Only 38 (16.89%) were examined for edema and 40 (17.78%) for muscle wasting. Health workers diagnosed only 21 (9%) children with malnutrition, while researchers found 94 (31.9%) with malnutrition. Children who missed opportunity to have malnutrition diagnosed at the health facility were 73 (32.9%). The knowledge of health workers on PEM is adequate, but their practice is inadequate. There is missed opportunity to diagnose and manage PEM among children who present with acute illnesses at the health centers, hence missed opportunity to prevent SAM.

  5. Experimental model considerations for the study of protein-energy malnutrition co-existing with ischemic brain injury.

    Science.gov (United States)

    Prosser-Loose, Erin J; Smith, Shari E; Paterson, Phyllis G

    2011-05-01

    Protein-energy malnutrition (PEM) affects ~16% of patients at admission for stroke. We previously modeled this in a gerbil global cerebral ischemia model and found that PEM impairs functional outcome and influences mechanisms of ischemic brain injury and recovery. Since this model is no longer reliable, we investigated the utility of the rat 2-vessel occlusion (2-VO) with hypotension model of global ischemia for further study of this clinical problem. Male, Sprague-Dawley rats were exposed to either control diet (18% protein) or PEM induced by feeding a low protein diet (2% protein) for 7d prior to either global ischemia or sham surgery. PEM did not significantly alter the hippocampal CA1 neuron death (p = 0.195 by 2-factor ANOVA) or the increase in dendritic injury caused by exposure to global ischemia. Unexpectedly, however, a strong trend was evident for PEM to decrease the consistency of hippocampal damage, as shown by an increased incidence of unilateral or no hippocampal damage (p=0.069 by chi-square analysis). Although PEM caused significant changes to baseline arterial blood pH, pO(2), pCO(2), and fasting glucose (p0.269). Intra-ischemic tympanic temperature and blood pressure were strictly and equally controlled between ischemic groups. We conclude that co-existing PEM confounded the consistency of hippocampal injury in the 2-VO model. Although the mechanisms responsible were not identified, this model of brain ischemia should not be used for studying this co-morbidity factor. © 2011 Bentham Science Publishers Ltd.

  6. Protein energy malnutrition during vaccination has limited influence on vaccine efficacy but abolishes immunity if administered during Mycobacterium tuberculosis infection.

    Science.gov (United States)

    Hoang, Truc; Agger, Else Marie; Cassidy, Joseph P; Christensen, Jan P; Andersen, Peter

    2015-05-01

    Protein energy malnutrition (PEM) increases susceptibility to infectious diseases, including tuberculosis (TB), but it is not clear how PEM influences vaccine-promoted immunity to TB. We demonstrate that PEM during low-level steady-state TB infection in a mouse model results in rapid relapse of Mycobacterium tuberculosis, as well as increased pathology, in both Mycobacterium bovis BCG-vaccinated and unvaccinated animals. PEM did not change the overall numbers of CD4 T cells in BCG-vaccinated animals but resulted in an almost complete loss of antigen-specific cytokine production. Furthermore, there was a change in cytokine expression characterized by a gradual loss of multifunctional antigen-specific CD4 T cells and an increased proportion of effector cells expressing gamma interferon and tumor necrosis factor alpha (IFN-γ(+) TNF-α(+) and IFN-γ(+) cells). PEM during M. tuberculosis infection completely blocked the protection afforded by the H56-CAF01 subunit vaccine, and this was associated with a very substantial loss of the interleukin-2-positive memory CD4 T cells promoted by this vaccine. Similarly, PEM during the vaccination phase markedly reduced the H56-CAF01 vaccine response, influencing all cytokine-producing CD4 T cell subsets, with the exception of CD4 T cells positive for TNF-α only. Importantly, this impairment was reversible and resupplementation of protein during infection rescued both the vaccine-promoted T cell response and the protective effect of the vaccine against M. tuberculosis infection. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  7. Diagnosis and prevalence of protein-energy wasting and its association with mortality in Japanese haemodialysis patients.

    Science.gov (United States)

    Kanazawa, Yoshie; Nakao, Toshiyuki; Murai, Seizo; Okada, Tomonari; Matsumoto, Hiroshi

    2017-07-01

    The International Society of Renal Nutrition and Metabolism (ISRNM) has proposed the diagnostic criteria for protein-energy wasting (PEW). We studied Japanese haemodialysis (HD) patients to verify the diagnostic method, especially with respect to the body mass index (BMI) criterion, as well as the prevalence of PEW and its association with mortality. Japanese patients receiving maintenance HD at three outpatient clinics in Tokyo (n = 210) were enrolled, and prospectively followed-up for 3 years. PEW was diagnosed at baseline, according to the four categories (serum chemistry, body mass, muscle mass and dietary intake) recommended by the ISRNM. For the category of body mass, we select a body mass index (BMI) and set up three thresholds, energy wasting, when the threshold of a BMI among the diagnostic criteria was defined as <18.5 kg/m 2 , was recognized as an independent risk factor for mortality. However, PEW was not recognized as a risk factor when the BMI diagnostic criterion was set at <20.0 or <23.0 kg/m 2 . Overall, 14.8% of the patients had PEW. The survival rate of PEW patients was significantly lower than that of non-PEW patients (log rank, P < 0.001). The diagnosis algorithm of PEW proposed by an expert panel of the ISRNM strongly associates with mortality. However, given differences in body size in Japan, we suggest to revise the BMI criterion from <23.0 kg/m 2 to <18.5 kg/m 2 . © 2016 Asian Pacific Society of Nephrology.

  8. Provision of Patient-Centered Transgender Care.

    Science.gov (United States)

    Selix, Nancy W; Rowniak, Stefan

    2016-11-01

    Transgender individuals have unique health care needs and experience health disparities. There is an increased need for transgender health care services and primary care for this underserved population. However, provision of appropriate health care services for transgender persons requires cultural competency and skill on the part of the health care provider, and providers need specific skills to address the needs of this population. A review of the literature was performed by accessing CINAHL, PsycINFO, and PubMed databases. Pertinent research was extracted and reviewed for relevance. References in these publications were reviewed to identify additional publications that address primary prevention, secondary prevention, and tertiary care of transgender individuals. Articles that include prevention, screening, and treatment of health problems of transgender persons were identified. Research on the health needs of the transgender population is limited. Whenever available, research findings that address this unique population should be incorporated into clinical practice. When research evidence is not available to address the unique needs of transgender individuals, research and clinical care guidelines from the general population may be applied for health screening and maintenance. This article provides information about primary care services for transgender individuals and seeks to improve awareness of the health disparities this underserved population experiences. Simple solutions to modify clinical settings to enhance care are provided. © 2016 by the American College of Nurse-Midwives.

  9. Advance Resource Provisioning in Bulk Data Scheduling

    Energy Technology Data Exchange (ETDEWEB)

    Balman, Mehmet

    2012-10-01

    Today?s scientific and business applications generate mas- sive data sets that need to be transferred to remote sites for sharing, processing, and long term storage. Because of increasing data volumes and enhancement in current net- work technology that provide on-demand high-speed data access between collaborating institutions, data handling and scheduling problems have reached a new scale. In this paper, we present a new data scheduling model with ad- vance resource provisioning, in which data movement operations are defined with earliest start and latest comple- tion times. We analyze time-dependent resource assign- ment problem, and propose a new methodology to improve the current systems by allowing researchers and higher-level meta-schedulers to use data-placement as-a-service, so they can plan ahead and submit transfer requests in advance. In general, scheduling with time and resource conflicts is NP-hard. We introduce an efficient algorithm to organize multiple requests on the fly, while satisfying users? time and resource constraints. We successfully tested our algorithm in a simple benchmark simulator that we have developed, and demonstrated its performance with initial test results.

  10. Impairment of the hematological response and interleukin-1β production in protein-energy malnourished mice after endotoxemia with lipopolysaccharide

    Energy Technology Data Exchange (ETDEWEB)

    Fock, R.A.; Vinolo, M.A.R.; Blatt, S.L.; Borelli, P. [Laboratório de Hematologia Experimental, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, SP (Brazil)

    2012-09-21

    The objectives of this study were to determine if protein-energy malnutrition (PEM) could affect the hematologic response to lipopolysaccharide (LPS), the interleukin-1β (IL-1β) production, leukocyte migration, and blood leukocyte expression of CD11a/CD18. Two-month-old male Swiss mice were submitted to PEM (N = 30) with a low-protein diet (14 days) containing 4% protein, compared to 20% protein in the control group (N = 30). The total cellularity of blood, bone marrow, spleen, and bronchoalveolar lavage evaluated after the LPS stimulus indicated reduced number of total cells in all compartments studied and different kinetics of migration in malnourished animals. The in vitro migration assay showed reduced capacity of migration after the LPS stimulus in malnourished animals (45.7 ± 17.2 × 10{sup 4} cells/mL) compared to control (69.6 ± 7.1 × 10{sup 4} cells/mL, P ≤ 0.05), but there was no difference in CD11a/CD18 expression on the surface of blood leukocytes. In addition, the production of IL-1β in vivo after the LPS stimulus (180.7 pg·h{sup −1}·mL{sup −1}), and in vitro by bone marrow and spleen cells (41.6 ± 15.0 and 8.3 ± 4.0 pg/mL) was significantly lower in malnourished animals compared to control (591.1 pg·h{sup −1}·mL{sup −1}, 67.0 ± 23.0 and 17.5 ± 8.0 pg/mL, respectively, P ≤ 0.05). The reduced expression of IL-1β, together with the lower number of leukocytes in the central and peripheral compartments, different leukocyte kinetics, and reduced leukocyte migration capacity are factors that interfere with the capacity to mount an adequate immune response, being partly responsible for the immunodeficiency observed in PEM.

  11. FERMENTED SOYBEAN CAKE AND ALBUMIN FORMULA AS NUTRITIONAL SUPPORT PREVENTS PROTEIN ENERGY MALNUTRITION AND AKI IN STROKE PATIENTS

    Directory of Open Access Journals (Sweden)

    Nanny Djaya

    2012-06-01

    Natrium and Kalium, could be corrected with appropriate nutritional support (adequate calorie, protein and mineral and therefore prevents acute kidney injury and protein energy malnutrition in elderly patients with anorexia.

  12. Structural and functional affection of the heart in protein energy malnutrition patients on admission and after nutritional recovery.

    Science.gov (United States)

    El-Sayed, H L; Nassar, M F; Habib, N M; Elmasry, O A; Gomaa, S M

    2006-04-01

    The pathogenesis of different malnutrition diseases was suggested to affect the heart. This study was designed to detect cardiac affection in protein energy malnutrition (PEM) patients, whether clinically or by electrocardiogram (ECG) and echocardiogram, and to assess the value of the cardiac marker troponin I in patients at risk of myocardial injury with special emphasis on the effect of nutritional rehabilitation. The present study was carried out on 30 PEM infants (16 nonedematous - 14 edematous) and 10 apparently healthy age and sex-matched infants acting as the control group. All studied infants were subjected to full history taking laying stress on dietetic history, thorough clinical and anthropometric measurements. Echocardiography and ECG were also performed. Laboratory investigations were performed including complete blood count, CRP, total proteins, albumin, liver and kidney functions as well as estimation of troponin-I in blood by immulite. Following initial evaluation, all malnourished infants were subjected to nutritional rehabilitation program for approximately 8 weeks, after which the patients were re-evaluated using the same preinterventional parameters. The results of the present study demonstrated that electrical properties of myocardium assessed by ECG showed significant decrease of R wave and QTc interval in patients compared to controls with significant improvement after nutritional rehabilitation. Echocardigraphic changes showed that cardiac mass index was significantly lower in both groups of malnourished cases compared to the controls with significant increase after nutritional rehabilitation. The study showed that the parameters of left ventricular (LV) systolic function which are the ejection fraction, fractional shortening and velocity of circumferential fiber shortening were not significantly reduced in patients compared to the controls. The diastolic function also showed no significant difference in the E wave/A wave (e/a) ratio between

  13. Impairment of the hematological response and interleukin-1β production in protein-energy malnourished mice after endotoxemia with lipopolysaccharide

    International Nuclear Information System (INIS)

    Fock, R.A.; Vinolo, M.A.R.; Blatt, S.L.; Borelli, P.

    2012-01-01

    The objectives of this study were to determine if protein-energy malnutrition (PEM) could affect the hematologic response to lipopolysaccharide (LPS), the interleukin-1β (IL-1β) production, leukocyte migration, and blood leukocyte expression of CD11a/CD18. Two-month-old male Swiss mice were submitted to PEM (N = 30) with a low-protein diet (14 days) containing 4% protein, compared to 20% protein in the control group (N = 30). The total cellularity of blood, bone marrow, spleen, and bronchoalveolar lavage evaluated after the LPS stimulus indicated reduced number of total cells in all compartments studied and different kinetics of migration in malnourished animals. The in vitro migration assay showed reduced capacity of migration after the LPS stimulus in malnourished animals (45.7 ± 17.2 × 10 4 cells/mL) compared to control (69.6 ± 7.1 × 10 4 cells/mL, P ≤ 0.05), but there was no difference in CD11a/CD18 expression on the surface of blood leukocytes. In addition, the production of IL-1β in vivo after the LPS stimulus (180.7 pg·h −1 ·mL −1 ), and in vitro by bone marrow and spleen cells (41.6 ± 15.0 and 8.3 ± 4.0 pg/mL) was significantly lower in malnourished animals compared to control (591.1 pg·h −1 ·mL −1 , 67.0 ± 23.0 and 17.5 ± 8.0 pg/mL, respectively, P ≤ 0.05). The reduced expression of IL-1β, together with the lower number of leukocytes in the central and peripheral compartments, different leukocyte kinetics, and reduced leukocyte migration capacity are factors that interfere with the capacity to mount an adequate immune response, being partly responsible for the immunodeficiency observed in PEM

  14. Impairment of the hematological response and interleukin-1β production in protein-energy malnourished mice after endotoxemia with lipopolysaccharide

    Science.gov (United States)

    Fock, R.A.; Vinolo, M.A.R.; Blatt, S.L.; Borelli, P.

    2012-01-01

    The objectives of this study were to determine if protein-energy malnutrition (PEM) could affect the hematologic response to lipopolysaccharide (LPS), the interleukin-1β (IL-1β) production, leukocyte migration, and blood leukocyte expression of CD11a/CD18. Two-month-old male Swiss mice were submitted to PEM (N = 30) with a low-protein diet (14 days) containing 4% protein, compared to 20% protein in the control group (N = 30). The total cellularity of blood, bone marrow, spleen, and bronchoalveolar lavage evaluated after the LPS stimulus indicated reduced number of total cells in all compartments studied and different kinetics of migration in malnourished animals. The in vitro migration assay showed reduced capacity of migration after the LPS stimulus in malnourished animals (45.7 ± 17.2 × 104 cells/mL) compared to control (69.6 ± 7.1 × 104 cells/mL, P ≤ 0.05), but there was no difference in CD11a/CD18 expression on the surface of blood leukocytes. In addition, the production of IL-1β in vivo after the LPS stimulus (180.7 pg·h−1·mL−1), and in vitro by bone marrow and spleen cells (41.6 ± 15.0 and 8.3 ± 4.0 pg/mL) was significantly lower in malnourished animals compared to control (591.1 pg·h−1·mL−1, 67.0 ± 23.0 and 17.5 ± 8.0 pg/mL, respectively, P ≤ 0.05). The reduced expression of IL-1β, together with the lower number of leukocytes in the central and peripheral compartments, different leukocyte kinetics, and reduced leukocyte migration capacity are factors that interfere with the capacity to mount an adequate immune response, being partly responsible for the immunodeficiency observed in PEM. PMID:22983177

  15. Validity of mid arm circumference to detect protein energy malnutrition among 8-11 months old infants in a rural medical college of West Bengal.

    Science.gov (United States)

    Sadhukhan, Sanjoy Kr; Chatterjee, Chitra; Shrivastava, Prabha; Sardar, Jadav Chandra; Joardar, Gautam Kr; Lahiri, Saibendu

    2010-09-01

    This institution-based cross-sectional observational validation study was conducted in the immunisation clinic of North Bengal Medical College and Hospital, Sushrutanagar. The objective was to identify the validity characteristics of mid arm circumference to detect protein energy malnutrition among 8-11 months infants and to find out a suitable cut-off value if any. Study variables were age, sex, body weight and mid arm circumference. Mid arm circumference was validated against weight for age criteria (gold standard) of malnutrition. The mean mid arm circumference of the infants was found to be almost constant with only about 2.22% change over 4 months, signifying that single cut-off point can be used to detect protein energy malnutrition. Mid arm circumference values from 13.0 to 12.5 cm were found to have the highest accuracy to detect protein energy malnutrition (about 86%). The cut-off values of 12.5 and 12.6 cm were noted to have a sensitivity and specificity of about 52% and 96% respectively, a false negativity of 48% but a false positivity of only 4%. Receiver operating characteristics curve detected 12.5(12.6) cm as the best diagnostic cut-off point which can detect more than 50% of the malnourished babies with very little false positivity/misdiagnosis (only 4%). A simple measuring tape with some reorientation of the health workers can detect the beginning of childhood malnutrition.

  16. 78 FR 18960 - Atlantic Coastal Fisheries Cooperative Management Act Provisions; General Provisions for Domestic...

    Science.gov (United States)

    2013-03-28

    ... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC586 Atlantic Coastal Fisheries Cooperative Management Act Provisions; General Provisions for Domestic Fisheries; Application for Exempted Fishing Permits AGENCY: National Marine Fisheries Service (NMFS), National Oceanic...

  17. 9 CFR 93.916 - Special provisions.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Special provisions. 93.916 Section 93... § 93.916 Special provisions. (a) Slaughter. Live VHS-regulated fish from VHS-regulated regions may be... establishment discharges its waste water to a municipal sewage system that includes waste water disinfection...

  18. 48 CFR 11.107 - Solicitation provision.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Solicitation provision. 11... transaction-based reporting method to report its use of voluntary consensus standards to the National... Use of Voluntary Consensus Standards and in Conformity Assessment Activities”). Use of the provision...

  19. Shelter provision and state sovereignty in Calais

    Directory of Open Access Journals (Sweden)

    Michael Boyle

    2017-06-01

    Full Text Available Government provision of shelter for Calais’ migrant population over the last twenty years has prioritised the assertion of state authority over the alleviation of human suffering. Policies in 2015-16, which involved the destruction of informal shelter and the provision of basic alternative accommodation, continued this trend.

  20. 22 CFR 63.9 - General provisions.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false General provisions. 63.9 Section 63.9 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES PAYMENTS TO AND ON BEHALF OF PARTICIPANTS IN THE INTERNATIONAL EDUCATIONAL AND CULTURAL EXCHANGE PROGRAM § 63.9 General provisions. The following...

  1. 22 CFR 226.48 - Contract provisions.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Contract provisions. 226.48 Section 226.48 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.48 Contract provisions. The...

  2. 30 CFR 847.2 - General provisions.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false General provisions. 847.2 Section 847.2 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR PERMANENT PROGRAM... court of competent jurisdiction enters a judgment against or convicts a person under these provisions...

  3. 12 CFR 931.9 - Transition provision.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Transition provision. 931.9 Section 931.9 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK RISK MANAGEMENT AND CAPITAL STANDARDS FEDERAL HOME LOAN BANK CAPITAL STOCK § 931.9 Transition provision. (a) In general. Each Bank shall comply...

  4. 12 CFR 1261.2 - General provisions.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false General provisions. 1261.2 Section 1261.2 Banks and Banking FEDERAL HOUSING FINANCE AGENCY FEDERAL HOME LOAN BANKS FEDERAL HOME LOAN BANK DIRECTORS Federal Home Loan Bank Boards of Directors: Eligibility and Elections § 1261.2 General provisions. (a...

  5. 40 CFR 141.76 - Recycle provisions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Recycle provisions. 141.76 Section 141...) NATIONAL PRIMARY DRINKING WATER REGULATIONS Filtration and Disinfection § 141.76 Recycle provisions. (a... recycle spent filter backwash water, thickener supernatant, or liquids from dewatering processes must meet...

  6. Energy provision under Obama administration

    Energy Technology Data Exchange (ETDEWEB)

    Gale, J. [IEA Greenhouse Gas R & D Programme, Cheltenham (United Kingdom)

    2009-03-15

    The new bill before the Senate, the American Recovery and Reinvestment Act of 2009, allows for an additional amount for 'Fossil Energy Research and Development' of $4.6 billion, to be available until 30 September 2010 and that $2 billion of that is available for one or more near zero emissions power plant(s). Two further provisions allow for an additional $1 billion for the Department's Clean Coal Power Initiative Round III and a further $1.5 billion for a competitive solicitations for projects that demonstrate carbon capture from industrial sources. Awards for such projects may include plant efficiency improvements for integration with carbon capture technology. The press seems to be divided whether this money will help revive the FutureGen project. The financial commitment should help the G8 achieve its objective of seeing 20 CCS demonstration projects around the world by 2020. An economic stimulus package proposed by the incoming Barack Obama administration include $150 billion to be spent over 10 years to spur next generation biofuels, plug in hybrid vehicles, a new digital electrical grid and new low emission coal plants. The proposal is intended to create jobs and address critical infrastructure in the US.

  7. Implementing the optimal provision of ecosystem services.

    Science.gov (United States)

    Polasky, Stephen; Lewis, David J; Plantinga, Andrew J; Nelson, Erik

    2014-04-29

    Many ecosystem services are public goods whose provision depends on the spatial pattern of land use. The pattern of land use is often determined by the decisions of multiple private landowners. Increasing the provision of ecosystem services, though beneficial for society as a whole, may be costly to private landowners. A regulator interested in providing incentives to landowners for increased provision of ecosystem services often lacks complete information on landowners' costs. The combination of spatially dependent benefits and asymmetric cost information means that the optimal provision of ecosystem services cannot be achieved using standard regulatory or payment for ecosystem services approaches. Here we show that an auction that sets payments between landowners and the regulator for the increased value of ecosystem services with conservation provides incentives for landowners to truthfully reveal cost information, and allows the regulator to implement the optimal provision of ecosystem services, even in the case with spatially dependent benefits and asymmetric information.

  8. Evaluating risk factors for protein-energy malnutrition in children under the age of six years: a case-control study from Iran

    Directory of Open Access Journals (Sweden)

    Sharghi A

    2011-08-01

    Full Text Available Afshan Sharghi1, Aziz Kamran2, Mohammad Faridan31Department of Community Medicine, Medical School, Ardebil University of Medical Sciences, Ardebil, 2Department of Public Health, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, 3Department of Public Health, Faculty of Health, Lorestan University of Medical Sciences, Lorestan, IranIntroduction: Protein-energy malnutrition is one of the most important public health problems in Iran. It not only accounts for more than half of child mortality but can also produce somatic and mental impairment in survivors. The main aim of this study was to identify risk factors for protein-energy malnutrition in children under 6 years of age in Namin city.Methods: This was a population-based, multicenter case-control study. Seventy-six children with malnutrition and 76 children without malnutrition were randomly recruited for case and control groups. The prevalence of risk factors in the two groups was compared. Data were gathered from a health center database and interviews with mothers and health workers. The Wilcoxon signed-rank test and logistic regression were used for data analysis.Results: Female gender, poverty, short maternal height, and use of unhygienic latrines in the home were significantly associated with childhood malnutrition (P , 0.05.Conclusion: The results of this study indicate four main factors (poverty, small maternal height, female gender, and absence of hygienic latrines in the home as underlying factors in malnutrition of children under the age of 6 years.Keywords: protein-energy malnutrition, children, risk factors, Namin

  9. Proposal for a coordination research programme (CRP) of the International Atomic Energy Agency (IAEA) on stable isotope tracer techniques for studies on protein-energy interactions

    International Nuclear Information System (INIS)

    Shetty, P.; James, W.P.T.

    1993-01-01

    This Report provides a rationale and justification for the initiation of a Coordinated Research programme to support studies using stable isotopic tracer techniques to address priority areas of human protein-energy interactions with special emphasis on the problems of human nutrition in developing countries. The Report suggests a modus for establishing such a practically oriented Coordinated Research Programme under the aegis of the International Atomic Energy Agency with concrete suggestions for its organization and the identification of probable participants in such a programme. The likely sources of additional funding to sustain such an activity viable for a period of 4 to 5 years are also indicated. 8 refs

  10. Maternal protein-energy malnutrition during early pregnancy in sheep impacts the fetal ornithine cycle to reduce fetal kidney microvascular development.

    OpenAIRE

    Dunford, L. J.; Sinclair, K. D.; Kwong, W. Y.; Sturrock, C.; Clifford, B. L.; Giles, T. C.; Gardner, D. S.

    2014-01-01

    This paper identifies a common nutritional pathway relating maternal through to fetal protein-energy malnutrition (PEM) and compromised fetal kidney development. Thirty-one twin-bearing sheep were fed either a control (n=15) or low-protein diet (n=16, 17 vs. 8.7 g crude protein/MJ metabolizable energy) from d 0 to 65 gestation (term, ?145 d). Effects on the maternal and fetal nutritional environment were characterized by sampling blood and amniotic fluid. Kidney development was characterized ...

  11. 28 CFR 16.1 - General provisions.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false General provisions. 16.1 Section 16.1 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION... administration of the Department of Justice. ...

  12. Constitutional Provisions And Administrative Disciplinary Powers ...

    African Journals Online (AJOL)

    Constitutional Provisions And Administrative Disciplinary Powers: The Medical ... and Dental Practitioners Act. This process of administrative adjudication is ... the rights guaranteed to the professionals when they appear before the Tribunal.

  13. 48 CFR 225.7605 - Solicitation provision.

    Science.gov (United States)

    2010-10-01

    ... SYSTEM, DEPARTMENT OF DEFENSE SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Secondary Arab Boycott of Israel... accordance with 225.7604, use the provision at 252.225-7031, Secondary Arab Boycott of Israel, in all...

  14. Post Fukushima safety enhancements in Indian PHWRS

    International Nuclear Information System (INIS)

    Ramasomayajulu, M.; Khot, Pankaj; Chauhan, Ashok

    2016-01-01

    Fukushima event was reviewed in Nuclear Power Corporation of India (NPCIL) and based on these reviews, safety enhancements were identified for Indian PHWRs. Safety enhancements such as additional emergency power sources, enhanced onsite water inventories, external water injection arrangements (Hook up points), measures related to hydrogen management, containment venting provision, seismic trip, mobile pumps, onsite emergency support Centre. These safety enhancements were reviewed by the regulatory body (Atomic Energy Regulatory Board, AERB) and were approved for implementation. Most of these are either implemented or in the advance stage of implementation. The paper elaborates above safety enhancements implemented post Fukushima accident; and preparedness to use these provisions. (author)

  15. Outsourcing, public Input provision and policy cooperation

    OpenAIRE

    Aronsson, Thomas; Koskela, Erkki

    2009-01-01

    This paper concerns public input provision as an instrument for redistribution under international outsourcing by using a model-economy comprising two countries, North and South, where firms in the North may outsource part of their low-skilled labor intensive production to the South. We consider two interrelated issues: (i) the incentives for each country to modify the provision of public input goods in response to international outsourcing, and (ii) whether international outsourcing justifie...

  16. Obligatory provisions for nuclear power plants

    International Nuclear Information System (INIS)

    Cloosters, W.

    2008-01-01

    To cover the expenses associated with decommissioning and disposal of their nuclear power plants, German nuclear power plant operators set aside a total of more than EUR 30 billion and entered the respective provisions into their balance sheets. One point of eminent importance in this regard is the question whether these provisions are adequate in amount and permitted under accounting and tax laws. The other point to be considered is whether the funds will be available reliably if and when needed. Against the backdrop of these issues, the practice and importance of making these provisions are described. This is followed by an outline of the basic accounting and taxation aspects. It is seen that obligations under public law can be the basis of financial provisions only if there is a obligation sufficiently concrete in terms of time and object. The following examination of applicable obligations under the Atomic Energy Act incumbent upon nuclear power plant operators with regard to decommissioning and disposal results in the finding that such obligations are only partly regulated in the Atomic Energy Act, and that specifications in terms of time and purpose are insufficient. If the national practice of making financial provisions is to be put on a reliable basis, it is recommended to express the law on decommissioning and its mode of financing in more concrete terms in the Atomic Energy Act. In addition to unequivocal decommissioning and disposal obligations, the Atomic Energy Act should also incorporate regulations about financial provisions for decomissioning which are in need of more precise language. The present practice of making provisions is characterized by the risk that the funds necessary for planned decommissioning and disposal may not be available when needed. It is against this background that possible solutions reducing that risk are discussed. A recommendation is expressed to establish a public fund for decommissioning and disposal to which the

  17. Economic Loan Loss Provision and Expected Loss

    Directory of Open Access Journals (Sweden)

    Stefan Hlawatsch

    2010-10-01

    Full Text Available The intention of a loan loss provision is the anticipation of the loan's expected losses by adjusting the book value of the loan. Furthermore, this loan loss provision has to be compared to the expected loss according to Basel II and, in the case of a difference, liable equity has to be adjusted. This however assumes that the loan loss provision and the expected loss are based on a similar economic rationale, which is only valid conditionally in current loan loss provisioning methods according to IFRS. Therefore, differences between loan loss provisions and expected losses should only result from different approaches regarding the parameter estimation within each model and not due to different assumptions regarding the outcome of the model. The provisioning and accounting model developed in this paper overcomes the before-mentioned shortcomings and is consistent with an economic rationale of expected losses. Additionally, this model is based on a close-to-market valuation of the loan that is in favor of the basic idea of IFRS. Suggestions for changes in current accounting and capital requirement rules are provided.

  18. Protein-energy malnutrition during early gestation in sheep blunts fetal renal vascular and nephron development and compromises adult renal function.

    Science.gov (United States)

    Lloyd, Louise J; Foster, Thomas; Rhodes, Phillip; Rhind, Stewart M; Gardner, David S

    2012-01-15

    A nutritionally poor maternal diet can reduce nephron endowment and pre-empt premature expression of markers for chronic renal disease in the offspring. A mechanistic pathway from variation in maternal diet through altered fetal renal development to compromised adult kidney structure and function with adult-onset obesity has not been described. We show that maternal protein-energy malnutrition in sheep blunts nephrogenic potential in the 0.44 gestation (65 days gestation, term ∼147 days) fetus by increasing apoptosis and decreasing angiogenesis in the nephrogenic zone, effects that were more marked in male fetuses. As adults, the low-protein-exposed sheep had reduced glomerular number and microvascular rarefaction in their kidneys compensated for, respectively, by glomerular hypertrophy and increased angiogenic support. In this study, the long-term mild anatomical deficits in the kidney would have remained asymptomatic in the lean state, but when superimposed on the broad metabolic challenge that obesity represents then microalbuminuria and blunted bilateral renal function revealed a long-term physiological compromise, that is only predicted to worsen with age. In conclusion, maternal protein-energy malnutrition specifically impacts fetal kidney vascular development and prevents full functionality of the adult kidney being achieved; these residual deficits are predicted to significantly increase the expected incidence of chronic kidney disease in prenatally undernourished individuals especially when coupled with a Western obesogenic environment.

  19. Desnutrição protéico-energética no paciente gastrectomizado Protein-energy deficiency in the gastrectomized patient

    Directory of Open Access Journals (Sweden)

    Silvia Justina PAPINI-BERTO

    2002-03-01

    Full Text Available Racional - A gastrectomia traz conseqüências nutricionais inevitáveis mas atenuáveis, dependendo da dietoterapia pós-operatória. Embora observada, essa desnutrição protéico-energética é pouco dimensionada, provavelmente, pela falta de consenso metodológico. Objetivo - Avaliar o grau de desnutrição protéico-energética do paciente gastrectomizado, utilizando-se de indicadores isolados ou combinados. Pacientes e Métodos - Foram estudados 71 pacientes com gastrectomia parcial (n = 53 ou total (n =18 em pós-operatório de 6 a 24 meses e 24-60 meses. Os dados dietéticos, composição corporal e bioquímicos foram analisados de acordo com o tipo de gastrectomia e tempo pós-operatório. Resultados - A cirurgia foi conseqüência de complicações de úlcera péptica (68% ou a câncer gástrico (32%. A perda de peso foi referida por 70% dos pacientes, sendo maior no grupo gastrectomia total (16 ± 5 kg do que no grupo gastrectomia parcial (10 ± 6 kg. Em geral, os pacientes apresentaram déficit antropométrico, albuminemia normal e baixa ingestão calórica, sugerindo deficiência energética crônica. A redução de hemoglobina, hematócrito e ferro ocorreu em maior intensidade e mais precocemente no grupo gastrectomia total. Assim, quando se associou hemoglobina aos indicadores albumina, linfócitos circunferência do braço e prega cutânea subescapular, a prevalência de desnutrição protéico-energética foi maior e em maior intensidade do que na ausência da hemoglobina. Conclusão - A gastrectomia resultou em desnutrição protéico-energética do tipo marasmática, acompanhada de anemia, mais intensa e precoce na gastrectomia total e gradativa na gastrectomia parcial, assemelhando-se à gastrectomia total no pós-operatório tardio.Background - Gastrectomy leads to nutritional consequences that although expected, are not usually measured due to methodological limitations. Aim - To assess the protein-energy deficiency degrees

  20. 10 CFR 603.875 - Foreign access to technology and U.S. competitiveness provisions.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Foreign access to technology and U.S. competitiveness... Foreign access to technology and U.S. competitiveness provisions. (a) Consistent with the objective of enhancing national security and United States competitiveness by increasing the public's reliance on the...

  1. 76 FR 16703 - Small Business Jobs Act Tour: Selected Provisions Having an Effect on Government Contracting

    Science.gov (United States)

    2011-03-25

    ... entrepreneurs and small business owners. The new law also contained numerous provisions to help enhance small... the President in April 2010 to identify ways in which to increase small business participation in the... lending policy, processing, and oversight. Room 3--EXPORTING Discussion of new exporting tools: increased...

  2. Bank loan loss provisions research: A review

    Directory of Open Access Journals (Sweden)

    Peterson K. Ozili

    2017-09-01

    Full Text Available We review the recent academic and policy literature on bank loan loss provisioning. Among other things, we observe that there exist some interaction between LLPs and existing prudential, accounting, institutional, cultural, religious, tax and fiscal frameworks which differ across countries; and we find that managerial discretion in provisioning is strongly linked to income smoothing, capital management, signalling, tax management and other objectives. We also address several issues including the ethical dimensions of income smoothing, factors influencing income smoothing, methodological issues in LLP modelling and the dynamic loan loss provisioning experiment; which opens up several avenues for further research such as: finding a balance between sufficient LLPs which regulators want versus transparent LLPs which standard setters want; the sensitivity of abnormal LLPs to changes in equity; the persistence of abnormal LLPs following CEO exit; country-specific interventions that induce LLP procyclicality in emerging countries; the impact of Basel III on banks' provisioning discretion; LLP behaviour among systemic and non-systemic financial institutions; etc. We conclude that regulators need to pay attention to how much discretion lending institutions should have in determining reported provision estimates, and this has been a long standing issue.

  3. Methods of Services Provision in Slovak Towns

    Directory of Open Access Journals (Sweden)

    Emília Sičáková-Beblavá

    2009-07-01

    Full Text Available This article deals with the methods of services provision in Slovak towns.  It addresses decision-making concerning selected services provision, based on a transaction cost economic model. The article looks at five types of services from that point of view. These are core services, i.e., services that are provided in most Slovak towns, thereby allowing outcomes of decision-making to be compared, and services which can be outsourced according to transaction cost theory. Findings partially confirm the hypothesis: Slovak towns do outsource, though “insourcing” moderately prevails. However, a comparison of several research studies in the area indicates a trend towards higher outsourcing of such local services provision.  The findings show that public bodies do not always select the most suitable methods of services provision, as suggested by the transaction costs theory (the Brown-Potoski model. This indicates that it is not only economic models that influence decision-making concerning the organization of services provision in the Slovak towns.

  4. 40 CFR 1042.640 - Special provisions for branded engines.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Special provisions for branded engines. 1042.640 Section 1042.640 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Special Compliance Provisions § 1042.640 Special provisions for branded engines. The following provisions...

  5. Content provision and multi-homing

    OpenAIRE

    Pires, Armando J. Garcia

    2015-01-01

    We analyze the effects of multi-homing consumers on content provision by media firms. We develop a model where media firms compete on content provision and advertising revenues, and consumers enjoy network effects from consuming content that other consumers also consume. Media firms have to choose if they are single-content or multi-content, and in the latter case how much content to offer. Competition for advertising revenues gives a two-sided market nature to our model, since advertisers pr...

  6. Dividends Provisions in Croatian Double Taxation Agreements

    Directory of Open Access Journals (Sweden)

    Marjeta Tomulić Vehovec

    2007-03-01

    Full Text Available This paper analyzes the provisions concerning dividends in the double taxation avoidance agreements concluded by the Republic of Croatia. Since the base for taxation is necessarily laid down in domestic law, Croatian legislation is examined as well. The author primarily discusses dividends provisions in four agreements signed with Germany, Austria, Switzerland and Slovenia, in addition to analyzing the differences from and similarities with the OECD Model Convention. Second, the paper briefly explains the methods for eliminating double taxation on income from dividends. Finally, it addresses the changes necessary for accession to the European Union.

  7. Do provisions to advance chemical facility safety also advance chemical facility security? - An analysis of possible synergies

    OpenAIRE

    Hedlund, Frank Huess

    2012-01-01

    The European Commission has launched a study on the applicability of existing chemical industry safety provisions to enhancing security of chemical facilities covering the situation in 18 EU Member States. This paper reports some preliminary analytical findings regarding the extent to which existing provisions that have been put into existence to advance safety objectives due to synergy effects could be expected advance security objectives as well.The paper provides a conceptual definition of...

  8. 12 CFR 714.8 - Are the early payment provisions, or interest rate provisions, applicable in leasing arrangements?

    Science.gov (United States)

    2010-01-01

    ... provisions, or interest rate provisions, applicable in leasing arrangements? You are not subject to the early... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Are the early payment provisions, or interest rate provisions, applicable in leasing arrangements? 714.8 Section 714.8 Banks and Banking NATIONAL...

  9. Etiology of the protein-energy wasting syndrome in chronic kidney disease: a consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM).

    Science.gov (United States)

    Carrero, Juan Jesús; Stenvinkel, Peter; Cuppari, Lilian; Ikizler, T Alp; Kalantar-Zadeh, Kamyar; Kaysen, George; Mitch, William E; Price, S Russ; Wanner, Christoph; Wang, Angela Y M; ter Wee, Pieter; Franch, Harold A

    2013-03-01

    Protein-energy wasting (PEW), a term proposed by the International Society of Renal Nutrition and Metabolism (ISRNM), refers to the multiple nutritional and catabolic alterations that occur in chronic kidney disease (CKD) and associate with morbidity and mortality. To increase awareness, identify research needs, and provide the basis for future work to understand therapies and consequences of PEW, ISRNM provides this consensus statement of current knowledge on the etiology of PEW syndrome in CKD. Although insufficient food intake (true undernutrition) due to poor appetite and dietary restrictions contribute, other highly prevalent factors are required for the full syndrome to develop. These include uremia-induced alterations such as increased energy expenditure, persistent inflammation, acidosis, and multiple endocrine disorders that render a state of hypermetabolism leading to excess catabolism of muscle and fat. In addition, comorbid conditions associated with CKD, poor physical activity, frailty, and the dialysis procedure per se further contribute to PEW. Published by Elsevier Inc.

  10. Early decrease in dietary protein:energy ratio by fat addition and ontogenetic changes in muscle growth mechanisms of rainbow trout: short- and long-term effects.

    Science.gov (United States)

    Alami-Durante, Hélène; Cluzeaud, Marianne; Duval, Carine; Maunas, Patrick; Girod-David, Virginia; Médale, Françoise

    2014-09-14

    As the understanding of the nutritional regulation of muscle growth mechanisms in fish is fragmentary, the present study aimed to (1) characterise ontogenetic changes in muscle growth-related genes in parallel to changes in muscle cellularity; (2) determine whether an early decrease in dietary protein:energy ratio by fat addition affects the muscle growth mechanisms of rainbow trout (Oncorhynchus mykiss) alevins; and (3) determine whether this early feeding of a high-fat (HF) diet to alevins had a long-term effect on muscle growth processes in juveniles fed a commercial diet. Developmental regulation of hyperplasia and hypertrophy was evidenced at the molecular (expression of myogenic regulatory factors, proliferating cell nuclear antigen and myosin heavy chains (MHC)) and cellular (number and diameter of white muscle fibres) levels. An early decrease in dietary protein:energy ratio by fat addition stimulated the body growth of alevins but led to a fatty phenotype, with accumulation of lipids in the anterior part, and less caudal muscle when compared at similar body weights, due to a decrease in both the white muscle hyperplasia and maximum hypertrophy of white muscle fibres. These HF diet-induced cellular changes were preceded by a very rapid down-regulation of the expression of fast-MHC. The present study also demonstrated that early dietary composition had a long-term effect on the subsequent muscle growth processes of juveniles fed a commercial diet for 3 months. When compared at similar body weights, initially HF diet-fed juveniles indeed had a lower mean diameter of white muscle fibres, a smaller number of large white muscle fibres, and lower expression levels of MyoD1 and myogenin. These findings demonstrated the strong effect of early feed composition on the muscle growth mechanisms of trout alevins and juveniles.

  11. Protein-energy malnutrition alters IgA responses to rotavirus vaccination and infection but does not impair vaccine efficacy in mice.

    Science.gov (United States)

    Maier, Elizabeth A; Weage, Kristina J; Guedes, Marjorie M; Denson, Lee A; McNeal, Monica M; Bernstein, David I; Moore, Sean R

    2013-12-17

    Conflicting evidence links malnutrition to the reduced efficacy of rotavirus vaccines in developing countries, where diarrhea and undernutrition remain leading causes of child deaths. Here, we adapted mouse models of rotavirus vaccination (rhesus rotavirus, RRV), rotavirus infection (EDIM), and protein-energy malnutrition (PEM) to test the hypothesis that undernutrition reduces rotavirus vaccine immunogenicity and efficacy. We randomized wild type Balb/C dams with 3-day-old pups to a control diet (CD) or an isocaloric, multideficient regional basic diet (RBD) that produces PEM. At 3 weeks of age, we weaned CD and RBD pups to their dams' diet and subrandomized weanlings to receive a single dose of either live oral rotavirus vaccine (RRV) or PBS. At 6 weeks of age, we orally challenged all groups with murine rotavirus (EDIM). Serum and stool specimens were collected before and after RRV and EDIM administration to measure viral shedding and antibody responses by ELISA. RBD pups and weanlings exhibited significant failure to thrive compared to age-matched CD mice (Pvaccination induced higher levels of serum anti-RV IgA responses in RBD vs. CD mice (PVaccination protected CD and RBD mice equally against EDIM infection, as measured by viral shedding. In unvaccinated RBD mice, EDIM shedding peaked 1 day earlier (Pvaccination (Pvaccination mitigated stool IgA responses to EDIM more in CD vs. RBD mice (Pvaccination and infection, undernutrition does not impair rotavirus vaccine efficacy nor exacerbate infection in this mouse model of protein-energy malnutrition. Alternative models are needed to elucidate host-pathogen factors undermining rotavirus vaccine effectiveness in high-risk global settings. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Information provision by regulated public transport companies

    DEFF Research Database (Denmark)

    Deborger, Bruno; Fosgerau, Mogens

    2012-01-01

    We study the interaction between pricing, frequency of service and information provision by public transport firms offering scheduled services, and we do so under various regulatory regimes. The model assumes that users can come to the bus stop or rail station at random or they can plan their trips...

  13. 15 CFR 748.1 - General provisions.

    Science.gov (United States)

    2010-01-01

    ... approval of the Secretary of Commerce or of the Under Secretary for Industry and Security. (d) Electronic... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false General provisions. 748.1 Section 748.1 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU...

  14. 28 CFR 105.27 - Miscellaneous provisions.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Miscellaneous provisions. 105.27 Section 105.27 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIMINAL HISTORY BACKGROUND CHECKS... has elected to opt out; or (ii) A participating State that has not yet established a process for...

  15. 5 CFR 534.506 - Conversion provisions.

    Science.gov (United States)

    2010-01-01

    ... conversion, other than to the minimum rate under 5 U.S.C. 5376, the increase must be approved by the head of... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Conversion provisions. 534.506 Section... OTHER SYSTEMS Pay for Senior-Level and Scientific and Professional Positions § 534.506 Conversion...

  16. 10 CFR 1706.6 - Solicitation provisions.

    Science.gov (United States)

    2010-01-01

    ... organizational conflicts of interest certificate from any marketing consultants engaged by an offeror in support... 10 Energy 4 2010-01-01 2010-01-01 false Solicitation provisions. 1706.6 Section 1706.6 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.6...

  17. 7 CFR 1956.57 - General provisions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true General provisions. 1956.57 Section 1956.57 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS... and surviving spouse, allowable funeral expenses, and dower and courtesy rights, and specific...

  18. 20 CFR 718.1 - Statutory provisions.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Statutory provisions. 718.1 Section 718.1 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND... establish criteria for the techniques to be used to take chest roentgenograms (X-rays) in connection with a...

  19. 15 CFR 301.1 - General provisions.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false General provisions. 301.1 Section 301.1 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE MISCELLANEOUS REGULATIONS INSTRUMENTS AND APPARATUS...

  20. 7 CFR 226.15 - Institution provisions.

    Science.gov (United States)

    2010-01-01

    ... personnel supported by funds provided under this part to support a nonprofit nutrition program for the... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.15...

  1. Mitigating Provider Uncertainty in Service Provision Contracts

    Science.gov (United States)

    Smith, Chris; van Moorsel, Aad

    Uncertainty is an inherent property of open, distributed and multiparty systems. The viability of the mutually beneficial relationships which motivate these systems relies on rational decision-making by each constituent party under uncertainty. Service provision in distributed systems is one such relationship. Uncertainty is experienced by the service provider in his ability to deliver a service with selected quality level guarantees due to inherent non-determinism, such as load fluctuations and hardware failures. Statistical estimators utilized to model this non-determinism introduce additional uncertainty through sampling error. Inability of the provider to accurately model and analyze uncertainty in the quality level guarantees can result in the formation of sub-optimal service provision contracts. Emblematic consequences include loss of revenue, inefficient resource utilization and erosion of reputation and consumer trust. We propose a utility model for contract-based service provision to provide a systematic approach to optimal service provision contract formation under uncertainty. Performance prediction methods to enable the derivation of statistical estimators for quality level are introduced, with analysis of their resultant accuracy and cost.

  2. 40 CFR 79.58 - Special provisions.

    Science.gov (United States)

    2010-07-01

    ... Non-baseline Products. A manufacturer with total annual sales less than $50 million is not required to... section. (3) Provisions Applicable to Atypical Products. A manufacturer with total annual sales less than... required for aerosol products. EPA will review the submitted information and, at EPA's discretion, may...

  3. 29 CFR 1926.900 - General provisions.

    Science.gov (United States)

    2010-07-01

    ... conduct blasting operations shall use every reasonable precaution including, but not limited to, visual... alternative provisions may be made which are adequately designed to prevent any premature firing of electric...) Blasting operations in the proximity of overhead power lines, communication lines, utility services, or...

  4. 7 CFR 249.25 - Other provisions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Other provisions. 249.25 Section 249.25 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE... (7 U.S.C. 2011, et seq.) and to any other Federal or State food or nutrition assistance program. (b...

  5. National Interference in Local Public Good Provision

    NARCIS (Netherlands)

    A.J. Dur (Robert); K. Staal (Klaas)

    2003-01-01

    textabstractWe analyze a simple model of local public good provision in a country consisting of a large number of heterogeneous regions, each comprising two districts, a city and a village. When districts remain autonomous and local public goods have positive spillover effects on the neighbouring

  6. 36 CFR 62.9 - General provisions.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false General provisions. 62.9 Section 62.9 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR... governments, or other interested individuals or groups to assist in administering the National Natural...

  7. Music Provision in UK Public Libraries

    Science.gov (United States)

    Dorney, Carl; McKnight, Cliff

    2004-01-01

    Public library music provision, as a less traditional role for public libraries, has always caused contention: a vital source of cultural materials within the community though never confirmed to be a core part of library services by the Government. This article concerns itself with a detailed consideration of the decline of music services over the…

  8. Incomplete Contracting Theory and EU Treaty Provisions

    DEFF Research Database (Denmark)

    Citi, Manuele; Jensen, Mads Dagnis

    , the paper utilises an automated text analysis approach to measure the ambiguity of Treaty provisions on a number of indicators. Empirically, the analysis demonstrates a significant association between the indicators of article ambiguity and the number of laws and court rulings. It thus provides support...

  9. 10 CFR 905.34 - Adjustment provisions.

    Science.gov (United States)

    2010-01-01

    ... continue to take place based on existing contract/marketing criteria principles. ... 10 Energy 4 2010-01-01 2010-01-01 false Adjustment provisions. 905.34 Section 905.34 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.34 Adjustment...

  10. 13 CFR 102.41 - Other provisions.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Other provisions. 102.41 Section 102.41 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION RECORD DISCLOSURE AND PRIVACY... the preservation of the constitutional principles of federalism and separation of powers. (d) Medical...

  11. Remote Health Care Provision in Care Homes.

    Science.gov (United States)

    Newbould, Louise; Mountain, Gail; Hawley, Mark; Ariss, Steve

    2017-01-01

    A survey was developed to map provision, knowledge, attitudes and views towards videoconferencing in care homes in Yorkshire and The Humber. The survey was sent to 859 care homes, with a 14% response rate. Twelve homes reported using videoconferencing. Non-users appeared skeptical, managers using the system reported improvements in outcomes.

  12. Wheelchair service provision education in academia

    Directory of Open Access Journals (Sweden)

    Karen H. Fung

    2017-09-01

    Conclusion: The majority of the educational institutions teach wheelchair education; however, there is great variability in what and how it is taught and evaluated. The results demonstrate the need for more in-depth investigation regarding the integration process of wheelchair education in educational institutions, with the ultimate goal of improving wheelchair service provision worldwide.

  13. 7 CFR 250.53 - Contract provisions.

    Science.gov (United States)

    2010-01-01

    ... the food service management company will ensure that its system of inventory management will not... recipient agency's fixed-price contract with a food service management company. Such provisions must also be... management company must credit the recipient agency for the value of all donated foods received for use in...

  14. 38 CFR 61.67 - Recovery provisions.

    Science.gov (United States)

    2010-07-01

    ...) VA HOMELESS PROVIDERS GRANT AND PER DIEM PROGRAM § 61.67 Recovery provisions. (a) If after 3 years from the date of award of a capital grant, the grant recipient has withdrawn from the VA Homeless Providers Grant and Per Diem Program (Program); does not establish the project for which the grant was made...

  15. 20 CFR 332.1 - Statutory provisions.

    Science.gov (United States)

    2010-04-01

    ..., or, with respect to a female employee, a calendar day on which, because of pregnancy, miscarriage, or... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Statutory provisions. 332.1 Section 332.1 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT...

  16. Constitutional provisions regarding juristic persons | Pienaar ...

    African Journals Online (AJOL)

    The interim Constitution of 1993 and the final Constitution of 1996 contain specific provisions applicable to juristic persons. Juristic persons are also entitled to the fundamental rights contained in the Bill of Rights to the extent that these rights are applicable to them. It must be kept in mind that juristic persons have peculiar ...

  17. 44 CFR 17.625 - Exception provision.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Exception provision. 17.625 Section 17.625 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (GRANTS) § 17.625 Exception...

  18. 42 CFR 412.200 - General provisions.

    Science.gov (United States)

    2010-10-01

    ... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Operating... the prospective payment system for inpatient operating costs. Except as provided in this subpart, the... for § 412.60, which deals with DRG classification and weighting factors, the provisions of subparts D...

  19. 15 CFR 700.70 - General provisions.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false General provisions. 700.70 Section 700.70 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE NATIONAL SECURITY INDUSTRIAL BASE REGULATIONS...

  20. 15 CFR 700.60 - General provisions.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false General provisions. 700.60 Section 700.60 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE NATIONAL SECURITY INDUSTRIAL BASE REGULATIONS...

  1. 15 CFR 700.50 - General provisions.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false General provisions. 700.50 Section 700.50 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE NATIONAL SECURITY INDUSTRIAL BASE REGULATIONS...

  2. 28 CFR 16.40 - General provisions.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false General provisions. 16.40 Section 16.40 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION..., commission, service, or administration of the Department of Justice. (2) Request for access to a record means...

  3. 7 CFR 760.808 - General provisions.

    Science.gov (United States)

    2010-01-01

    ... harvested production does not exist; (2) The loss is due to an ineligible cause of loss or practices, soil... provisions. (a) For calculations of loss, the participant's existing unit structure will be used as the basis... (2) For NAP covered crops, part 1437 of this title. (b) County average yield for loss calculations...

  4. 31 CFR 25.400 - Loan provisions.

    Science.gov (United States)

    2010-07-01

    ... SALES LOANS MADE BY THE DEFENSE SECURITY ASSISTANCE AGENCY AND FOREIGN MILITARY SALES LOANS MADE BY THE FEDERAL FINANCING BANK AND GUARANTEED BY THE DEFENSE SECURITY ASSISTANCE AGENCY Form of Private Loan § 25... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Loan provisions. 25.400 Section 25...

  5. 33 CFR 135.405 - Appeal provisions.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Appeal provisions. 135.405 Section 135.405 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OFFSHORE OIL POLLUTION COMPENSATION FUND...

  6. 5 CFR 9901.361 - General provisions.

    Science.gov (United States)

    2010-01-01

    ...) Introduction. As provided in § 9901.303(a)(2), the provisions of 5 U.S.C. chapter 55, subchapter V, and related... market supplements are treated the same as locality pay under 5 U.S.C. 5304 and are included in computing...

  7. 42 CFR 421.5 - General provisions.

    Science.gov (United States)

    2010-10-01

    ... U.S. Revised Statutes or any other provision of law that requires competitive bidding. (b.... (a) Competitive bidding not required for carriers. CMS may enter into contracts with carriers, or... certain administrative responsibilities that the law imposes. Accordingly, their agreements and contracts...

  8. 31 CFR 281.9 - General provisions.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false General provisions. 281.9 Section 281.9 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE FOREIGN EXCHANGE OPERATIONS § 281.9 General...

  9. 40 CFR 63.1433 - Wastewater provisions.

    Science.gov (United States)

    2010-07-01

    ... for Hazardous Air Pollutant Emissions for Polyether Polyols Production § 63.1433 Wastewater provisions... operation of the treatment process or control technique, the owner or operator shall instead comply with the... calibration gas for Method 25A, 40 CFR part 60, appendix A shall be the single organic HAP representing the...

  10. Advance Provision of Emergency Contraception for Adolescents

    Science.gov (United States)

    Adamji, Jehan-Marie; Swartwout, Kathryn

    2010-01-01

    Emergency contraception is most effective at preventing unintended pregnancy when taken as early as possible following unprotected sexual intercourse. Advance provision of this medication supports more timely and effective use. In the midst of rising teen pregnancy rates, current policies often limit access to emergency contraception for…

  11. Factors Predicting the Provision of Smoking Cessation Services Among Occupational Health Nurses in Thailand.

    Science.gov (United States)

    Chatdokmaiprai, Kannikar; Kalampakorn, Surintorn; McCullagh, Marjorie; Lagampan, Sunee; Keeratiwiriyaporn, Sansanee

    2017-06-01

    The purpose of this study was to identify factors predicting occupational health nurses' provision of smoking cessation services. Data were collected via a self-administered questionnaire distributed to 254 occupational health nurses in Thailand. Analysis by structural equation modeling revealed that self-efficacy directly and positively influenced smoking cessation services, and mediated the relationship between workplace factors, nurse factors, and smoking cessation services. The final model had good fit to the data, accounting for 20.4% and 38.0% of the variance in self-efficacy and smoking cessation services, respectively. The findings show that self-efficacy is a mediator that influences provision of smoking cessation services by occupational health nurses. Interventions to enhance nurses' self-efficacy in providing smoking cessation services are expected to promote provision of smoking cessation services to workers.

  12. Who should carry the cost of ecosystem service provision? A pan-European citizens’ view

    DEFF Research Database (Denmark)

    Prokofieva, Irina; Mavsar, Robert; Bartczak, Anna

    2014-01-01

    accepted concept in theory, the legitimacy of which nevertheless has not yet been challenged in practice. In our study, we conducted an extensive survey in five European countries – Finland, Denmark, Poland, Italy and Spain – with the aim to explore citizens’ opinions of who should carry the costs...... of ecosystem services provision. The ecosystem services in question were biodiversity, recreation, carbon sequestration, water quality, and scenic beauty. Our results show that the majority of respondents in all studied countries generally think that the costs of enhanced provision of ecosystem services shall......The underlying notion of payments for environmental services is that beneficiaries of environmental services (directly or indirectly) financially support their provision by covering at least part of the costs landowners incur to generate them. This so-called “beneficiary-pay principle” is a widely...

  13. Empowering change: The effects of energy provision on individual aspirations in slum communities

    International Nuclear Information System (INIS)

    Parikh, Priti; Chaturvedi, Sankalp; George, Gerard

    2012-01-01

    This paper discusses the role of energy provision in influencing the social aspirations of people living in slums. We examine factors that influence the shift in aspirations in five slum settlements using data from 500 interviews conducted in serviced and non-serviced slums from the state of Gujarat in India. The non-serviced slums did not have access to basic services namely water, sanitation, energy, roads, solid waste and rainwater management. We find empirical evidence which suggests that when basic infrastructure provisions are met, slum dwellers shift their focus from lower order aspirations to the higher order aspirations like health, education, housing and land ownership. We argue that energy provision enhances productivity and enables slum dwellers to shift their aspirations upwards. Furthermore, we test the effect of work days lost due to illness on the relationship between higher order aspirations and aspirations for energy provision. When provision of energy is low, higher work day loss dampens higher order aspirations. For policy makers, this study highlights the critical link between the infrastructure services preferred by slum dwellers and their social aspirations for growth. - Highlights: ► We examine the role of energy provision in influencing social aspirations of people living in slums. ► 500 household interviews conducted in five Indian slum settlements used for the analysis. ► Shift in slum dwellers aspirations from non-serviced to serviced conditions examined using Herzberg’s theory. ► Link between energy provision and higher order aspirations established through a regression model. ► Policy recommendation is to encourage investment in infrastructure services as a driver for development.

  14. Mutuality in the provision of Scottish healthcare.

    Science.gov (United States)

    Howieson, Brian

    2015-11-01

    The backdrop to this article is provided by the Better Health, Better Care Action Plan (Scottish Government, 2007), Section 1 of which is entitled 'Towards a Mutual NHS'. According to Better Health, Better Care (Scottish Government, 2007: 5): 'Mutual organisations are designed to serve their members. They are designed to gather people around a common sense of purpose. They are designed to bring the organisation together in what people often call "co-production."' The aim of this article is to précis the current knowledge of mutuality in the provision of Scottish healthcare. In detail, it will: introduce the 'mutual' organisation; offer a historical perspective of mutuality; suggest why healthcare mutuality is important; and briefly, detail the differences in mutual health-care policy in England and Scotland. It is hoped that this analysis will help researchers and practitioners alike appreciate further the philosophy of mutuality in the provision of Scottish healthcare. © The Author(s) 2015.

  15. The spares provisioning problem with parts inventory

    OpenAIRE

    Abboud, Nadim E.

    1990-01-01

    In this research, we consider the spares provisioning problem, where a finite population of homogeneous machines are being deployed to meet a constant demand. While a machine is operating, it could become inoperable due to the failure of a critical built-in part in the machine. Before repairs on the machine can be initiated, however, a replacement part must be obtained. If a replacement part is available from stock, the machine is immediately transferred to the repair subsystem...

  16. Fringe Benefits Provision by Rural Small Businesses

    OpenAIRE

    Jayachandran N. Variyam; David S. Kraybill

    1998-01-01

    We examine the relationship between employer size and the provision of fringe benefits in a large sample of rural businesses. A clear employer size-benefits relationship exists only in the case of health insurance, while other benefits are not strongly linked to employer size. The negative relationship between employer size and health insurance is weaker, though still existent, in businesses whose employees have relatively high skill levels. Single, independent establishments and sole proprie...

  17. Arm's Length Provision of Public Services

    DEFF Research Database (Denmark)

    Bennedsen, Morten; Schultz, Christian

    We analyze the economic consequences of strategic delegation of the right to decide between public or private provision of governmental service and/or the authority to negotiate and renegotiate with the chosen service provider. Our model encompass both bureaucratic delegation from a government...... contracts. The bargaining effect improves the bargaining position vis a vis a private firm with market power and leads to a lower price for the service...

  18. COMPONENTS PROVISION MANAGEMENT FOR MACHINE BUILDING MANUFACTURER

    Directory of Open Access Journals (Sweden)

    Ekaterina P. Bochkareva

    2014-01-01

    Full Text Available In the paper is given an approach to themanagement of components provision formachine building manufacturer based uponinternational standards and best practicesof leading international companies. Thecomplex expertise methods are used forthe development of the proposed machinebuilding manufacturer suppliers’ operational management method. At a strategic level is proposed a tool for planning the suppliers’portfolio and a machine building manufacturer supplier development methodology.

  19. Collateral in Loan Classification and Provisioning

    OpenAIRE

    In W Song

    2002-01-01

    Adequate loan classification practices are an essential part of a sound and effective credit risk-management process in a bank. Failure to identify deterioration in credit quality in a timely manner can aggravate and prolong the problem. Two key issues arise with regard to the use of collateral in the context of loan classification and provisioning. In particular, the questions arise whether collateral should be taken into account in classifying a collateralized loan, and whether it should be...

  20. The Full Costs of Electricity Provision

    International Nuclear Information System (INIS)

    Horst Keppler, Jan; Rothwell, Geoffrey; Cometto, Marco; Deffrennes, Marc; Iracane, Daniel; Ha, Jaejoo; Paillere, Henri; ); Aspelund, Karl; Aydil, Ismail; ); Berthelemy, Michel; Devezeaux De Lavergne, Jean-Guy; Burtin, Alain; Crozat, Matthew P.; D'Haeseleer, William; Friedrich, Reiner; Gonzalez Jimenez, Antonio; Hirschberg, Stefan; Kiso, Jan-Ole; ); Lee, Manki; Le Masne, Dominique; ); Lundmark, Roger J.; Neumann, Doris; ); Politis, Savvas; ); Prin, Coralie; Skonieczny, Olgierd; Voss, Alfred

    2018-01-01

    Electricity provision touches upon every facet of life in OECD and non-OECD countries alike, and choosing how this electricity is generated - whether from fossil fuels, nuclear energy or renewables - affects not only economic outcomes but individual and social well-being in the broader sense. Research on the overall costs of electricity is an ongoing effort, as only certain costs of electricity provision are perceived directly by producers and consumers. Other costs, such as the health impacts of air pollution, damage from climate change or the effects on the electricity system of small-scale variable production are not reflected in market prices and thus diminish well-being in unaccounted for ways. Accounting for these social costs in order to establish the full costs of electricity provision is difficult, yet such costs are too important to be disregarded in the context of the energy transitions currently under way in OECD and NEA countries. This report draws on evidence from a large number of studies concerning the social costs of electricity and identifies proven instruments for internalising them so as to improve overall welfare. The results outlined in the report should lead to new and more comprehensive research on the full costs of electricity, which in turn would allow policy makers and the public to make better informed decisions along the path towards fully sustainable electricity systems

  1. Security infrastructure for dynamically provisioned cloud infrastructure services

    NARCIS (Netherlands)

    Demchenko, Y.; Ngo, C.; de Laat, C.; Lopez, D.R.; Morales, A.; García-Espín, J.A.; Pearson, S.; Yee, G.

    2013-01-01

    This chapter discusses conceptual issues, basic requirements and practical suggestions for designing dynamically configured security infrastructure provisioned on demand as part of the cloud-based infrastructure. This chapter describes general use cases for provisioning cloud infrastructure services

  2. Bank Loan Loss Provisions, Investor Protection and the Macroeconomy

    OpenAIRE

    Ozili, Peterson K

    2017-01-01

    This study investigates the non-discretionary determinants of bank loan loss provisions in Africa after controlling for macroeconomic fluctuation, financial development and investor protection. We find that non-performing loans, loan-to-asset ratio and loan growth are significant non-discretionary drivers of bank provisions in the African region. We observe that bank provision is a positive function of non-performing loans up to a threshold beyond which bank provisions will no longer increase...

  3. An Approach to Measuring Provisions for Collateralised Lending

    OpenAIRE

    Cho-hoi Hui; Tom Fong

    2006-01-01

    Under the framework of Basel II, banks which adopt the internal ratings-based approach will be required to compare their actual provisions with expected losses. Any shortfall (i.e., the expected loss exceeds the provision) should be deducted from capital of the bank. It is therefore important to ensure banks make adequate provisions against expected losses. In addition, both sound policy and the Banking Ordinance require banks to take a forward-looking view of provisions. These requirements r...

  4. 7 CFR 457.166 - Blueberry crop insurance provisions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Blueberry crop insurance provisions. 457.166 Section... CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.166 Blueberry crop insurance provisions. The Blueberry Crop Insurance Provisions for the 2005 and succeeding crop years are as follows...

  5. Children's Rights, School Exclusion and Alternative Educational Provision

    Science.gov (United States)

    McCluskey, Gillean; Riddell, Sheila; Weedon, Elisabet

    2015-01-01

    This paper examines findings from a recent study in Wales of school exclusion and alternative educational provision. Many, but not all, children in alternative provision have been excluded from school. The most recent statistics reveal that nearly 90% of pupils in alternative provision have special educational needs, nearly 70% are entitled to…

  6. 7 CFR 457.142 - Northern potato crop insurance provisions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Northern potato crop insurance provisions. 457.142... INSURANCE CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.142 Northern potato crop insurance provisions. The Northern Potato Crop Insurance Provisions for the 2008 and succeeding...

  7. 7 CFR 457.123 - Almond crop insurance provisions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Almond crop insurance provisions. 457.123 Section 457... CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.123 Almond crop insurance provisions. The Almond Crop Insurance Provisions for the 2008 and succeeding crop years are as follows: FCIC...

  8. 7 CFR 457.162 - Nursery crop insurance provisions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Nursery crop insurance provisions. 457.162 Section 457... CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.162 Nursery crop insurance provisions. The Nursery Crop Insurance Provisions for the 2006 and succeeding crop years are as follows: FCIC...

  9. 10 CFR 625.3 - Standard sales provisions.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Standard sales provisions. 625.3 Section 625.3 Energy DEPARTMENT OF ENERGY (CONTINUED) SALES REGULATION PRICE COMPETITIVE SALE OF STRATEGIC PETROLEUM RESERVE PETROLEUM § 625.3 Standard sales provisions. (a) Contents. The Standards Sales Provisions shall contain...

  10. Protein-energy malnutrition during early childhood and periodontal disease in the permanent dentition of Haitian adolescents aged 12-19 years: a retrospective cohort study.

    Science.gov (United States)

    Russell, Stefanie L; Psoter, Walter J; Jean-Charles, Germain; Prophte, Samuel; Gebrian, Bette

    2010-05-01

    The aim of this retrospective cohort study was to examine whether exposure to early childhood protein-energy malnutrition (ECPEM) is related to worsened periodontal status in the permanent dentition during adolescence. A trained clinician/researcher examined the periodontal status of 96 persons aged 12-19 living in rural Haiti using WHO diagnostic criteria (Community Periodontal Index, WHO 1997). Malnutrition data of the study participants had been collected during the years 1988-1993 by a nongovernmental organization. We compared those who had been malnourished in early childhood, based on z-scores for anthropomorphic data collected during the first 5 years of life, with those who had not been malnourished, regarding mean Community Periodontal Index (CPI) score, controlling for age, sex, socioeconomic status, and smoking. Overall, 57.3% of the participants demonstrated a CPI score of 3 or greater in at least one sextant. ECPEM was independently and positively related to mean CPI score, when controlling for sex and smoking. More than half of these young Haitians demonstrated CPI scores of 3 or greater, and ECPEM was related to poorer periodontal status, as measured by CPI, in the permanent dentition.

  11. Maternal protein-energy malnutrition during early pregnancy in sheep impacts the fetal ornithine cycle to reduce fetal kidney microvascular development.

    Science.gov (United States)

    Dunford, Louise J; Sinclair, Kevin D; Kwong, Wing Y; Sturrock, Craig; Clifford, Bethan L; Giles, Tom C; Gardner, David S

    2014-11-01

    This paper identifies a common nutritional pathway relating maternal through to fetal protein-energy malnutrition (PEM) and compromised fetal kidney development. Thirty-one twin-bearing sheep were fed either a control (n=15) or low-protein diet (n=16, 17 vs. 8.7 g crude protein/MJ metabolizable energy) from d 0 to 65 gestation (term, ∼ 145 d). Effects on the maternal and fetal nutritional environment were characterized by sampling blood and amniotic fluid. Kidney development was characterized by histology, immunohistochemistry, vascular corrosion casts, and molecular biology. PEM had little measureable effect on maternal and fetal macronutrient balance (glucose, total protein, total amino acids, and lactate were unaffected) or on fetal growth. PEM decreased maternal and fetal urea concentration, which blunted fetal ornithine availability and affected fetal hepatic polyamine production. For the first time in a large animal model, we associated these nutritional effects with reduced micro- but not macrovascular development in the fetal kidney. Maternal PEM specifically impacts the fetal ornithine cycle, affecting cellular polyamine metabolism and microvascular development of the fetal kidney, effects that likely underpin programming of kidney development and function by a maternal low protein diet. © FASEB.

  12. Assessment of the reliability and consistency of the "malnutrition inflammation score" (MIS) in Mexican adults with chronic kidney disease for diagnosis of protein-energy wasting syndrome (PEW).

    Science.gov (United States)

    González-Ortiz, Ailema Janeth; Arce-Santander, Celene Viridiana; Vega-Vega, Olynka; Correa-Rotter, Ricardo; Espinosa-Cuevas, María de Los Angeles

    2014-10-04

    The protein-energy wasting syndrome (PEW) is a condition of malnutrition, inflammation, anorexia and wasting of body reserves resulting from inflammatory and non-inflammatory conditions in patients with chronic kidney disease (CKD).One way of assessing PEW, extensively described in the literature, is using the Malnutrition Inflammation Score (MIS). To assess the reliability and consistency of MIS for diagnosis of PEW in Mexican adults with CKD on hemodialysis (HD). Study of diagnostic tests. A sample of 45 adults with CKD on HD were analyzed during the period June-July 2014.The instrument was applied on 2 occasions; the test-retest reliability was calculated using the Intraclass Correlation Coefficient (ICC); the internal consistency of the questionnaire was analyzed using Cronbach's αcoefficient. A weighted Kappa test was used to estimate the validity of the instrument; the result was subsequently compared with the Bilbrey nutritional index (BNI). The reliability of the questionnaires, evaluated in the patient sample, was ICC=0.829.The agreement between MIS observations was considered adequate, k= 0.585 (p <0.001); when comparing it with BNI, a value of k = 0.114 was obtained (p <0.001).In order to estimate the tendency, a correlation test was performed. The r² correlation coefficient was 0.488 (P <0.001). MIS has adequate reliability and validity for diagnosing PEW in the population with chronic kidney disease on HD. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  13. Urinary metabonomics study in a rat model in response to protein-energy malnutrition by using gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry.

    Science.gov (United States)

    Wu, Zeming; Li, Min; Zhao, Chunxia; Zhou, Jia; Chang, Yuwei; Li, Xiang; Gao, Peng; Lu, Xin; Li, Yousheng; Xu, Guowang

    2010-11-01

    Systematic studies were performed on the biological perturbations in metabolic phenotype responding to protein-energy malnutrition through global metabolic profiling analysis, in combination with pattern recognition. The malnutrition rat model was established through five weeks of strict diet restriction, and the metabonome data obtained from gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry (LC-MS) were integrated to approximate the comprehensive metabolic signature. Principal component analysis and orthogonal projection to latent structure analysis were used for the classification of metabolic phenotypes and discovery of differentiating metabolites. The perturbations in the urine profiles of malnourished rats were marked by higher levels of creatine, threitol, pyroglutamic acid, gluconic acid and kynurenic acid, as well as decreased levels of succinic acid, cis-aconitic acid, citric acid, isocitric acid, threonic acid, trimethylglycine, N-methylnicotinic acid and uric acid. The alterations in these metabolites were associated with perturbations in energy metabolism, carbohydrate, amino acid, and fatty acid metabolism, purine metabolism, cofactor and vitamin metabolism, in response to protein and energy malnutrition. Our findings show the integration of GC-MS and LC-MS techniques for untargeted metabolic profiling analysis was promising for nutriology.

  14. Associations of Protein-Energy Wasting Syndrome Criteria With Body Composition and Mortality in the General and Moderate Chronic Kidney Disease Populations in the United States.

    Science.gov (United States)

    Beddhu, Srinivasan; Chen, Xiaorui; Wei, Guo; Raj, Dominic; Raphael, Kalani L; Boucher, Robert; Chonchol, Michel B; Murtaugh, Maureen A; Greene, Tom

    2017-05-01

    It is unknown whether the criteria used to define Protein-energy wasting (PEW) syndrome in dialysis patients reflect protein or energy wasting in the general and moderate CKD populations. In 11,834 participants in the 1999-2004 National Health and Nutrition Examination Survey, individual PEW syndrome criteria and the number of PEW syndrome categories were related to lean body and fat masses (measured by dual-energy absorptiometry) using linear regression in the entire cohort and CKD sub-population. Serum chemistry, body mass and muscle mass PEW criteria tended to be associated with lower lean body and fat masses, but the low dietary protein and energy intake criteria were associated with significantly higher protein and energy stores. When the number of PEW syndrome categories was defined by non-dietary categories alone, there was a monotonic inverse relationship with lean body and fat masses and strong positive relationship with mortality. In contrast, when dietary category alone was present, mean BMI was in the obesity range; additional presence of two non-dietary categories was associated with lower BMI and lower lean body and fat masses. Thus, the association of dietary category plus two additional non-dietary categories with lower protein or energy stores was driven by the presence of the two non-dietary categories. Results were similar in CKD subgroup. Hence, a definition of PEW syndrome without dietary variables has face validity and reflects protein or energy wasting.

  15. Nutritional evaluation of patients receiving dialysis for the management of protein-energy wasting: what is old and what is new?

    Science.gov (United States)

    Riella, Miguel C

    2013-05-01

    Advances in the nutritional support of hospitalized patients in the early 1970s led to the recognition that tools were needed to evaluate the nutritional status of patients. The observation that malnutrition in patients receiving dialysis was associated with increased morbidity and mortality prompted many expert groups to develop nutritional scoring systems to be applied in these patients. Given the diverse and confusing terminologies that emerged from these publications, the International Society of Renal Nutritional and Metabolism convened an expert panel to recommend a new nomenclature and preferred methods to evaluate the nutritional status of patients with chronic kidney disease (CKD). The new and inclusive term protein-energy wasting (PEW) refers to a systematically defined condition based on certain criteria and reflects malnutrition and wasting caused not only by inadequate nutrient intake but also by depletion resulting from the inflammatory and noninflammatory conditions that prevail in this population. Serial assessment of nutritional status for detection and management of PEW is recommended using old and new scoring tools, including the Subjective Global Assessment (SGA), malnutrition inflammation score (MIS), Geriatric Nutritional Risk Index (GNRI), and PEW definition criteria. These tools, which are reliable methods and predictors of outcomes, are reviewed in this article. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  16. Prevention and treatment of protein energy wasting in chronic kidney disease patients: a consensus statement by the International Society of Renal Nutrition and Metabolism.

    Science.gov (United States)

    Ikizler, T Alp; Cano, Noel J; Franch, Harold; Fouque, Denis; Himmelfarb, Jonathan; Kalantar-Zadeh, Kamyar; Kuhlmann, Martin K; Stenvinkel, Peter; TerWee, Pieter; Teta, Daniel; Wang, Angela Yee-Moon; Wanner, Christoph

    2013-12-01

    Protein energy wasting (PEW) is common in patients with chronic kidney disease (CKD) and is associated with adverse clinical outcomes, especially in individuals receiving maintenance dialysis therapy. A multitude of factors can affect the nutritional and metabolic status of CKD patients requiring a combination of therapeutic maneuvers to prevent or reverse protein and energy depletion. These include optimizing dietary nutrient intake, appropriate treatment of metabolic disturbances such as metabolic acidosis, systemic inflammation, and hormonal deficiencies, and prescribing optimized dialytic regimens. In patients where oral dietary intake from regular meals cannot maintain adequate nutritional status, nutritional supplementation, administered orally, enterally, or parenterally, is shown to be effective in replenishing protein and energy stores. In clinical practice, the advantages of oral nutritional supplements include proven efficacy, safety, and compliance. Anabolic strategies such as anabolic steroids, growth hormone, and exercise, in combination with nutritional supplementation or alone, have been shown to improve protein stores and represent potential additional approaches for the treatment of PEW. Appetite stimulants, anti-inflammatory interventions, and newer anabolic agents are emerging as novel therapies. While numerous epidemiological data suggest that an improvement in biomarkers of nutritional status is associated with improved survival, there are no large randomized clinical trials that have tested the effectiveness of nutritional interventions on mortality and morbidity.

  17. Security Cooperation: Comparison of Proposed Provisions for the FY2017 National Defense Authorization Act (NDAA)

    Science.gov (United States)

    2016-11-01

    In support of such a shift, Congress has incrementally provided DOD with some 80 or more authorities, apart from those in Title 22, to interact with...Congressional Research Service  enhanced budgeting transparency and reporting requirements to Congress; and  required assessment, monitoring...decision-making. The incremental nature of Congress’s adjustments to DOD’s Title 10 authorities, however, has resulted in some 80 or more provisions

  18. Money is an Experience Good: Competition and Trust in the Private Provision of Money

    OpenAIRE

    MARIMON, Ramon; NICOLINI, Juan Pablo; TELES, Pedro

    2011-01-01

    A previous version of this paper was circulated with the title 'Competition and Reputation'. We would like to thank Fernando Alvarez, Huberto Ennis, Robert Lucas, David Levine, and an anonymous referee, for their comments, as well as the participants in the seminars and conferences where this work was presented. We study the interplay between competition and trust as efficiency-enhancing mechanisms in the private provision of money. With commitment, trust is automatically achieved and comp...

  19. Strategy for incumbent wireline operator: customers' provision of broadband wireless access

    Science.gov (United States)

    Khan, Naveed Ahmed; Kan, Kaili; Tareen, Abdul Wahid

    2011-10-01

    The phenomenal growth in mobile market during last decade has left incumbent wireline operators with very low fixed line customer base. The incumbent wireline operators are losing their market dominant position and wireline resources are lying underutilized. This paper proposed a cost effective strategy for incumbent wireline operators for customers' provision of broadband wireless access. The strategy will make wireline networks more value added and customer base will increase. The revenue will enhance and wireline resources will be utilized more efficiently.

  20. The effect of balanced protein energy supplementation in undernourished pregnant women and child physical growth in low- and middle-income countries: a systematic review and meta-analysis.

    Science.gov (United States)

    Stevens, Briony; Buettner, Petra; Watt, Kerrianne; Clough, Alan; Brimblecombe, Julie; Judd, Jenni

    2015-10-01

    The beneficial effect of balanced protein energy supplementation during pregnancy on subsequent child growth is unclear and may depend upon the mother entering pregnancy adequately nourished or undernourished. Systematic reviews to-date have included studies from high-, middle- and low-income countries. However, the effect of balanced protein energy supplementation should not be generalised. This review assesses the effect of balanced protein energy supplementation in undernourished pregnant women from low- and middle-income countries on child growth. A systematic review of articles published in English (1970-2015) was conducted via MEDLINE, Scopus, the Cochrane Register and hand searching. Only peer-reviewed experimental studies analysing the effects of balanced protein energy supplementation in undernourished pregnant women from low- and middle-income countries with measures of physical growth as the primary outcome were included. Two reviewers independently assessed full-text articles against inclusion criteria. Validity of eligible studies was ascertained using the Quality Assessment Tool for Quantitative Studies (EPHPP QAT). In total, seven studies met the inclusion criteria. All studies reported on birthweight, five on birth length, three on birth head circumference, and one on longer-term growth. Standardised mean differences were calculated using a random-effects meta-analysis. Balanced protein energy supplementation significantly improved birthweight (seven randomised controlled trials, n = 2367; d = 0.20, 95% confidence interval, 0.03-0.38, P = 0.02). No significant benefit was observed on birth length or birth head circumference. Impact of intervention could not be determined for longer-term physical growth due to limited evidence. Additional research is required in low- and middle-income countries to identify impacts on longer-term infant growth. © 2015 John Wiley & Sons Ltd.

  1. Legal provisions governing gaseous effluents radiological monitoring

    International Nuclear Information System (INIS)

    Winkelmann, I.

    1985-01-01

    This contribution explains the main provisions governing radiological monitoring of gaseous effluents from LWR type nuclear power plants. KTA rule 1503.1 defines the measuring methods and tasks to be fulfilled by reactor operators in order to safeguard due monitoring and accounting of radioactive substances in the plants' gaseous effluents. The routine measurements are checked by a supervisory programme by an independent expert. The routine controls include analysis of filter samples, comparative measurement of radioactive noble gases, interlaboratory comparisons, and comparative evaluation of measured values. (DG) [de

  2. Public Service Provision in Clientelistic Political Settlements

    DEFF Research Database (Denmark)

    Whitfield, Lindsay; Hirvi, Marja

    2015-01-01

    The politics of public-service delivery continues to be neglected under the supposedly more context-sensitive post-Washington Consensus. Using interviews and documentary evidence from Ghana, this article provides an account of the networks of political interference and informal practices in Ghana......'s public water utility. It argues that, in order to understand why private-sector participation succeeds or fails and why similar arrangements have different outcomes across developing countries, we need to examine the effects of the informal institutional context, particularly the country......-specific political settlement in which public-service provision operates....

  3. Temporary provision against Kernkraftwerk Biblis dismissed

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    With its decision of November 19, 1979 - VIII IG 13/79 -, the Administrative Court of Hesse has refused the complaint of a Darmstadt resident whose application for a temporary provision interdicting further operation of the power plant units Biblis A and B had been refused by the Darmstadt Administrative Court. The costs of the procedure, including the extra-judicial costs of the witnesses heard, are to be paid by the plaintiff. The value in litigation was raised to DM 10 000,-. (orig./HP) 891 HP/orig.- 892 CKA [de

  4. Approaches to education provision for mobile pastoralists.

    Science.gov (United States)

    Dyer, C

    2016-11-01

    Experiences of mobile pastoralists often attest to a wide range of contradictions about the presumed advantages of formal education. While effort to 'reach' pastoralists has intensified under the global Education for All movement, there remain considerable difficulties in finding ways to make formal education relate to pastoralist livelihoods and complement endogenous knowledge. This paper examines how these dynamics play out across models of formal and non-formal education service provision, and identifies innovations that offer promising ways forward: Alternative Basic Education, Open and Distance Learning, and Pastoralist Field Schools.

  5. Household and kin provisioning by Hadza men.

    Science.gov (United States)

    Wood, Brian M; Marlowe, Frank W

    2013-09-01

    We use data collected among Hadza hunter-gatherers between 2005 and 2009 to examine hypotheses about the causes and consequences of men's foraging and food sharing. We find that Hadza men foraged for a range of food types, including fruit, honey, small animals, and large game. Large game were shared not like common goods, but in ways that significantly advantaged producers' households. Food sharing and consumption data show that men channeled the foods they produced to their wives, children, and their consanguineal and affinal kin living in other households. On average, single men brought food to camp on 28% of days, married men without children at home on 31% of days, and married men with children at home on 42% of days. Married men brought fruit, the least widely shared resource, to camp significantly more often than single men. A model of the relationship between hunting success and household food consumption indicates that the best hunters provided 3-4 times the amount of food to their families than median or poor hunters. These new data fill important gaps in our knowledge of the subsistence economy of the Hadza and uphold predictions derived from the household and kin provisioning hypotheses. Key evidence and assumptions backing prior claims that Hadza hunting is largely a form of status competition were not replicated in our study. In light of this, family provisioning is a more viable explanation for why good hunters are preferred as husbands and have higher fertility than others.

  6. Key state legislative provisions on purchasing alliances.

    Science.gov (United States)

    Wicks, E K; Curtis, R E; Haugh, K

    1994-01-01

    In order to function effectively in post-reform healthcare markets, behavioral healthcare professionals must understand and interact with health purchasing alliances. Healthcare reform initiatives based upon the principles of managed competition envision an important role for cooperative health purchasing organizations, or "health alliances," that collect premiums and contract with health plans for the provision of comprehensive health services delivered within the framework of a standardized benefit package. Health purchasing alliances have already been implemented in eight states, and this trend is expected to grow. The following article illustrates the structure and authority of the health alliances that are already in operation, and is presented here to give Behavioral Healthcare Tomorrow journal readers an up-to-date overview of reforming healthcare markets. This matrix arrays recent state laws which we identify as clearly including components of managed competition or purchasing alliances. Other states undoubtedly have elements of reform that include some aspects of these concepts. For example, under legislation, a Vermont health care authority was established and, among other things, charged with developing two comprehensive reform proposals, one of which will involve multipayors and the other a single-payor system. Options will likely embody many of the activities of alliances. Vermont is not included in this matrix because these provisions are still in the developmental stage.

  7. Well-being, work engagement, or both? Explaining the linkage between information provision, communication climate, and performance

    NARCIS (Netherlands)

    ter Hoeven, C.; Fransen, M.

    2012-01-01

    For organizations, it is valuable to know how employees’ performance can be guaranteed. The aim of the current study was to examine whether information provision may improve employee performance by enhancing communication climate, work engagement, and employee well-being. To this end, employees (N =

  8. Do provisions to advance chemical facility safety also advance chemical facility security? An analysis of possible synergies

    DEFF Research Database (Denmark)

    Hedlund, Frank Huess

    2012-01-01

    The European Commission has launched a study on the applicability of existing chemical industry safety provisions to enhancing security of chemical facilities covering the situation in 18 EU Member States. This paper reports some preliminary analytical findings regarding the extent to which exist...

  9. Nonorthogonal multiple access and carrierless amplitude phase modulation for flexible multiuser provisioning in 5G mobile networks

    NARCIS (Netherlands)

    Altabas, J.A.; Rommel, S.; Puerta, R.; Izquierdo, D.; Ignacio Garces, J.; Antonio Lazaro, J.; Vegas Olmos, J.J.; Tafur Monroy, I.

    2017-01-01

    In this paper, a combined nonorthogonal multiple access (NOMA) and multiband carrierless amplitude phase modulation (multiCAP) scheme is proposed for capacity enhancement of and flexible resource provisioning in 5G mobile networks. The proposed scheme is experimentally evaluated over a W-band

  10. Management of protein-energy wasting in non-dialysis-dependent chronic kidney disease: reconciling low protein intake with nutritional therapy1234

    Science.gov (United States)

    Kovesdy, Csaba P; Kopple, Joel D; Kalantar-Zadeh, Kamyar

    2013-01-01

    Protein-energy wasting (PEW), characterized by a decline in body protein mass and energy reserves, including muscle and fat wasting and visceral protein pool contraction, is an underappreciated condition in early to moderate stages of chronic kidney disease (CKD) and a strong predictor of adverse outcomes. The prevalence of PEW in early to moderate CKD is ≥20–25% and increases as CKD progresses, in part because of activation of proinflammatory cytokines combined with superimposed hypercatabolic states and declines in appetite. This anorexia leads to inadequate protein and energy intake, which may be reinforced by prescribed dietary restrictions and inadequate monitoring of the patient's nutritional status. Worsening uremia also renders CKD patients vulnerable to potentially deleterious effects of uncontrolled diets, including higher phosphorus and potassium burden. Uremic metabolites, some of which are anorexigenic and many of which are products of protein metabolism, can exert harmful effects, ranging from oxidative stress to endothelial dysfunction, nitric oxide disarrays, renal interstitial fibrosis, sarcopenia, and worsening proteinuria and kidney function. Given such complex pathways, nutritional interventions in CKD, when applied in concert with nonnutritional therapeutic approaches, encompass an array of strategies (such as dietary restrictions and supplementations) aimed at optimizing both patients’ biochemical variables and their clinical outcomes. The applicability of many nutritional interventions and their effects on outcomes in patients with CKD with PEW has not been well studied. This article reviews the definitions and pathophysiology of PEW in patients with non-dialysis-dependent CKD, examines the current indications for various dietary modification strategies in patients with CKD (eg, manufactured protein-based supplements, amino acids and their keto acid or hydroxyacid analogues), discusses the rationale behind their potential use in

  11. Performance and Parasitology of Semi-intensively Managed West African Dwarf Sheep Exposed to Gastrointestinal Helminth Infect-ed Paddocks and Varied Protein-energy Feeds

    Directory of Open Access Journals (Sweden)

    Adekayode Olarinwaju SONIBARE

    2016-12-01

    Full Text Available Background: The performance and parasitology of semi-intensively managed West African dwarf (WAD lambs were evaluated following exposure to gastrointestinal helminth infected paddock and varied protein-energy feeds.Methods: Twenty four lambs obtained from the Department of Animal Breeding and Genetics and brought to Directorate of University farm (DUFARM of Federal University of Agriculture Abeokuta, Ogun state, Nigeria, where the research was carried out in 2014, were grouped into four each containing six animals based on different energy-protein feed combination thus; group 1(G1 low energy low protein, group 2 (G2 low energy high protein, group 3 (G3 high energy low protein and group 4 (G4 high energy high protein. Experimental animals were supplemented with concentrate feed after grazing on daily in a nematode infected paddock. Clinical signs of infection were monitored. Live weight, faecal egg count (FEC, worm counts, packed cell volume (PCV, haemoglobin concentration (Hb and red blood cell count (RBC were determined using standard methods.Results: Anorexia and intermittent diarrhea were the observed signs. Worm counts did not differ significantly (P=0.309 among the groups. The weight and FEC differed significantly (P˂0.05 across the days and among the groups, while haematological parameters increased significantly (P˂0.05 across the days and among the groups.Conclusion: Lambs in G2 followed by G4 showed improved parameters and superior performance when compared to the other groups. It is therefore recommended that feed high in protein content is capable of mitigating deleterious effect of gastrointestinal helminth parasitism.

  12. Protein-energy malnutrition developing after global brain ischemia induces an atypical acute-phase response and hinders expression of GAP-43.

    Science.gov (United States)

    Smith, Shari E; Figley, Sarah A; Schreyer, David J; Paterson, Phyllis G

    2014-01-01

    Protein-energy malnutrition (PEM) is a common post-stroke problem. PEM can independently induce a systemic acute-phase response, and pre-existing malnutrition can exacerbate neuroinflammation induced by brain ischemia. In contrast, the effects of PEM developing in the post-ischemic period have not been studied. Since excessive inflammation can impede brain remodeling, we investigated the effects of post-ischemic malnutrition on neuroinflammation, the acute-phase reaction, and neuroplasticity-related proteins. Male, Sprague-Dawley rats were exposed to global forebrain ischemia using the 2-vessel occlusion model or sham surgery. The sham rats were assigned to control diet (18% protein) on day 3 after surgery, whereas the rats exposed to global ischemia were assigned to either control diet or a low protein (PEM, 2% protein) diet. Post-ischemic PEM decreased growth associated protein-43, synaptophysin and synaptosomal-associated protein-25 immunofluorescence within the hippocampal CA3 mossy fiber terminals on day 21, whereas the glial response in the hippocampal CA1 and CA3 subregions was unaltered by PEM. No systemic acute-phase reaction attributable to global ischemia was detected in control diet-fed rats, as reflected by serum concentrations of alpha-2-macroglobulin, alpha-1-acid glycoprotein, haptoglobin, and albumin. Acute exposure to the PEM regimen after global brain ischemia caused an atypical acute-phase response. PEM decreased the serum concentrations of albumin and haptoglobin on day 5, with the decreases sustained to day 21. Serum alpha-2-macroglobulin concentrations were significantly higher in malnourished rats on day 21. This provides the first direct evidence that PEM developing after brain ischemia exerts wide-ranging effects on mechanisms important to stroke recovery.

  13. Comparison of malnutrition inflammation score, anthropometry and biochemical parameters in assessing the difference in protein-energy wasting between normal weight and obese patients undergoing haemodialysis.

    Science.gov (United States)

    Alipoor, Elham; Hosseinzadeh-Attar, Mohammad Javad; Mahdavi-Mazdeh, Mitra; Yaseri, Mehdi; Zahed, Narges S

    2017-07-01

    Protein-energy wasting (PEW) is prevalent in haemodialysis. Obesity is an independent risk factor of kidney insufficiency, but it is proposed to have beneficial roles in better outcomes in the final stage of disease. Better nutritional status and body reserves are among probable mechanisms, but direct examinations are limited. The present study aimed to investigate whether obese patients have preferable nutritional status compared to normal weight patients based on malnutrition inflammation score (MIS) and other PEW parameters in haemodialysis. This case-control study investigated 52 normal weight (18.5 < body mass index (BMI) < 25 kg/m 2 ) and 48 obese (BMI≥30 kg/m 2 ) patients on regular haemodialysis. PEW was assessed based on anthropometric and biochemical factors, recent weight changes, appetite, anorexia, dietary intake and MIS. Obese patients had better MIS compared with the normal weight group (P < 0.001), although varying degrees of wasting were prevalent among this group too (75% mild and 25% moderate wasting). The obese group had less significant weight loss (4.2 vs 8%) and anorexia and better appetite. However, a considerable percentage of patients in both groups showed muscle (94.6% of normal weight and 19.5% of obese) and peripheral fat tissue (89.2% of normal weight and 31.7% of obese) losses compared to the 50th percentile. Biochemical parameters were not significantly different between groups except for triglyceride (P = 0.001), transferrin and total iron-binding capacity (P = 0.028). MIS was significantly better in obese patients; however, both groups showed degrees of wasting based on MIS and other PEW parameters. Nutritional status of obese haemodialysis patients should be monitored regularly because of high risk of PEW like other BMI categories. © 2017 Dietitians Association of Australia.

  14. Protein-energy malnutrition halts hemopoietic progenitor cells in the G0/G1 cell cycle stage, thereby altering cell production rates

    Directory of Open Access Journals (Sweden)

    P. Borelli

    2009-06-01

    Full Text Available Protein energy malnutrition (PEM is a syndrome that often results in immunodeficiency coupled with pancytopenia. Hemopoietic tissue requires a high nutrient supply and the proliferation, differentiation and maturation of cells occur in a constant and balanced manner, sensitive to the demands of specific cell lineages and dependent on the stem cell population. In the present study, we evaluated the effect of PEM on some aspects of hemopoiesis, analyzing the cell cycle of bone marrow cells and the percentage of progenitor cells in the bone marrow. Two-month-old male Swiss mice (N = 7-9 per group were submitted to PEM with a low-protein diet (4% or were fed a control diet (20% protein ad libitum. When the experimental group had lost about 20% of their original body weight after 14 days, we collected blood and bone marrow cells to determine the percentage of progenitor cells and the number of cells in each phase of the cell cycle. Animals of both groups were stimulated with 5-fluorouracil. Blood analysis, bone marrow cell composition and cell cycle evaluation was performed after 10 days. Malnourished animals presented anemia, reticulocytopenia and leukopenia. Their bone marrow was hypocellular and depleted of progenitor cells. Malnourished animals also presented more cells than normal in phases G0 and G1 of the cell cycle. Thus, we conclude that PEM leads to the depletion of progenitor hemopoietic populations and changes in cellular development. We suggest that these changes are some of the primary causes of pancytopenia in cases of PEM.

  15. Management of protein-energy wasting in non-dialysis-dependent chronic kidney disease: reconciling low protein intake with nutritional therapy.

    Science.gov (United States)

    Kovesdy, Csaba P; Kopple, Joel D; Kalantar-Zadeh, Kamyar

    2013-06-01

    Protein-energy wasting (PEW), characterized by a decline in body protein mass and energy reserves, including muscle and fat wasting and visceral protein pool contraction, is an underappreciated condition in early to moderate stages of chronic kidney disease (CKD) and a strong predictor of adverse outcomes. The prevalence of PEW in early to moderate CKD is ≥20-25% and increases as CKD progresses, in part because of activation of proinflammatory cytokines combined with superimposed hypercatabolic states and declines in appetite. This anorexia leads to inadequate protein and energy intake, which may be reinforced by prescribed dietary restrictions and inadequate monitoring of the patient's nutritional status. Worsening uremia also renders CKD patients vulnerable to potentially deleterious effects of uncontrolled diets, including higher phosphorus and potassium burden. Uremic metabolites, some of which are anorexigenic and many of which are products of protein metabolism, can exert harmful effects, ranging from oxidative stress to endothelial dysfunction, nitric oxide disarrays, renal interstitial fibrosis, sarcopenia, and worsening proteinuria and kidney function. Given such complex pathways, nutritional interventions in CKD, when applied in concert with nonnutritional therapeutic approaches, encompass an array of strategies (such as dietary restrictions and supplementations) aimed at optimizing both patients' biochemical variables and their clinical outcomes. The applicability of many nutritional interventions and their effects on outcomes in patients with CKD with PEW has not been well studied. This article reviews the definitions and pathophysiology of PEW in patients with non-dialysis-dependent CKD, examines the current indications for various dietary modification strategies in patients with CKD (eg, manufactured protein-based supplements, amino acids and their keto acid or hydroxyacid analogues), discusses the rationale behind their potential use in patients

  16. Intradialytic parenteral nutrition in maintenance hemodialysis patients suffering from protein-energy wasting. Results of a multicenter, open, prospective, randomized trial.

    Science.gov (United States)

    Marsen, Tobias A; Beer, Justinus; Mann, Helmut

    2017-02-01

    Protein-energy wasting (PEW) is increasingly becoming a clinical problem in maintenance hemodialysis patients and guidelines call for nutritional interventions. Serum prealbumin (transthyretin) represents a critical nutritional marker positively correlated with patient survival and negatively correlated with morbidity. Nutritional counseling, oral supplementation as well as intradialytic parenteral nutrition (IDPN) are recommended to fight PEW, however clinical trials on their use are scarce. We conducted a prospective, multicenter, randomized, open-label, controlled, parallel-group Phase IV clinical trial in 107 maintenance hemodialysis patients suffering from PEW to assess the impact of IDPN on prealbumin and other biochemical and clinical parameters reflecting nutritional status. Patients randomized to the intervention group received standardized nutritional counseling plus IDPN three times weekly over 16 weeks followed by a treatment-free period of 12 weeks. The control group received standardized nutritional counseling only. Main trial inclusion criteria included moderate to severe malnutrition (SGA score B or C), maintenance hemodialysis therapy (3 times per week) for more than six months, and presence of two out of the following three criteria: albumin 30 mg/L at week 16 (48.7% vs. 31.8%). Prealbumin response to IDPN therapy was more prominent in patients suffering from moderate malnutrition (SGA score B) compared to patients with severe malnutrition (SGA score C). The results of this trial demonstrate for the first time that IDPN therapy, given three times weekly in a 16-week short-term intervention, results in a statistically significant and clinically relevant increase in mean serum prealbumin, a surrogate marker for outcome and survival in hemodialysis patients suffering from PEW, and is superior to nutritional counseling. Clinical trial registry:www.clinicaltrials.gov (NCT00501956). Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights

  17. Cost of provision of opioid substitution therapy provision in Tijuana, Mexico.

    Science.gov (United States)

    Burgos, Jose Luis; Cepeda, Javier A; Kahn, James G; Mittal, Maria Luisa; Meza, Emilio; Lazos, Raúl Rafael Palacios; Vargas, Psyché Calderón; Vickerman, Peter; Strathdee, Steffanie A; Martin, Natasha K

    2018-05-23

    Mexico recently enacted drug policy reform to decriminalize possession of small amounts of illicit drugs and mandated that police refer identified substance users to drug treatment. However, the economic implications of drug treatment expansion are uncertain. We estimated the costs of opioid substitution therapy (OST) provision in Tijuana, Mexico, where opioid use and HIV are major public health concerns. We adopted an economic health care provider perspective and applied an ingredients-based micro-costing approach to quantify the average monthly cost of OST (methadone maintenance) provision at two providers (one private and one public) in Tijuana, Mexico. Costs were divided by type of input (capital, recurrent personnel and non-personnel). We defined "delivery cost" as all costs except for the methadone and compared total cost by type of methadone (powdered form or capsule). Cost data were obtained from interviews with senior staff and review of expenditure reports. Service provision data were obtained from activity logs and senior staff interviews. Outcomes were cost per OST contact and cost per person month of OST. We additionally collected information on patient charges for OST provision from published rates. The total cost per OST contact at the private and public sites was $3.12 and $5.90, respectively, corresponding to $95 and $179 per person month of OST. The costs of methadone delivery per OST contact were similar at both sites ($2.78 private and $3.46 public). However, cost of the methadone itself varied substantially ($0.34 per 80 mg dose [powder] at the private site and $2.44 per dose [capsule] at the public site). Patients were charged $1.93-$2.66 per methadone dose. The cost of OST provision in Mexico is consistent with other upper-middle income settings. However, evidenced-based (OST) drug treatment facilities in Mexico are still unaffordable to most people who inject drugs.

  18. Soil management shapes ecosystem service provision and trade-offs in agricultural landscapes.

    Science.gov (United States)

    Tamburini, Giovanni; De Simone, Serena; Sigura, Maurizia; Boscutti, Francesco; Marini, Lorenzo

    2016-08-31

    Agroecosystems are principally managed to maximize food provisioning even if they receive a large array of supporting and regulating ecosystem services (ESs). Hence, comprehensive studies investigating the effects of local management and landscape composition on the provision of and trade-offs between multiple ESs are urgently needed. We explored the effects of conservation tillage, nitrogen fertilization and landscape composition on six ESs (crop production, disease control, soil fertility, water quality regulation, weed and pest control) in winter cereals. Conservation tillage enhanced soil fertility and pest control, decreased water quality regulation and weed control, without affecting crop production and disease control. Fertilization only influenced crop production by increasing grain yield. Landscape intensification reduced the provision of disease and pest control. We also found tillage and landscape composition to interactively affect water quality regulation and weed control. Under N fertilization, conventional tillage resulted in more trade-offs between ESs than conservation tillage. Our results demonstrate that soil management and landscape composition affect the provision of several ESs and that soil management potentially shapes the trade-offs between them. © 2016 The Author(s).

  19. Challenges Affecting Participation In Provision Of Public Services In Arusha City Council Tanzania

    Directory of Open Access Journals (Sweden)

    Joel

    2015-08-01

    Full Text Available ABSTRACT In recently world creating opportunities under appropriate circumstances for people to manipulate decisions that affect them will increase the sense of ownership and care that is why participation has become a question of concern for any public and private project development and sustainability. The purpose of this study was to assessing the challenges affecting participation in provision of public services in Arusha city council. The specific objective of this study was to find out the challenges affecting public consultations and involvement in provision of public services at Arusha city council. The researcher use survey design technique in studying 150 samples from 416442 which included public citizens mayor councilors and employees at the Arusha city council office. The sample was selected through non- probability sampling techniques which was purposive and convenience. The data was collected through questionnaire and structured interview schedule and data was qualitatively analyzed where the factual and logical interpretation was explained through using of table and percentages. From the findings of the study provision of effective public services in Arusha city council is less effective and unsatisfactory because of insufficient number of staff poor technology conservatism bureaucracy culture relationship politics and poor communication. In order to address the issues the researcher recommends that the governance is weak and it needed to be reviewed in order to enhance the effectiveness of the entire process in provision of effective public services.

  20. Global Mapping of Provisioning Ecosystem Services

    Science.gov (United States)

    Bingham, Lisa; Straatsma, Menno; Karssenberg, Derek

    2016-04-01

    Attributing monetary value to ecosystem services for decision-making has become more relevant as a basis for decision-making. There are a number of problematic aspects of the calculations, including consistency of economy represented (e.g., purchasing price, production price) and determining which ecosystem subservices to include in a valuation. While several authors have proposed methods for calculating ecosystem services and calculations are presented for global and regional studies, the calculations are mostly broken down into biomes and regions without showing spatially explicit results. The key to decision-making for governments is to be able to make spatial-based decisions because a large spatial variation may exist within a biome or region. Our objective was to compute the spatial distribution of global ecosystem services based on 89 subservices. Initially, only the provisioning ecosystem service category is presented. The provisioning ecosystem service category was calculated using 6 ecosystem services (food, water, raw materials, genetic resources, medical resources, and ornaments) divided into 41 subservices. Global data sets were obtained from a variety of governmental and research agencies for the year 2005 because this is the most data complete and recent year available. All data originated either in tabular or grid formats and were disaggregated to 10 km cell length grids. A lookup table with production values by subservice by country were disaggregated over the economic zone (either marine, land, or combination) based on the spatial existence of the subservice (e.g. forest cover, crop land, non-arable land). Values express the production price in international dollars per hectare. The ecosystem services and the ecosystem service category(ies) maps may be used to show spatial variation of a service within and between countries as well as to specifically show the values within specific regions (e.g. countries, continents), biomes (e.g. coastal, forest

  1. Safety provisions of nuclear power plants

    International Nuclear Information System (INIS)

    Niehaus, F.

    1994-01-01

    Safety of nuclear power plants is determined by a deterministic approach complemented by probabilistic considerations. Much use has been made of the wealth of information from more than 6000 years of reactor operation. Design, construction and operation is governed by national and international safety standards and practices. The IAEA has prepared a set of Nuclear Safety Standards as recommendations to its Member States, covering the areas of siting, design, operations, quality assurance, and governmental organisations. In 1988 the IAEA published a report by the International Nuclear Safety Advisory Group on Basic Safety Principles for Nuclear Power Plants, summarizing the underlying objectives and principles of excellence in nuclear safety and the way in which its aspects are interrelated. The paper will summarize some of the key safety principles and provisions, and results and uses of Probabilistic Safety Assessments. Some comments will be made on the safety of WWER 440/230 and WWER-1000 reactors which are operated on Bulgaria. 8 figs

  2. Provisions for containment venting in Germany

    International Nuclear Information System (INIS)

    Wilhelm, J.G.

    1997-01-01

    In this short paper an overlook is given of the systems developed in Germany for filtered containment venting and their implementation in nuclear power plants. More information on the development can be found in the Proceedings of the DOE/NRC Aircleaning Conferences. In Germany, 28.8 % of the electric energy is produced by 19 nuclear power reactors. No new power reactor is expected to be built at least within the next ten years, but France and Germany cooperate in the development of a future European Power Reactor (ERP). This reactor type will be fitted with a core catcher and passive cooling in order to avoid serious consequences of a hypothetical core meltdown accident so that provisions for containment venting are not required. 3 refs., 6 figs., 1 tab

  3. Provision of genetics services on Guam.

    Science.gov (United States)

    McWalter, Kirsty; Hasegawa, Lianne; Au, Sylvia Mann

    2013-12-01

    Guam's geographic isolation and lack of community resources have resulted in unique healthcare needs. In 2006, the Western States Genetic Services Collaborative (WSGSC) conducted a genetics needs assessment and found that professional development is limited, families lack access to genetic services, and improved coverage of genetic testing is needed. With funding from the WSGSC, a Guam genetics outreach clinic was established and staffed by genetic counselors and a medical geneticist from Hawaii. Four clinics have been held to date. Although several challenges have been encountered, including minimal coverage of genetic testing by Guam insurance companies, limited referrals for families with private insurance, and inappropriate referral indications, the outreach clinic has been successful at increasing access to genetic services and improving professional development. With more collaborative work by staff from Guam, Hawaii, and the WSGSC, provision and reimbursement of genetic services and testing will continue to improve.

  4. Municipal service provision in rural communities

    DEFF Research Database (Denmark)

    Nørgaard, Helle

    EU policies for rural development stress the importance of investments rather than subsidies and aim at integrating different sectoral policies in order to improve the coherence and effectiveness of public expenditure. Policies also emphasize a place-based approach for rural development and thereby...... hierarchies and considering local resources and place bound potentials.  This paper draws on a study of rural municipalities in Denmark examining how service adjustments e.g. closing of local schools are managed by rural municipalities and local communities. The paper further discusses whether rural...... municipalities can plan strategically, manage service provision and support place bound potential in rural communities in light of a competitive framework for local development....

  5. Provisions for containment venting in Germany

    Energy Technology Data Exchange (ETDEWEB)

    Wilhelm, J.G.

    1997-08-01

    In this short paper an overlook is given of the systems developed in Germany for filtered containment venting and their implementation in nuclear power plants. More information on the development can be found in the Proceedings of the DOE/NRC Aircleaning Conferences. In Germany, 28.8 % of the electric energy is produced by 19 nuclear power reactors. No new power reactor is expected to be built at least within the next ten years, but France and Germany cooperate in the development of a future European Power Reactor (ERP). This reactor type will be fitted with a core catcher and passive cooling in order to avoid serious consequences of a hypothetical core meltdown accident so that provisions for containment venting are not required. 3 refs., 6 figs., 1 tab.

  6. Memory provisions for the Manche Surface Repository

    International Nuclear Information System (INIS)

    Dumont, Jean-Noel; Espiet-Subert, Florence

    2015-01-01

    The French La Manche repository site received its last radioactive waste package in 1994. In 2003, the official surveillance phase of the closed repository started under the supervision of Andra (the national industrial operator), the French Nuclear Safety Authority (ASN) and society (e.g. the local municipalities). Florence Espiet explained that information on the existence of the repository, its content, how it was operated and how it works needs to be preserved. It also is planned to review the information periodically for a minimum of 300 years. She described the creation of two documents on memory (a detailed and a summary one), both on permanent paper, and the preservation of the land registration. The latter constitutes 'passive' provisions for preserving memory. In addition, a number of 'active' provisions are and will be put in place: guided visits, exhibitions, partnerships with organisations dealing with memory preservation, and the creation of a think tank. The latter consists of local citizens and politicians, retired employees from Andra and artists that meet several times a year and reflect on memory preservation from the perspective of, for instance, local history, education, arts and rituals. Finally, two types of markers will be used to preserve the repository's memory: i) three herbaria cataloguing the plants growing on the site of the repository, including a very short description of the repository, will be stored at different sites in France; ii) a stele indicating the main characteristics of the repository, potentially linked to an art work, will be erected at the repository

  7. A practical approach to Events Medicine provision.

    Science.gov (United States)

    Smith, Susan P; Cosgrove, Joseph F; Driscoll, Peter J; Smith, Andrew; Butler, John; Goode, Peter; Waldmann, Carl; Vallis, Christopher J; Topham, Fiona; Mythen, Michael Monty

    2017-08-01

    In the past three decades, mass casualty incidents have occurred worldwide at multiple sporting events and other mass gatherings. Organisational safety and healthcare provision can consequently be scrutinised post-event. Within the UK, such incidents in the 1980s provided incentives to improve medical services and subsequent high profile UK-based international sporting events (London Olympics and Paralympics 2012, Glasgow Commonwealth Games 2014, Rugby World Cup 2015) added a further catalyst for developing services. Furthermore in the aftermath of the abandoned France versus Germany association football match at the Stade de France ( Paris Terrorist Attacks, November 2015) and the 2016 UK report from HM Coroner on the Hillsborough Inquest , medical cover at sporting events is being further reviewed. Doctors providing spectator cover therefore need to have an awareness of their likely roles at sporting venues. Formal guidance exists in many countries for the provision of such cover but remains generic even though Events Medicine is increasingly recognised as a necessary service. The current evidence base is limited with best practice examples often anecdotally cited by acute care specialists (eg, emergency medicine) who provide cover. This article is therefore intended to present an overview for doctors of the knowledge and skills required to treat ill and injured spectators and enable them to adequately risk-assess venues in cooperation with other health and safety providers, including preparation for a major incident. It also gives guidance on how activity can be adequately assessed and how doctors can have management roles in Events Medicine. 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/.

  8. 29 CFR 780.305 - 500 man-day provision.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false 500 man-day provision. 780.305 Section 780.305 Labor...) Statutory Provisions § 780.305 500 man-day provision. (a) Section 3(u) of the Act defines man-day to mean “any day during which an employee performs agricultural labor for not less than 1 hour.” 500 man-days...

  9. A conceptual framework to assess effectiveness in wheelchair provision

    Directory of Open Access Journals (Sweden)

    Deepan C. Kamaraj

    2017-09-01

    Conclusion: We believe that adoption of this conceptual framework could have broad applications in wheelchair provision globally to develop evidence-based practices. Such a perspective will help in the comparison of different strategies employed in wheelchair provision and further improve clinical guidelines. Further work is being conducted to test the efficacy of this conceptual framework to evaluate effectiveness of wheelchair service provision in various settings across the globe.

  10. 48 CFR 247.270-2 - Technical provisions.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT TRANSPORTATION Contracts for Transportation or for Transportation... sometimes within the same port, it is not practical to develop standard technical provisions covering all...

  11. Provision of Prosthetic Services Following Lower Limb Amputation in Malaysia

    Science.gov (United States)

    Arifin, Nooranida; Hasbollah, Hasif Rafidee; Hanafi, Muhammad Hafiz; Ibrahim, Al Hafiz; Rahman, Wan Afezah Wan Abdul; Aziz, Roslizawati Che

    2017-01-01

    The incidence of lower limb amputation is high across the globe and continues to be a major threat to morbidity and mortality. Consequently, the provision of high quality and effective prosthetics services have been known as an essential component for a successful rehabilitation outcome. In Malaysia, amputation prevalence has been increasing in which several main components of service delivering aspects (such as service intervention, prosthetic personnel) should be anticipated to accommodate for the increasing demand. This article highlights the hurdles experienced in providing prosthetic services in Malaysia from multiple aspects such as financial burden to acquire the prosthesis and lack of expertise to produce quality prosthesis. This paramount issues consequently justify for the urgency to carry out national level survey on the current statistics of lower limb amputation and to ascertain the available workforce to provide a quality prosthetics services. Only with accurate and current information from the national survey, strategies and policies aimed at enhancing the outcome from prosthetics services can be achieved. PMID:29386978

  12. Hitos conceptuales en la historia de la desnutrición proteico-energética Conceptual landmarks in the history of protein-energy malnutrition

    Directory of Open Access Journals (Sweden)

    Leopoldo Vega-Franco

    1999-07-01

    Full Text Available Aunque ancestralmente los jinetes bíblicos del hambre, la peste y la guerra han cabalgado juntos por el sendero de la historia, puede ser que las consecuencias de estas calamidades -desnutrición y muerte- hayan sido secularmente vistas de manera tan natural como la vida misma. Tal vez ésta sea la razón por la que hasta el siglo XIX -y para ser preciso, hasta 1865-, se documentó la primera descripción clínica de lo que ahora se conoce como desnutrición proteico-energética. La limitada difusión de este hallazgo dio lugar a que la enfermedad fuese redescubierta y descrita exitosamente en lengua inglesa en 1933. Un año después de creadas en 1949, la Organización Mundial de la Salud (OMS y el Fondo para la Agricultura y la Alimentación (FAO tomaron la decisión de unificar los criterios de diagnóstico de esta enfermedad e impulsar su investigación. En este ensayo se destacan algunos de los hitos en la historia del conocimiento científico de esta enfermedad.Although the biblical horsemen of hunger, plague and war have proverbially ridden together, the consequences of these adversities, i.e. malnutrition and death, may have been secularly interpreted as natural as life itself. This may be the reason why the first clinical description of what is now known as protein-energy malnutrition, did not appear until the 19th century, in 1865 to be precise. The limited dissemination of this finding, originally written in Spanish, brought about a rediscovery and successful description of the disease in English in 1933. In 1949, one year after their creation, the World Health Organization (WHO and the Food and Agriculture Organization (FAO decided to unify their diagnostic criteria of malnutrition, and endorse further research. The present assay describes some of the major conceptual landmarks in the history of the scientific knowledge of this disease.

  13. The role of private developers in local infrastructure provision in Malaysia

    Science.gov (United States)

    Salleh, Dani; Okinono, Otega

    2016-08-01

    Globally, the challenge of local infrastructure provision has attracted much debate amongst different nations including Malaysia, on how to achieve an effective and efficient infrastructural management. This approach therefore, has intensified the efforts of local authorities in incorporating private developers in their developmental agenda in attaining a sustainable infrastructural development in local areas. Basically, the knowledge of the need for adequate provision of local infrastructure is well understood by both local and private authorities. Likewise, the divergent opinions on the usage of private delivery services. Notwithstanding the common perception, significant loopholes have been identified on the most appropriate and ideal approach and practices to adopt in enhancing local infrastructure development. The study therefore examined the role of private developers in local infrastructure provision and procedure adopted by both local authorities and the privates sector in local infrastructure development. Data was obtained using the questionnaire through purposive sampling, administered to 22 local authorities and 16 developers which was descriptively analysed. Emanating from the study findings, the most frequently approved practices by local authorities are joint venture and complete public delivery systems. Likewise, negotiation was identified as a vital tool for stimulating the acquisition of local infrastructure provision. It was also discovered the one of the greatest challenge in promoting private sector involvement in local infrastructure development is due to unregulated-procedure. The study therefore recommends, there is need for local authorities to adopt a collective and integrated approach, nevertheless, cognisance and priority should be given to developing a well-structured and systematic process of local infrastructure provision and development.

  14. Evaluation of Drought Implications on Ecosystem Services: Freshwater Provisioning and Food Provisioning in the Upper Mississippi River Basin.

    Science.gov (United States)

    Li, Ping; Omani, Nina; Chaubey, Indrajeet; Wei, Xiaomei

    2017-05-08

    Drought is one of the most widespread extreme climate events with a potential to alter freshwater availability and related ecosystem services. Given the interconnectedness between freshwater availability and many ecosystem services, including food provisioning, it is important to evaluate the drought implications on freshwater provisioning and food provisioning services. Studies about drought implications on streamflow, nutrient loads, and crop yields have been increased and these variables are all process-based model outputs that could represent ecosystem functions that contribute to the ecosystem services. However, few studies evaluate drought effects on ecosystem services such as freshwater and food provisioning and quantify these services using an index-based ecosystem service approach. In this study, the drought implications on freshwater and food provisioning services were evaluated for 14 four-digit HUC (Hydrological Unit Codes) subbasins in the Upper Mississippi River Basin (UMRB), using three drought indices: standardized precipitation index ( SPI ), standardized soil water content index ( SSWI ), and standardized streamflow index ( SSI ). The results showed that the seasonal freshwater provisioning was highly affected by the precipitation deficits and/or surpluses in summer and autumn. A greater importance of hydrological drought than meteorological drought implications on freshwater provisioning was evident for the majority of the subbasins, as evidenced by higher correlations between freshwater provisioning and SSI 12 than SPI 12. Food provisioning was substantially affected by the precipitation and soil water deficits during summer and early autumn, with relatively less effect observed in winter. A greater importance of agricultural drought effects on food provisioning was evident for most of the subbasins during crop reproductive stages. Results from this study may provide insights to help make effective land management decisions in responding to

  15. Distribution Grid Services and Flexibility Provision by Electric Vehicles: a Review of Options

    DEFF Research Database (Denmark)

    Knezovic, Katarina; Marinelli, Mattia; Codani, Paul

    2015-01-01

    Due to the increasing penetration of distributed generation and new high-power consumption loads – such as electric vehicles (EVs) – distribution system operators (DSO) are facing new grid security challenges. DSOs have historically dealt with such issues by making investments in grid reinforcement...... on current grid conditions. In return, flexibility provision should be remunerated accordingly. In this paper, the authors are interested in making an accurate description of the flexibility services at the distribution level which could be provided by EVs as well as their requirements, e.g. location......, activation time and duration. Market design recommendations for enhancing the provision of DSO grid services by EVs are derived from the conducted analysis....

  16. Advance Network Reservation and Provisioning for Science

    Energy Technology Data Exchange (ETDEWEB)

    Balman, Mehmet; Chaniotakis, Evangelos; Shoshani, Arie; Sim, Alex

    2009-07-10

    We are witnessing a new era that offers new opportunities to conduct scientific research with the help of recent advancements in computational and storage technologies. Computational intensive science spans multiple scientific domains, such as particle physics, climate modeling, and bio-informatics simulations. These large-scale applications necessitate collaborators to access very large data sets resulting from simulations performed in geographically distributed institutions. Furthermore, often scientific experimental facilities generate massive data sets that need to be transferred to validate the simulation data in remote collaborating sites. A major component needed to support these needs is the communication infrastructure which enables high performance visualization, large volume data analysis, and also provides access to computational resources. In order to provide high-speed on-demand data access between collaborating institutions, national governments support next generation research networks such as Internet 2 and ESnet (Energy Sciences Network). Delivering network-as-a-service that provides predictable performance, efficient resource utilization and better coordination between compute and storage resources is highly desirable. In this paper, we study network provisioning and advanced bandwidth reservation in ESnet for on-demand high performance data transfers. We present a novel approach for path finding in time-dependent transport networks with bandwidth guarantees. We plan to improve the current ESnet advance network reservation system, OSCARS [3], by presenting to the clients, the possible reservation options and alternatives for earliest completion time and shortest transfer duration. The Energy Sciences Network (ESnet) provides high bandwidth connections between research laboratories and academic institutions for data sharing and video/voice communication. The ESnet On-Demand Secure Circuits and Advance Reservation System (OSCARS) establishes

  17. Organic Food and the Plural Moralities of Food Provisioning

    Science.gov (United States)

    Andersen, Anne Holst

    2011-01-01

    The aim of this paper is twofold. The first aim is to unfold the moral complexity of organic food consumption as part of household food provisioning. By acknowledging this complexity, and the difficulty of determining what is "good" and "right" in food provisioning, the idea is to allow for a better understanding of how organic…

  18. 9 CFR 145.4 - General provisions for all participants.

    Science.gov (United States)

    2010-01-01

    ..., DEPARTMENT OF AGRICULTURE LIVESTOCK IMPROVEMENT NATIONAL POULTRY IMPROVEMENT PLAN FOR BREEDING POULTRY General Provisions § 145.4 General provisions for all participants. (a) Records of purchases and sales and... Agency. (b) Products, records of sales and purchase of products, and material used to advertise products...

  19. 31 CFR 586.406 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 586.406 Section 586.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... & MONTENEGRO) KOSOVO SANCTIONS REGULATIONS Interpretations § 586.406 Provision of services. (a) Except as...

  20. Funding and provision of resources in public and private school ...

    African Journals Online (AJOL)

    The work discussed funding for libraries in selected public and private schools in Imo State as well as provision of resources in their libraries. The major aim of the work was that there is a corollary between funding and provision of resources such that the funding directly affects the resources of the library. The survey ...

  1. 48 CFR 25.1103 - Other provisions and clauses.

    Science.gov (United States)

    2010-10-01

    ... currency offers. Insert the provision at 52.225-17, Evaluation of Foreign Currency Offers, in solicitations that permit the use of other than a specified currency. Insert in the provision the source of the rate to be used in the evaluation of offers. (d) The contracting officer shall include in each...

  2. 48 CFR 828.106-72 - Contract provision.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contract provision. 828... GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Bonds and Other Financial Protections 828.106-72 Contract provision. Insert 852.228-72, Assisting Service-Disabled Veteran-Owned and Veteran-Owned Small...

  3. 48 CFR 970.1170-2 - Contract provision.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contract provision. 970... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Describing Agency Needs 970.1170-2 Contract provision. The Contracting Officer shall insert the clause at 970.5211-1, Work authorization, in each...

  4. 12 CFR 226.12 - Special credit card provisions.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Special credit card provisions. 226.12 Section... SYSTEM TRUTH IN LENDING (REGULATION Z) Open-End Credit § 226.12 Special credit card provisions. (a) Issuance of credit cards. Regardless of the purpose for which a credit card is to be used, including...

  5. 46 CFR 401.425 - Provision for additional pilot.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Provision for additional pilot. 401.425 Section 401.425... REGULATIONS Rates, Charges, and Conditions for Pilotage Services § 401.425 Provision for additional pilot. The... Authority, Ltd., Canada, may require the assignment of two pilots to a ship upon request of the ship or when...

  6. 21 CFR 179.25 - General provisions for food irradiation.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 3 2010-04-01 2009-04-01 true General provisions for food irradiation. 179.25... (CONTINUED) FOOD FOR HUMAN CONSUMPTION (CONTINUED) IRRADIATION IN THE PRODUCTION, PROCESSING AND HANDLING OF FOOD Radiation and Radiation Sources § 179.25 General provisions for food irradiation. For the purposes...

  7. Parenting in Direct Provision: Parents' Perspectives Regarding Stresses and Supports

    Science.gov (United States)

    Ogbu, Helen Uchechukwu; Brady, Bernadine; Kinlen, Louise

    2014-01-01

    The Irish direct provision system for asylum seekers is acknowledged as providing a very challenging and exclusionary living environment for adults and children. To date, there has been little research focused specifically on the ways in which the direct provision environment impacts on the parenting role. This qualitative study explores the…

  8. Outsourcing as a Mean of Service for Security Provision

    Directory of Open Access Journals (Sweden)

    D.I. Persanov

    2012-03-01

    Full Text Available The article highlights the implementation of outsourcing as a mean of service for security provision. Analysis is performed to describe the current issues affecting the management decision in favor of outsourcing. Investigation covers the processes of physical, information and economical security. The main recommendations to use outsourcing for security provision are described in the conclusion.

  9. 29 CFR 778.409 - Provision for overtime pay.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Provision for overtime pay. 778.409 Section 778.409 Labor... Regular Rate Principles Guaranteed Compensation Which Includes Overtime Pay § 778.409 Provision for overtime pay. The section 7(f) contract must provide for compensation at not less than one and one-half...

  10. Profiles of Merit Pay Provisions in Ohio School Districts

    Science.gov (United States)

    Willis, Chris; Ingle, W. Kyle

    2018-01-01

    A small number of districts in Ohio from a variety of locales have adopted merit pay provisions. Using Springer's (2009) taxonomy of teacher compensation, we analyzed compensation provisions of these districts. We asked: What are the characteristics of these districts? What criteria are used to determine merit? Who is determining who receives…

  11. 7 CFR 457.111 - Pear crop insurance provisions.

    Science.gov (United States)

    2010-01-01

    ... alternating or mixed pattern. Marketable. Pear production acceptable for processing or other human consumption... irrigation water supply, if caused by an insured peril that occurs during the insurance period. (b) In... provisions of the Basic Provisions are not applicable. 13. Pear Quality Adjustment Endorsement (a) This...

  12. Quality provisioning and accountability in African higher | Maila ...

    African Journals Online (AJOL)

    Excellence in educational quality provisioning and accountability is an obligatory function for higher education. Currently certain scholars allege that poor provisioning and lack of accountability are rife in most higher education institutions. They cite varied reasons for the failures. Of note, African higher education institutions ...

  13. 29 CFR 570.102 - General scope of statutory provisions.

    Science.gov (United States)

    2010-07-01

    ... REGULATIONS CHILD LABOR REGULATIONS, ORDERS AND STATEMENTS OF INTERPRETATION General Statements of Interpretation of the Child Labor Provisions of the Fair Labor Standards Act of 1938, as Amended General § 570.... The most important of the child labor provisions are contained in sections 12(a), 12(c), and 3(l) of...

  14. 29 CFR 552.108 - Child labor provisions.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Child labor provisions. 552.108 Section 552.108 Labor... OF THE FAIR LABOR STANDARDS ACT TO DOMESTIC SERVICE Interpretations § 552.108 Child labor provisions. Congress made no change in section 12 as regards domestic service employees. Accordingly, the child labor...

  15. 26 CFR 20.6321 - Statutory provisions; lien for taxes.

    Science.gov (United States)

    2010-04-01

    ... addition thereto) shall be a lien in favor of the United States upon all property and rights to property... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Statutory provisions; lien for taxes. 20.6321... Administration § 20.6321 Statutory provisions; lien for taxes. Sec. 6321. Lien for taxes. If any person liable to...

  16. 29 CFR 1910.19 - Special provisions for air contaminants.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 5 2010-07-01 2010-07-01 false Special provisions for air contaminants. 1910.19 Section 1910.19 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... Standards § 1910.19 Special provisions for air contaminants. (a) Asbestos, tremolite, anthophyllite, and...

  17. Implication of Copyright Provisions for Literary Works in Films and ...

    African Journals Online (AJOL)

    The emphasis of copyright is on original literary works, films, sound recordings and others. The focus of this paper is to discuss the various provisions of the copyright law as they affect films, video and by extension video CD. The study examines the various interpretations of the provisions of the copyright law as they affect ...

  18. Provision of Family Planning Services in Tanzania: A Comparative ...

    African Journals Online (AJOL)

    Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based on 529 health ...

  19. 40 CFR 63.1408 - Aggregate batch vent stream provisions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 11 2010-07-01 2010-07-01 true Aggregate batch vent stream provisions... § 63.1408 Aggregate batch vent stream provisions. (a) Emission standards. Owners or operators of aggregate batch vent streams at a new or existing affected source shall comply with either paragraph (a)(1...

  20. 42 CFR 417.937 - Loan and loan guarantee provisions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Loan and loan guarantee provisions. 417.937 Section... HEALTH CARE PREPAYMENT PLANS Administration of Outstanding Loans and Loan Guarantees § 417.937 Loan and loan guarantee provisions. (a) Disbursement of loan proceeds. The principal amount of any loan made or...

  1. Information provision in medical libraries: An evidence based ...

    African Journals Online (AJOL)

    The paper examined information provision in special libraries such as medical libraries. It provides an overview of evidence based practice as a concept for information provision by librarians. It specifically proffers meaning to the term evidence as used in evidence based practice and to evidence based medicine from where ...

  2. 40 CFR 63.650 - Gasoline loading rack provisions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 10 2010-07-01 2010-07-01 false Gasoline loading rack provisions. 63... loading rack provisions. (a) Except as provided in paragraphs (b) through (c) of this section, each owner or operator of a Group 1 gasoline loading rack classified under Standard Industrial Classification...

  3. 26 CFR 509.102 - Applicable provisions of law.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 19 2010-04-01 2010-04-01 false Applicable provisions of law. 509.102 Section... UNDER TAX CONVENTIONS SWITZERLAND General Income Tax § 509.102 Applicable provisions of law. (a) General... reason of any alteration of law in relation to internal revenue. (b) Retroactivity of regulations or...

  4. 7 CFR 457.108 - Sunflower seed crop insurance provisions.

    Science.gov (United States)

    2010-01-01

    ... Crop Provisions If a conflict exists among the policy provisions, the order of priority is as follows... insufficient or improper application of disease control measures; (e) Wildlife; (f) Earthquake; (g) Volcanic... the United States as being injurious to human or animal health. (3) Quality will be a factor in...

  5. 49 CFR 805.735-15 - Miscellaneous statutory provisions.

    Science.gov (United States)

    2010-10-01

    ... TRANSPORTATION SAFETY BOARD EMPLOYEE RESPONSIBILITIES AND CONDUCT § 805.735-15 Miscellaneous statutory provisions. Each Member and employee shall acquaint himself with the statutory provisions in appendix I, attached hereto and made a part thereof, which relate to his ethical and other conduct as a Member and employee of...

  6. 40 CFR 63.1434 - Equipment leak provisions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 11 2010-07-01 2010-07-01 true Equipment leak provisions. 63.1434... Standards for Hazardous Air Pollutant Emissions for Polyether Polyols Production § 63.1434 Equipment leak provisions. (a) The owner or operator of each affected source shall comply with the HON equipment leak...

  7. 40 CFR 63.1410 - Equipment leak provisions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 11 2010-07-01 2010-07-01 true Equipment leak provisions. 63.1410... leak provisions. The owner or operator of each affected source shall comply with the requirements of 40 CFR part 63, subpart UU (national emission standards for equipment leaks (control level 2)) for all...

  8. 24 CFR 107.25 - Provisions in legal instruments.

    Science.gov (United States)

    2010-04-01

    ... Provisions in legal instruments. (a) The following documents shall contain provisions or statements requiring...) Approvals of financial institutions and other lenders as approved FHA mortgagees, (5) Requests for subdivision reports under home mortgage procedures and for preapplication analysis of multifamily and land...

  9. 40 CFR 51.117 - Additional provisions for lead.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Additional provisions for lead. 51.117... Additional provisions for lead. In addition to other requirements in §§ 51.100 through 51.116 the following requirements apply to lead. To the extent they conflict, there requirements are controlling over those of the...

  10. 5 CFR 9701.106 - Relationship to other provisions.

    Science.gov (United States)

    2010-01-01

    ....106 Section 9701.106 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES... SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM General Provisions § 9701.106 Relationship to other provisions....S.C. 5545(d); (iv) Recruitment, relocation, and retention payments under 5 U.S.C. 5753-5754; (v...

  11. 40 CFR 76.3 - General Acid Rain Program provisions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false General Acid Rain Program provisions. 76.3 Section 76.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.3 General Acid Rain Program provisions...

  12. Objective Provision Tree for K-DEMO

    International Nuclear Information System (INIS)

    Oh, Kyemin; Kang, Myung-suk; Heo, Gyunyoung; Kim, Hyoung-chan

    2014-01-01

    In current nuclear field based on technology-neutral approach, safety principles and design have been considered for Generation IV (Gen-IV) nuclear power plants in parallel. This strategy can save resource, time, and manpower while keeping achievable safety. For this reason, the studies related with safety affecting significant design parameters for planned construction or fusion plants was needed and required even though K-DEMO is staying in pre-conceptual design phase. Objective Provision Tree (OPT) is one of the tools of Integrated Safety Assessment Methodology (ISAM) developed by Risk and Safety Working Group (RSWG) for design and assessment of Gen-IV. This is suitable tool to recognize and investigate safety issues from previous engineering experience. The purpose of this paper is to suggest multiple barriers/critical safety function and to describe the current status of the OPT for the conceptual design of K-DEMO. In this paper, critical safety functions were defined and OPT for K-DEMO was described and performed. We have carried out researches related to safety for fusion power plant in collaboration with the academies funded by NFRI during the past 4 years. As part of this research, Integrated Safety Assessment Methodology (ISAM), which was used to develop GEN-IV nuclear systems, was used to determine the technical safety issues and regulatory requirements for K-DEMO. OPT is one of ISAM tools

  13. The provision of radiological protection services

    International Nuclear Information System (INIS)

    1965-01-01

    This publication is a code of practice for the provision or radiological protection services for establishments in which, or in part of which, work is primarily with radiation sources. It was prepared with the help of an international panel of experts and representatives of international organizations which have an interest in this field and was promulgated by the Director General of the Agency under the authority of the Board of Governors of the Agency as a code of practice in the framework of the Agency's Safety Standards. The Board of Governors also authorized the Director General to recommend to Member States that the code of practice be taken into account in the formulation of national regulations or recommendations. The Appendix to the code contains a number of examples of the organization of radiological protection services that have been provided by the members of the panel of experts. These examples do not form a part of the code of practice, but are intended to illustrate the methods of organization which have been adopted in different countries.

  14. Spatial Aspects of the Provision of Forest Ecosystem Services

    DEFF Research Database (Denmark)

    Nielsen, Anne Sofie Elberg

    to the incorporation of spatial factors into cost and benefit evaluation of FES provision. Focus is on assessing where forest ecosystem provision should be undertaken, determinants of private stakeholder provision efforts and welfare consequences of changes in the provision level. Provision of carbon sequestration...... estimates for the U.S. counties of the cost of carbon sequestration from afforestation (conversion of non-forest land to forest), when afforestation is restricted by Holdridge zone climatic conditions. Aside from assessing the overall marginal cost schedule, the spatial distribution of these are examined......, to assess where afforestation should be undertaken for given carbon prices. The second paper investigates the determinants of landowner participation in a Danish voluntary conservation program. Combining contract data of landowners’ actual choices, GIS information on area specific characteristics...

  15. German research reactor back-end provisions

    International Nuclear Information System (INIS)

    Koester, Siegfried; Gruber, Gerhard

    2002-01-01

    Germany has several types of Research Reactors in operation. These reactors use fuel containing uranium of U.S. origin. Basically all the fuel which will be spent until May 2006 will be returned to the U.S. under existing contracts with the U.S. Department of Energy. The contracts are based on the U.S. FRR SNF (Foreign Research Reactor Spent Nuclear Fuel) Program which started in May 1996 and which will last for 10 years. In 1990, the German Federal Government started a program to long-term store (approx. 40 years) and finally dispose of spent fuel in Germany after the so-called U.S. fuel return window will be closed. In order to long-term store the fuel, a special container was designed which covers all different types of spent fuel from the Research Reactors. The container called 'CASTOR MTR 2' is basically licensed and is already in use for the spent fuel of Russian origin from the 'Research Reactor Rossendorf' in the eastern part of Germany. All that fuel is expected to be stored in the existing intermediate storage facility, the so-called BZA (Brennelemente Zwischenlager Ahaus). BZA already accomodates spent fuel from the former THTR-300 high temperature reactor. A final repository does not yet exist in Germany. Alternative provisions to close the back-end of the Research Reactor fuel cycle are reprocessing at COGEMA (France) or in Russian facilities, perspectively. Waste return in a form to be agreed will be mandatory, at least in France. (author)

  16. Network information provision to potential generators: Appendices

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    This Code of Practice (CoP) has been prepared to outline the standard of information that Distribution Network Operators (DNOs) should be required to produce in relation to the provision of network maps, schematic diagrams and specific network data. Network information from DNOs may be required by generators (and other customers) in order to assess the potential opportunities available for the connection of new generation plant. Seven Year Statements are published annually by the Transmission Licensees operating in Great Britain, i.e. The National Grid Company, Scottish Power and Scottish Hydro Electric, and contain all the network information relating to each transmission system, e.g. Generation Capacities, System Parameters and Plant Fault Levels. A similar arrangement for DNOs has been outlined in the Electricity Distribution Licence published by Ofgem. Under Condition 25 of the licence, 'The Long Term Development Statement', distribution licence holders are required to make available historic and planned network data. By providing sufficient network information, competition in generation will be improved. At the time of writing, any party interested in assessing distribution network information needs to make contact with the appropriate DNO, identifying the correct department and person. Written applications are then sent to that person, describing the type of network information that is required. Information required from embedded generators by DNOs is specified in detail in both of The Distribution Codes of England and Wales, and Scotland. However, there are no guidelines or details of network information to be provided by DNOs. This Code of Practise is designed to balance this situation and help DNOs, prospective generators and other applicants for information to achieve satisfaction by clarifying expectations. (Author)

  17. Restructuring the Schoolbook Provision System in Indonesia

    Directory of Open Access Journals (Sweden)

    Dedi Supriadi

    1999-03-01

    Full Text Available Schoolbooks account for between 65% and 75% of all publishing activity in Indonesia. The amount of money allocated is continually increasing. Priority is given to the primary and junior secondary school levels (6+3 years, which are compulsory. Between 1969 and 1988, the Government of Indonesia (GOI has produced some 550 million primary textbooks and library books. Up to the year 2000, the GOI has decided to allocate the total of US$ 355.2 million to produce 250 million copies of primary and junior secondary school textbooks to reach the ratio of one book for each student. In addition, around Rp 20-50 billion (US$ 10-20 million annually is spent to purchase 8-17 million copies of reading books which are aimed at stimulating the reading interest of primary school children. These books are distributed free to some 168,000 primary and 26,969 junior secondary schools throughout Indonesia. Following the massive efforts to increase book availability at schools, some innovative policies are being taken. Book evaluation standards have been improved to ensure that only high quality books are used at schools. The distribution system has been restructured to guarantee that books reach targeted schools. Consequently, the book monitoring system has had to be strengthened to examine whether or not the books really reach the schools and are used properly by students and teachers in the classrooms. In the last three years, there has also been a growing concern with multicultural issues in schoolbook provision programs. In such a culturally diverse nation as Indonesia, schoolbooks should also be culturally sensitive and be recognize the varied sociocultural backgrounds which affect students' learning.

  18. 7 CFR 457.148 - Fresh market pepper crop insurance provisions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Fresh market pepper crop insurance provisions. 457.148... pepper crop insurance provisions. The fresh market pepper crop insurance provisions for the 1999 and... Fresh Market Pepper Crop Provisions If a conflict exists among the policy provisions, the order of...

  19. A Study on Strategic Provisioning of Cloud Computing Services

    Directory of Open Access Journals (Sweden)

    Md Whaiduzzaman

    2014-01-01

    Full Text Available Cloud computing is currently emerging as an ever-changing, growing paradigm that models “everything-as-a-service.” Virtualised physical resources, infrastructure, and applications are supplied by service provisioning in the cloud. The evolution in the adoption of cloud computing is driven by clear and distinct promising features for both cloud users and cloud providers. However, the increasing number of cloud providers and the variety of service offerings have made it difficult for the customers to choose the best services. By employing successful service provisioning, the essential services required by customers, such as agility and availability, pricing, security and trust, and user metrics can be guaranteed by service provisioning. Hence, continuous service provisioning that satisfies the user requirements is a mandatory feature for the cloud user and vitally important in cloud computing service offerings. Therefore, we aim to review the state-of-the-art service provisioning objectives, essential services, topologies, user requirements, necessary metrics, and pricing mechanisms. We synthesize and summarize different provision techniques, approaches, and models through a comprehensive literature review. A thematic taxonomy of cloud service provisioning is presented after the systematic review. Finally, future research directions and open research issues are identified.

  20. Financial provisions for decommissioning and disposal: the operators' view

    International Nuclear Information System (INIS)

    Mueller-Dehn, C.

    2008-01-01

    The German system of making provisions for nuclear power has been the subject of frequent examinations, and has been approved in each case - by the German federal government, the European Commission, the Court of First Instance of the European Communities and, recently, also by the European Court of Justice. The article describes the basic legal principles entailing the obligation to make financial provisions for decommissioning and disposal by setting aside the required funds in line with current practice. The management of the assets balancing the provisions, the system of controls, the economic strength of the firms involved and, especially, the demand for the product they sell, i.e. electricity, ensure permanent availability of these funds. Numerous subsidiary legal provisions ensure transparency of these financial provisions. The external fund model analyzed as an alternative is the rejected both on account of drawbacks in its contents and for legal reasons. Attention is paid to the recommendation by the European Commission of October 2006 about financial provisions for decommissioning and disposal, to which the German system conforms and which does not require the establishment of external funds either. As the system of financial provisions has been operated successfully and reliably in Germany since the beginnings of the use of nuclear power, a plea is made in favor of upholding its structures and functions. (orig.)

  1. A study on strategic provisioning of cloud computing services.

    Science.gov (United States)

    Whaiduzzaman, Md; Haque, Mohammad Nazmul; Rejaul Karim Chowdhury, Md; Gani, Abdullah

    2014-01-01

    Cloud computing is currently emerging as an ever-changing, growing paradigm that models "everything-as-a-service." Virtualised physical resources, infrastructure, and applications are supplied by service provisioning in the cloud. The evolution in the adoption of cloud computing is driven by clear and distinct promising features for both cloud users and cloud providers. However, the increasing number of cloud providers and the variety of service offerings have made it difficult for the customers to choose the best services. By employing successful service provisioning, the essential services required by customers, such as agility and availability, pricing, security and trust, and user metrics can be guaranteed by service provisioning. Hence, continuous service provisioning that satisfies the user requirements is a mandatory feature for the cloud user and vitally important in cloud computing service offerings. Therefore, we aim to review the state-of-the-art service provisioning objectives, essential services, topologies, user requirements, necessary metrics, and pricing mechanisms. We synthesize and summarize different provision techniques, approaches, and models through a comprehensive literature review. A thematic taxonomy of cloud service provisioning is presented after the systematic review. Finally, future research directions and open research issues are identified.

  2. A conceptual framework to assess effectiveness in wheelchair provision.

    Science.gov (United States)

    Kamaraj, Deepan C; Bray, Nathan; Rispin, Karen; Kankipati, Padmaja; Pearlman, Jonathan; Borg, Johan

    2017-01-01

    Currently, inadequate wheelchair provision has forced many people with disabilities to be trapped in a cycle of poverty and deprivation, limiting their ability to access education, work and social facilities. This issue is in part because of the lack of collaboration among various stakeholders who need to work together to design, manufacture and deliver such assistive mobility devices. This in turn has led to inadequate evidence about intervention effectiveness, disability prevalence and subsequent costeffectiveness that would help facilitate appropriate provision and support for people with disabilities. In this paper, we describe a novel conceptual framework that can be tested across the globe to study and evaluate the effectiveness of wheelchair provision. The Comparative Effectiveness Research Subcommittee (CER-SC), consisting of the authors of this article, housed within the Evidence-Based Practice Working Group (EBP-WG) of the International Society of Wheelchair Professionals (ISWP), conducted a scoping review of scientific literature and standard practices used during wheelchair service provision. The literature review was followed by a series of discussion groups. The three iterations of the conceptual framework are described in this manuscript. We believe that adoption of this conceptual framework could have broad applications in wheelchair provision globally to develop evidence-based practices. Such a perspective will help in the comparison of different strategies employed in wheelchair provision and further improve clinical guidelines. Further work is being conducted to test the efficacy of this conceptual framework to evaluate effectiveness of wheelchair service provision in various settings across the globe.

  3. Coarse-Grain QoS-Aware Dynamic Instance Provisioning for Interactive Workload in the Cloud

    Directory of Open Access Journals (Sweden)

    Jianxiong Wan

    2014-01-01

    Full Text Available Cloud computing paradigm renders the Internet service providers (ISPs with a new approach to deliver their service with less cost. ISPs can rent virtual machines from the Infrastructure-as-a-Service (IaaS provided by the cloud rather than purchasing them. In addition, commercial cloud providers (CPs offer diverse VM instance rental services in various time granularities, which provide another opportunity for ISPs to reduce cost. We investigate a Coarse-grain QoS-aware Dynamic Instance Provisioning (CDIP problem for interactive workload in the cloud from the perspective of ISPs. We formulate the CDIP problem as an optimization problem where the objective is to minimize the VM instance rental cost and the constraint is the percentile delay bound. Since the Internet traffic shows a strong self-similar property, it is hard to get an analytical form of the percentile delay constraint. To address this issue, we purpose a lookup table structure together with a learning algorithm to estimate the performance of the instance provisioning policy. This approach is further extended with two function approximations to enhance the scalability of the learning algorithm. We also present an efficient dynamic instance provisioning algorithm, which takes full advantage of the rental service diversity, to determine the instance rental policy. Extensive simulations are conducted to validate the effectiveness of the proposed algorithms.

  4. Corporate Governance Provisions, Family Involvement, and Firm Performance in Publicly Traded Family Firms

    Directory of Open Access Journals (Sweden)

    Esra Memili

    2015-07-01

    Full Text Available This study examines the moderation effects of corporate governance provisions on the link between family involvement (i.e., family ownership and family management in publicly-traded firms and firm performance by drawing upon agency theory, with a focus on principal-principal agency issues, and the extant family governance literature. We develop and test the hypotheses on 386 of the S&P 500 firms longitudinally. Findings support the hypotheses suggesting the moderation effects of the use of provisions (a protecting controlling owners in terms of their sustainability of controlling status, and (b protecting management legally on the inverted U-shaped relationship between family ownership and firm performance. We also found support for the moderation effects of provisions (c protecting controlling owners in terms of their voting rights, (d protecting noncontrolling owners, and (e protecting management monetarily on the inverted U-shaped relationship between family management and firm performance. By this, our study provides empirical support for the principal-principal agency perspective on the corporate governance in publicly-traded family firms. As such, it suggests new avenues of research for both the corporate governance literature, as well as for the theory of the family firm. Our study also offers insights to policy directed toward monitoring the actions of large shareholders such as family and enhancing the overall shareholder value in publicly-traded family firms.

  5. The provision of therapy mattresses for pressure ulcer prevention.

    Science.gov (United States)

    Pagnamenta, Fania

    2017-03-23

    Preventing pressure ulcers is complex and involves skin care, the provision of therapy mattresses, repositioning, the management of incontinence and adequate nutritional support. This article describes a model of therapy mattress provision that is based on non-powered products. Evaluating the efficiency of this model is challenging, due to the complexities of care, but Safety Thermometer data and incidents reports offer reassurance that non-powered therapy mattresses can provide adequate pressure ulcer prevention. Therapy mattress provision is only one of the five interventions and these are described in details to give readers a fuller picture of the model used at the author's trust.

  6. Learning in Educational Computer Games for Novices: The Impact of Support Provision Types on Virtual Presence, Cognitive Load, and Learning Outcomes

    Directory of Open Access Journals (Sweden)

    Claudia Schrader

    2012-06-01

    Full Text Available Embedding support devices in educational computer games has been asserted to positively affect learning outcomes. However, there is only limited direct empirical evidence on which design variations of support provision influence learning. In order to better understand the impact of support design on novices’ learning, the current study investigates how support devices and their type of provision (intrinsic vs. extrinsic determine games’ effectiveness on learning outcomes. This effectiveness is also related to how the design-type of provision influences learners’ virtual presence and cognitive load. Compared to an educational adventure game without additional support, the results indicate that the game equipped with support devices enhances learning outcomes, although no differences in cognitive load were found. A variation in the design of provision shows no effect. In order to gain a more thorough understanding of support devices and their design for games, additional learner characteristics (e.g., interest should be considered in future research.

  7. Public-private provision of protection measures against natural hazards

    Science.gov (United States)

    Gruber, M.

    2009-04-01

    Natural hazards threaten human lives as well as economic values of a society. Due to an increasing population density, augmenting property holdings in congested areas as well as higher frequencies of catastrophic events, the damage potential associated with natural hazards is growing. In order to safeguard societal assets against this threat, active and passive protection measures can be established. While passive protection measures provide for this type of risk by means of thorough land use planning, active protection measures aim at improving safety through technical or biological protective systems and structures. However, these provisions are costly and need to be handled prudentially. In most European countries protection measures against natural hazards are provided by the public. Specific governmental funds have been set up for the establishment of preventive systems as well as for damage compensation payments after the occurrence of catastrophic events. Though, additional capital is urgently needed in order to facilitate the realisation of all necessary projects in this field and to provide for maximal safety. One potential solution for such financial deficiencies can be found in Public Private Partnerships (PPP). PPPs have been implemented as attractive concepts for the funding of diverse projects in the fields of e.g. road construction, municipal, health and social services. In principle, they could also provide alternative funding solutions for the establishment of crucial protective infrastructure in respect of natural hazards, adding private financial means to the currently available public funds. Thereby, the entire capacities for catastrophe funding could be enhanced. Beside PPPs, also alternative funding mechanisms such as the emission of catastrophe bonds, contingent credit lines or leasing arrangements may enhance available capacities for the financing of protection measures. This contribution discusses innovative solutions for the funding of

  8. Capacity, pressure, demand, and flow: A conceptual framework for analyzing ecosystem service provision and delivery

    Science.gov (United States)

    Villamagna, Amy M.; Angermeier, Paul L.; Bennett, Elena M.

    2013-01-01

    Ecosystem services provide an instinctive way to understand the trade-offs associated with natural resource management. However, despite their apparent usefulness, several hurdles have prevented ecosystem services from becoming deeply embedded in environmental decision-making. Ecosystem service studies vary widely in focal services, geographic extent, and in methods for defining and measuring services. Dissent among scientists on basic terminology and approaches to evaluating ecosystem services create difficulties for those trying to incorporate ecosystem services into decision-making. To facilitate clearer comparison among recent studies, we provide a synthesis of common terminology and explain a rationale and framework for distinguishing among the components of ecosystem service delivery, including: an ecosystem's capacity to produce services; ecological pressures that interfere with an ecosystem's ability to provide the service; societal demand for the service; and flow of the service to people. We discuss how interpretation and measurement of these four components can differ among provisioning, regulating, and cultural services. Our flexible framework treats service capacity, ecological pressure, demand, and flow as separate but interactive entities to improve our ability to evaluate the sustainability of service provision and to help guide management decisions. We consider ecosystem service provision to be sustainable when demand is met without decreasing capacity for future provision of that service or causing undesirable declines in other services. When ecosystem service demand exceeds ecosystem capacity to provide services, society can choose to enhance natural capacity, decrease demand and/or ecological pressure, or invest in a technological substitute. Because regulating services are frequently overlooked in environmental assessments, we provide a more detailed examination of regulating services and propose a novel method for quantifying the flow of

  9. 76 FR 78009 - Information Collection; Implementation of Information Technology Security Provision

    Science.gov (United States)

    2011-12-15

    ...] Information Collection; Implementation of Information Technology Security Provision AGENCY: General Services... collection requirement regarding Implementation of Information Technology Security Provision. Public comments... Information Collection 3090- 0294, Implementation of Information Technology Security Provision, by any of the...

  10. Access control infrastructure for on-demand provisioned virtualised infrastructure services

    NARCIS (Netherlands)

    Demchenko, Y.; Ngo, C.; de Laat, C.; Smari, W.W.; Fox, G.C.

    2011-01-01

    Cloud technologies are emerging as a new way of provisioning virtualised computing and infrastructure services on-demand for collaborative projects and groups. Security in provisioning virtual infrastructure services should address two general aspects: supporting secure operation of the provisioning

  11. 78 FR 45617 - Student Assistance General Provisions, Federal Perkins Loan Program, Federal Family Education...

    Science.gov (United States)

    2013-07-29

    ..., et al. Student Assistance General Provisions, Federal Perkins Loan Program, Federal Family Education... General Provisions, Federal Perkins Loan Program, Federal Family Education Loan Program, and William D... General Provisions, Federal Perkins Loan (Perkins Loan) Program, Federal Family Education Loan (FFEL...

  12. The Impact of Product Market Competition on Training Provision

    DEFF Research Database (Denmark)

    Lai, Tat-kei; Ng, Travis

    's Workplace and Employee Survey, we find that increased competition is strongly associated with more training provision within workplace. We show that this association is unlikely to be driven by unobservable workplace heterogeneity, the specific measures used, and other relevant factors which can affect...... training provisions. To the extent that training is a significant source of human capital and industry competitiveness, our empirical results suggest increasing training is a significant channel through which competition raises productivity.......While standard models of training focus on how the structure of the input market affects training provisions of firms, this paper investigates the relationship between product market competition and training provision. Using the longitudinal and nationally representative data from Statistics Canada...

  13. The Digital Society and Provision of Welfare Services

    DEFF Research Database (Denmark)

    Pedersen, John Storm; Wilkinson, Adrian

    2018-01-01

    The digital society has been announced and subconsequently, the digital welfare state. The digital society and the digital welfare state changes the provision of welfare services to the citizens as end-users. The article analyses how....

  14. Resource Provision in Primary Schools--An Australian Perspective.

    Science.gov (United States)

    Yarrow, Allan; Millwater, Jan

    1994-01-01

    This Australian perspective on the resource provision in primary schools offers a framework for conceptualizing resources; explores the notion of equality; and provides suggestions for making resourcing more equitable. (AEF)

  15. Adapted SERVQUAL for evaluating the provision of information as ...

    African Journals Online (AJOL)

    SERVQUAL) for measuring the provision of information as an Extension Service. It explores agricultural Extension Services as a customer service and SERVQUAL as a service evaluation tool. The study aims to provide an adapted SERVQUAL instrument ...

  16. Access control for on-demand provisioned cloud infrastructure services

    NARCIS (Netherlands)

    Ngo, C.T.

    2016-01-01

    The evolution of Cloud Computing brings advantages to both customers and service providers to utilize and manage computing and network resources more efficiently with virtualization, service-oriented architecture technologies, and automated on-demand resource provisioning. However, these advantages

  17. Ontario: prostitution-related provisions of Criminal Code struck down.

    Science.gov (United States)

    Chu, Sandra Ka Hon

    2011-04-01

    In September 2010, the Ontario Superior Court of Justice held that three provisions of the Criminal Code dealing with prostitution violated sex workers' constitutional rights, were not in accordance with the principles of fundamental justice and must be struck down.

  18. 48 CFR 570.604 - Deviations to provisions and clauses.

    Science.gov (United States)

    2010-10-01

    ... modify the language of a provision or clause mandated by statute (e.g., GSAR 552.203-5, Covenant Against... for Disabled Veterans and Veterans of the Vietnam Era; and 52.222-36, Affirmative Action for Workers...

  19. 77 FR 46121 - Notice of Proposed Information Collection; General Provisions

    Science.gov (United States)

    2012-08-02

    ... jurisdiction of surface coal mining and reclamation operations, petitions for rulemaking, and citizen suits... DEPARTMENT OF THE INTERIOR Office of Surface Mining Reclamation and Enforcement Notice of Proposed Information Collection; General Provisions AGENCY: Office of Surface Mining Reclamation and Enforcement...

  20. Forensic mental health services: Current service provision and ...

    African Journals Online (AJOL)

    Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape. Kiran Sukeri, Orlando A. Betancourt, Robin Emsley, Mohammed Nagdee, Helmut Erlacher ...

  1. Afforestation, Subsequent Forest Fires and Provision of Hydrological Services

    NARCIS (Netherlands)

    Nunes, João Pedro; Naranjo Quintanilla, Paula; Santos, Juliana Marisa; Serpa, Dalila; Carvalho-Santos, Cláudia; Rocha, João; Keizer, Jan Jacob; Keesstra, Saskia Deborah

    2018-01-01

    Mediterranean landscapes have experienced extensive abandonment and reforestation in recent decades, which should have improved the provision of hydrological services such as flood mitigation, soil erosion protection and water quality regulation. However, these forests are fire-prone, and the

  2. 48 CFR 625.7002 - Solicitation provision and contract clause.

    Science.gov (United States)

    2010-10-01

    ... SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Arab League Boycott and Related Provisions 625.7002 Solicitation... accordance with DOSAR 625.7001(c): (a) 652.225-70, Arab League Boycott of Israel; and. (b) 652.225-71...

  3. Page | 138 JUDICIAL REVIEW OF OUSTER CLAUSE PROVISIONS ...

    African Journals Online (AJOL)

    Fr. Ikenga

    ouster of jurisdiction of the courts on pre-election matters and impeachment of the executive do constitute an ... NAUJILJ 9 (1) 2018. Page | .... Ouster clauses are general provisions, which preclude an organ of government from exercising its.

  4. Contraceptive Provision to Adolescent Females Prescribed Teratogenic Medications.

    Science.gov (United States)

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

    2016-01-01

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

  5. Power Provision Based on Self-Sacrificing Craft

    Science.gov (United States)

    Hinchey, Michael G. (Inventor); Vassev, Emil I. (Inventor); Hinchey, Bridget (Inventor); Sterrit, Roy (Inventor)

    2015-01-01

    A biologically-inspired system and method is provided for self-adapting behavior of swarm-based exploration missions, whereby individual components, for example, spacecraft, in the system can sacrifice themselves for the greater good of the entire system. The self-sacrifice can involve donating resources or assets, such as power provisions, to a different component of an autonomous system. A receiving component of the system can benefit from receiving the donated resource or power provision.

  6. The Information Provision of the Non-Financial Reporting

    OpenAIRE

    Korol Svitlana Ya.

    2017-01-01

    The article is aimed at developing the methodological foundations together with a scientific substantiation of the methodical recommendations for accounting and information provision of the non-financial reporting of enterprise. As a basis for this study have been taken recommendations by the Global Reporting Initiative. The indicators of non-financial report have been grouped with regard to their possible information provision. The article proves the possibility to use a single database to g...

  7. Provisions of communication between NPP operational personnel: drifts of development

    International Nuclear Information System (INIS)

    Piskarev, S.A; Aksenov, V.R.

    2001-01-01

    At present Russia has a problem of new NPPs construction, which have to replace old one. The main goal here is provision of safety operation. Communication provision between operational personnel and variety of plant systems is one of the aspects of it. The aim of this paper is research of foreign experience in communication and operator support systems development, consideration of several modern projects based on these systems, definition drifts of development. (authors)

  8. Software-Programmed Optical Networking with Integrated NFV Service Provisioning

    DEFF Research Database (Denmark)

    Mehmeri, Victor; Wang, Xi; Basu, Shrutarshi

    2017-01-01

    We showcase demonstrations of “program & compile” styled optical networking as well as open platforms & standards based NFV service provisioning using a proof-of-concept implementation of the Software-Programmed Networking Operating System (SPN OS).......We showcase demonstrations of “program & compile” styled optical networking as well as open platforms & standards based NFV service provisioning using a proof-of-concept implementation of the Software-Programmed Networking Operating System (SPN OS)....

  9. The application of security provisions in accommodation facility – hotel

    OpenAIRE

    Rotbauer, Josef

    2010-01-01

    This thesis treats of security provisions, which hotels are using to protect health and property of accommodated persons. In the opening part is caught the progress of attendance and capacities of hotels in the Czech republic during a specific time period. The next chapter focuses on possible threats, which are imminent to hotels during the operation. The third part of the thesis solves particular methods of application of security provisions, these are verified in two concrete hotels in the ...

  10. Provisions for the dismantling of nuclear facilities are sufficient

    International Nuclear Information System (INIS)

    Le Ngoc, B.

    2016-01-01

    The European Union has assessed the provisions made by the nuclear plant operators to face the future costs of dismantling. The United-Kingdom and the Netherlands are the single E.U. members to have provisions covering the whole of the expenses (respectively 100% and 94%). The figure for France is very low 33% (far below the European average of 56%). According to French authorities the provisions for the dismantling of nuclear facilities are strictly defined by law: they must be made progressively till the decommissioning and they must be composed by dedicated assets. The costs of the dismantling is regularly re-assessed for taking into account technological progress and changes in regulation. Furthermore the French system limits the period in which provisions are made to the initial operating life of the plant: mostly 40 years which is a prudent measure. In other E.U. members like Germany, the provisions are not covered by dedicated assets which might endanger the capacity of the operator to face the future costs. The progressiveness of the French systems of provision-making is fair because the dismantling costs are spread equally over the entire operating period of the facility. (A.C.)

  11. Matching of Energy Provisions in Multihop Wireless Infra-Structures

    Directory of Open Access Journals (Sweden)

    Rui Teng

    2016-01-01

    Full Text Available Recently there have been large advances in energy technologies for battery-operated systems, including green energy resources and high capacity batteries. The effective use of battery energy resources in wireless infrastructure networks to improve the versatility and reliability of wireless communications is an important issue. Emerging applications of smart cities, Internet of Things (IoT, and emergency responses highly rely on the basic communication network infrastructures that enable ubiquitous network connections. However, energy consumption by nodes in a wireless infrastructure network depends on the transmissions of other nodes in the network. Considering this inter-dependence is necessary to achieve efficient provision of energy in wireless networks. This paper studies the issue of energy provision for wireless relay nodes in Wireless Multihop Infrastructures (WMI assuming constraints on the total energy provision. We introduce a scheme of Energy Provision Matching (Matching-EP for WMI which optimizes energy provision based on matching of energy provision with estimates of differentiated position-dependent energy consumption by wireless nodes distributed in the network. The evaluation results show that Matching-EP with 4%–34% improvement in energy matching degree enables 10%–40% improvement of the network lifetime, and 5%–40% improvement of packet delivery compared with conventional WMI networks.

  12. 75 FR 48728 - The Hydrostatic Testing Provision of the Portable Fire Extinguishers Standard; Extension of the...

    Science.gov (United States)

    2010-08-11

    ... Hydrostatic Testing Provision of the Portable Fire Extinguishers Standard; Extension of the Office of... the information collection requirements contained in the Hydrostatic Testing provision of the Portable... 48729

  13. Scalability Modeling for Optimal Provisioning of Data Centers in Telenor: A better balance between under- and over-provisioning

    OpenAIRE

    Rygg, Knut Helge

    2012-01-01

    The scalability of an information system describes the relationship between system ca-pacity and system size. This report studies the scalability of Microsoft Lync Server 2010 in order to provide guidelines for provisioning hardware resources. Optimal pro-visioning is required to reduce both deployment and operational costs, while keeping an acceptable service quality.All Lync servers in the test setup are virtualizedusingVMware ESXi 5.0 and the system runs on a Cisco Unified Computing System...

  14. The composition of readily available carbon sources produced by fermentation of fish faeces is affected by dietary protein:energy ratios

    DEFF Research Database (Denmark)

    Letelier-Gordo, Carlos Octavio; Larsen, Bodil Katrine; Dalsgaard, Johanne

    2017-01-01

    , 17, 19, 21 and 23 g/MJ) to rainbow trout (Oncorhynchus mykiss) on the production of volatile fatty acids (VFAs) and ethanol during 7 days fermentation of the produced fish faeces. The total yields of VFAs and ethanol obtained (expressed as chemical oxygen demand (COD)) ranged between 0.21–0.24 g...... of acetic and valeric acid. Changing the diet composition thus affects the composition of readily available carbon that can be derived from the faeces. This can be applied to enhance on-farm single sludge denitrification and reduce the need for adding external carbon sources such as e.g. methanol....

  15. A conceptual framework to assess effectiveness in wheelchair provision

    Science.gov (United States)

    Kankipati, Padmaja

    2017-01-01

    Background Currently, inadequate wheelchair provision has forced many people with disabilities to be trapped in a cycle of poverty and deprivation, limiting their ability to access education, work and social facilities. This issue is in part because of the lack of collaboration among various stakeholders who need to work together to design, manufacture and deliver such assistive mobility devices. This in turn has led to inadequate evidence about intervention effectiveness, disability prevalence and subsequent costeffectiveness that would help facilitate appropriate provision and support for people with disabilities. Objectives In this paper, we describe a novel conceptual framework that can be tested across the globe to study and evaluate the effectiveness of wheelchair provision. Method The Comparative Effectiveness Research Subcommittee (CER-SC), consisting of the authors of this article, housed within the Evidence-Based Practice Working Group (EBP-WG) of the International Society of Wheelchair Professionals (ISWP), conducted a scoping review of scientific literature and standard practices used during wheelchair service provision. The literature review was followed by a series of discussion groups. Results The three iterations of the conceptual framework are described in this manuscript. Conclusion We believe that adoption of this conceptual framework could have broad applications in wheelchair provision globally to develop evidence-based practices. Such a perspective will help in the comparison of different strategies employed in wheelchair provision and further improve clinical guidelines. Further work is being conducted to test the efficacy of this conceptual framework to evaluate effectiveness of wheelchair service provision in various settings across the globe. PMID:28936421

  16. ACR-1000 design provisions for severe accidents

    International Nuclear Information System (INIS)

    Popov, N.K.; Santamaura, P.; Shapiro, H.; Snell, V.G.

    2006-01-01

    Atomic Energy of Canada Limited (AECL) developed the Advanced CANDU Reactor-700 (ACR-700) as an evolutionary advancement of the current CANDU 6 reactor. As a further advancement of the ACR design, AECL is currently developing the ACR-1000 for the Canadian and international market. The ACR-1000 is aimed at producing electrical power for a capital cost and a unit-energy cost significantly less than that of the current generation of operating nuclear plants, while achieving enhanced safety features, shorter construction schedule, high plant capacity factor, improved operations and maintenance, and increased operating life. The reference ACR-1000 plant design is based on an integrated two-unit plant, using enriched fuel and light-water coolant, with each unit having a nominal gross output of about 1200 MWe. The ACR-1000 design meets Canadian regulatory requirements and follows established international practice with respect to severe accident prevention and mitigation. This paper presents the ACR-1000 features that are designed to mitigate limited core damage and severe core damage states, including core retention within vessel, core damage termination, and containment integrity maintenance. While maintaining existing structures of CANDU reactors that provide inherent prevention and retention of core debris, the ACR-1000 design includes additional features for prevention and mitigation of severe accidents. Core retention within vessel in CANDU-type reactors includes both retention within fuel channels, and retention within the calandria vessel. The ACR-1000 calandria vessel design permits for passive rejection of decay heat from the moderator to the shield water. Also, the calandria vessel is designed for debris retention by minimizing penetrations at the bottom periphery and by accommodating thermal and weight loads of the core debris. The ACR-1000 containment is required to withstand external events such as earthquakes, tornados, floods and aircraft crashes

  17. Theoretical approaches to determining the financial provision of public transportation

    Directory of Open Access Journals (Sweden)

    O.A. Vygovska

    2018-03-01

    Full Text Available The work is devoted to the improvement of theoretical approaches in determining the financial provision of transportation by public transport at the regional level. The author summarizes the concept of the «financial security» and defines the main difference from the term «financing». The systematization of key differences in the financial provision of a transport company from other financial entities of the economic sector at the national and regional levels is carried out. The disadvantages and advantages of sources of financial support are analyzed. The purpose of the article is to study theoretical approaches in determining the financial provision of transportation by public transport at the regional level. The prospects for further scientific research are the need to identify new scientific approaches and techniques to substantiate and elaborate the concept of the «financial provision of transportation by public transport». The practical application of the research should be formed in a detailed analysis of cash flow streams in the system of «state – regional authority – economic entity». The financial provision of transportation by public transport at the regional level has not been given the sufficient attention in the scientific research within the country. This fact confirms the need for a thorough analysis of the transport industry as a whole.

  18. 32 CFR 37.875 - Should my TIA include a provision concerning foreign access to technology?

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Should my TIA include a provision concerning... Related to Other Administrative Matters Intellectual Property § 37.875 Should my TIA include a provision... provision in the TIA that addresses foreign access to technology developed under the TIA. (b) The provision...

  19. 7 CFR 457.129 - Fresh market sweet corn crop insurance provisions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Fresh market sweet corn crop insurance provisions. 457... sweet corn crop insurance provisions. The fresh market sweet corn crop insurance provisions for the 2008... Reinsured Policies Fresh Market Sweet Corn Crop Provisions 1. Definitions Allowable cost.—The dollar amount...

  20. 40 CFR 1051.645 - What special provisions apply to branded engines?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false What special provisions apply to branded engines? 1051.645 Section 1051.645 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Provisions § 1051.645 What special provisions apply to branded engines? The following provisions apply if you...

  1. 40 CFR 1048.635 - What special provisions apply to branded engines?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false What special provisions apply to branded engines? 1048.635 Section 1048.635 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Compliance Provisions § 1048.635 What special provisions apply to branded engines? The following provisions...

  2. 10 CFR 600.381 - Special provisions for Small Business Innovation Research Grants.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Special provisions for Small Business Innovation Research... Organizations Additional Provisions § 600.381 Special provisions for Small Business Innovation Research Grants. (a) General. This section contains provisions applicable to the Small Business Innovation Reserach...

  3. Occupational health provision and health surveillance in the semiconductor industry.

    Science.gov (United States)

    Kinoulty, Mary; Williams, Nerys

    2006-03-01

    To identify the nature of occupational health provision in UK semiconductor-manufacturing plants. To identify the level of industry compliance with legal health surveillance requirements. A national inspection programme was carried out by Health & Safety Executive inspectors using a developed protocol. A wide range of occupational health provision was identified from none to use of an accredited specialist. The majority of work was of a reactive nature even where there was specialist occupational health input. Seven companies were identified as not meeting legal compliance and one as having unacceptable compliance for health surveillance. The spectrum of occupational health provision was very wide. Where health surveillance was provided, it was poorly targeted with limited interpretation and feedback to management.

  4. Waste management provisions in the political focus again

    International Nuclear Information System (INIS)

    Heller, W.

    2008-01-01

    In early January 2008, before the elections to the state parliament, the Social Democratic Party (SPD) in Hesse surprisingly announced that a state government led by the SPD would launch a legal initiative right away through the Federal Council 'to do away with the indirect subsidizing of nuclear power plant operators in connection with the provisions made for nuclear waste management and in the form of extensive exemptions from adequate nuclear liability'. The practice of making waste management provisions is subjected to a detailed analysis under aspects of law, business economics, the national economy, and fiscal regulations. The outcome shows that the legal provisions, confirmed also by a ruling of the European Court of Justice of December 2007, constitute neither a concession in the sense of a government subsidy nor a competitive advantage or a tax privilege. (orig.)

  5. SDN-based QoS Aware Network Service Provisioning

    DEFF Research Database (Denmark)

    Caba, Cosmin Marius; Soler, José

    2015-01-01

    One of the applicability areas of SDN is for creating services for dynamic provisioning of network resources with strict QoS requirements. The research available in this field focuses mainly on the service logic implemented over the functionality of the SDN Controller (SDNC). However, there is much...... to be covered regarding the specific mechanisms used by the SDNC to enforce the QoS in the data plane devices. To this end, the current paper proposes a data plane QoS architecture, together with the invariants that have to be maintained by the SDNC in order to ensure predictable QoS for the network services....... More specifically, the paper will look into on demand provisioning of Virtual Circuits (VCs) with specific QoS, based on the SDN paradigm. The aim is to analyze and compare the strategies for network resources management for two cases: a coarse granular and a fine granular VC provisioning service...

  6. Do improved patient recall and the provision of memory support enhance treatment adherence?

    Science.gov (United States)

    Dong, Lu; Lee, Jason Y; Harvey, Allison G

    2017-03-01

    Patient adherence to psychosocial treatment is an important but understudied topic. The aim of this study was to examine whether better patient recall of treatment contents and therapist use of memory support (MS) were associated with better treatment adherence. Data were drawn from a pilot randomized controlled trial. Participants were 48 individuals (mean age = 44.27 years, 29 females) with Major Depressive Disorder randomized to receive either Cognitive Therapy (CT) with an adjunctive Memory Support Intervention (CT + Memory Support) or CT-as-usual. Therapist and patient ratings of treatment adherence were collected during each treatment session. Patient recall was assessed at mid-treatment. Therapist use of MS was manually coded for a random selection of sessions. Patient recall was significantly associated with better therapist and patient ratings of adherence. Therapist use of Application, a specific MS strategy, predicted higher therapist ratings of adherence. Attention Recruitment, another specific MS strategy, appeared to attenuate the positive impact of session number on patient ratings of adherence. Treatment groups, MS summary scores and other specific MS strategies were not significantly associated with adherence. The measure for treatment adherence is in the process of being formally validated. Results were based on small sample. These results support the importance of patient recall in treatment adherence. Although collectively the effects of MS on treatment adherence were not significant, the results support the use of certain specific MS strategy (i.e., application) as a potential pathway to improve treatment adherence. Larger-scale studies are needed to further examine these constructs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. 78 FR 39617 - Data Practices, Computer III Further Remand: BOC Provision of Enhanced Services

    Science.gov (United States)

    2013-07-02

    ... contain data for reporting categories that are still active, such as business and Centrex-based services....S. Providers of International Telecommunications Services, Amendment of Part 43 of the Commission's... information in the context of an individual complaint proceeding under section 208 of the Act than through...

  8. WORKFORCE INVESTMENT ACT: Youth Provisions Promote New Service Strategies, but Additional Guidance Would Enhance Program Development

    National Research Council Canada - National Science Library

    2002-01-01

    .... Historically, programs designed to assist at-risk youth to attain employment and self-sufficiency were a patchwork of short-term, stand alone services delivered by a loosely coordinated network...

  9. 76 FR 45181 - Enhancing Airline Passenger Protections: Limited Delay of Effective Date for Certain Provisions

    Science.gov (United States)

    2011-07-28

    ... for not only online advertising but also print advertising so that consumers receive consistent... same effective date to print advertising so that consumers do not see different advertising displays in... January 24, 2012 for requirements pertaining to full fare advertising. The effective date remains August...

  10. Tip enhancement

    CERN Document Server

    Kawata, Satoshi

    2007-01-01

    This book discusses the recent advances in the area of near-field Raman scattering, mainly focusing on tip-enhanced and surface-enhanced Raman scattering. Some of the key features covered here are the optical structuring and manipulations, single molecule sensitivity, analysis of single-walled carbon nanotubes, and analytic applications in chemistry, biology and material sciences. This book also discusses the plasmonic materials for better enhancement, and optical antennas. Further, near-field microscopy based on second harmonic generation is also discussed. Chapters have been written by some of the leading scientists in this field, who present some of their recent work in this field.·Near-field Raman scattering·Tip-enhanced Raman spectroscopy·Surface-enhanced Raman spectroscopy·Nano-photonics·Nanoanalysis of Physical, chemical and biological materials beyond the diffraction limits·Single molecule detection

  11. Public attitudes to genomic science: an experiment in information provision.

    Science.gov (United States)

    Sturgis, Patrick; Brunton-Smith, Ian; Fife-Schaw, Chris

    2010-03-01

    We use an experimental panel study design to investigate the effect of providing "value-neutral" information about genomic science in the form of a short film to a random sample of the British public. We find little evidence of attitude change as a function of information provision. However, our results show that information provision significantly increased dropout from the study amongst less educated respondents. Our findings have implications both for our understanding of the knowledge-attitude relationship in public opinion toward genomic science and for science communication more generally.

  12. Sociality as a natural mechanism of public goods provision.

    Directory of Open Access Journals (Sweden)

    Elliot T Berkman

    Full Text Available In the recent literature, several hypotheses have been offered to explain patterns of human behavior in social environments. In particular, these patterns include 'prosocial' ones, such as fairness, cooperation, and collective good provision. Psychologists suggest that these prosocial behaviors are driven not by miscalculations, but by salience of social identity, in-group favoritism, emotion, or evolutionary adaptations. This paper imports psychology scholarship into an economic model and results in a sustainable solution to collective action problems without any external enforcement mechanisms. This natural mechanism of public goods provision is created, analyzed, and observed in a controlled laboratory environment using experimental techniques.

  13. The Impact of Product Market Competition on Training Provision

    DEFF Research Database (Denmark)

    Lai, Tat-kei; Ng, Travis

    2014-01-01

    While standard models of training focus on how input market affects firms' training decisions, this paper investigates the impact of product market competition on training provision. Using the longitudinal data from Statistics Canada's Workplace and Employee Survey, we find that increased...... that increasing training is an important channel through which competition raises productivity....

  14. 17 CFR 200.735-3 - General provisions.

    Science.gov (United States)

    2010-04-01

    ... by law or regulation (including the provisions of this subpart), which would result in or might... section do not prohibit members and employees from the following: (i) The acceptance of food and refreshments, not lavish in kind, offered free in the course of a meeting or other group function, not...

  15. Internet Use for Service Provision and Research in Libraries and ...

    African Journals Online (AJOL)

    This study discussed internet, the services and the uses, it can be put to in the provision of library services, or in an information centre. Literature search was used to elicit information for this study. The results revealed that whenever internet intervenes in library operations, these is bridge in time, space, minimized cost and ...

  16. The Impact of Health Insurance on Health Care Provision in ...

    African Journals Online (AJOL)

    This study assesses the impact of the NHIS scheme in promoting access to health care. It identifies a need for all stakeholders to engage in the active promotion of awareness on health insurance as option of health care provisioning. It argues that health insurance can make health care more accessible to a wider segment ...

  17. Barriers to and opportunities for provision and dissemination of ...

    African Journals Online (AJOL)

    This paper discusses factors affecting the provision of information on sexuality and reproductive health to girls in secondary schools in Kenya. The factors include lack of enforcement of national guidelines to educate the girls effectively on sexuality and reproductive health, lack of appropriate information sources, ...

  18. 45 CFR 73.735-1201 - General provisions.

    Science.gov (United States)

    2010-10-01

    ... Disciplinary Action § 73.735-1201 General provisions. (a) Violations of the regulations contained in the Part may be cause for disciplinary action which could be in addition to any penalty prescribed by law. (For a list of some offenses for which disciplinary action may be taken and “The Code of Ethics for...

  19. 20 CFR 726.204 - Statutory policy provisions.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Statutory policy provisions. 726.204 Section 726.204 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR'S...

  20. Viewing the proposed South African Business Rescuie Provisions ...

    African Journals Online (AJOL)

    This article makes some comparisons between the Australian corporate rescue provisions and those proposed to be adopted in South Africa in the Companies Bill 2007. By so doing it may assist in the debate in South Africa over how the legislation is framed as the experience in Australia may be useful as an indicator of ...

  1. Provisions for Climate Change Technological Capability in the ...

    African Journals Online (AJOL)

    organisational) that enable farm or actors to efficiently use equipment and information and improve technology. The paper reviewed the climate change technological capability provisions in agricultural policies, acts and initiatives in Nigeria. The technological capabilities examined were production, investment, minor ...

  2. 107 an appraisal of the scope of provisions under

    African Journals Online (AJOL)

    Fr. Ikenga

    EZE & EZE: An Appraisal of the Scope of Provisions Under The 1999 Nigerian Constitution for the Control of Pollution. Arising from the Oil and Gas Industry. AN APPRAISAL OF THE .... However, in a historic judgment, a Federal High Court sitting in Benin-City and presided over by Nwokorie J, held that continued gas flaring ...

  3. Self Adaptive Safe Provisioning of Wireless Power Using DCOPs

    NARCIS (Netherlands)

    Leeuwen, C.J. van; Yildirim, K.S.; Pawelczak, P.

    2017-01-01

    Wireless Power Transfer (WPT) technologies aim at getting rid of cables used by consumer devices for energy provision. As long distance WPT is becoming mature, the health impact of WPT becomes increasingly important to consider. In this paper we look at how to maximize the wireless power transfer to

  4. Provision of Abortion Services by Midwives in Limpopo Province of ...

    African Journals Online (AJOL)

    South Africa's Choice on Termination of Pregnancy (CTOP) Act of 1996 allows provision of abortion on request up to 12 weeks of gestation and permits midwives who have completed required training to conduct termination of pregnancies. This unique codification of midwives' role in abortion care reflects legislators' ...

  5. Provision of Effectiveness of University Education on the Market Economy

    Science.gov (United States)

    Kuznetsov, Nikolai; Usenko, Lyudmila; Ivanova, Olga; Kostoglodova, Elena

    2017-01-01

    Purpose: The purpose of this paper is to evaluate and determine the effectiveness of university education on the economy of various countries. Design/methodology/approach: To determine the necessity and expedience of making provision for the effectiveness of university education on the market economy, this work uses the method of regression and…

  6. Forest ecosystem services: Provisioning of non-timber forest products

    Science.gov (United States)

    James L. Chamberlain; Gregory E. Frey; C. Denise Ingram; Michael G. Jacobson; Cara Meghan Starbuck Downes

    2017-01-01

    The purpose of this chapter is to describe approaches to calculate a conservative and defensible estimate of the marginal value of forests for non-timber forest products (NTFPs). 'Provisioning" is one of four categories of benefits, or services that ecosystems provide to humans and was described by the Millennium Ecosystem Assessment as 'products...

  7. 7 CFR 800.199 - Conflict-of-interest provisions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Conflict-of-interest provisions. 800.199 Section 800... Delegations, Designations, Approvals, Contracts, and Conflicts of Interest § 800.199 Conflict-of-interest...) Prohibited conflicts of interest. Unless waived on a case-by-case basis by the Administrator under section 11...

  8. Strengthening implant provision and acceptance in South Africa with ...

    African Journals Online (AJOL)

    Implanon's convenience for women, and reduce removal procedures and costs of ... implants inserted in the public sector has fallen from ~175 000 in ... Provision of immediate postpartum and post-abortion implants is safe and highly acceptable, yet ... in rural Northern Nigeria, where CHWs were tasked with inserting.

  9. Security framework for virtualised infrastructure services provisioned on-demand

    NARCIS (Netherlands)

    Ngo, C.; Membrey, P.; Demchenko, Y.; de Laat, C.

    2011-01-01

    Cloud computing is developing as a new wave of ICT technologies, offering a common approach to on-demand provisioning computation, storage and network resources which are generally referred to as infrastructure services. Most of currently available commercial Cloud services are built and organized

  10. Cultural Differences in Support Provision: The Importance of Relationship Quality.

    Science.gov (United States)

    Chen, Jacqueline M; Kim, Heejung S; Sherman, David K; Hashimoto, Takeshi

    2015-11-01

    Emotional expression is highly valued in individualistic cultures, whereas emotional restraint is prioritized in collectivistic cultures. We hypothesized that high-quality relationships in these cultures would exhibit the forms of support provision congruent with their respective expectations. Study 1 examined support transactions among friends in response to a laboratory stressor and found that objectively judged relationship quality (RQ) more strongly positively predicted emotion-focused support provision behaviors by European Americans than by Asian Americans. Study 2, a questionnaire study, found that self-reported RQ predicted emotion-focused support provision more strongly among European Americans than among Japanese. Study 3 investigated more indirect forms of support and found that RQ more strongly predicted worrying about and monitoring close others enduring stressors and spending time with them without talking about the stressor among Asian Americans compared with European Americans. These findings suggest that RQ is expressed in terms of support provision in culturally normative ways. © 2015 by the Society for Personality and Social Psychology, Inc.

  11. 48 CFR 809.507-1 - Solicitation provisions.

    Science.gov (United States)

    2010-10-01

    ... COMPETITION AND ACQUISITION PLANNING CONTRACTOR QUALIFICATIONS Organizational and Consultant Conflicts of Interest 809.507-1 Solicitation provisions. (a) While conflicts of interest may not presently exist, award of certain types of contracts may create potential future organizational conflicts of interest (see...

  12. Free provision of services and cross-border labour recruitment

    NARCIS (Netherlands)

    Cremers, Jan

    2013-01-01

    Overview of the EU acquis related to the free movement of workers and the posting of workers in the frame of the free service provision. The article identifies how the use of the European Union (EU) mobility rules, as formulated by the EU's Posting Directive, has been linked to the temporary

  13. Political determinants of electricity provision in small island developing states

    International Nuclear Information System (INIS)

    Boräng, Frida; Jagers, Sverker C.; Povitkina, Marina

    2016-01-01

    This paper approaches provision of affordable and reliable electricity in Small Island Developing States (SIDS) as a case of public good provision. It aims to contribute to our understanding of how regime type and the quality of implementing institutions within political systems affect the prerequisites for successful electrification in SIDS. More specifically, we analyse the independent and interdependent effects of level of democracy and control of corruption on per capita household electricity consumption in SIDS, using data from 34 SIDS over the period 1996–2009. The results show that although the independent effects of level of democracy and control of corruption are sensitive to model specification, these two factors do have an interdependent impact on per capita household electricity consumption: democratization has positive effects on provision of electricity to the general population only when there is a certain level of corruption control in place. The results imply a) that it is important for policy actors to acknowledge the interaction between regime type and the quality of implementing institutions, and b) when planning electrification projects in SIDS, it is necessary to have information about the social and political context in order to design the most effective projects. - Highlights: • Effects of political institutions on household electricity consumption in SIDS. • Electrification is seen as an example of public good provision. • Democracy has a positive impact on electricity consumption when corruption is low. • Electrification projects can gain from being sensitive to institutional context.

  14. households' ability and willingness to pay for the provision of ...

    African Journals Online (AJOL)

    2017-10-02

    Oct 2, 2017 ... Using probit regression, it is observed that gender, educational status and ... The current study seeks to bridge this gap by examining the ... section two was on willingness and ability to pay for the provision of toilet facilities in ... The reason being that, the CVM method is more superior to other valuation.

  15. ASSESSMENT OF IMPORTANT SEISMIC PROVISIONS OF EBCS 8 ...

    African Journals Online (AJOL)

    resistant design of structures in Ethiopia have been made available since the' time of release of the three-volume. Ethiopian Standard Code of Practice (ESCP) in. 1983. The seismic provisions in this code occupied only few pages in the small volume for loading,. 'ESCP 1, and were limited to pseudo-static analysis.

  16. 76 FR 56868 - Pilot Project on NAFTA Trucking Provisions

    Science.gov (United States)

    2011-09-14

    ...-0097] Pilot Project on NAFTA Trucking Provisions AGENCY: Federal Motor Carrier Safety Administration... that have applied to participate in the Agency's long- haul pilot program to test and demonstrate the... proceed with the initiation of a U.S.-Mexico cross-border long-haul trucking pilot program to test and...

  17. 77 FR 12356 - Pilot Program on NAFTA Trucking Provisions

    Science.gov (United States)

    2012-02-29

    ...-0097] Pilot Program on NAFTA Trucking Provisions AGENCY: Federal Motor Carrier Safety Administration... that applied to participate in the Agency's long-haul pilot program to test and demonstrate the ability... cross-border long-haul trucking pilot program to test and demonstrate the ability of Mexico-domiciled...

  18. 78 FR 25525 - Pilot Program on NAFTA Trucking Provisions

    Science.gov (United States)

    2013-05-01

    ...-0097] Pilot Program on NAFTA Trucking Provisions AGENCY: Federal Motor Carrier Safety Administration..., which applied to participate in the Agency's long-haul pilot program to test and demonstrate the ability... long-haul trucking pilot program to test and demonstrate the ability of Mexico-domiciled motor carriers...

  19. 77 FR 40938 - Pilot Program on NAFTA Trucking Provisions

    Science.gov (United States)

    2012-07-11

    ...-0097] Pilot Program on NAFTA Trucking Provisions AGENCY: Federal Motor Carrier Safety Administration... Morales Guevara (DBA Fletes Morales) which applied to participate in the Agency's long-haul pilot program...] its intent to proceed with the initiation of a U.S.-Mexico cross-border long-haul trucking pilot...

  20. 77 FR 27837 - Pilot Program on NAFTA Trucking Provisions

    Science.gov (United States)

    2012-05-11

    ...-0097] Pilot Program on NAFTA Trucking Provisions AGENCY: Federal Motor Carrier Safety Administration... carriers that applied to participate in the Agency's long- haul pilot program to test and demonstrate the... intent to proceed with the initiation of a U.S.-Mexico cross-border long-haul trucking pilot program to...

  1. 78 FR 26106 - Pilot Program on NAFTA Trucking Provisions

    Science.gov (United States)

    2013-05-03

    ... DEPARTMENT OF TRANSPORTATION Federal Motor Carrier Safety Administration [Docket No FMCSA-2011-0097] Pilot Program on NAFTA Trucking Provisions AGENCY: Federal Motor Carrier Safety Administration (FMCSA). ACTION: Notice; correction. SUMMARY: The FMCSA published a document in the Federal Register of...

  2. 78 FR 24293 - Pilot Program on NAFTA Trucking Provisions

    Science.gov (United States)

    2013-04-24

    ...-0097] Pilot Program on NAFTA Trucking Provisions AGENCY: Federal Motor Carrier Safety Administration... in the Agency's long-haul pilot program to test and demonstrate the ability of Mexico- domiciled... cross-border long-haul trucking pilot program to test and demonstrate the ability of Mexico-domiciled...

  3. 76 FR 56272 - Pilot Project on NAFTA Trucking Provisions

    Science.gov (United States)

    2011-09-12

    ...-0097] Pilot Project on NAFTA Trucking Provisions AGENCY: Federal Motor Carrier Safety Administration... that have applied to participate in the Agency's long- haul pilot program to test and demonstrate the... cross-border long-haul trucking pilot program to test and demonstrate the ability of Mexico-domiciled...

  4. 76 FR 73765 - Pilot Project on NAFTA Trucking Provisions

    Science.gov (United States)

    2011-11-29

    ...-0097] Pilot Project on NAFTA Trucking Provisions AGENCY: Federal Motor Carrier Safety Administration... that have applied to participate in the Agency's long- haul pilot program to test and demonstrate the... proceed with the initiation of a U.S.-Mexico cross-border long-haul trucking pilot program to test and...

  5. 22 CFR Appendix A to Part 226 - Contract Provisions

    Science.gov (United States)

    2010-04-01

    ... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Pt. 226, App. A Appendix A to Part 226—Contract Provisions All contracts, awarded by... Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements,” and any...

  6. Competition policy for health care provision in Norway.

    Science.gov (United States)

    Brekke, Kurt R; Straume, Odd Rune

    2017-02-01

    Competition policy has played a very limited role for health care provision in Norway. The main reason is that Norway has a National Health Service (NHS) with extensive public provision and a wide set of sector-specific regulations that limit the scope for competition. However, the last two decades, several reforms have deregulated health care provision and opened up for provider competition along some dimensions. For specialised care, the government has introduced patient choice and (partly) activity (DRG) based funding, but also corporatised public hospitals and allowed for more private provision. For primary care, a reform changed the payment scheme to capitation and (a higher share of) fee-for-service, inducing almost all GPs on fixed salary contracts to become self-employed. While these reforms have the potential for generating competition in the Norwegian NHS, the empirical evidence is quite limited and the findings are mixed. We identify a set of possible caveats that may weaken the incentives for provider competition - such as the partial implementation of DRG pricing, the dual purchaser-provider role of regional health authorities, and the extensive consolidation of public hospitals - and argue that there is great scope for competition policy measures that could stimulate provider competition within the Norwegian NHS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. The Public-Private Partnership in ECEC Provision in Norway

    Science.gov (United States)

    Haug, Peder

    2014-01-01

    This article seeks to answer three central questions pertaining to public-private partnership in early childhood education and care (ECEC provision) in Norway: How has public-private partnership developed during the last four decades? How is public-private partnership understood in Norwegian ECEC policy? What seem to be the future challenges in…

  8. Parental Provision of Structure: Implementation and Correlates in Three Domains

    Science.gov (United States)

    Grolnick, Wendy S.; Raftery-Helmer, Jacquelyn N.; Marbell, Kristine N; Flamm, Elizabeth S.; Cardemil, Esteban V.

    2014-01-01

    This study examined parents' provision of "structure," defined as the organization of the environment to facilitate competence, and the degree to which it supports versus controls children's autonomy, in the domains of homework and studying, unsupervised time, and responsibilities in a diverse sample of sixth-grade children and their…

  9. 19 CFR 210.36 - General provisions for hearings.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false General provisions for hearings. 210.36 Section 210.36 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Prehearing Conferences and Hearings § 210.36 General...

  10. 19 CFR 210.27 - General provisions governing discovery.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false General provisions governing discovery. 210.27 Section 210.27 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Discovery and Compulsory Process § 210.27 General...

  11. Provision of Information to Rural Communities in Bama Local ...

    African Journals Online (AJOL)

    Provision of Information to Rural Communities in Bama Local Government Area of Borno State, Nigeria. Y Aliyu, E Camble ... findings of the study showed that rural people in the Soye district have identifiable information needs mainly in the areas of agriculture, health, government programmes and small scale industries.

  12. Security infrastructure for on-demand provisioned Cloud infrastructure services

    NARCIS (Netherlands)

    Demchenko, Y.; Ngo, C.; de Laat, C.; Wlodarczyk, T.W.; Rong, C.; Ziegler, W.

    2011-01-01

    Providing consistent security services in on-demand provisioned Cloud infrastructure services is of primary importance due to multi-tenant and potentially multi-provider nature of Clouds Infrastructure as a Service (IaaS) environment. Cloud security infrastructure should address two aspects of the

  13. Optimal Provision of Infrastructure Using Public-Private Partnership Contracts

    NARCIS (Netherlands)

    van der Laan, G.; Ruys, P.H.M.; Talman, A.J.J.

    2000-01-01

    This paper deals with the optimal provision of infrastructure by means of public-private partnership contracts.In the economic literature infrastructure is characterized as a large, indivisible and non-rival capital good that produces services for its users.Users can be both consumers and producers.

  14. 76 FR 22295 - National Poultry Improvement Plan and Auxiliary Provisions

    Science.gov (United States)

    2011-04-21

    ... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection 9 CFR Part 145 [Docket No. APHIS-2009-0031] RIN 0579-AD21 National Poultry Improvement Plan and Auxiliary Provisions Correction In rule document 2011-6539 appearing on pages 15791-15798 in the issue of Tuesday, March 22, 2011, make the...

  15. Challenges facing eTextbook provision to South African schools

    CSIR Research Space (South Africa)

    Dlodlo, N

    2012-10-01

    Full Text Available international companies are very expensive for the South African environment, and this would result in uneven access to such resources. Therefore South Africa has to come up with its own low-cost appropriate technologies to enable eBook provision to the schools...

  16. 7 CFR 457.140 - Dry pea crop insurance provisions.

    Science.gov (United States)

    2010-01-01

    ... of the Basic Provisions that limit the amount of a replant payment to the actual cost of replanting... present that are identified by the Food and Drug Administration or other public health organizations of... feasible. We may obtain prices from any buyer of our choice. If we obtain prices from one or more buyers...

  17. Public – Private Partnership initiative and provision of Information ...

    African Journals Online (AJOL)

    This study ex amine d the relationship between public -private partnership in the provision of Information Communication Technology (ICT) resources and academic library services in the South - East geo -political zone Nigeria. Seventeen (17) academic institutions (made up of nine universities and eight polytechnics) were ...

  18. Provision for Community College Faculty Development in Collective Bargaining Agreements

    Science.gov (United States)

    Wallace, Terry H. Smith

    1976-01-01

    Trends of collective negotiations were examined as they affect inservice education, through an examination of collective bargaining agreements. Conclusion: the trend is presently one of negotiation of provisions in a piecemeal fashion rather than one with the goal of establishing comprehensive professional improvement programs. (Editor/JT)

  19. 48 CFR 22.1505 - Solicitation provision and contract clause.

    Science.gov (United States)

    2010-10-01

    ....222-19, Child Labor—Cooperation with Authorities and Remedies, in all solicitations and contracts for... contract clause. 22.1505 Section 22.1505 Federal Acquisition Regulations System FEDERAL ACQUISITION... contract clause. (a) Except as provided in paragraph (b) of 22.1503, insert the provision at 52.222-18...

  20. 40 CFR 63.1329 - Process contact cooling towers provisions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 11 2010-07-01 2010-07-01 true Process contact cooling towers... Process contact cooling towers provisions. (a) The owner or operator of each new affected source that... end finisher process that utilizes a process contact cooling tower shall comply with paragraph (c) of...

  1. 48 CFR 411.171 - Solicitation provisions and contract clauses.

    Science.gov (United States)

    2010-10-01

    ... provision at 452.211-70, Brand Name or Equal, in solicitations, other than those for construction, where “brand name or equal” purchase descriptions are used. (b) Contracting officers shall insert the clause at..., Attachment to Statement of Work/Specifications, when there are attachments to the description (statement of...

  2. Secondary Education Development Plan (SEDP) and the provision ...

    African Journals Online (AJOL)

    This article examines the status of school library service provision after the establishment of the Secondary Education Development Plan (SEDP) in Sumbawanga Municipality, Tanzania. Data were collected through questionnaires, interviews and observation from four secondary schools. Findings show that the surveyed ...

  3. Defining generic architecture for Cloud IaaS provisioning model

    NARCIS (Netherlands)

    Demchenko, Y.; de Laat, C.; Mavrin, A.; Leymann, F.; Ivanov, I.; van Sinderen, M.; Shishkov, B.

    2011-01-01

    Infrastructure as a Service (IaaS) is one of the provisioning models for Clouds as defined in the NIST Clouds definition. Although widely used, current IaaS implementations and solutions doesn’t have common and well defined architecture model. The paper attempts to define a generic architecture for

  4. 48 CFR 726.7102 - PD 20 provision.

    Science.gov (United States)

    2010-10-01

    ..., Internationally Recognized Workers' Rights 726.7102 PD 20 provision. Relocation of U.S. Businesses, Assistance to Export Processing Zones, Internationally Recognized Workers' Rights (JAN 1994) No funds or other support... may be used in an activity which contributes to the violation of internationally recognized rights of...

  5. 7 CFR 457.104 - Cotton crop insurance provisions.

    Science.gov (United States)

    2010-01-01

    ... conflict exists among the policy provisions, the order of priority is as follows: (1) The Catastrophic Risk... the previous fall; and (2) Qualifies as a skip-row planting pattern as defined by the Farm Service... harvested, until the earlier of our inspection or 15 days after harvest of the balance of the unit is...

  6. The provision of education for minorities in South Africa | Mothata ...

    African Journals Online (AJOL)

    In the light of a lack of a consensus on the definition of the concept minority and the continuing debates on minorities and their rights in education, policy makers need to consider the adequate provision of education suitable to different minorities. The issue of minority rights in education is particularly sensitive in South Africa ...

  7. 20 CFR 71.1 - General administrative provisions.

    Science.gov (United States)

    2010-04-01

    ... term “compensation”. (6) The terms “disability”, “wages”, “child”, “grandchild”, “brother”, “sister... COMPENSATION FOR INJURY, DISABILITY OR DEATH OF CIVILIAN AMERICAN CITIZENS INCURRED WHILE DETAINED BY OR IN.... 1240) makes provision for the payment of benefits with respect to the injury, disability or death...

  8. Appraisal of the Performance of Contingency Cost Provision for ...

    African Journals Online (AJOL)

    The paper appraised performance of contingency allowance in addressing projects' cost risk. To achieve this aim, impact of contingency provision in some selected building projects were evaluated. Data for the study was collected by means of checklist from 40 completed projects' files. Furthermore, 100 questionnaires on ...

  9. Barriers to information provision regarding breast cancer and its treatment.

    Science.gov (United States)

    Campbell-Enns, Heather J; Woodgate, Roberta L; Chochinov, Harvey M

    2017-10-01

    Women with breast cancer require information about their cancer and its treatment during the process of treatment decision-making, yet it is unclear if there are barriers to information support. This study explores the experience of making treatment decisions in breast cancer, paying particular attention to the barriers experienced to the provision of information. Using a grounded theory methodology, semi-structured interviews were conducted with 22 women with invasive breast cancer exploring the experience of treatment decision-making. Data was organized using ATLAS.ti software and analyzed using constant comparisons. Analysis of the data showed that barriers to cancer and treatment information include intrapersonal and interpersonal communication challenges (emotional distress, patient-provider communication, "making it personal," access to information) which reside at different levels of the breast cancer experience (individual, dyad, group, organization). A model is provided to depict this experience. Women want information about their cancer and its treatment and experience barriers to information provision at various levels. Satisfactory information provision cannot occur without addressing barriers at every level. Utilizing interprofessional models of care may minimize existing barriers to information provision and empower patients to make satisfying treatment decisions that are consistent with their individual wishes.

  10. Library and information provision for distance learners in Tanzania ...

    African Journals Online (AJOL)

    The paper discusses some of the library and information provision research and evaluation aspects in the distance education context in Tanzania. It explores some current and potential areas that can be considered for research and evaluation by library and information personnel, scholars and researchers. It does so by ...

  11. Optimal portfolio selection for general provisioning and terminal wealth problems

    NARCIS (Netherlands)

    van Weert, K.; Dhaene, J.; Goovaerts, M.

    2010-01-01

    In Dhaene et al. (2005), multiperiod portfolio selection problems are discussed, using an analytical approach to find optimal constant mix investment strategies in a provisioning or a savings context. In this paper we extend some of these results, investigating some specific, real-life situations.

  12. Optimal portfolio selection for general provisioning and terminal wealth problems

    NARCIS (Netherlands)

    van Weert, K.; Dhaene, J.; Goovaerts, M.

    2009-01-01

    In Dhaene et al. (2005), multiperiod portfolio selection problems are discussed, using an analytical approach to find optimal constant mix investment strategies in a provisioning or savings context. In this paper we extend some of these results, investigating some specific, real-life situations. The

  13. 19 CFR 200.735-113 - Miscellaneous statutory provisions.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Miscellaneous statutory provisions. 200.735-113... Government Service.” (b) Chapter 11 of Title 18, United States Code, relating to bribery, graft, and... agent of a foreign principal registered under the Foreign Agents Registration Act (18 U.S.C. 219). [31...

  14. 49 CFR Appendix I to Part 805 - Miscellaneous Statutory Provisions

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Miscellaneous Statutory Provisions I Appendix I to...) Chapter 11 of Title 18, United States Code, relating to bribery, graft, and conflicts of interest (18 U.S... acting as the agent of a foreign principal registered under the Foreign Agents Registration Act (18 U.S.C...

  15. 29 CFR 1400.735-21 - Miscellaneous statutory provisions.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Miscellaneous statutory provisions. 1400.735-21 Section... Service.” (b) Chapter 11 of title 18, United States Code, relating to bribery, graft, and conflicts of... Registration Act (18 U.S.C. 219). (r) Penalties: The following table, copied from the Federal Personnel Manual...

  16. 11 CFR 7.16 - Miscellaneous statutory provisions.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Miscellaneous statutory provisions. 7.16... bribery, graft, and conflicts of interest, as appropriate to the employees concerned. (b) The prohibition... employee acting as the agent of a foreign principal registered under the Foreign Agents Registration Act...

  17. 25 CFR 700.565 - Miscellaneous statutory provisions.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Miscellaneous statutory provisions. 700.565 Section 700... States Code, relating to bribery, graftm and conflicts of interest, as appropriate to the employees... registered under the Foreign Agents Registration Act (18 U.S.C. 219). ...

  18. 22 CFR 1203.735-216 - Miscellaneous statutory provisions.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Miscellaneous statutory provisions. 1203.735-216..., United States Code, relating to bribery, graft, and conflicts of interest, as appropriate to the... employee acting as the agent of a foreign principal registered under the Foreign Agents Registration Act...

  19. The Practice of Feedback Provision in teaching writing skills: Adu ...

    African Journals Online (AJOL)

    The study showed that the teachers and students had positive perception towards the contribution of feedback provision in improving writing skills. The study also showed that teachers don't provide regular writing activities which create conducive environment and encourage multi draft writing. The study further showed that ...

  20. Managing Risk in Information Resources and Services Provision in ...

    African Journals Online (AJOL)

    Risk management forms an integral part of the Library's planning and monitoring process and its internal control framework. It is therefore a vital element of good governance and management. This paper discusses the strategies for managing risks in the provision of information services in University Libraries. The concept ...

  1. 7 CFR 457.135 - Onion crop insurance provisions.

    Science.gov (United States)

    2010-01-01

    ... Basic Provisions with (1) controlling (2) etc. 1. Definitions Damaged onion production. Storage type... method and production practice. Harvest. Removal of the onions from the field after topping and lifting... production. Onions of recoverable size and condition, with excess dirt and foliage material removed and that...

  2. Curriculum Provisions for Children with Special Educational Needs ...

    African Journals Online (AJOL)

    The study sought to examine curriculum provisions for children with special educational needs in mainstream schools in Bulawayo Metropolitan. Data were collected using the Likert scale questionnaire design. A total of ten teachers and ten school heads participated in the study. Major findings show that teachers in the ...

  3. 48 CFR 3027.409 - Solicitation provisions and contract clauses.

    Science.gov (United States)

    2010-10-01

    ... containing the basic clause unless the HCA approves an exclusion. Additional non-conflicting alternates may... and contract clauses. 3027.409 Section 3027.409 Federal Acquisition Regulations System DEPARTMENT OF..., AND COPYRIGHTS Rights in Data and Copyrights 3027.409 Solicitation provisions and contract clauses...

  4. Provision of RPA advice to users of minor radioactive sources

    International Nuclear Information System (INIS)

    French, A.P.; Anderson, A.G.

    1991-01-01

    The problems of providing cost effective Radiation Protection Supervisor (RPS) training and appropriate storage for minor radioactive sources are discussed. Threshold limits of radioactive holdings are proposed, above which an RPS should be formally trained and specialised source storage facilities provided. Proposals are made for the provision of practical radiation protection advice without need of a detailed hazard assessment. (author)

  5. 45 CFR 73a.735-501 - General provisions.

    Science.gov (United States)

    2010-10-01

    ...: FOOD AND DRUG ADMINISTRATION SUPPLEMENT Financial Interests § 73a.735-501 General provisions. (a) No... activity employee (defined in § 73a.735-502), may have financial interests: (1) In an organization whose FDA-regulated activities are an insignificant part of its total operations, i.e., no more than 10...

  6. 76 FR 44776 - Provisions Common to Registered Entities

    Science.gov (United States)

    2011-07-27

    ... framework for regulating the execution of transactions, requiring DCMs, like MGEX, to provide a competitive... fungibility.'' Given the potential adverse effect on innovation and other proposed regulatory provisions, the... subject to legal challenge. Legal challenges or disputes can be not only disruptive to the marketplace but...

  7. Higher Education Provision Using Systems Thinking Approach--Case Studies

    Science.gov (United States)

    Dhukaram, Anandhi Vivekanandan; Sgouropoulou, Cleo; Feldman, Gerald; Amini, Ardavan

    2018-01-01

    The purpose of this paper is to highlight the complexities involved in higher education provision and how systems thinking and socio-technical systems (STS) thinking approach can be used to understand the education ecosystem. Systems thinking perspective is provided using two case studies: the development of European Learner Mobility (EuroLM)…

  8. Social Provisions of Real and Imaginary Relationships in Early Childhood.

    Science.gov (United States)

    Gleason, Tracy R.

    2002-01-01

    This study compared perceptions of relationships with parents, best friends, siblings, and imaginary companions among 4-year-olds with invisible friends, object companions, or no imaginary companion. Findings indicated that parents afforded instrumental help, and siblings were associated with conflict. Real and imaginary friendship provisions were…

  9. the meaning of the provision of the 1996 constitution | Venter ...

    African Journals Online (AJOL)

    The introduction of this notion in South African law and its meaning in general is ... be it of a private or public law nature, can escape the test of constitutionality. ... to international authorities and definitions of these concepts are developed. ... The Constitutional Court has determined that, although no express provision to this ...

  10. 19 CFR 351.511 - Provision of goods or services.

    Science.gov (United States)

    2010-04-01

    ... 351.511 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE ANTIDUMPING AND... services. (a) Benefit—(1) In general. In the case where goods or services are provided, a benefit exists to... import duties. (b) Time of receipt of benefit. In the case of the provision of a good or service, the...

  11. Maternity Leave Provisions for Classroom Teachers in Larger School Systems.

    Science.gov (United States)

    Educational Research Service Circular, 1966

    1966-01-01

    Maternity leave provisions for classroom teachers in 129 school systems having enrollments of 25,000 or more are reported for 1965-66 in this national survey. Tables contain information on compulsory absence prior to anticipated date of birth and earliest permissible return from maternity leaves. Brief descriptions of maternity leave practices are…

  12. 48 CFR 3432.771 - Provision for incremental funding.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Provision for incremental funding. 3432.771 Section 3432.771 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION..., Incremental Funding, in a solicitation if a cost-reimbursement contract using incremental funding is...

  13. Free riding and the provision of candy bars

    NARCIS (Netherlands)

    Haan, M.A.; Kooreman, P.

    A wealth of experimental literature studies the effect of repetition and group size on the extent of free riding in the provision of public goods. In this paper, we use data from honor systems for candy bars in 166 firms to test whether such effects can be found outside the laboratory. We find that

  14. Traditional Versus Birth Attendants in Provision of Maternity Care ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    delivering babies by herself or working with other ... failed to show any association between the training ... provision of social safety nets in terms of cost ... methods. Examples of such novel use of TBAs are beginning to emerge in many parts of ...

  15. Active and Adaptive Services Resource Provisioning with Personalized Customization

    NARCIS (Netherlands)

    Wen, B.; Luo, Z.; Liang, P.

    2013-01-01

    Software as a service(SaaS), we are moving to the age of service-oriented software engineering(SOSE). But for the goal of services computing, namely on-demand service, it has not been able to achieved by far, especially the active provisioning approach for services resource. In view of these facts

  16. 31 CFR 544.405 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 544.405 Section 544.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE..., provide legal, accounting, financial, brokering, freight forwarding, transportation, public relations, or...

  17. 31 CFR 541.405 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 541.405 Section 541.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE.... persons may not, except as authorized by or pursuant to this part, provide legal, accounting, financial...

  18. 31 CFR 537.405 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 537.405 Section 537.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE.... persons may not, except as authorized by or pursuant to this part, provide legal, accounting, financial...

  19. 31 CFR 594.406 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 594.406 Section 594.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... to this part, provide legal, accounting, financial, brokering, freight forwarding, transportation...

  20. 31 CFR 593.405 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 593.405 Section 593.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE.... persons may not, except as authorized by or pursuant to this part, provide legal, accounting, financial...

  1. 31 CFR 542.405 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 542.405 Section 542.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE.... persons may not, except as authorized by or pursuant to this part, provide legal, accounting, financial...

  2. 31 CFR 536.406 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 536.406 Section 536.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... authorized by the Office of Foreign Assets Control by or pursuant to this part, provide legal, accounting...

  3. 31 CFR 595.406 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 595.406 Section 595.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... Office of Foreign Assets Control by or pursuant to this part, provide legal, accounting, public relations...

  4. 31 CFR 548.405 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 548.405 Section 548.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE.... persons may not, except as authorized by or pursuant to this part, provide legal, accounting, financial...

  5. 31 CFR 587.405 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 587.405 Section 587.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE...) Example: U.S. persons may not, except as authorized by or pursuant to this part, provide legal, accounting...

  6. 31 CFR 598.406 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 598.406 Section 598.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... legal, accounting, financial, brokering, freight forwarding, transportation, public relations, or other...

  7. 31 CFR 547.405 - Provision of services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 547.405 Section 547.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE.... persons may not, except as authorized by or pursuant to this part, provide legal, accounting, financial...

  8. Optimal provision of public goods with rank dependent expected utility

    OpenAIRE

    Eide, Erling

    2003-01-01

    In this paper the theory of rank-dependent expected utility (RDEU) is substituted for the theory of expected utility (EU) in a model of optimal provision of public goods. The substitution generalizes the Samuelson rule, previously modified to include deadweight loss and tax evasion loss.

  9. Pre-School Educational Provision in Rural Areas. Interchange 69.

    Science.gov (United States)

    Copus, Andrew; Petrie, Scott; Shucksmith, Janet; Shucksmith, Mark; Still, Margaret; Watt, Joyce

    The Scottish Executive Education Department has pledged to achieve universal provision of preschool education for 3- and 4-year-olds, whose parents want it, by 2002. The particular factors affecting delivery of preschool education in rural areas were examined through telephone interviews with local education authorities and voluntary preschool…

  10. 36 CFR Appendix A to Part 1210 - Contract Provisions

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Contract Provisions A Appendix A to Part 1210 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION... market, or contracts for transportation or transmission of intelligence. 5. Rights to Inventions Made...

  11. 7 CFR 1718.103 - Loan contract provisions.

    Science.gov (United States)

    2010-01-01

    ... AGRICULTURE LOAN SECURITY DOCUMENTS FOR ELECTRIC BORROWERS Loan Contracts With Distribution Borrowers § 1718... security for the loan will be reasonably adequate and that the loan will be repaid according to the terms... other provisions as RUS may require to ensure loan repayment and reasonably adequate loan security. ...

  12. 26 CFR 1.422-5 - Permissible provisions.

    Science.gov (United States)

    2010-04-01

    ... of the incentive stock option are subject to a substantial risk of forfeiture and not transferable...) INCOME TAXES Certain Stock Options § 1.422-5 Permissible provisions. (a) General rule. An option that otherwise qualifies as an incentive stock option does not fail to be an incentive stock option merely...

  13. 26 CFR 1.42-11 - Provision of services.

    Science.gov (United States)

    2010-04-01

    ... Against Tax § 1.42-11 Provision of services. (a) General rule. The furnishing to tenants of services other... for purposes of section 42(g). (b) Services that are optional—(1) General rule. A service is optional... low-income building with a common dining facility, the cost of meals is not included in gross rent for...

  14. 40 CFR 63.1331 - Equipment leak provisions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 11 2010-07-01 2010-07-01 true Equipment leak provisions. 63.1331... Standards for Hazardous Air Pollutant Emissions: Group IV Polymers and Resins § 63.1331 Equipment leak... in pumps and agitator seals in light liquid service shall not be considered to be a leak. For...

  15. 5 CFR 9901.106 - Relationship to other provisions.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Relationship to other provisions. 9901.106 Section 9901.106 Administrative Personnel DEPARTMENT OF DEFENSE HUMAN RESOURCES MANAGEMENT AND....S.C. 5545b; and (iii) Recruitment, relocation, and retention payments under 5 U.S.C. 5753 through...

  16. Community Eligibility Provision Evaluation. Nutrition Assistance Program Report

    Science.gov (United States)

    Logan, Christopher W.; Connor, Patty; Harvill, Eleanor L.; Harkness, Joseph; Nisar, Hiren; Checkoway, Amy; Peck, Laura R.; Shivji, Azim; Bein, Edwin; Levin, Marjorie; Enver, Ayesha

    2014-01-01

    Section 104(a) of the Healthy, Hunger Free Kids Act (HHFKA) of 2010 made the Community Eligibility Provision (CEP) available to Local Educational Agencies (LEAs) and schools in high poverty areas. Under the CEP, families are not required to submit applications for free or reducedprice (FRP) meals, and schools must provide free lunch and breakfast…

  17. Information provision for sustainable agricultural production in the ...

    African Journals Online (AJOL)

    The study sought to identify the methods of information provision to farmers and to evaluate how information is made accessible to farmers as well as the constraints farmers face in the Tolon-Kumbungu District of the Northern Region. Six communities were used for the study. Data was collected from one hundred and fifty ...

  18. Collaboration in Foundation Degree Provision: A Case Study in Kent

    Science.gov (United States)

    Thurgate, Claire; MacGregor, Janet

    2008-01-01

    Health and Social Care Foundation Degree (FD HSC) development commenced at Canterbury Christ Church University (CCCU) in 2005: the university already had a variety of validated programmes of this design, thus this new provision was able to draw on expertise of proven worth in the local economy. Over the past two years this programme has expanded…

  19. 26 CFR 1.457-10 - Miscellaneous provisions.

    Science.gov (United States)

    2010-04-01

    ... gross income by reason of the transfer, if the conditions in paragraph (b)(8)(ii) of this section are... to which section 415 does not apply by reason of section 415(k)(3). (iii) Example. The provisions of... at $100,000 under the plan. Pursuant to the divorce, a court issues a qualified domestic relations...

  20. The impact of market exposure on public goods provision

    DEFF Research Database (Denmark)

    Shami, Mahvish

    Low levels of public goods provision in many developing countries’ rural communities often force the poor to approach someone with considerable command over both financial and social resources to act as their patron. However engaging with the patron – typically a landlord – does not guarantee...