Sample records for environmental specialists led
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Chang, Angela T; Gavaghan, Belinda; O'Leary, Shaun; McBride, Liza-Jane; Raymer, Maree
2017-05-15
Objective The aim of the present study was to determine the rates of re-referral to specialist out-patient clinics for patients previously managed and discharged from an advanced practice physiotherapy-led service in three metropolitan hospitals. Methods A retrospective audit was undertaken of 462 patient cases with non-urgent musculoskeletal conditions discharged between 1 April 2014 and 30 March 2015 from three metropolitan hospitals. These patients had been discharged from the physiotherapy-led service without requiring specialist medical review. Rates and patterns of re-referral to specialist orthopaedic, neurosurgical, chronic pain, or rheumatology services within 12 months of discharge were investigated. Results Forty-six of the 462 patients (10.0%) who were managed by the physiotherapy-led service were re-referred to specialist medical orthopaedic, neurosurgical, chronic pain or rheumatology departments within 12 months of discharge. Only 22 of these patients (4.8%) were re-referred for the same condition as managed previously and discharged. Conclusions Ninety-five per cent of patients with non-urgent musculoskeletal conditions managed by an advanced practice physiotherapy-led service at three metropolitan hospitals did not re-present to access public specialist medical services for the same condition within 12 months of discharge. This is the first time that re-presentation rates have been reported for patients managed in advanced practice physiotherapy services and the findings support the effectiveness of these models of care in managing demand for speciality out-patient services. What is known about the topic? Advanced practice physiotherapy-led services have been implemented to address the needs of patients referred with non-urgent musculoskeletal conditions to hospital specialist out-patient services. Although this model is widely used in Australia, there has been very little information about whether patients managed in these services subsequently re
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Jackson, Cath; Coe, Anne; Cheater, Francine M; Wroe, Stephen
2007-04-01
This paper is a report of an exploratory study to evaluate the effectiveness and acceptability of a specialist health visitor-led weight management clinic in primary care. Tackling obesity is a global health priority. Whilst there is evidence to support a role for primary healthcare professionals in its management, provision in England varies widely. Using designated 'obesity specialists' is an approach warranting further investigation. In 2003-2004, patients with a body mass index of 30 or more received a specialist health visitor-led intervention based on the Jan Felgens 'I2E2' model. Clinical outcome data and self-reported dietary consumption data were collected at weeks 1, 13, 27 and 52. Quantitative and qualitative data on patient acceptability of the clinic were collected at week 26. Eighty-nine patients attended the clinic. Mean body weight and body mass index and systolic and diastolic blood pressure decreased over time by statistically significant amounts. There was a non-significant decrease in fasting blood sugar over time, but approximately one in 10 patients with undiagnosed diabetes were identified. No statistically significant change was evident for cholesterol levels. Mean self-reported weekly consumption of cakes, desserts and snacks decreased and that of fruit and vegetables increased, each by statistically significant amounts. Participants found the clinic highly acceptable and identified the specialist health visitor as fundamental to its success. A partnership approach to weight management through which patients are empowered to make sustainable lifestyle changes now needs to be tested in a multi-centre randomized controlled trial.
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Host specialist clownfishes are environmental niche generalists
Litsios, Glenn; Kostikova, Anna; Salamin, Nicolas
2014-01-01
Why generalist and specialist species coexist in nature is a question that has interested evolutionary biologists for a long time. While the coexistence of specialists and generalists exploiting resources on a single ecological dimension has been theoretically and empirically explored, biological systems with multiple resource dimensions (e.g. trophic, ecological) are less well understood. Yet, such systems may provide an alternative to the classical theory of stable evolutionary coexistence of generalist and specialist species on a single resource dimension. We explore such systems and the potential trade-offs between different resource dimensions in clownfishes. All species of this iconic clade are obligate mutualists with sea anemones yet show interspecific variation in anemone host specificity. Moreover, clownfishes developed variable environmental specialization across their distribution. In this study, we test for the existence of a relationship between host-specificity (number of anemones associated with a clownfish species) and environmental-specificity (expressed as the size of the ecological niche breadth across climatic gradients). We find a negative correlation between host range and environmental specificities in temperature, salinity and pH, probably indicating a trade-off between both types of specialization forcing species to specialize only in a single direction. Trade-offs in a multi-dimensional resource space could be a novel way of explaining the coexistence of generalist and specialists. PMID:25274370
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Energy Technology Data Exchange (ETDEWEB)
Tuenge, Jason R.; Hollomon, Brad; Dillon, Heather E.; Snowden-Swan, Lesley J.
2013-03-01
This report covers the third part of a larger U.S. Department of Energy (DOE) project to assess the life-cycle environmental and resource impacts in the manufacturing, transport, use, and disposal of light-emitting diode (LED) lighting products in relation to incumbent lighting technologies. All three reports are available on the DOE website (www.ssl.energy.gov/tech_reports.html). • Part 1: Review of the Life-Cycle Energy Consumption of Incandescent, Compact Fluorescent and LED Lamps; • Part 2: LED Manufacturing and Performance; • Part 3: LED Environmental Testing. Parts 1 and 2 were published in February and June 2012, respectively. The Part 1 report included a summary of the life-cycle assessment (LCA) process and methodology, provided a literature review of more than 25 existing LCA studies of various lamp types, and performed a meta-analysis comparing LED lamps with incandescent and compact fluorescent lamps (CFLs). Drawing from the Part 1 findings, Part 2 performed a more detailed assessment of the LED manufacturing process and used these findings to provide a comparative LCA taking into consideration a wider range of environmental impacts. Both reports concluded that the life-cycle environmental impact of a given lamp is dominated by the energy used during lamp operation—the upstream generation of electricity drives the total environmental footprint of the product. However, a more detailed understanding of end-of-life disposal considerations for LED products has become increasingly important as their installation base has grown. The Part 3 study (reported herein) was undertaken to augment the LCA findings with chemical analysis of a variety of LED, CFL, and incandescent lamps using standard testing procedures. A total of 22 samples, representing 11 different models, were tested to determine whether any of 17 elements were present at levels exceeding California or Federal regulatory thresholds for hazardous waste. Key findings include: • The selected
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Fabbruzzo-Cota, Christina; Frecea, Monica; Kozell, Kathryn; Pere, Katalin; Thompson, Tamara; Tjan Thomas, Julie; Wong, Angela
2016-01-01
The purpose of this clinical nurse specialist-led interprofessional quality improvement project was to reduce hospital-acquired pressure ulcers (HAPUs) using evidence-based practice. Hospital-acquired pressure ulcers (PUs) have been linked to morbidity, poor quality of life, and increasing costs. Pressure ulcer prevention and management remain a challenge for interprofessional teams in acute care settings. Hospital-acquired PU rate is a critical nursing quality indicator for healthcare organizations and ties directly with Mount Sinai Hospital's (MSH's) mission and vision, which mandates providing the highest quality care to patients and families. This quality improvement project, guided by the Donabedian model, was based on the Registered Nurses' Association of Ontario Best Practice Guideline Risk Assessment & Prevention of Pressure Ulcers. A working group was established to promote evidence-based practice for PU prevention. Initiatives such as documentation standardization, development of staff education and patient and family educational resources, initiation of a hospital-wide inventory for support surfaces, and procurement of equipment were implemented to improve PU prevention and management across the organization. An 80% decrease in HAPUs has been achieved since the implementation of best practices by the Best Practice Guideline Pressure Ulcer working group. The implementation of PU prevention strategies led to a reduction in HAPU rates. The working group will continue to work on building interprofessional awareness and collaboration in order to prevent HAPUs and promote an organizational culture that supports staff development, teamwork and communication. This quality improvement project is a successful example of an interprofessional clinical nurse specialist-led initiative that impacts patient/family and organization outcomes through the identification and implementation of evidence-based nursing practice.
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Vinall-Collier, Karen; Madill, Anna; Firth, Jill
2016-07-01
Nurse-led care is well established in Rheumatology in the UK and provides follow-up care to people with inflammatory arthritis including treatment, monitoring, patient education and psychosocial support. The aim of this study is to compare and contrast interactional style with patients in physician-led and nurse-led Rheumatology clinics. A multi-centre mixed methods approach was adopted. Nine UK Rheumatology out-patient clinics were observed and audio-recorded May 2009-April 2010. Eighteen practitioners agreed to participate in clinic audio-recordings, researcher observations, and note-taking. Of 9 nurse specialists, 8 were female and 5 of 9 physicians were female. Eight practitioners in each group took part in audio-recorded post-clinic interviews. All patients on the clinic list for those practitioners were invited to participate and 107 were consented and observed. In the nurse specialist cohort 46% were female; 71% had a diagnosis of Rheumatoid Arthritis (RA). The physician cohort comprised 31% female; 40% with RA and 16% unconfirmed diagnosis. Nineteen (18%) of the patients observed were approached for an audio-recorded telephone interview and 15 participated (4 male, 11 female). Forty-four nurse specialist and 63 physician consultations with patients were recorded. Roter's Interactional Analysis System (RIAS) was used to code this data. Thirty-one semi-structured interviews were conducted (16 practitioner, 15 patients) within 24h of observed consultations and were analyzed using thematic analysis. RIAS results illuminated differences between practitioners that can be classified as 'socio-emotional' versus 'task-focussed'. Specifically, nurse specialists and their patients engaged significantly more in the socio-emotional activity of 'building a relationship'. Across practitioners, the greatest proportion of 'patient initiations' were in 'giving medical information' and reflected what patients wanted the practitioner to know rather than giving insight into
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The predictability of phytophagous insect communities: host specialists as habitat specialists.
Directory of Open Access Journals (Sweden)
Jörg Müller
Full Text Available The difficulties specialized phytophagous insects face in finding habitats with an appropriate host should constrain their dispersal. Within the concept of metacommunities, this leads to the prediction that host-plant specialists should sort into local assemblages according to the local environmental conditions, i.e. habitat conditions, whereas assemblages of host-plant generalists should depend also on regional processes. Our study aimed at ranking the importance of local environmental factors and species composition of the vegetation for predicting the species composition of phytophagous moth assemblages with either a narrow or a broad host range. Our database consists of 351,506 specimens representing 820 species of nocturnal Macrolepidoptera sampled between 1980 and 2006 using light traps in 96 strict forest reserves in southern Germany. Species were grouped as specialists or generalists according to the food plants of the larvae; specialists use host plants belonging to one genus. We used predictive canonical correspondence and co-correspondence analyses to rank the importance of local environmental factors, the species composition of the vegetation and the role of host plants for predicting the species composition of host-plant specialists and generalists. The cross-validatory fit for predicting the species composition of phytophagous moths was higher for host-plant specialists than for host-plant generalists using environmental factors as well as the composition of the vegetation. As expected for host-plant specialists, the species composition of the vegetation was a better predictor of the composition of these assemblages than the environmental variables. But surprisingly, this difference for specialized insects was not due to the occurrence of their host plants. Overall, our study supports the idea that owing to evolutionary constraints in finding a host, host-plant specialists and host-plant generalists follow two different models of
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Energy Technology Data Exchange (ETDEWEB)
NONE
1977-07-01
The Specialists Meeting on Properties of Primary Circuit Structural Materials of LMFBRs covered the following topics: overview of materials program in different countries; mechanical properties of materials in air; fracture mechanics studies - component related activities; impact of environmental influences on mechanical properties; relationship of material properties and design methods. The purpose of the meeting was to provide a forum for exchange of information on structural materials behaviour in primary circuit of fast breeder reactors. Special emphasis was placed on environmental effects such as influence of sodium and irradiation on mechanical properties of reactor materials.
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International Nuclear Information System (INIS)
1977-01-01
The Specialists Meeting on Properties of Primary Circuit Structural Materials of LMFBRs covered the following topics: overview of materials program in different countries; mechanical properties of materials in air; fracture mechanics studies - component related activities; impact of environmental influences on mechanical properties; relationship of material properties and design methods. The purpose of the meeting was to provide a forum for exchange of information on structural materials behaviour in primary circuit of fast breeder reactors. Special emphasis was placed on environmental effects such as influence of sodium and irradiation on mechanical properties of reactor materials
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Trinidade, A; Yung, M W
2014-04-01
A specialist balance clinic to effectively deal with dizzy patients is recommended by ENT-UK. We audit the patient pathway before and following the introduction of a consultant-led dedicated balance clinic. Process evaluation and audit. ENT outpatients department of a district general hospital. The journey of dizzy patients seen in the general ENT clinic was mapped from case notes and recorded retrospectively. A consultant-led, multidisciplinary balance clinic involving an otologist, a senior audiologist and a neurophysiotherapist was then set up, and the journey was prospectively recorded and compared with that before the change. Of the 44 dizzy patients seen in the general clinic, 41% had further follow-up consultations; 64% were given definitive or provisional diagnoses; 75% were discharged without a management plan. Oculomotor examination was not systematically performed. The mean interval between Visits 1 and 2 was 8.4 weeks and the mean number of visits was 3. In the consultant-led dedicated balance clinic, following Visit 1, only 8% of patients required follow-up; 97% received definitive diagnoses, which guided management; all patients left with definitive management plans in place. In all patients, oculomotor assessment was systematically performed and all patients received consultant and, where necessary, allied healthcare professional input. By standardising the management experience for dizzy patients, appropriate and timely treatment can be achieved, allowing for a more seamless and efficient patient journey from referral to treatment. A multidisciplinary balance clinic led by a consultant otologist is the ideal way to achieve this. © 2014 John Wiley & Sons Ltd.
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Salamanca-Balen, Natalia; Seymour, Jane; Caswell, Glenys; Whynes, David; Tod, Angela
2018-02-01
Patients with palliative care needs do not access specialist palliative care services according to their needs. Clinical Nurse Specialists working across a variety of fields are playing an increasingly important role in the care of such patients, but there is limited knowledge of the extent to which their interventions are cost-effective. To present results from a systematic review of the international evidence on the costs, resource use and cost-effectiveness of Clinical Nurse Specialist-led interventions for patients with palliative care needs, defined as seriously ill patients and those with advanced disease or frailty who are unlikely to be cured, recover or stabilize. Systematic review following PRISMA methodology. Medline, Embase, CINAHL and Cochrane Library up to 2015. Studies focusing on the outcomes of Clinical Nurse Specialist interventions for patients with palliative care needs, and including at least one economic outcome, were considered. The quality of studies was assessed using tools from the Joanna Briggs Institute. A total of 79 papers were included: 37 randomized controlled trials, 22 quasi-experimental studies, 7 service evaluations and other studies, and 13 economic analyses. The studies included a wide variety of interventions including clinical, support and education, as well as care coordination activities. The quality of the studies varied greatly. Clinical Nurse Specialist interventions may be effective in reducing specific resource use such as hospitalizations/re-hospitalizations/admissions, length of stay and health care costs. There is mixed evidence regarding their cost-effectiveness. Future studies should ensure that Clinical Nurse Specialists' roles and activities are clearly described and evaluated.
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Russell, Cynthia L
2010-01-01
A clinical nurse specialist-led intervention to improve medication adherence in chronically ill adults using renal transplant recipients as an exemplar population is proposed. Meta-analyses and systematic reviews of chronically ill and transplant patients indicate that patient-specific characteristics not only are poor and inconsistent predictors for medication nonadherence but also are not amenable to intervention. Adherence has not meaningfully improved, despite meta-analyses and systematic narrative reviews of randomized controlled trials (RCTs) dealing with medication nonadherence in acutely and chronically ill persons and RCTs dealing with transplant patients. Interventions with a superior potential to enhance medication adherence must be developed. Use of a clinical nurse specialist-led continuous self-improvement intervention with adult renal transplant recipients is proposed. Continuous self-improvement focuses on improving personal systems thinking and behavior using the plan-do-check-act process. Electronic medication monitoring reports, one of several objective measures of medication adherence, are used by the clinician to provide patient feedback during the check process on medication-taking patterns. Continuous self-improvement as an intervention holds promise in supporting patient self-management and diminishing the blame that clinicians place on patients for medication nonadherence. Using an objective measure of medication adherence such as an electronic monitoring report fosters collaborative patient-clinician discussions of daily medication-taking patterns. Through collaboration, ideas for improving medication taking can be explored. Changes can be followed and evaluated for effectiveness through the continuous self-improvement process. Future studies should include RCTs comparing educational and/or behavioral interventions to improve medication adherence.
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Miles, K; Penny, N; Mercey, D; Power, R
2002-04-01
To assess the care process and clinical outcomes for two different models of GUM clinic for women: one led by specialist nurses and the other by senior house officers (SHOs). An open randomised controlled trial was carried out in a central London genitourinary medicine (GUM) women's clinic. Of 1172 women telephoning for an appointment, 880 were randomised to provide 169 eligible patients in the specialist nurse arm and 178 in the SHO arm. Of the eligible patients a total of 224 attended their appointment. The clinical records of the randomised women were audited for adequacy of care according to local guidelines. 30 key variables were objectively assessed and recorded on a standard audit form. An overall unitary index score (%) was calculated for each patient. The main variables associated with the outcome of specialist nurse and SHO decision making (diagnostic test request, preliminary diagnosis, and treatment provided) were then analysed independently. The median documentation audit scores for specialist nurses (n=103) and SHOs (n=121) were 92% and 85% respectively (pnurses' documentation was significantly (pnurses performed equally to the SHOs with regard to requesting the correct diagnostic tests, providing the correct preliminary diagnosis, and providing the correct treatment. A model of care using trained GUM nurses working within agreed protocols can provide comprehensive patient care for female patients that is equal to care provided by SHOs. Our results raise important issues regarding advanced GUM nursing education and training, protocol development, and accountability.
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Lim, Seong-Rin; Kang, Daniel; Ogunseitan, Oladele A; Schoenung, Julie M
2011-01-01
Light-emitting diodes (LEDs) are advertised as environmentally friendly because they are energy efficient and mercury-free. This study aimed to determine if LEDs engender other forms of environmental and human health impacts, and to characterize variation across different LEDs based on color and intensity. The objectives are as follows: (i) to use standardized leachability tests to examine whether LEDs are to be categorized as hazardous waste under existing United States federal and California state regulations; and (ii) to use material life cycle impact and hazard assessment methods to evaluate resource depletion and toxicity potentials of LEDs based on their metallic constituents. According to federal standards, LEDs are not hazardous except for low-intensity red LEDs, which leached Pb at levels exceeding regulatory limits (186 mg/L; regulatory limit: 5). However, according to California regulations, excessive levels of copper (up to 3892 mg/kg; limit: 2500), Pb (up to 8103 mg/kg; limit: 1000), nickel (up to 4797 mg/kg; limit: 2000), or silver (up to 721 mg/kg; limit: 500) render all except low-intensity yellow LEDs hazardous. The environmental burden associated with resource depletion potentials derives primarily from gold and silver, whereas the burden from toxicity potentials is associated primarily with arsenic, copper, nickel, lead, iron, and silver. Establishing benchmark levels of these substances can help manufacturers implement design for environment through informed materials substitution, can motivate recyclers and waste management teams to recognize resource value and occupational hazards, and can inform policymakers who establish waste management policies for LEDs.
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Energy Technology Data Exchange (ETDEWEB)
Scholand, Michael; Dillon, Heather E.
2012-05-01
Part 2 of the project (this report) uses the conclusions from Part 1 as a point of departure to focus on two objectives: producing a more detailed and conservative assessment of the manufacturing process and providing a comparative LCA with other lighting products based on the improved manufacturing analysis and taking into consideration a wider range of environmental impacts. In this study, we first analyzed the manufacturing process for a white-light LED (based on a sapphire-substrate, blue-light, gallium-nitride LED pumping a yellow phosphor), to understand the impacts of the manufacturing process. We then conducted a comparative LCA, looking at the impacts associated with the Philips Master LEDbulb and comparing those to a CFL and an incandescent lamp. The comparison took into account the Philips Master LEDbulb as it is now in 2012 and then projected forward what it might be in 2017, accounting for some of the anticipated improvements in LED manufacturing, performance and driver electronics.
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Strand, Linn B; Tong, Shilu; Aird, Rosemary; McRae, David
2010-07-28
There is overwhelming scientific evidence that human activities have changed and will continue to change the climate of the Earth. Eco-environmental health, which refers to the interdependencies between ecological systems and population health and well-being, is likely to be significantly influenced by climate change. The aim of this study was to examine perceptions from government stakeholders and other relevant specialists about the threat of climate change, their capacity to deal with it, and how to develop and implement a framework for assessing vulnerability of eco-environmental health to climate change. Two focus groups were conducted in Brisbane, Australia with representatives from relevant government agencies, non-governmental organisations, and the industry sector (n = 15) involved in the discussions. The participants were specialists on climate change and public health from governmental agencies, industry, and non-governmental organisations in South-East Queensland. The specialists perceived climate change to be a threat to eco-environmental health and had substantial knowledge about possible implications and impacts. A range of different methods for assessing vulnerability were suggested by the participants and the complexity of assessment when dealing with multiple hazards was acknowledged. Identified factors influencing vulnerability were perceived to be of a social, physical and/or economic nature. They included population growth, the ageing population with associated declines in general health and changes in the vulnerability of particular geographical areas due to for example, increased coastal development, and financial stress. Education, inter-sectoral collaboration, emergency management (e.g. development of early warning systems), and social networks were all emphasised as a basis for adapting to climate change. To develop a framework, different approaches were discussed for assessing eco-environmental health vulnerability, including literature
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Directory of Open Access Journals (Sweden)
McRae David
2010-07-01
Full Text Available Abstract Background There is overwhelming scientific evidence that human activities have changed and will continue to change the climate of the Earth. Eco-environmental health, which refers to the interdependencies between ecological systems and population health and well-being, is likely to be significantly influenced by climate change. The aim of this study was to examine perceptions from government stakeholders and other relevant specialists about the threat of climate change, their capacity to deal with it, and how to develop and implement a framework for assessing vulnerability of eco-environmental health to climate change. Methods Two focus groups were conducted in Brisbane, Australia with representatives from relevant government agencies, non-governmental organisations, and the industry sector (n = 15 involved in the discussions. The participants were specialists on climate change and public health from governmental agencies, industry, and non-governmental organisations in South-East Queensland. Results The specialists perceived climate change to be a threat to eco-environmental health and had substantial knowledge about possible implications and impacts. A range of different methods for assessing vulnerability were suggested by the participants and the complexity of assessment when dealing with multiple hazards was acknowledged. Identified factors influencing vulnerability were perceived to be of a social, physical and/or economic nature. They included population growth, the ageing population with associated declines in general health and changes in the vulnerability of particular geographical areas due to for example, increased coastal development, and financial stress. Education, inter-sectoral collaboration, emergency management (e.g. development of early warning systems, and social networks were all emphasised as a basis for adapting to climate change. To develop a framework, different approaches were discussed for assessing eco-environmental
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Energy Technology Data Exchange (ETDEWEB)
1989-02-01
This report presents the preliminary environmental findings from the first phase of the Environmental Survey of the US Department of Energy (DOE) Naval Petroleum Reserves 1 (NPR-1) and 2 (NPR-2) in California (NPRC), conducted May 9--20, 1988. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment Safety and Health's Office of Environmental Audit. Individual team specialists are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with NPRC. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involved the review of existing site environmental data, observations of the operations carried on at NPRC, and interviews with site personnel. 120 refs., 28 figs., 40 tabs.
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A Business Case Framework for Planning Clinical Nurse Specialist-Led Interventions.
Bartlett Ellis, Rebecca J; Embree, Jennifer L; Ellis, Kurt G
2015-01-01
The purpose of this article is to describe a business case framework that can guide clinical nurse specialists (CNS) in clinical intervention development. Increased emphasis on cost-effective interventions in healthcare requires skills in analyzing the need to make the business case, especially for resource-intensive interventions. This framework assists the CNS to anticipate resource use and then consider if the intervention makes good business sense. We describe a business case framework that can assist the CNS to fully explore the problem and determine if developing an intervention is a good investment. We describe several analyses that facilitate making the business case to include the following: problem identification and alignment with strategic priorities, needs assessment, stakeholder analysis, market analysis, intervention implementation planning, financial analysis, and outcome evaluation. The findings from these analyses can be used to develop a formal proposal to present to hospital leaders in a position to make decisions. By aligning intervention planning with organizational priorities and engaging patients in the process, interventions will be more likely to be implemented in practice and produce robust outcomes. The business case framework can be used to justify to organization decision makers the need to invest resources in new interventions that will make a difference for quality outcomes as well as the financial bottom line. This framework can be used to plan interventions that align with organizational strategic priorities, plan for associated costs and benefits, and outcome evaluation. Clinical nurse specialists are well positioned to lead clinical intervention projects that will improve the quality of patient care and be cost-effective. To do so requires skill development in making the business case.
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Educational programme on radiation protection for veterinary medicine specialists
International Nuclear Information System (INIS)
Djuric, G.; Popovic, D.
1992-01-01
The education of radiation protection for veterinary medicine specialists on the University of Belgrade is integrated both in regular graduate studies and in postgraduate studies. Within the graduate studies, students attend courses in physics and biophysics and in radiation hygiene. During postgraduate or specialistic veterinary medicine studies, veterinary medicine specialists expand their knowledge in radiation protection through a number of courses on radiation biophysics, radioecology, nuclear instrumentation and environmental protection. (author)
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2010-04-01
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Specialists. 62.26 Section 62.26 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Specific Program... such areas, for example, as mass media communication, environmental science, youth leadership...
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Building a Leadership Culture for Environmental Health in a Nurse-Led Clinic
Directory of Open Access Journals (Sweden)
Shanda L Demorest
2017-10-01
Full Text Available Climate change is the biggest global health threat of the 21st century (Costello et al., 2009. Temperature shifts caused by greenhouse gases have negative health impacts such as worsening of chronic diseases and increases in vector-borne diseases (American Public Health Association, 2016, which nurses are ethically responsible to address (American Nurses Association, 2015. At an interdisciplinary nurse-led clinic, staff were not prepared to assist patients in building resiliency related to the health impacts of climate change or to implement environmental sustainability in their workplace. Based on principles of partnership-based healthcare (Eisler & Potter, 2014, this project included Climate Conversations - sharing stories, values, and knowledge about climate change – (Minnesota Interfaith Power & Light, 2010 and evidence-based transformational leadership. The Nurses’ Environmental Awareness Tool (Schenk et al., 2015 was used to survey staff before and after they participated in behavioral interventions to incorporate environmental sustainability at their workplace. Compared to baseline, staffs’ knowledge of environmental sustainability increased significantly (pp
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Environmental Survey preliminary report, Portsmouth Uranium Enrichment Complex, Piketon, Ohio
International Nuclear Information System (INIS)
1987-08-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Portsmouth Uranium Enrichment Complex (PUEC), conducted August 4 through August 15, 1986. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Team specialists are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations performed at PUEC, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by Argonne National Laboratory. When completed, the results will be incorporated into the PUEC Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the PUEC Survey. 55 refs., 22 figs., 21 tabs
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Provision and practice of specialist preterm labour clinics: a UK survey of practice.
Sharp, A N; Alfirevic, Z
2014-03-01
To identify the current status of specialist preterm labour (PTL) clinic provision and management within the UK. Postal survey of clinical practice. All consultant-led obstetric units within the UK. A questionnaire was sent by post to all 210 NHS consultant-led obstetric units within the UK. Units that had a specialist PTL clinic were asked to complete a further 20 questions defining their protocol for risk stratification and management. Current practice in specialist preterm labour clinics. We have identified 23 specialist clinics; the most common indications for attendance were previous PTL (100%), preterm prelabour rupture of membranes (95%), two large loop excisions of the transformation zone (95%) or cone biopsy (95%). There was significant heterogeneity in the indications for and method of primary treatment for short cervix, with cervical cerclage used in 45% of units, progesterone in 18% of units and Arabin cervical pessary in 5%. A further 23% used multiple treatment modalities in combination. A significant heterogeneity in all topics surveyed suggests an urgent need for networking, more evidence-based guidelines and prospective comparative audits to ascertain the real impact of specialist PTL clinics on the reduction in preterm birth and its sequelae. © 2013 Royal College of Obstetricians and Gynaecologists.
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Energy Technology Data Exchange (ETDEWEB)
1988-09-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the US Department of Energy (DOE) Pittsburgh Energy Technology Center (PETC) conducted December 7--11, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team specialists are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with PETC. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at PETC, and interviews with site personnel. The Survey team developed a Sampling and Analysis (S A) Plan to assist in further assessing certain environmental problems identified during its on-site Survey activities at PETC. The S A Plan will be executed by the Oak Ridge National Laboratory (ORNL). When completed, the Plan's results will be incorporated into the PETC Survey findings for inclusion into the Environmental Survey Summary Report. 64 refs., 23 figs., 29 tabs.
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... Healthy Children > Family Life > Medical Home > Pediatric Specialists Pediatric Specialists Article Body Your pediatrician may refer your child to a pediatric specialist for further evaluation and treatment. Pediatric specialists ...
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Exploring the scope of oncology specialist nurses' practice in the UK.
Farrell, Carole; Molassiotis, Alexander; Beaver, Kinta; Heaven, Cathy
2011-04-01
Revolutionary changes have taken place to nurses' roles and clinical responsibilities over the past decade, leading to new ways of working and higher levels of nursing practice. However, despite the development of nurse-led clinics and services within oncology there has been little formal evaluation. A survey of 103 UK oncology specialist nurses was undertaken to explore their scope of practice, with emphasis on nurse-led services. The survey highlighted significant developments within nurses' roles and nurse-led services, although there was a distinct lack of clarity between nurses' titles and their roles/responsibilities. Most nurses had extended their role. However there were significant differences in the nature of clinical practice, such as clinical examination and nurse prescribing. Overall, new roles were greatly valued by the multidisciplinary team, reducing waiting times and providing benefits for patients. However other nurses felt frustrated by deficiencies in infrastructure and support, which often overshadowed potential benefits. There is a great diversity in oncology specialist nurses' roles; however lack of clarity in titles, training, competencies and responsibilities is creating confusion. Role developments and nurse-led clinics have been ad hoc and poorly evaluated. The introduction of a competency framework, national standards and a system of clinical appraisals seems key to providing increased transparency and vital safeguards for both nurses and patients. Without further exploration and evaluation of nurse-led initiatives it is difficult to fully appreciate their impact on patients, staff and service delivery. Copyright © 2010 Elsevier Ltd. All rights reserved.
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Environmental Survey preliminary report, Fermi National Accelerator Laboratory, Batavia, Illinois
International Nuclear Information System (INIS)
1988-10-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the US Department of Energy (DOE) Fermi National Accelerator Laboratory (Fermilab), conducted September 14 through 25, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual participants for the Survey team are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with Fermilab. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations performed at Fermilab, and interviews with site personnel. 110 refs., 26 figs., 41 tabs
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Environmental Survey preliminary report, Solar Energy Research Institute, Golden, Colorado
Energy Technology Data Exchange (ETDEWEB)
1988-10-01
This report presents the preliminary findings of the first phase of the Environmental Survey of the US Department of Energy's (DOE) Solar Energy Research Institute (SERI), conducted December 14 through 18, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. The team includes outside experts supplied by private contractors. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with SERI. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at SERI, and interviews with site personnel. 33 refs., 22 figs., 21 tabs.
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Environmental Survey preliminary report, Fermi National Accelerator Laboratory, Batavia, Illinois
Energy Technology Data Exchange (ETDEWEB)
1988-10-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the US Department of Energy (DOE) Fermi National Accelerator Laboratory (Fermilab), conducted September 14 through 25, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual participants for the Survey team are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with Fermilab. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations performed at Fermilab, and interviews with site personnel. 110 refs., 26 figs., 41 tabs.
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Environmental Survey preliminary report, Oak Ridge National Laboratory (X-10), Oak Ridge, Tennessee
Energy Technology Data Exchange (ETDEWEB)
1988-07-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the US Department of Energy (DOE) Oak Ridge National Laboratory (ORNL), X-10 site, conducted August 17 through September 4, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team specialists are outside experts supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with ORNL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at ORNL, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by a DOE National Laboratory or a support contractor. When completed, the results will be incorporated into the Environmental Survey Interim Report for ORNL. The Interim Report will reflect the final determinations of the ORNL Survey. 120 refs., 68 figs., 71 tabs.
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Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science.
Gruen, Russell; Bailie, Ross
2004-10-01
People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of 'state of the art' specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.
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Environmental Survey preliminary report, Strategic Petroleum Reserve, Texas and Louisiana Gulf Coast
Energy Technology Data Exchange (ETDEWEB)
1989-01-01
This report presents the preliminary environmental findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Strategic Petroleum Reserve (SPR), located in Louisiana and Texas, and conducted in two segments from November 30 through December 11, 1987, and February 1 through 10, 1988. The Survey is being conducted by a multidisciplinary team of environmental specialists led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team specialists are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with SPR. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involved the review of existing site environmental data, observations of the operations carried on at SPR, and interviews with site personnel. The Survey team has developed a Sampling and Analysis Plan to assist in further assessing specific environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by Idaho National Engineering Laboratory. When completed, the results will be incorporated into the SPR Survey findings for inclusion into the Environmental Survey Summary Report. The Summary Report will reflect the final determinations of the SPR Survey and the other DOE site-specific Surveys. 200 refs., 50 figs., 30 tabs.
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Regression analysis for LED color detection of visual-MIMO system
Banik, Partha Pratim; Saha, Rappy; Kim, Ki-Doo
2018-04-01
Color detection from a light emitting diode (LED) array using a smartphone camera is very difficult in a visual multiple-input multiple-output (visual-MIMO) system. In this paper, we propose a method to determine the LED color using a smartphone camera by applying regression analysis. We employ a multivariate regression model to identify the LED color. After taking a picture of an LED array, we select the LED array region, and detect the LED using an image processing algorithm. We then apply the k-means clustering algorithm to determine the number of potential colors for feature extraction of each LED. Finally, we apply the multivariate regression model to predict the color of the transmitted LEDs. In this paper, we show our results for three types of environmental light condition: room environmental light, low environmental light (560 lux), and strong environmental light (2450 lux). We compare the results of our proposed algorithm from the analysis of training and test R-Square (%) values, percentage of closeness of transmitted and predicted colors, and we also mention about the number of distorted test data points from the analysis of distortion bar graph in CIE1931 color space.
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Directory of Open Access Journals (Sweden)
Amit K. Sharma
2009-01-01
Full Text Available The laser LED based optical sensor and its multifunctional operation for detection of environmental pollutants are described. The work will provide the instructions to design of circuitry for optical sensor instrument with a program based on a microcontroller (8902051-24PI, and to allow this program to communicate via RS-232 with computer. An algorithm is outlined by which the sensor instrument can use three laser LEDs (blue, Green and red to quantify the composition of pollutant. The operation of measurement through optical sensor has been applied to the study of detection and rate of reaction of pollutant i.e. methyl parathion and the produced informative data were also correlated with UV-vis spectrophotometry for the validation of results. The purpose of designed optical sensor is that the sophisticated analytical techniques show costly impact, time taking process, high consumable solvents and not suit for field application purpose which focuses the merits of the optical sensor.
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Zwier, Sandra
2017-01-01
Websites from medical specialist providers are becoming increasingly marketing oriented, but there exists a paucity of empirical research on the effects. This experimental study explored effects of exposure to real websites from medical specialist providers among Dutch adults under physician gatekeeper arrangements. Exposure led to a stronger intention to seek treatment from the specialist provider and motivation to rely on the providers' claims. Weaker to absent effects were found for intention to question the physician gatekeeper's referral and this was chiefly motivated by the belief that "the doctor knows best." Implications for specialist provider marketing under gatekeeping arrangements are discussed.
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Dome diagnostics system of optical parameters and characteristics of LEDs
Peretyagin, Vladimir S.; Pavlenko, Nikita A.
2017-09-01
Scientific and technological progress of recent years in the production of the light emitting diodes (LEDs) has led to the expansion of areas of their application from the simplest systems to high precision lighting devices used in various fields of human activity. However, development and production (especially mass production) of LED lighting devices are impossible without a thorough analysis of its parameters and characteristics. There are many ways and devices for analysis the spatial, energy and colorimetric parameters of LEDs. The most methods are intended for definition only one parameter (for example, luminous flux) or one characteristic (for example, the angular distribution of energy or the spectral characteristics). Besides, devices used these methods are intended for measuring parameters in only one point or plane. This problem can be solved by using a dome diagnostics system of optical parameters and characteristics of LEDs, developed by specialists of the department OEDS chair of ITMO University in Russia. The paper presents the theoretical aspects of the analysis of LED's spatial (angular), energy and color parameters by using mentioned of diagnostics system. The article also presents the results of spatial), energy and color parameters measurements of some LEDs brands.
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Infectious Disease Specialist: What Is an Infectious Disease Specialist?
... medical professionals? When do I need an ID specialist? Many common infections can be treated by your ... diseases. Back to Top How was my ID specialist trained? Your ID Physician has 9-10 years ...
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Personalizing protocol-driven care: the case of specialist heart failure nurses.
Sanders, Tom; Harrison, Stephen; Checkland, Katherine
2010-09-01
This paper is a report of a study conducted to explore how specialist heart failure nurses negotiate treatment advice with patients, in the context of an increasing expectation that clinical staff in the National Health Services will follow guidelines in their daily work. The development of specialist nurse roles has given rise to questions about their compatibility with patient-centred care. However, research has revealed little about how specialist nurses balance clinical guidelines with traditional caring tasks. Semi-structured interviews (n = 10) were conducted with specialist heart failure nurses in northern England recruited from a heart failure specialist nursing contact list. In addition, non-participant observations were carried out on nurse-patient consultations (n = 16) in one regional nurse-led heart failure clinic. Data were collected between 2003 and 2005, and analysed using a variation of grounded theory. Heart failure nurses sought to combine traditional caring work with the wider goal of improving patient outcomes by 'personalizing' their advice to patients and presenting their heart failure as 'typical'. They accommodated protocol-driven care into their daily routines, and perceived no disjuncture between evidence-based practice and patient-centredness. However, their approach allowed little space for the exploration of each patient's own priorities about their illness. There is a need both to re-examine the appropriateness of traditional caring concepts, and to reflect on the need to incorporate patients' own values into the consultation process.
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Specialist Bibliographic Databases
Gasparyan, Armen Yuri; Yessirkepov, Marlen; Voronov, Alexander A.; Trukhachev, Vladimir I.; Kostyukova, Elena I.; Gerasimov, Alexey N.; Kitas, George D.
2016-01-01
Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and d...
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Energy Technology Data Exchange (ETDEWEB)
NONE
2010-07-01
This collection of articles on the subject of light emitting diodes (LED) provides technical information on LED technology, examines latest developments and provides examples of LED use in practice. An 'ABC' of LED technology is presented and fifteen common LED mistakes are noted. The chances and risks of LED use are discussed as is the retrofitting of lighting installations with LEDs. The use of LEDs in street lighting is examined. The journal also includes interviews with architects and a lighting designer. Practical examples of the use of LEDs include the refurbished parliamentary library in Berne, their use in the bird sanctuary headquarters in Sempach, Switzerland, as well as LED use in sales outlets. Also, the use of LED lighting in a spa gazebo in Lucerne is examined.
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Specialist Bibliographic Databases.
Gasparyan, Armen Yuri; Yessirkepov, Marlen; Voronov, Alexander A; Trukhachev, Vladimir I; Kostyukova, Elena I; Gerasimov, Alexey N; Kitas, George D
2016-05-01
Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls.
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Specialist Bibliographic Databases
2016-01-01
Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls. PMID:27134485
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Paterson, Janice; Ostaszkiewicz, Joan; Suyasa, I Gede Putu Darma; Skelly, Jennifer; Bellefeuille, Lesley
Although nurses have specialized in the management of incontinence, bladder, bowel, and pelvic floor dysfunction for more than 30 years, there is a lack of awareness and underutilization of their role. This article describes a 6-year project to define, characterize, and validate a role profile of the Nurse Continence Specialist. Data collection used a 2-phase, mixed-methods design. Phase 1 of the project resulted in a draft Nurse Continence Specialist role profile and Phase 2 led to validation of the draft profile. The result was a broad consensus about what constitutes the specific skill set for Nurse Continence Specialist specialization within nursing.
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Sustainable LED Fluorescent Light Replacement Technology
Energy Technology Data Exchange (ETDEWEB)
None, None
2011-09-30
Ilumisys and the National Center for Manufacturing Sciences (NCMS) partnered on a three-year project awarded by the United States (U.S.) Department of Energy (DOE), to quantify the impacts of LED lamps, incandescent lamps and fluorescent benchmark lamps over a product lifecycle – i.e. to develop a sustainable design and manufacturing strategy that addresses product manufacturing, use, recycling and disposal scenarios for LED-based lighting. Based on the knowledge gained from extensive product tear-down studies of fluorescent and screw-in lighting products, lifecycle assessment tools, and accelerated lifecycle testing protocols, an interactive Sustainable LED Design Guide has been developed to aid architectural and lighting designers and engineers in making design decisions that consider three important environmental impacts (greenhouse gas emissions, energy use and mercury emission) across all phases of the life of an LED lighting product. Critical information developed for the lifecycle analysis and product feature comparisons is the useful life of the lighting product as well as its performance. The Design Guide is available at www.ncms.org, and was developed based on operational and durability testing of a variety of lighting products including power consumption, light output, and useful life of a lamp in order to allow a more realistic comparison of lamp designs. This report describes the main project tasks, results and innovative features of the lifecycle assessment (LCA)-based design tools, and the key considerations driving the sustainable design of LED lighting systems. The Design Guide incorporates the following three novel features for efficiently evaluating LED lighting features in value-chains: Bill-of-Materials (BOM) Builder – Designers may import process data for each component and supply functional data for the product, including power, consumption, lumen output and expected useful life: Environmental Impact Review – Designs are comparable
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Hunt, Kevin; Mitchell, Murray; Maina, Michael; Griffin, Lisa
2015-01-01
The purpose of this study was to describe and contrast selected approaches to the supervision of student teachers between Content Specialist and Non-Content Specialist university supervisors. Content Specialist supervisors were identified as trained university supervisors with a background in physical education. Non-Content Specialist supervisors…
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Environmental Survey preliminary report, Argonne National Laboratory, Argonne, Illinois
International Nuclear Information System (INIS)
1988-11-01
This report presents the preliminary findings of the first phase of the Environmental Survey of the United States Department of Energy's (DOE) Argonne National Laboratory (ANL), conducted June 15 through 26, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. The team includes outside experts supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with ANL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at ANL, and interviews with site personnel. The Survey team developed a Sampling and Analysis (S ampersand A) Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The S ampersand A Plan will be executed by the Oak Ridge National Laboratory (ORNL). When completed, the S ampersand A results will be incorporated into the Argonne National Laboratory Environmental Survey findings for inclusion in the Environmental Survey Summary Report. 75 refs., 24 figs., 60 tabs
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Environmental Survey preliminary report, Argonne National Laboratory, Argonne, Illinois
Energy Technology Data Exchange (ETDEWEB)
1988-11-01
This report presents the preliminary findings of the first phase of the Environmental Survey of the United States Department of Energy's (DOE) Argonne National Laboratory (ANL), conducted June 15 through 26, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. The team includes outside experts supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with ANL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at ANL, and interviews with site personnel. The Survey team developed a Sampling and Analysis (S A) Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The S A Plan will be executed by the Oak Ridge National Laboratory (ORNL). When completed, the S A results will be incorporated into the Argonne National Laboratory Environmental Survey findings for inclusion in the Environmental Survey Summary Report. 75 refs., 24 figs., 60 tabs.
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Spectral Design Flexibility of LED Brings Better life
DEFF Research Database (Denmark)
Ou, Haiyan; Corell, Dennis Dan; Ou, Yiyu
2012-01-01
Light-emitting diodes (LEDs) are penetrating into the huge market of general lighting because they are energy saving and environmentally friendly. The big advantage of LED light sources, compared to traditional incandescent lamps and fluorescent light tubes, is the flexible spectral design to make...
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Environmental Survey preliminary report, Rocky Flats Plant, Golden, Colorado
International Nuclear Information System (INIS)
1987-06-01
This report presents the preliminary findings of the Environmental Survey of the United States Department of Energy (DOE), Rocky Flats Plant (RFP), conducted August 11 through 22, 1986. The Survey is being conducted by an multidisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team members are outside experts supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the RFP. The Survey covers all environmental media and all areas of environmental regulations. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data observations of the operations carried on at RFP, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain environmental problems identified during its on-site activates. The Sampling and Analysis Plan is being executed by DOE's Oak Ridge National Laboratory. When completed, the results will be incorporated into the RFP Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the RFP Survey. 75 refs., 24 figs., 33 tabs
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Environmental Survey preliminary report, Rocky Flats Plant, Golden, Colorado
Energy Technology Data Exchange (ETDEWEB)
1987-06-01
This report presents the preliminary findings of the Environmental Survey of the United States Department of Energy (DOE), Rocky Flats Plant (RFP), conducted August 11 through 22, 1986. The Survey is being conducted by an multidisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team members are outside experts supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the RFP. The Survey covers all environmental media and all areas of environmental regulations. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data observations of the operations carried on at RFP, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain environmental problems identified during its on-site activates. The Sampling and Analysis Plan is being executed by DOE's Oak Ridge National Laboratory. When completed, the results will be incorporated into the RFP Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the RFP Survey. 75 refs., 24 figs., 33 tabs.
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Specialist nectar-yeasts decline with urbanization in Berlin
Wehner, Jeannine; Mittelbach, Moritz; Rillig, Matthias C.; Verbruggen, Erik
2017-03-01
Nectar yeasts are common inhabitants of insect-pollinated flowers but factors determining their distribution are not well understood. We studied the influence of host identity, environmental factors related to pollution/urbanization, and the distance to a target beehive on local distribution of nectar yeasts within Robinia pseudoacacia L. and Tilia tomentosa Moench in Berlin, Germany. Nectar samples of six individuals per species were collected at seven sites in a 2 km radius from each target beehive and plated on YM-Agar to visualise the different morphotypes, which were then identified by sequencing a section of the 26S rDNA gene. Multivariate linear models were used to analyze the effects of all investigated factors on yeast occurrence per tree. Yeast distribution was mainly driven by host identity. The influence of the environmental factors (NO2, height of construction, soil sealing) strongly depended on the radius around the tree, similar to the distance of the sampled beehive. Incidence of specialist nectar-borne yeast species decreased with increasing pollution/urbanization index. Given that specialist yeast species gave way to generalist yeasts that have a reduced dependency on pollinators for between-flower dispersal, our results indicate that increased urbanization may restrict the movement of nectar-specialized yeasts, via limitations of pollinator foraging behavior.
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Environmental Survey preliminary report, Nevada Test Site, Mercury, Nevada
International Nuclear Information System (INIS)
1988-04-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Nevada Test Site (NTS), conducted June 22 through July 10, 1987. The Survey is being conducted by a multidisciplinary team of environmental specialists led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team members are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the NTS. The Survey covers all environment media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations and activities performed at the NTS, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain environmental problems identified during its on-site activities. The Sampling and Analysis Plan is being executed by the Battelle Columbus Division under contract with DOE. When completed, the results will be incorporated into the NTS Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the NTS Survey. 165 refs., 42 figs., 52 tabs
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Morán López, Jesús Manuel; Piedra León, María; Enciso Izquierdo, Fidel Jesús; Luengo Pérez, Luis Miguel; Amado Señaris, José Antonio
2016-01-01
Adequate nutritional support includes many different aspects, but poor understanding of clinical nutrition by health care professionales often results in an inadequate prescription. A study was conducted to compare enteral and parenteral nutritional support plans prescribed by specialist and non-specialist physicians. Non-specialist physicians recorded anthropometric data from only 13.3% of patients, and none of them performed nutritional assessments. Protein amounts provided by non-specialist physicians were lower than estimated based on ESPEN (10.29g of nitrogen vs 14.62; Pspecialist group (14.88g of nitrogen; P=.072). Calorie and glutamine provision and laboratory controls prescribed by specialists were significantly closer to those recommended by clinical guidelines. Nutritional support prescribed by specialists in endocrinology and nutrition at San Pedro de Alcántara Hospital was closer to clinical practice guideline standards and of higher quality as compared to that prescribed by non-specialists. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.
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Energy Technology Data Exchange (ETDEWEB)
1989-02-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) activities at the Santa Susana Field Laboratories Site (DOE/SSFL), conducted May 16 through 26, 1988. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual participants for the Survey team are being supplied by an private contractor. The objective of the survey is to identify environmental problems and areas of environmental risk associated with DOE activities at SSFL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations performed at SSFL, and interviews with site personnel. 90 refs., 17 figs., 28 tabs.
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Environmental Survey preliminary report, Hanford Site, Richland, Washington
International Nuclear Information System (INIS)
1987-08-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Hanford Site, conducted August 18 through September 5, 1986. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the Hanford Site. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at the Hanford Site, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by a DOE National Laboratory or a support contractor. When completed, the results will be incorporated into the Environmental Survey Interim Report for the Hanford Site. The Interim Report will reflect the final determinations of the Hanford Site Survey. 44 refs., 88 figs., 74 tabs
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Environmental Survey preliminary report, Hanford Site, Richland, Washington
Energy Technology Data Exchange (ETDEWEB)
1987-08-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Hanford Site, conducted August 18 through September 5, 1986. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the Hanford Site. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at the Hanford Site, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by a DOE National Laboratory or a support contractor. When completed, the results will be incorporated into the Environmental Survey Interim Report for the Hanford Site. The Interim Report will reflect the final determinations of the Hanford Site Survey. 44 refs., 88 figs., 74 tabs.
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Environmental Survey preliminary report, Pantex Facility, Amarillo, Texas
International Nuclear Information System (INIS)
1987-09-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Pantex Facility, conducted November 3 through 14, 1986.The Survey is being conducted by an interdisciplinary team of environmental specialist, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the Pantex Facility. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at the Pantex Facility, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by the Oak Ridge National Laboratory. When completed, the results will be incorporated into the Pantex Facility Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the Survey for the Pantex Facility. 65 refs., 44 figs., 27 tabs
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Environmental Survey preliminary report, Pantex Facility, Amarillo, Texas
Energy Technology Data Exchange (ETDEWEB)
1987-09-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Pantex Facility, conducted November 3 through 14, 1986.The Survey is being conducted by an interdisciplinary team of environmental specialist, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the Pantex Facility. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at the Pantex Facility, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by the Oak Ridge National Laboratory. When completed, the results will be incorporated into the Pantex Facility Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the Survey for the Pantex Facility. 65 refs., 44 figs., 27 tabs.
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The Role of the Environmental Health Specialist in the Penal and Correctional System
Walker, Bailus, Jr.; Gordon, Theodore J.
1976-01-01
Implementing a health and hygiene program in penal systems necessitates coordinating the entire staff. Health specialists could participate in facility planning and management, policy formation, and evaluation of medical care, housekeeping, and food services. They could also serve as liaisons between correctional staff and governmental or…
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Environmental Survey preliminary report, Kansas City Plant, Kansas City, Missouri
Energy Technology Data Exchange (ETDEWEB)
1988-01-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE), Kansas City Plant (KCP), conducted March 23 through April 3, 1987. The Survey is being conducted by a multidisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team members are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the KCP. The Survey covers all environmental media and all areas of environmental regulations. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data observations of the operations performed at the KCP, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain environmental problems identified during its on-site activities. The Sampling and Analysis Plan is being executed by DOE's Argonne National Laboratory. When completed, the results will be incorporated into the KCP Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the KCP Survey. 94 refs., 39 figs., 55 tabs.
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Environmental Survey preliminary report, Kansas City Plant, Kansas City, Missouri
International Nuclear Information System (INIS)
1988-01-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE), Kansas City Plant (KCP), conducted March 23 through April 3, 1987. The Survey is being conducted by a multidisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team members are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the KCP. The Survey covers all environmental media and all areas of environmental regulations. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data observations of the operations performed at the KCP, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain environmental problems identified during its on-site activities. The Sampling and Analysis Plan is being executed by DOE's Argonne National Laboratory. When completed, the results will be incorporated into the KCP Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the KCP Survey. 94 refs., 39 figs., 55 tabs
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Environmental Survey preliminary report, Feed Materials Production Center, Fernald, Ohio
Energy Technology Data Exchange (ETDEWEB)
1987-03-01
This report presents the preliminary findings from the first phase of the environmental survey of the United States Department of Energy (DOE) Feed Materials Production Center (FMPC), conducted June 16 through 27, 1986. The survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the survey is to identify environmental problems and areas of environmental risk associated with the FMPC. The survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the survey involves the review of existing site environmental data, observations of the operations carried on at FMPC, and interviews with site personnel. The survey team developed a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its onsite activities. The Sampling and Analysis Plan will be executed by a DOE national laboratory or a support contractor. When completed, the results will be incorporated into the FMPC Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the FMPC survey. 41 refs., 20 figs., 25 tabs.
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Environmental Survey preliminary report, Brookhaven National Laboratory, Upton, New York
Energy Technology Data Exchange (ETDEWEB)
1988-06-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Brookhaven National Laboratory (BNL) conducted April 6 through 17, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with BNL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at BNL, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing specific environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by Oak Ridge National Laboratory. When completed, the results will be incorporated into the BNL Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the BNL Survey. 80 refs., 24 figs., 48 tabs.
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Energy Technology Data Exchange (ETDEWEB)
1987-12-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the Department of Energy (DOE) Lawrence Livermore National Laboratory (LLNL), conducted December 1 through 19, 1986. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with LLNL. The Survey covers all environmental media all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations performed at LLNL, and interviews with site personnel. A Sampling and Analysis Plan was developed to assist in further assessing certain of the environmental problems identified during performance of on-site activities. The Sampling and Analysis Plan will be executed by a DOE National Laboratory. When completed, the results will be incorporated into the LLNL Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the LLNL Survey. 70 refs., 58 figs., 52 tabs.,
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Environmental Survey preliminary report, Brookhaven National Laboratory, Upton, New York
International Nuclear Information System (INIS)
1988-06-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Brookhaven National Laboratory (BNL) conducted April 6 through 17, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with BNL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at BNL, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing specific environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by Oak Ridge National Laboratory. When completed, the results will be incorporated into the BNL Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the BNL Survey. 80 refs., 24 figs., 48 tabs
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Environmental Survey preliminary report, Oak Ridge Gaseous Diffusion Plant, Oak Ridge, Tennessee
International Nuclear Information System (INIS)
1989-02-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the US Department of Energy's (DOE) Oak Ridge Gaseous Diffusion Plant (ORGDP) conducted March 14 through 25, 1988. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental risk associated with ORGDP. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at ORGDP, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during is on-site activities. The Sampling and Analysis Plan will be executed by Idaho National Engineering Laboratory (INEL). When completed, the results will be incorporated into the ORGDP Survey findings for in inclusion into the Environmental Survey Summary Report. 120 refs., 41 figs., 74 tabs
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48 CFR 552.236-72 - Specialist.
2010-10-01
... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Specialist. 552.236-72... FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 552.236-72 Specialist. As prescribed in 536.570-3, insert the following clause: Specialist (APR 1984) The term “Specialist...
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The work setting of diabetes nursing specialists in the Netherlands: a questionnaire survey.
van den Berg, Tilja I J; Vrijhoef, Hubertus J M; Tummers, Gladys; Landeweerd, Jan A; van Merode, Godefridus G
2008-10-01
The aim of this study is to explore whether the work organisation of diabetes specialist nurses (DSNs) differs significantly from nurses working in hospital and nursing home and if so, does this difference result in positive or negative consequences regarding work and health. In traditional health care settings, nurses exhibit a high level of environmental uncertainty and low decision-making authority, which has a negative effect on psychological reactions towards work. In professional nursing, specialisation, e.g. diabetic nursing, is a current trend in many countries. Therefore, insight into the determinants of the work situation of nursing specialists is becoming increasingly relevant. Comparisons were made between 3 different samples: 1204 nurses employed by 15 hospitals, 1058 nurses employed by 14 nursing homes, and 350 diabetes nurses working in other health care settings throughout the Netherlands. Data concerning organisation, work aspects, and psychological reactions were measured via questionnaires. Variances between the groups were analysed with ANCOVA, besides hierarchical multiple regression analysis was applied. Environmental uncertainty scored lower amongst diabetes nurses when compared to nurses working in the other two types of health care settings. Social support and role conflict scored low for diabetes nursing specialists who simultaneously perceived autonomy and role ambiguity highest. Diabetes nursing specialists also scored highest on intrinsic work motivation and job satisfaction and lowest for psychosomatic health. Except for social support and role ambiguity, diabetic nurses rate their [work] organisation, [work] aspects and psychological [work] reactions more positively than nurses employed in other health care settings.
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Environmental Survey preliminary report, Nevada Test Site, Mercury, Nevada
Energy Technology Data Exchange (ETDEWEB)
1988-04-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Nevada Test Site (NTS), conducted June 22 through July 10, 1987. The Survey is being conducted by a multidisciplinary team of environmental specialists led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team members are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the NTS. The Survey covers all environment media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations and activities performed at the NTS, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain environmental problems identified during its on-site activities. The Sampling and Analysis Plan is being executed by the Battelle Columbus Division under contract with DOE. When completed, the results will be incorporated into the NTS Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the NTS Survey. 165 refs., 42 figs., 52 tabs.
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Environmental Survey preliminary report, Princeton Plasma Physics Laboratory, Princeton, New Jersey
International Nuclear Information System (INIS)
1989-05-01
This report presents the preliminary findings of the first phase of the Environmental Survey of the United States Department of Energy's (DOE) Princeton Plasma Physics Laboratory (PPPL), conducted June 13 through 17, 1988. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Team members are being provided by private contractors. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with PPPL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at PPPL, and interviews with site personnel. The Survey team developed a Sampling and Analysis (S ampersand A) Plan to assist in further assessing certain of the environment problems identified during its on-site activities. The S ampersand A plan is being developed by the Idaho National Engineering Laboratory. When completed, the S ampersand A results will be incorporated into the PPPL Survey findings for inclusion in the Environmental Survey Summary Report. 70 refs., 17 figs., 21 tabs
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Goenka, N; Turner, B; Vora, J
2011-12-01
The increasing prevalence of diabetes, the drive to develop community services for diabetes and the Quality and Outcomes Framework for diabetes have led to improvements in the management of diabetes in primary care settings, with services traditionally provided only in specialist care now provided for many patients with diabetes by non-specialists. Consequently, there is a need to redefine roles, responsibilities and components of a specialist diabetes service to provide for the needs of patients in the National Health Service (NHS) today. The delivery of diabetes care is complex and touches on almost every aspect of the health service. It is the responsibility of those working within commissioning and specialist provider roles to work together with people with diabetes to develop, organize and deliver a full range of integrated diabetes care services. The local delivery model agreed within the local diabetes network, comprising specialist teams, primary care teams, commissioners and people with diabetes, should determine how the diabetes specialist services are organizsed. It should identify the roles and responsibilities of provider organizations to ensure that the right person provides the right care, at the right time, and in the right place. We summarize a report entitled 'Commissioning Diabetes Specialist Services for Adults with Diabetes', which has been produced, as a 'Task and Finish' group activity within Diabetes UK, to assist managers, commissioners and healthcare professionals to provide advice on the structure, roles and components of specialist diabetes services for adults. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.
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Environmental Survey preliminary report, Y-12 Plant, Oak Ridge, Tennessee
International Nuclear Information System (INIS)
1987-11-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the Department of Energy (DOE), Y-12 Plant, conducted November 10 through 21 and December 9 through 11, 1986. This Survey is being conducted by a multidisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team members are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the Y-12 Plant. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations performed at Y-12, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain environmental problems identified during its on-site activities. The Sampling and Analysis Plan is being executed by DOE's Argonne National Laboratory. When completed, the results will be incorporated into the Y-12 Plant Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the Y-12 Plant Survey. 80 refs., 76 figs., 61 tabs
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Environmental Survey preliminary report, Y-12 Plant, Oak Ridge, Tennessee
Energy Technology Data Exchange (ETDEWEB)
1987-11-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the Department of Energy (DOE), Y-12 Plant, conducted November 10 through 21 and December 9 through 11, 1986. This Survey is being conducted by a multidisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team members are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the Y-12 Plant. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations performed at Y-12, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain environmental problems identified during its on-site activities. The Sampling and Analysis Plan is being executed by DOE's Argonne National Laboratory. When completed, the results will be incorporated into the Y-12 Plant Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the Y-12 Plant Survey. 80 refs., 76 figs., 61 tabs.
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Pain chronification: what should a non-pain medicine specialist know?
Morlion, Bart; Coluzzi, Flaminia; Aldington, Dominic; Kocot-Kepska, Magdalena; Pergolizzi, Joseph; Mangas, Ana Cristina; Ahlbeck, Karsten; Kalso, Eija
2018-04-12
Pain is one of the most common reasons for an individual to consult their primary care physician, with most chronic pain being treated in the primary care setting. However, many primary care physicians/non-pain medicine specialists lack enough awareness, education and skills to manage pain patients appropriately, and there is currently no clear, common consensus/formal definition of "pain chronification". This article, based on an international Change Pain Chronic Advisory Board meeting which was held in Wiesbaden, Germany, in October 2016, provides primary care physicians/non-pain medicine specialists with a narrative overview of pain chronification, including underlying physiological and psychosocial processes, predictive factors for pain chronification, a brief summary of preventive strategies, and the role of primary care physicians and non-pain medicine specialists in the holistic management of pain chronification. Based on currently available evidence, we propose the following consensus-based definition of pain chronification which provides a common framework to raise awareness among non-pain medicine specialists: "Pain chronification describes the process of transient pain progressing into persistent pain; pain processing changes as a result of an imbalance between pain amplification and pain inhibition; genetic, environmental and biopsychosocial factors determine the risk, the degree, and time-course of chronification." Early intervention plays an important role in preventing pain chronification and, as key influencers in the management of patients with acute pain, it is critical that primary care physicians are equipped with the necessary awareness, education and skills to manage pain patients appropriately.
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14 CFR 1214.305 - Payload specialist responsibilities.
2010-01-01
... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialist responsibilities. 1214... Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist... commander has ultimate responsibility and authority for all assigned crew duties. The payload specialist is...
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Przybylska, Anna S; Boratyński, Jan S; Wojciechowski, Michał S; Jefimow, Małgorzata
2017-07-01
According to theoretical predictions, endothermic homeotherms can be classified as either thermal specialists or thermal generalists. In high cost environments, thermal specialists are supposed to be more prone to using facultative heterothermy than generalists. We tested this hypothesis at the intraspecific level using male laboratory mice (C57BL/cmdb) fasted under different thermal conditions (20 and 10°C) and for different time periods (12-48 h). We predicted that variability of body temperature ( T b ) and time spent with T b below normothermy would increase with the increase of environmental demands (duration of fasting and cold). To verify the above prediction, we measured T b and energy expenditure of fasted mice. We did not record torpor bouts but we found that variations in T b and time spent in hypothermia increased with environmental demands. In response to fasting, mice also decreased their energy expenditure. Moreover, animals that showed more precise thermoregulation when fed had more variable T b when fasted. We postulate that the prediction of the thermoregulatory generalist-specialist trade-off can be applied at the intraspecific level, offering a valid tool for identifying mechanistic explanations of the differences in animal responses to variations in energy supply. © 2017. Published by The Company of Biologists Ltd.
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Environmental Survey preliminary report, Oak Ridge Gaseous Diffusion Plant, Oak Ridge, Tennessee
Energy Technology Data Exchange (ETDEWEB)
1989-02-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the US Department of Energy's (DOE) Oak Ridge Gaseous Diffusion Plant (ORGDP) conducted March 14 through 25, 1988. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental risk associated with ORGDP. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at ORGDP, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during is on-site activities. The Sampling and Analysis Plan will be executed by Idaho National Engineering Laboratory (INEL). When completed, the results will be incorporated into the ORGDP Survey findings for in inclusion into the Environmental Survey Summary Report. 120 refs., 41 figs., 74 tabs.
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Environmental Survey preliminary report, Stanford Linear Accelerator Center, Stanford, California
Energy Technology Data Exchange (ETDEWEB)
1988-07-01
This report presents the preliminary findings from the first phase of the Survey of the US Department of Energy (DOE) Stanford Linear Accelerator Center (SLAC) at Stanford, California, conducted February 29 through March 4, 1988. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the SLAC. The Survey covers all environmental media and all areas of environmental regulation and is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations at the SLAC, and interviews with site personnel. The Survey team is developing a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by a DOE National Laboratory or a support contractor. When completed, the results will be incorporated into the Environmental Survey Interim Report for the SLAC facility. The Interim Report will reflect the final determinations of the SLAC Survey. 95 refs., 25 figs., 25 tabs.
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Environmental Survey preliminary report, Stanford Linear Accelerator Center, Stanford, California
International Nuclear Information System (INIS)
1988-07-01
This report presents the preliminary findings from the first phase of the Survey of the US Department of Energy (DOE) Stanford Linear Accelerator Center (SLAC) at Stanford, California, conducted February 29 through March 4, 1988. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the SLAC. The Survey covers all environmental media and all areas of environmental regulation and is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations at the SLAC, and interviews with site personnel. The Survey team is developing a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by a DOE National Laboratory or a support contractor. When completed, the results will be incorporated into the Environmental Survey Interim Report for the SLAC facility. The Interim Report will reflect the final determinations of the SLAC Survey. 95 refs., 25 figs., 25 tabs
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48 CFR 536.570-3 - Specialist.
2010-10-01
... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Specialist. 536.570-3... CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 536.570-3 Specialist. Insert 552.236-72, Specialist, in solicitations and contracts for construction if the technical sections...
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DEFF Research Database (Denmark)
Trøstrup, Jeanette; Mikkelsen, Lone Ramer; Juhl, Carsten
with advanced clinical competencies; Clinical Specialist Physiotherapists (CSP). The use of CSPs instead of OSs to perform diagnostic assessment of patients with musculoskeletal complaints has been implemented in several countries (1). Earlier systematic reviews have evaluated CSPs effectiveness in diagnosing...... methodological quality where one study of high methodological quality found that CSP-clinics were more expensive than OS-led clinics. Patient satisfaction (n=12) ranged from 77–100 % being satisfied (n=9) with similar satisfaction in studies of low, acceptable and high methodological quality. In three studies...
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Directory of Open Access Journals (Sweden)
Marlene Kollmayer
2018-06-01
Full Text Available This experimental online-survey study investigated if different written language forms in German have an effect on male bias in thinking. We used answers to the specialist riddle as an indicator for male bias in mental representations of expertise. The difficulty of this thinking task lies in the fact that a gender-unspecified specialist is often automatically assumed to be a man due to gender stereotypes. We expected that reading a text in gender-fair language before processing the specialist riddle helps readers achieve control over automatically activated gender stereotypes and thus facilitates the restructuring and reinterpretation of the problem, which is necessary to reach the conclusion that the specialist is a woman. We randomly assigned 517 native German speakers (68% women to reading a text on expertise written either in gender-fair language or in masculine generics. Subsequently, participants were asked to solve the specialist riddle. The results show that reading a text in gender-fair language before processing the riddle led to higher rates of answers indicating that the specialist is a women compared to reading a text in masculine generics (44% vs. 33% in women and men regardless of their self-stereotyping concerning agency and communion. The findings indicate that reading even a very short text in gender-fair language can help people break their gender-stereotype habit and thus reduce male bias in thinking. Our research emphasizes the importance of using gender-fair language in German-language texts for reducing gender stereotypes.
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What Is a Pediatric Infectious Diseases Specialist?
... Text Size Email Print Share What is a Pediatric Infectious Diseases Specialist? Page Content Article Body If ... the teen years. What Kind of Training Do Pediatric Infectious Diseases Specialists Have? Pediatric infectious diseases specialists ...
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What Is a Pediatric Critical Care Specialist?
... Text Size Email Print Share What is a Pediatric Critical Care Specialist? Page Content Article Body If ... in the PICU. What Kind of Training Do Pediatric Critical Care Specialists Have? Pediatric critical care specialists ...
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Environmental Survey preliminary report, Los Alamos National Laboratory, Los Alamos, New Mexico
International Nuclear Information System (INIS)
1988-01-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy's (DOE) Los Alamos National Laboratory (LANL), conducted March 29, 1987 through April 17, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the LANL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at the LANL, and interviews with site personnel. The Survey team developed Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by the Idaho National Engineering Laboratory. When completed, the results will be incorporated into the LANL Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the Survey for the LANL. 65 refs., 68 figs., 73 tabs
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Environmental Survey preliminary report, Los Alamos National Laboratory, Los Alamos, New Mexico
Energy Technology Data Exchange (ETDEWEB)
1988-01-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy's (DOE) Los Alamos National Laboratory (LANL), conducted March 29, 1987 through April 17, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the LANL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at the LANL, and interviews with site personnel. The Survey team developed Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by the Idaho National Engineering Laboratory. When completed, the results will be incorporated into the LANL Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the Survey for the LANL. 65 refs., 68 figs., 73 tabs.
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Spectral design flexibility of LED brings better life
Ou, Haiyan; Corell, Dennis; Ou, Yiyu; Poulsen, Peter B.; Dam-Hansen, Carsten; Petersen, Paul-Michael
2012-03-01
Light-emitting diodes (LEDs) are penetrating into the huge market of general lighting because they are energy saving and environmentally friendly. The big advantage of LED light sources, compared to traditional incandescent lamps and fluorescent light tubes, is the flexible spectral design to make white light using different color mixing schemes. The spectral design flexibility of white LED light sources will promote them for novel applications to improve the life quality of human beings. As an initial exploration to make use of the spectral design flexibility, we present an example: 'no blue' white LED light source for sufferers of disease Porphyria. An LED light source prototype, made of high brightness commercial LEDs applying an optical filter, was tested by a patient suffering from Porphyria. Preliminary results have shown that the sufferer could withstand the light source for much longer time than the standard light source. At last future perspectives on spectral design flexibility of LED light sources improving human being's life will be discussed, with focus on the light and health. The good health is ensured by the spectrum optimized so that vital hormones (melatonin and serotonin) are produced during times when they support human daily rhythm.
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International Nuclear Information System (INIS)
1988-03-01
This report presents the preliminary findings from the first phase of the Survey of the United States Department of Energy (DOE) Laboratory for Energy-Related Health Research (LEHR) at the University of California, Davis (UC Davis), conducted November 16 through 20, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the LEHR. The Survey covers all environmental media and all areas of environmental regulation, and is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations at the LEHR and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by a DOE National Laboratory or a support contractor. When completed, the results will be incorporated into the Environmental Survey Interim Report for the LEHR at UC Davis. The Interim Report will reflect the final determinations of the LEHR Survey. 75 refs., 26 figs., 23 tabs
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STS-95 Mission Specialist Pedro Duque in white room
1998-01-01
In the environmental chamber known as the white room, STS-95 Mission Specialist Pedro Duque of Spain, with the European Space Agency, is prepared by white room crew members Danny Wyatt (left) and Travis Thompson (right) for entry into the Space Shuttle Discovery for his first flight into space. The STS-95 mission, targeted for launch at 2 p.m. EST on Oct. 29, is expected to last 8 days, 21 hours and 49 minutes, and return to KSC at 11:49 a.m. EST on Nov. 7.
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High Power UV LED Industrial Curing Systems
Energy Technology Data Exchange (ETDEWEB)
Karlicek, Robert, F., Jr; Sargent, Robert
2012-05-14
UV curing is a green technology that is largely underutilized because UV radiation sources like Hg Lamps are unreliable and difficult to use. High Power UV LEDs are now efficient enough to replace Hg Lamps, and offer significantly improved performance relative to Hg Lamps. In this study, a modular, scalable high power UV LED curing system was designed and tested, performing well in industrial coating evaluations. In order to achieve mechanical form factors similar to commercial Hg Lamp systems, a new patent pending design was employed enabling high irradiance at long working distances. While high power UV LEDs are currently only available at longer UVA wavelengths, rapid progress on UVC LEDs and the development of new formulations designed specifically for use with UV LED sources will converge to drive more rapid adoption of UV curing technology. An assessment of the environmental impact of replacing Hg Lamp systems with UV LED systems was performed. Since UV curing is used in only a small portion of the industrial printing, painting and coating markets, the ease of use of UV LED systems should increase the use of UV curing technology. Even a small penetration of the significant number of industrial applications still using oven curing and drying will lead to significant reductions in energy consumption and reductions in the emission of green house gases and solvent emissions.
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Acoustic outsourcing: New employment possibilities for the specialists
Perez, Patricia; Rios, Heriberto; Andrade, Armando; Ramirez, Mario
2002-11-01
The need for companies to be more competitive has led them to resort to training, external consultantship, continuous improvement programs, but with the aim of achieving maximum productivity, the big companies go even further: they are opting to focus on their high-priority activities, leaving some nonstrategic functions in the hands of third parties (organizations or individuals). Acoustic outsourcing presents immense business opportunities for the specialists in this area when offering services or completing a production process that the company carries out in an internal way but that is not its main function or activity. Outsourcing contemplates a serious long term commitment between the two parties; a kind of strategic alliance, all with the purpose of increasing efficiency and the quality of the products that the company develops, besides solving acoustic problems related to the production stage. (To be presented in Spanish.)
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Cabral, Linda; Strother, Heather; Muhr, Kathy; Sefton, Laura; Savageau, Judith
2014-01-01
Mental health peer specialists develop peer-to-peer relationships of trust with clients to improve their health and well-being, functioning in ways similar to community health workers. Although the number of peer specialists in use has been increasing, their role in care teams is less defined than that of the community health worker. This qualitative study explored how the peer specialist role is defined across different stakeholder groups, the expectations for this role and how the peer specialist is utilised and integrated across different types of mental health services. Data were collected through interviews and focus groups conducted in Massachusetts with peer specialists (N = 44), their supervisors (N = 14) and clients (N = 10) between September 2009 and January 2011. A consensus coding approach was used and all data outputs were reviewed by the entire team to identify themes. Peer specialists reported that their most important role is to develop relationships with clients and that having lived mental health experience is a key element in creating that bond. They also indicated that educating staff about the recovery model and peer role is another important function. However, they often felt a lack of clarity about their role within their organisation and care team. Supervisors valued the unique experience that peer specialists bring to an organisation. However, without a defined set of expectations for this role, they struggled with training, guiding and evaluating their peer specialist staff. Clients reported that the shared lived experience is important for the relationship and that working with a peer specialist has improved their mental health. With increasing support for person-centred integrated healthcare delivery models, the demand for mental health peer specialist services will probably increase. Therefore, clearer role definition, as well as workforce development focused on team orientation, is necessary for peer specialists to be fully integrated
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29 CFR 42.9 - Farm Labor Specialist (ESA).
2010-07-01
... 29 Labor 1 2010-07-01 2010-07-01 true Farm Labor Specialist (ESA). 42.9 Section 42.9 Labor Office of the Secretary of Labor COORDINATED ENFORCEMENT § 42.9 Farm Labor Specialist (ESA). (a) The Assistant Secretary for ESA shall designate ESA Compliance Officers as Farm Labor Specialists (Specialists...
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Handbook of Research on Environmental Taxation
2012-01-01
The Handbook of Research on Environmental Taxation captures the state of the art of research on environmental taxation. Written by 36 specialists in environmental taxation from 16 countries, it takes an interdisciplinary and international approach, focusing on issues that are universal to using taxation to achieve environmental goals.The Handbook explores the conceptual foundations of environmental taxation, essential elements for designing environmental tax measures, factors that influence t...
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Directory of Open Access Journals (Sweden)
Grogan Sarah C
2011-09-01
Full Text Available Abstract Background There is growing recognition that a sedentary lifestyle is being driven, at least in part, by environmental factors that affect individuals' physical activity choices and health behaviours. In other words, the environments in which we live, and with which we interact, have become ones that encourage lifestyle choices that decrease physical activity and encourage over-consumption of foods. However, evidence from community-led interventions to change local neighbourhood environments to support physical activity and healthy eating is lacking. This article summarises the research protocol developed to evaluate a community-led intervention "My Health Matters" aimed at reducing health inequalities relating to increasing physical activity and healthy eating as defined by community members themselves. Methods/Design This study includes three of the most deprived electoral wards in Stoke-on-Trent. In each of these areas, environmental factors including proximity of physical activity spaces, greenspace and leisure facilities, neighbourhood connectivity and walkability, land-use-mix and population density, traffic, safety and crime, and food outlets will be mapped using Geographical Information Systems (GIS. A community postal survey of randomly selected addresses assessing environmental characteristics relating to physical activity, perceived health status, social capital, fruit and vegetable consumption and levels of physical activity will be undertaken (baseline and at 2 year follow-up. Based on baseline findings an intervention will be designed and implemented over a 2 year period that includes the following; use of community participatory research to build effective community partnerships; use of partnership consensus to identify, prioritise and design intervention(s related to specific health disparities; recruitment of local residents to help with the delivery and sustainability of target intervention(s; and the development of
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Davey, Rachel C; Hurst, Gemma L; Smith, Graham R; Grogan, Sarah C; Kurth, Judy
2011-09-12
There is growing recognition that a sedentary lifestyle is being driven, at least in part, by environmental factors that affect individuals' physical activity choices and health behaviours. In other words, the environments in which we live, and with which we interact, have become ones that encourage lifestyle choices that decrease physical activity and encourage over-consumption of foods. However, evidence from community-led interventions to change local neighbourhood environments to support physical activity and healthy eating is lacking. This article summarises the research protocol developed to evaluate a community-led intervention "My Health Matters" aimed at reducing health inequalities relating to increasing physical activity and healthy eating as defined by community members themselves. This study includes three of the most deprived electoral wards in Stoke-on-Trent. In each of these areas, environmental factors including proximity of physical activity spaces, greenspace and leisure facilities, neighbourhood connectivity and walkability, land-use-mix and population density, traffic, safety and crime, and food outlets will be mapped using Geographical Information Systems (GIS). A community postal survey of randomly selected addresses assessing environmental characteristics relating to physical activity, perceived health status, social capital, fruit and vegetable consumption and levels of physical activity will be undertaken (baseline and at 2 year follow-up). Based on baseline findings an intervention will be designed and implemented over a 2 year period that includes the following; use of community participatory research to build effective community partnerships; use of partnership consensus to identify, prioritise and design intervention(s) related to specific health disparities; recruitment of local residents to help with the delivery and sustainability of target intervention(s); and the development of local systems for ongoing monitoring and evaluation
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Microbial raw data for UV-C LED disinfection study
U.S. Environmental Protection Agency — This study evaluated ultraviolet (UV) light emitting diodes (LEDs) emitting at 260 nm, 280 nm, and the combination of 260|280 nm together for their efficacy at...
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Education of nuclear energy specialists
International Nuclear Information System (INIS)
Paulikas, V.
1999-01-01
Preparation system of nuclear energy specialists in Lithuania is presented. Nuclear engineers are being prepared at Kaunas University of Technology. Post-graduates students usually continue studies at Obninsk Nuclear Energy Institute in Russia. Many western countries like Sweden, Finland and US is providing assistance in education of Lithuanian specialists. Many of them were trained in these countries
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Haslerud, Torjan; Tulipan, Andreas Julius; Gray, Robert M; Biermann, Martin
2017-07-01
While e-learning has become an important tool in teaching medical students, the training of specialists in medical imaging is still dominated by lecture-based courses. To assess the potential of e-learning in specialist education in medical imaging. An existing lecture-based five-day course in Clinical Nuclear Medicine (NM) was enhanced by e-learning resources and activities, including practical exercises. An anonymized survey was conducted after participants had completed and passed the multiple choice electronic course examination. Twelve out of 15 course participants (80%) responded. Overall satisfaction with the new course format was high, but 25% of the respondents wanted more interactive elements such as discussions and practical exercises. The importance of lecture handouts and supplementary online material such as selected original articles and professional guidelines was affirmed by all the respondents (92% fully, 8% partially), while 75% fully and 25% partially agreed that the lectures had been interesting and relevant. E-learning represents a hitherto unrealized potential in the education of medical specialists. It may expedite training of medical specialists while at the same time containing costs.
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Attitudes regarding specialist referrals in periodontics.
Sharpe, G; Durham, J A; Preshaw, P M
2007-02-24
To examine the attitudes of dental practitioners towards specialist periodontal referral in the North East of England. Semi-structured interviews were conducted with a purposive sample of 10 practitioners. Interviews continued until data saturation occurred. The data were organised using a framework and analysed by two researchers working independently. Perceptions of periodontal disease and treatment appear to be heavily influenced by the NHS remuneration system. Treatment in general practice was limited to simple scaling and there was an apparent reluctance to treat advanced periodontitis. Such cases were commonly referred to specialists, confirming the demand for a referral service in periodontics. The perceived potential for medico-legal consequences was a strong driver of referrals. Distance to the referral centre and the perceived costs of treatment were significant barriers to referral. Dentists valued the specialist's personal reputation and clinical skills more highly than academic status. Deficiencies in communication between primary and secondary care were highlighted. Increased resources are required to manage periodontal diseases within the NHS. There is a need for a periodontal referral service in the North East of England to improve accessibility to specialist care. This would appear to be most appropriately delivered by increased numbers of specialist practitioners.
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Wittich, Walter; Höbler, Fiona; Jarry, Jonathan; McGilton, Katherine S
2018-01-26
This study aimed to identify screening tools, technologies and strategies that vision and hearing care specialists recommend to front-line healthcare professionals for the screening of older adults in long-term care homes who have dementia. An environmental scan of healthcare professionals took place via telephone interviews between December 2015 and March 2016. All interviews were audio recorded, transcribed, proofed for accuracy, and their contents thematically analysed by two members of the research team. A convenience sample of 11 professionals from across Canada specialising in the fields of vision and hearing healthcare and technology for older adults with cognitive impairment were included in the study. As part of a larger mixed-methods project, this qualitative study used semistructured interviews and their subsequent content analysis. Following a two-step content analysis of interview data, coded citations were grouped into three main categories: (1) barriers, (2) facilitators and (3) tools and strategies that do or do not work for sensory screening of older adults with dementia. We report on the information offered by participants within each of these themes, along with a summary of tools and strategies that work for screening older adults with dementia. Recommendations from sensory specialists to nurses working in long-term care included the need for improved interprofessional communication and collaboration, as well as flexibility, additional time and strategic use of clinical intuition and ingenuity. These suggestions at times contradicted the realities of service provision or the need for standardised and validated measures. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Mission Specialist Scott Parazynski arrives at KSC
1998-01-01
STS-95 Mission Specialist Scott E. Parazynski notes the time on his watch upon his late arrival aboard a T-38 jet at the Shuttle Landing Facility. Parazynski's first plane experienced problems at the stop at Tyndall AFB and he had to wait for another jet and pilot to finish the flight to KSC. He joined other crewmembers Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, Mission Specialist Pedro Duque, with the European Space Agency (ESA), and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA), for final pre-launch preparations. STS-95 is expected to launch at 2 p.m. EST on Oct. 29, last 8 days, 21 hours and 49 minutes, and land at 11:49 a.m. EST on Nov. 7.
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Boczkowski, A
2001-01-01
A questionnaire has been developed and disseminated in several European countries to determine common key competences required of occupational medicine specialists. The questionnaire contained 115 subjects relating to eight fields of activity of an occupational medicine physician (occupational hazards to health, assessment of disability and fitness for work, communications, research methods, management, environmental medicine, occupational health law and ethics, and health promotion). Items in each part were classified into three categories: knowledge, skills and experience. For each of the subjects respondents were asked to allocate a score from 0 (not necessary) to 5 (most important or essential). In Poland the questionnaire was distributed among two groups of specialists: (1) chief administrators of occupational health services, and (2) relatively young occupational medicine physicians attending a specialist training. A comprehensive analysis of the completed questionnaires had three dimensions: (a) substantive (classification of the importance of particular key competences, as perceived by Polish specialists in occupational medicine); (b) personal (differences in opinions among occupational medicine physicians and an attempt to explain these differences in sociological terms); and (c) comparative (evaluation and interpretation of similarities and differences between two groups).
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Are peer specialists happy on the job?
Jenkins, Sarah; Chenneville, Tiffany; Salnaitis, Christina
2018-03-01
This study was designed to examine the impact of role clarity and job training on job satisfaction among peer specialists. A 3-part survey assessing job training, job satisfaction, and role clarity was administered online to 195 peer specialists who are members of the International Association of Peer Specialists. Data was analyzed using descriptive statistics, correlational analyses to include multiple linear regressions and analysis of variance. Self-study and online training methods were negatively correlated with job satisfaction while job shadowing was positively correlated with job satisfaction. Role clarity was positively correlated with job satisfaction and job training satisfaction as well as job shadowing and one-on-one training. The use of self-study and online training for peer specialists is contraindicated by current findings, which suggest the need to utilize job shadowing or training methods that allow for personal interaction between peer specialists and their colleagues. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Energy Technology Data Exchange (ETDEWEB)
1988-06-01
This report presents the preliminary findings from the first phase of the Environmental Survey of the US Department of Energy (DOE) Morgantown Energy Technology Center (METC) conducted November 30 through December 4, 1987. In addition, the preliminary findings of the Laramie Project Office (LPO) Survey, which was conducted as part of the METC Survey on January 25 through 29, 1988, are presented in Appendices E and F. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with METC. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at METC, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain environmental problems identified during its on-site activities at METC. The Sampling and Analysis Plan will be executed by the Oak Ridge National Laboratory (ORNL). When completed, the results will be incorporated into the METC Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the Survey METC. 60 refs., 28 figs., 43 tabs.
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Brazilian infectious diseases specialists: who and where are they?
Cassenote, Alex Jones Flores; Scheffer, Mario César; Segurado, Aluísio Augusto Cotrim
2016-01-01
The infectious diseases specialist is a medical doctor dedicated to the management of infectious diseases in their individual and collective dimensions. The aim of this paper was to evaluate the current profile and distribution of infectious diseases specialists in Brazil. This is a cross-sectional study using secondary data obtained from institutions that register medical specialists in Brazil. Variables of interest included gender, age, type of medical school (public or private) the specialist graduated from, time since finishing residency training in infectious diseases, and the interval between M.D. graduation and residency completion. Maps are used to study the geographical distribution of infectious diseases specialists. A total of 3229 infectious diseases specialist registries were counted, with 94.3% (3045) of individual counts (heads) represented by primary registries. The mean age was 43.3 years (SD 10.5), and a higher proportion of females was observed (57%; 95% CI 55.3-58.8). Most Brazilian infectious diseases specialists (58.5%) practice in the Southeastern region. However, when distribution rates were calculated, several states exhibited high concentration of infectious diseases specialists, when compared to the national rate (16.06). Interestingly, among specialists working in the Northeastern region, those trained locally had completed their residency programs more recently (8.7yrs; 95% CI 7.9-9.5) than physicians trained elsewhere in the country (13.6yrs: 95% CI 11.8-15.5). Our study shows that Brazilian infectious diseases specialists are predominantly young and female doctors. Most have concluded a medical residency training program. The absolute majority practice in the Southeastern region. However, some states from the Northern, Northeastern and Southeastern regions exhibit specialist rates above the national average. In these areas, nonetheless, there is a strong concentration of infectious diseases specialists in state capitals and in
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The design of optical module of LED street lamp with non-axial symmetrical reflector
Lu, Ming-Jun; Chen, Chi-An; Chen, Yi-Yung; Whang, Allen Jong-Woei
2010-05-01
In recently, many research focus on the LED applications for environmental protection so a number of LED street lamps are presented. Although LED has many advantages for environmental protection, its special optical characteristics, such as intensity distribution, always limit the advantages in many applications. Therefore, we always need to do the secondary optical design for LED street lamp to replace the traditional optical designs that are designed for high-pressure sodium lamps and mercury lamps. According to the situation, we design an optical module of LED street lamp with LEDs and secondary optical design. First, the LEDs are placed on freeform reflector for the specific illuminated conditions. We design the optical module of street lamp with the two conditions that include the uniformity and the ratio of length to width in the illuminated area and without any light pollution. According to the simulation with the designed optical module, the uniformity in the illuminated area is about 0.6 that is better than the general condition, 0.3, and the ratio of length to width in the illuminated area is 3:1 in which the length is 30 meters and the width is 10 meters. Therefore, the design could let LED street lamp fits the two conditions, uniformity and ratio in the illuminated area.
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Cabassa, Leopoldo J; Stefancic, Ana; O'Hara, Kathleen; El-Bassel, Nabila; Lewis-Fernández, Roberto; Luchsinger, José A; Gates, Lauren; Younge, Richard; Wall, Melanie; Weinstein, Lara; Palinkas, Lawrence A
2015-09-02
The risk for obesity is twice as high in people with serious mental illness (SMI) compared to the general population. Racial and ethnic minority status contribute additional health risks. The aim of this study is to describe the protocol of a Hybrid Trial Type 1 design that will test the effectiveness and examine the implementation of a peer-led healthy lifestyle intervention in supportive housing agencies serving diverse clients with serious mental illness who are overweight or obese. The Hybrid Trial Type 1 design will combine a randomized effectiveness trial with a mixed-methods implementation study. The effectiveness trial will test the health impacts of a peer-led healthy lifestyle intervention versus usual care in supportive housing agencies. The healthy lifestyle intervention is derived from the Group Lifestyle Balanced Program, lasts 12 months, and will be delivered by trained peer specialists. Repeated assessments will be conducted at baseline and at 6, 12, and 18 months post randomization. A mixed-methods (e.g., structured interviews, focus groups, surveys) implementation study will be conducted to examine multi-level implementation factors and processes that can inform the use of the healthy lifestyle intervention in routine practice, using data from agency directors, program managers, staff, and peer specialists before, during, and after the implementation of the effectiveness trial. This paper describes the use of a hybrid research design that blends effectiveness trial methodologies and implementation science rarely used when studying the physical health of people with SMI and can serve as a model for integrating implementation science and health disparities research. Rigorously testing effectiveness and exploring the implementation process are both necessary steps to establish the evidence for large-scale delivery of peer-led healthy lifestyle intervention to improve the physical health of racial/ethnic minorities with SMI. www
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Light Emitting Diode (LED) circular traffic signal lifetime management system.
2011-02-01
The objective of this research is to build lifetime curves for red, yellow, and green LED circular traffic signals through 20,000-hr. accelerated stress testing of samples operating under Louisianas environmental conditions.
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A formative evaluation of a nurse practitioner-led interprofessional geriatric outpatient clinic.
Hansen, Kevin T; McDonald, Cheryl; O'Hara, Sue; Post, Leslie; Silcox, Susan; Gutmanis, Iris A
2017-07-01
The number of older adults with multiple complex comorbidities and frailty is expected to increase dramatically in the coming decades, which will necessitate a concomitant increase in the need for skilled clinicians who are able to manage complex geriatric needs. Many physicians, however, lack the required formal training, often leading to long wait-lists for specialist clinics. Yet, clinics led by non-physician professionals specialising in geriatric care could decrease these delays. This article describes the development and evaluation of a nurse practitioner-led interprofessional geriatric outpatient clinic (Inter-D Clinic). A combination of semi-structured clinician interviews, post-clinic follow-up phone calls, satisfaction surveys, and information from the hospital workload management system served as data sources for this formative programme evaluation. Between January 2013 and December 2014, 293 patients were seen in the clinic with the majority being referred for either memory issues (49%) or functional decline (35%). The clinic assessment frequently uncovered other issues, which led to guidance around falls prevention, improved nutrition, medication management, and referrals to available community supports. Both patients and referring physicians were very satisfied with this model of care, which is likely transferable to other locations provided the needed clinical expertise and community support services are available.
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Preparing Elementary Mathematics-Science Teaching Specialists.
Miller, L. Diane
1992-01-01
Describes a professional development program to train math/science specialists for the upper elementary school grades. Using results from an interest survey, 30 teachers were chosen to participate in a 3-year program to become math/science specialists. Presents the teaching model used and the advantages for teachers and students in having subject…
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A Lifetime Prediction Method for LEDs Considering Real Mission Profiles
DEFF Research Database (Denmark)
Qu, Xiaohui; Wang, Huai; Zhan, Xiaoqing
2017-01-01
operations due to the varying operational and environmental conditions during the entire service time (i.e., mission profiles). To overcome the challenge, this paper proposes an advanced lifetime prediction method, which takes into account the field operation mission profiles and also the statistical......The Light-Emitting Diode (LED) has become a very promising alternative lighting source with the advantages of longer lifetime and higher efficiency than traditional ones. The lifetime prediction of LEDs is important to guide the LED system designers to fulfill the design specifications...... properties of the life data available from accelerated degradation testing. The electrical and thermal characteristics of LEDs are measured by a T3Ster system, used for the electro-thermal modeling. It also identifies key variables (e.g., heat sink parameters) that can be designed to achieve a specified...
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DEFF Research Database (Denmark)
Packer, Rowena M A; Berendt, Mette; Bhatti, Sofie
2015-01-01
neurology specialists and non-specialists) on the description and classification of videos depicting paroxysmal events, without knowing any results of diagnostic workup. An online questionnaire study was conducted, where participants watched 100 videos of dogs and cats exhibiting paroxysmal events...... low levels of agreement described here highlight the need for further discussions between neurology experts regarding classifying and describing epileptic seizures, and additional training of non-specialists to facilitate accurate diagnosis. There is a need for diagnostic tools (e...
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Assessing the impact of heart failure specialist services on patient populations
Directory of Open Access Journals (Sweden)
Lyratzopoulos Georgios
2004-05-01
Full Text Available Abstract Background The assessment of the impact of healthcare interventions may help commissioners of healthcare services to make optimal decisions. This can be particularly the case if the impact assessment relates to specific patient populations and uses timely local data. We examined the potential impact on readmissions and mortality of specialist heart failure services capable of delivering treatments such as b-blockers and Nurse-Led Educational Intervention (N-LEI. Methods Statistical modelling of prevented or postponed events among previously hospitalised patients, using estimates of: treatment uptake and contraindications (based on local audit data; treatment effectiveness and intolerance (based on literature; and annual number of hospitalization per patient and annual risk of death (based on routine data. Results Optimal treatment uptake among eligible but untreated patients would over one year prevent or postpone 11% of all expected readmissions and 18% of all expected deaths for spironolactone, 13% of all expected readmisisons and 22% of all expected deaths for b-blockers (carvedilol and 20% of all expected readmissions and an uncertain number of deaths for N-LEI. Optimal combined treatment uptake for all three interventions during one year among all eligible but untreated patients would prevent or postpone 37% of all expected readmissions and a minimum of 36% of all expected deaths. Conclusion In a population of previously hospitalised patients with low previous uptake of b-blockers and no uptake of N-LEI, optimal combined uptake of interventions through specialist heart failure services can potentially help prevent or postpone approximately four times as many readmissions and a minimum of twice as many deaths compared with simply optimising uptake of spironolactone (not necessarily requiring specialist services. Examination of the impact of different heart failure interventions can inform rational planning of relevant healthcare
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Assessing the impact of heart failure specialist services on patient populations.
Lyratzopoulos, Georgios; Cook, Gary A; McElduff, Patrick; Havely, Daniel; Edwards, Richard; Heller, Richard F
2004-05-24
The assessment of the impact of healthcare interventions may help commissioners of healthcare services to make optimal decisions. This can be particularly the case if the impact assessment relates to specific patient populations and uses timely local data. We examined the potential impact on readmissions and mortality of specialist heart failure services capable of delivering treatments such as b-blockers and Nurse-Led Educational Intervention (N-LEI). Statistical modelling of prevented or postponed events among previously hospitalised patients, using estimates of: treatment uptake and contraindications (based on local audit data); treatment effectiveness and intolerance (based on literature); and annual number of hospitalization per patient and annual risk of death (based on routine data). Optimal treatment uptake among eligible but untreated patients would over one year prevent or postpone 11% of all expected readmissions and 18% of all expected deaths for spironolactone, 13% of all expected readmisisons and 22% of all expected deaths for b-blockers (carvedilol) and 20% of all expected readmissions and an uncertain number of deaths for N-LEI. Optimal combined treatment uptake for all three interventions during one year among all eligible but untreated patients would prevent or postpone 37% of all expected readmissions and a minimum of 36% of all expected deaths. In a population of previously hospitalised patients with low previous uptake of b-blockers and no uptake of N-LEI, optimal combined uptake of interventions through specialist heart failure services can potentially help prevent or postpone approximately four times as many readmissions and a minimum of twice as many deaths compared with simply optimising uptake of spironolactone (not necessarily requiring specialist services). Examination of the impact of different heart failure interventions can inform rational planning of relevant healthcare services.
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78 FR 50022 - Environmental Impact Statement; Asian Longhorned Beetle Eradication Program
2013-08-16
... submit comments regarding the environmental impact statement by either of the following methods: Federal..., Environmental Protection Specialist, Environmental and Risk Analysis Services, PPD, APHIS, 4700 River Road Unit...] Environmental Impact Statement; Asian Longhorned Beetle Eradication Program AGENCY: Animal and Plant Health...
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Tibby, David; Corpus, Rohan; Walters, Darren L
2010-01-01
Cardiovascular diseases are the leading cause of mortality in Indigenous Australians. Indigneous Australians present at a younger age and have a greater incidence of cardiac risk including smoking and diabetes than non-Indigenous Australians. Access to specialist health services is an important determinant of health care outcomes for these patients. We describe an innovative and successful for model for providing Outreach Cardiac Specialist services to Indigenous communities in rural and remote locations. The approach involves a step-wise process of a) community engagement, b) delivering recovery interventions to improve health outcomes, c) building community capacity to self manage chronic illness and promoting health and well being with the aim of d) community self governance of chronic disease and health promotion. Key elements to this process are community participation in the program, disease self-management led by local health care workers, open access that is all-inclusive utilising community-generated referral, and the translation of scientific knowledge of disease processes into community understanding and making culturally relevant connections. Specialist cardiac services and point of care diagnostics have been provided to 18 sites across rural and remote Queensland. More than 1400 episodes of care have been provided to Indigenous Australians with rheumatic heart disease, ischaemic heart disease and congenital heart conditions. Traditional values can work harmoniously with an inclusive medical approach in this relational model. Crown Copyright 2010. Published by Elsevier B.V. All rights reserved.
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[New business model for medical specialists].
Houwen, L G H J Louis
2013-01-01
The reforms in the field of medical specialist care have important implications for the professional practice of medical specialists and their working relationship with the hospital. This leads to a considerable amount of pressure placed upon the way physicians have traditionally practiced their liberal professions, which is by forming partnerships and practicing from within the hospitals based on an admission agreement. As of 2015, the tax benefits for entrepreneurs will be abolished and the formation of regional partnerships will be discouraged. These developments not only pose threats but also offer opportunities for both the entrepreneurial medical specialist and the innovative hospital. In this article, the prospect of a future business model for specialist medical care will be outlined and explored by proposing three new organizational forms. The central vision of this model is that physicians who wish to retain their status of liberal professional practitioners in the twenty-first century should be more involved in the ownership structure of hospitals. The social importance of responsible patient care remains paramount.
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Assessment of community led total sanitation uptake in rural Kenya
African Journals Online (AJOL)
K. N. Ogendo, Bsc, MPH, Living goods Nairobi, Kenya,Ministry of Health, Environmental Health ... led drive to set up pit latrines in rural kenya with an aim of promoting sustainable ... Development and Sustainable Development goals lay.
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van Bodegom-Vos, Leti; Verhoef, John; Dickmann, Margot; Kleijn, Marjon; van Vliet, Ingrid; Hurkmans, Emalie; van der Wees, Philip; Vliet Vlieland, Thea
2012-10-01
Although the increasing complexity and expansion of the body of knowledge in physical therapy have led to specialized practice areas to provide better patient care, the impact of specialization on guideline implementation has been scarcely studied. Objectives The objective of this study was to identify the similarities and differences in barriers to the implementation of a Dutch rheumatoid arthritis (RA) guideline by generalist and specialist physical therapists. Design This observational study consisted of 4 focus group interviews in which 24 physical therapists (13 generalist and 11 specialist physical therapists) participated. Physical therapists were asked to discuss barriers to the implementation of the RA guideline. Data were analyzed qualitatively using a directed approach to content analysis. Both the interviews and the interview analysis were informed by a previously developed conceptual framework. Besides a number of similarities (eg, lack of time), the present study showed important, although subtle, differences in barriers to the implementation of the RA guideline between generalist physical therapists and specialist physical therapists. Generalist physical therapists more frequently reported difficulties in interpreting the guideline (cognitive barriers) and had less favorable opinions about the guideline (affective barriers) than specialist physical therapists. Specialist physical therapists were hampered by external barriers that are outside the scope of generalist physical therapists, such as a lack of agreement about the roles and responsibilities of medical professionals involved in the care of the same patient. The identified differences in barriers to the implementation of the RA guideline indicated that the effectiveness of implementation strategies could be improved by tailoring them to the level of specialization of physical therapists. However, it is expected that tailoring implementation strategies to barriers that hamper both generalist
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Directory of Open Access Journals (Sweden)
Zoriana Dvulit
2017-12-01
Full Text Available The subject of the research is to study the state of issue of advanced training of environmental professionals and specialists on six railways of Ukrzaliznytsia PJSC: Donetsk, Lviv, Odesa, Pivdenna (Southern, Pivdenno-Zakhidna (Southwestern and Pridniprovska Railways. The purpose of the article is to study the issue of providing the necessary qualification level of postgraduate education (advanced training of environmental professionals and specialists at six Ukrainian railways. The methodology of the research: In order to achieve the goal, the following methods are used in the article: 1 statistical methods and methods of comparative analysis; 2 questionnaires and expert surveys of environmental professionals and specialists; 3 taxonomic methods. The novelty of the research. The state of the issue of ensuring the necessary level of professional development of environmental professionals and specialists at six railways of Ukrzaliznytsia PJSC is investigated. Namely: 1. the state of the level of professional development of environmental professionals and specialists of 6 railways of Ukrzaliznytsia PJSC for the period from 2012 to 2016 is researched and evaluated; its structural and dynamic analysis is carried out; 2. calculations of taxonomic indicators of the level of development of career development system for environmental professionals and specialists as distribution of expenses for advanced training for 6 railways for 2012–2016 are made; 3. carried out a questionnaire of environmental professionals and specialists, whose list of functional responsibilities, in accordance with the job description (both staffed and part-time workers, includes issues of the use of natural resources and environmental protection – in order to clarify the availability of environmental education, the length of work in the railway, the length of work in positions associated with environmental activities, the level of satisfaction with the content of their work
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14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.
2010-01-01
... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialist relationship with... ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload specialist relationship with sponsoring institutions. Specialists who are not U.S. Government employees must...
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The need for PGY2-trained clinical pharmacy specialists.
Ragucci, Kelly R; O'Bryant, Cindy L; Campbell, Kristin Bova; Buck, Marcia L; Dager, William E; Donovan, Jennifer L; Emerson, Kayleigh; Gubbins, Paul O; Haight, Robert J; Jackevicius, Cynthia; Murphy, John E; Prohaska, Emily
2014-06-01
The American College of Clinical Pharmacy and other stakeholder organizations seek to advance clinical pharmacist practitioners, educators, and researchers. Unfortunately, there remains an inadequate supply of residency-trained clinical specialists to meet the needs of our health care system, and nonspecialists often are called on to fill open specialist positions. The impact of clinical pharmacy specialists on pharmacotherapy outcomes in both acute care and primary care settings demonstrates the value of these specialists. This commentary articulates the need for postgraduate year two (PGY2)-trained clinical specialists within the health care system by discussing various clinical and policy rationales, interprofessional support, economic justifications, and their impact on quality of care and drug safety. The integrated practice model that has grown out of the American Society of Health-System Pharmacists Pharmacy Practice Model Initiative (PPMI) could threaten the growth and development of future clinical specialists. Therefore, the ways in which PGY2-trained clinical pharmacist specialists are deployed in the PPMI require further consideration. PGY2 residencies provide education and training opportunities that cannot be achieved in traditional professional degree programs or postgraduate year one residencies. These specialists are needed to provide direct patient care to complex patient populations and to educate and train pharmacy students and postgraduate residents. Limitations to training and hiring PGY2-trained clinical pharmacy specialists include site capacity limitations and lack of funding. A gap analysis is needed to define the extent of the mismatch between the demand for specialists by health care systems and educational institutions versus the capacity to train clinical pharmacists at the specialty level. © 2014 Pharmacotherapy Publications, Inc.
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Academic learning for specialist nurses: a grounded theory study.
Millberg, Lena German; Berg, Linda; Brämberg, Elisabeth Björk; Nordström, Gun; Ohlén, Joakim
2014-11-01
The aim was to explore the major concerns of specialist nurses pertaining to academic learning during their education and initial professional career. Specialist nursing education changed in tandem with the European educational reform in 2007. At the same time, greater demands were made on the healthcare services to provide evidence-based and safe patient-care. These changes have influenced specialist nursing programmes and consequently the profession. Grounded Theory guided the study. Data were collected by means of a questionnaire with open-ended questions distributed at the end of specialist nursing programmes in 2009 and 2010. Five universities were included. Further, individual, pair and group interviews were used to collect data from 12 specialist nurses, 5-14 months after graduation. A major concern for specialist nurses was that academic learning should be "meaningful" for their professional future. The specialist nurses' "meaningful academic learning process" was characterised by an ambivalence of partly believing in and partly being hesitant about the significance of academic learning and partly receiving but also lacking support. Specialist nurses were influenced by factors in two areas: curriculum and healthcare context. They felt that the outcome of contribution to professional confidence was critical in making academic learning meaningful. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Druss, Benjamin G; Singh, Manasvini; von Esenwein, Silke A; Glick, Gretl E; Tapscott, Stephanie; Tucker, Sherry Jenkins; Lally, Cathy A; Sterling, Evelina W
2018-02-01
Individuals with serious mental illnesses have high rates of general medical comorbidity and challenges in managing these conditions. A growing workforce of certified peer specialists is available to help these individuals more effectively manage their health and health care. However, few studies have examined the effectiveness of peer-led programs for self-management of general medical conditions for this population. This randomized study enrolled 400 participants with a serious mental illness and one or more chronic general medical conditions across three community mental health clinics. Participants were randomly assigned to the Health and Recovery Peer (HARP) program, a self-management program for general medical conditions led by certified peer specialists (N=198), or to usual care (N=202). Assessments were conducted at baseline and three and six months. At six months, participants in the intervention group demonstrated a significant differential improvement in the primary study outcome, health-related quality of life. Specifically, compared with the usual care group, intervention participants had greater improvement in the Short-Form Health Survey physical component summary (an increase of 2.7 versus 1.4 points, p=.046) and mental component summary (4.6 versus 2.5 points, p=.039). Significantly greater six-month improvements in mental health recovery were seen for the intervention group (p=.02), but no other between-group differences in secondary outcome measures were significant. The HARP program was associated with improved physical health- and mental health-related quality of life among individuals with serious mental illness and comorbid general medical conditions, suggesting the potential benefits of more widespread dissemination of peer-led disease self-management in this population.
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Cooperation among medical specialists : "pain" or "gain"?
Stoffels, Antoinette Marie-Rose Renée
2008-01-01
This thesis investigates the cooperation among medical specialists in multidisciplinary teams as well as its antecedents and consequences. During meetings, medical specialists combine their knowledge and expertise, discuss the health problems of patients, weigh possible treatment options and decide
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Mission Specialist Scott Parazynski arrives late at KSC
1998-01-01
The T-38 jet aircraft arrives at the Shuttle Landing Facility carrying STS-95 Mission Specialist Scott E. Parazynski (second seat). The pilot is astronaut Kent Rominger. Parazynski's first plane experienced problems at the stop at Tyndall AFB and he had to wait for another jet and pilot to finish the flight to KSC. He joined other crewmembers Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, Mission Specialist Pedro Duque, with the European Space Agency (ESA), and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA), for final pre-launch preparations. STS-95 is expected to launch at 2 p.m. EST on Oct. 29, last 8 days, 21 hours and 49 minutes, and land at 11:49 a.m. EST on Nov. 7.
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The Predictability of Phytophagous Insect Communities: Host Specialists as Habitat Specialists
Müller, J.; Stadler, J.; Jarzabek-Müller, A.; Hacker, H.; Braak, ter C.J.F.; Brandl, R.
2011-01-01
The difficulties specialized phytophagous insects face in finding habitats with an appropriate host should constrain their dispersal. Within the concept of metacommunities, this leads to the prediction that host-plant specialists should sort into local assemblages according to the local
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Pharmacy specialists' attitudes toward pharmaceutical service quality at community pharmacies.
Urbonas, Gvidas; Jakušovaitė, Irayda; Savickas, Arūnas
2010-01-01
The main objective of this study was to analyze pharmacy specialists' attitudes toward the quality of pharmaceutical services at Lithuanian community pharmacies. Between April and June 2009, a total of 471 Lithuanian community pharmacy specialists completed a questionnaire designed to evaluate their attitudes toward the quality of pharmaceutical services at community pharmacies. The main dimensions of pharmaceutical service quality were extracted by principal component analysis. Two main dimensions of pharmaceutical service quality were extracted: pharmacotherapeutic aspects (provision of information about drug therapy, possible side effects, health promotion, the amount of time spent with a patient, and the ascertainment that a patient understood the provided information) and socioeconomic aspects (considering patient's needs and financial capabilities, making a patient confident with the services provided). Pharmacy specialists evaluated the quality of both dimensions positively, but the quality of the first dimension was rated significantly worse than that of the second dimension. The attitudes of pharmacy specialists working at independent pharmacies were more positive toward pharmacotherapeutic aspects as compared to the specialists working at chain or state pharmacies. Pharmacotherapeutic aspects were rated better by pharmacy specialists, aged ≥ 55 years, than those younger than 45 years. Moreover, the attitudes of 45-54-year-old pharmacy specialists toward the socioeconomic aspects were more positive as compared with those of 35-44-year olds. Pharmacists rated the socioeconomic aspects of pharmaceutical service quality worse as compared with pharmacy technicians. The attitudes of pharmacy specialists working at pharmacies with 6-9 specialists were more negative toward pharmacotherapeutic aspects than those of the pharmacies with 1-2 specialists. Pharmacy specialists working at pharmacies with ≥ 10 specialists reported lower scores of socioeconomic
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Naeser, Margaret A.; Saltmarche, Anita; Krengel, Maxine H.; Hamblin, Michael R.; Knight, Jeffrey A.
2010-02-01
Two chronic, traumatic brain injury (TBI) cases are presented, where cognitive function improved following treatment with transcranial light emitting diodes (LEDs). At age 59, P1 had closed-head injury from a motor vehicle accident (MVA) without loss of consciousness and normal MRI, but unable to return to work as development specialist in internet marketing, due to cognitive dysfunction. At 7 years post-MVA, she began transcranial LED treatments with cluster heads (2.1" diameter with 61 diodes each - 9x633nm, 52x870nm; 12-15mW per diode; total power, 500mW; 22.2 mW/cm2) on bilateral frontal, temporal, parietal, occipital and midline sagittal areas (13.3 J/cm2 at scalp, estimated 0.4 J/cm2 to brain cortex per area). Prior to transcranial LED, focused time on computer was 20 minutes. After 2 months of weekly, transcranial LED treatments, increased to 3 hours on computer. Performs nightly home treatments (now, 5 years, age 72); if stops treating >2 weeks, regresses. P2 (age 52F) had history of closed-head injuries related to sports/military training and recent fall. MRI shows fronto-parietal cortical atrophy. Pre-LED, was not able to work for 6 months and scored below average on attention, memory and executive function. Performed nightly transcranial LED treatments at home (9 months) with similar LED device, on frontal and parietal areas. After 4 months of LED treatments, returned to work as executive consultant, international technology consulting firm. Neuropsychological testing (post- 9 months of transcranial LED) showed significant improvement in memory and executive functioning (range, +1 to +2 SD improvement). Case 2 reported reduction in PTSD symptoms.
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FORMATION OF ECOLOGICAL AWARENESS AND ENVIRONMENTAL CULTURE OF MEDICAL STUDENTS
Directory of Open Access Journals (Sweden)
Olena Snisar
2017-03-01
Full Text Available The article considers the important problem of searching and introducing innovative forms and methods of ecological upbringing and environmental education in the educational process of the medical educational establishment. Medical workers first face the negative impact of environmental problems on human health, therefore formation of high level of their environmental awareness and culture, ability to apply knowledge of medical ecology while performing their professional duties is an important condition for their qualitative vocational training. The aim of the article is to analyze the benefits of creating an environmental squad in the medical educational establishment with a purpose to create a high level of the studets’ environmental awareness, environmental culture and expositive behavior. The experience of the environmental squad Cherkasy medical academy to attract students to the ecological and elucidative and environmental protection, scientific research ecologically oriented. Effective methods and forms of environmental squad’s work in spreading ecological knowledge are characterized, the main topics of scientific research work are presented. Stages of forming ecological awareness and ecological culture of future doctors have been analyzed, while working in the environmental squad, from expanding and systematization of ecological knowledge to the development of ecological style of thinking and environmentally safe behavior. The results of the study led to the conclusion that activity of such structure as an ecological squad in the medical educational establishment provides improved ecological upbringing and environmental education and allows training of medical specialists, who understand the danger of a complicated ecological situation for human health, will promote healthy lifestyle, help reduce the negative impact of harmful factors on the health of patients, as well as a conscious citizen, which is a patriot of his country, take
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Environmental education on wood preservatives and preservative ...
African Journals Online (AJOL)
The development and use of wood preservatives in Nigeria should address not only the cost and demand functions but also the potential hazards in environmental equations. Forest products specialists are often asked about the perceived risks and environmental costs of treated wood products. Evidently, the civil society is ...
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CSHCN in Texas: meeting the need for specialist care.
Young, M Cherilyn; Drayton, Vonna L C; Menon, Ramdas; Walker, Lesa R; Parker, Colleen M; Cooper, Sam B; Bultman, Linda L
2005-06-01
Assuring the sufficiency and suitability of systems of care and services for children with special health care needs (CSHCN) presents a challenge to Texas providers, agencies, and state Title V programs. To meet the need for specialist care, referrals from primary care doctors are often necessary. The objective of this study was to describe the factors associated with the need for specialist care and problems associated with obtaining referrals in Texas. Bivariate and multivariate analyses were performed using the National Survey of Children with Special Health Care Needs (NS-CSHCN) weighted sample for Texas (n = 719,014) to identify variables associated with the need for specialist care and problems obtaining referrals for specialist care. Medical need of the CSHCN and sensitivity to family values/customs was associated with greater need for specialist care, and Hispanic ethnicity and lower maternal education were associated with less need. Medical need, amount of time spent with doctors and sensitivity to values/customs, living in a large metropolitan statistical area, and lack of medical information were associated with problems obtaining a specialist care referral. Findings revealed some similarities and differences with meeting the need for specialist care when comparing Texas results to other studies. In Texas, aspects of customer satisfaction variables, especially doctors' sensitivity to family values/customs and parents' not receiving enough information on medical problems, were significantly associated with problems obtaining specialist referrals. Findings indicate a need to further research relationships and communication among doctors, CSHCN, and their families.
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Multiple Primary LED Lamp Colour Controller with Inherent Brightness Limitation
Barcena, R.; Ackermann, B.
2007-01-01
There is a strong interest in using LEDs for general illumination due to the potential they offer for energy saving, environmental friendliness, new opportunities in lighting design, and control of the intensity, colour, and spatial distribution of light. General illumination requires primarily
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School Library Media Specialist-Teacher Collaboration: Characteristics, Challenges, Opportunities
Cooper, O. P.; Bray, Marty
2011-01-01
The most successful school library media specialists are those who collaborate with teachers as full partners in the instructional process. Without assertive action by the school library media specialist, however, school administrators and teachers are likely to be more aware of the media specialist's administrative role than the roles of teacher,…
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Environmental Protection Versus Foundry Engineering Practice
Maj M.; Werrtz J.; Piekło J.
2017-01-01
• Theory and practice of environmental protection in the case of foundries in Europe and Asia • Experience resulting from the cooperation with the foundries in a few European countries, China and India • Phenomena and factors affecting the pollution of the natural environment and the implementation of measures aiming at the environmental protection. Every specialist dealing with foundry processes and their impact on environmental pollution must have encountered in their professional careers n...
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International Nuclear Information System (INIS)
1988-09-01
This report presents the preliminary findings of the first phase of the Environmental Survey of the United States Department of Energy's (DOE) Idaho National Engineering Laboratory (INEL) and Component Development and Integration Facility (CDIF), conducted September 14 through October 2, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. The team includes outside experts supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the INEL and CDIF. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations' carried on at the INEL and the CDIF, and interviews with site personnel. The Survey team developed a Sampling and Analysis (S ampersand A) Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The S ampersand A Plan will be executed by the Oak Ridge National Laboratory. When completed, the S ampersand A results will be incorporated into the INEL/CDIF Survey findings for inclusion into the Environmental Survey Summary Report. 90 refs., 95 figs., 77 tabs
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Energy Technology Data Exchange (ETDEWEB)
1988-09-01
This report presents the preliminary findings of the first phase of the Environmental Survey of the United States Department of Energy's (DOE) Idaho National Engineering Laboratory (INEL) and Component Development and Integration Facility (CDIF), conducted September 14 through October 2, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. The team includes outside experts supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the INEL and CDIF. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations' carried on at the INEL and the CDIF, and interviews with site personnel. The Survey team developed a Sampling and Analysis (S A) Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The S A Plan will be executed by the Oak Ridge National Laboratory. When completed, the S A results will be incorporated into the INEL/CDIF Survey findings for inclusion into the Environmental Survey Summary Report. 90 refs., 95 figs., 77 tabs.
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Evaluation of a diabetes nurse specialist prescribing project.
Wilkinson, Jill; Carryer, Jenny; Adams, Jeffery
2014-08-01
To evaluate the diabetes nurse specialist prescribing project with the aim of determining whether diabetes nurse specialist prescribing is safe and effective and to inform the implementation and extension of registered nurse prescribing. Registered nurses in many countries are able to prescribe medicines, but in New Zealand, prior to the diabetes nurse specialist project, nurse practitioners were the only nurses who could prescribe medicines. New regulations allowed the nurses to prescribe a limited number of prescription medicines. The study was a process and outcome clinical programme evaluation. The project took place between April-September 2011 and involved 12 diabetes nurse specialist in four localities. Quantitative data were collected from clinical records maintained by the diabetes nurse specialist for the project (1274 patients and 3402 prescribing events), from surveys with stakeholders (general practitioners, n = 30; team members, n = 19; and patients, n = 89) and audits from patient notes (n = 117) and prescriptions (n = 227), and qualitative data from interviews with project participants (n = 18) and patients (n = 19). All data were analysed descriptively. Diabetes nurse specialist prescribing was determined to be safe, of high quality and appropriate. It brought important benefits to the effectiveness of specialist diabetes services, was acceptable to patients and was supported by the wider healthcare team. These findings are consistent with the findings reported in the international literature about nurse prescribing in a range of different practice areas. Clarification of the education and competence requirements and resourcing for the ongoing supervision of nurses is recommended if the prescribing model is to be extended. Diabetes nurse specialist prescribing improved access to medicines by providing a more timely service. Nurses felt more satisfied with their work because they could independently provide a complete episode of care
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Energy Technology Data Exchange (ETDEWEB)
2013-11-01
Many countries around the globe are designing and implementing low emission development strategies (LEDS). These LEDS seek to achieve social, economic, and environmental development goals while reducing long-term greenhouse gas (GHG) emissions and increasing resiliency to climate change impacts. The LEDS Global Partnership (LEDS GP) harnesses the collective knowledge and resources of more than 120 countries and international donor and technical organizations to strengthen climate-resilient low emission development efforts around the world.
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Dittrich, T. M.
2012-12-01
The University of Colorado-Boulder is one of a few universities in the country that has a licensed Treatment, Storage, and Disposal Facility (TSDF) for hazardous waste on campus. This facility, located on the bottom floor of the Environmental Health and Safety (EH&S) building, allows CU to more economically treat hazardous waste by enabling treatment specialists on staff to safely collect and organize the hazardous waste generated on campus. Hazardous waste is anything that contains a regulated chemical or compound and most chemicals used in engineering labs (e.g., acids, solvents, metal solutions) fall into this category. The EH&S staff is able to treat close almost 33% of the waste from campus and the rest is packed for off-site treatment at various places all over the country for disposal (e.g., Sauget, IL, Port Aurthor, TX). The CU-Boulder campus produced over 50 tons of hazardous waste in 2010 costing over $300,000 in off-campus expenses. The EH&S staff assigns one of over 50 codes to the waste which will determine if the waste can be treated on campus of must be shipped off campus to be disposed of. If the waste can be treated on campus, it will undergo one of three processes: 1) neutralization, 2) UV-ozone oxidation, or 3) ion exchange. If the waste is acidic but contains no heavy metals, the acid is neutralized with sodium hydroxide (a base) and can be disposed "down the drain" to the Boulder Wastewater Treatment Plant. If the waste contains organic compounds and no metals, a UV-ozone oxidation system is used to break down the organic compounds. Silver from photography wastewater can be removed using ion exchange columns. Undergraduate and graduate students worked with the hazardous waste treatment facility at the Environmental Health and Safety (EH&S) building on the CU-Boulder campus during the fall of 2011 and fall of 2012. Early in the semester, students receive a tour of the three batch treatment processes the facility is equipped with. Later in the
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Tensions related to implementation of postgraduate degree projects in specialist nursing education.
German Millberg, Lena; Berg, Linda; Lindström, Irma; Petzäll, Kerstin; Öhlén, Joakim
2011-04-01
In conjunction with the introduction of the Bologna process in Sweden, specialist nursing education programmes were moved up to the second cycle of higher education with the opportunity to take a one-year master's degree, which also meant that students would undertake a degree project carrying 15 ECTS. The purpose of this study was to examine the introduction of postgraduate degree projects on the second-cycle level into Swedish specialist nursing programmes in accordance with the Bologna process. Five universities were involved and the study design took the form of action research. Problem formulation, planning, evaluation and follow-up with reflection led to new actions over a period of 2 1/2 years. Through a review of local curriculum documents, the implementation of a postgraduate degree project was monitored and these reviews, together with field notes, were analysed by means of constant comparative analysis. The results revealed a variety of tensions that arose when postgraduate degree projects were introduced, taking the form of differing views on the relationship between research, clinical development, specific professional objectives and academic objectives. These tensions were reflected in six areas of change. In summary, it can be noted that implementation of the postgraduate degree projects highlighted tensions related to basic views of learning. Copyright © 2010 Elsevier Ltd. All rights reserved.
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Directory of Open Access Journals (Sweden)
Rajka Bračun Sova
2015-12-01
Full Text Available Since Bourdieu, it has been argued that art appreciation requires “knowledge”. The focus of this qualitative study was to examine art appreciation as a learned competence by exploring two different groups of museum visitors: art specialists and art non-specialists. The research was conducted at Moderna galerija in Ljubljana. Twenty-three adults were recruited and accompanied during their visit to the museum. Participants were requested to “think out loud”, which meant to talk about what they saw, thought, and felt about the artworks. There was a short interview conducted with each participant before entering the museum to gain insight into their art-related and museum-visiting experience. The analysis of the data revealed that some processes of art appreciation were similar within the two groups. Both art specialists and art non-specialists interact with museum objects physically and intellectually; they see contents and formal qualities as a whole; they respond emotionally to artworks; appreciation includes their personal experience; they search museum interpretation/information for their understanding. Some noticeable differences were found. Art specialists respond to artworks with more understanding and are willing to put more effort into art appreciation, whereas art non-specialists respond with less understanding and put less effort into art appreciation. This paper focuses on the differences between the two groups; reflective and spontaneous appreciation of art, objective and subjective appreciation of art and the effort put into art appreciation. The paper ends with a discussion of the implications of the study for the teaching of art and museum education.
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Courtenay, Molly; Carey, Nicola
2008-08-01
To identify, summarise and critically appraise the current evidence regarding the impact and effectiveness of nurse-led care in acute and chronic pain. A diverse range of models of care exist within the services available for the management of acute and chronic pain. Primary studies have been conducted evaluating these models, but, review and synthesis of the findings from these studies has not been undertaken. Literature review. Searches of Pubmed (NLM) Medline, CINAHL, Web of Knowledge (Science Index, Social Science index), British Nursing Index from January 1996-March 2007 were conducted. The searches were supplemented by an extensive hand search of the literature through references identified from retrieved articles and by contact with experts in the field. Twenty-one relevant publications were identified and included findings from both primary and secondary care. The areas, in which nurses, caring for patients in pain are involved, include assessment, monitoring, evaluation of pain, interdisciplinary collaboration and medicines management. Education programmes delivered by specialist nurses can improve the assessment and documentation of acute and chronic pain. Educational interventions and the use of protocols by specialist nurses can improve patients understanding of their condition and improve pain control. Acute pain teams, led by nurses, can reduce pain intensity and are cost effective. Nurses play key roles in the diverse range of models of care that exist in acute and chronic pain. However, there are methodological weaknesses across this body of research evidence and under researched issues that point to a need for further rigorous evaluation. Nurse-led care is an integral element of the pain services offered to patients. This review highlights the effect of this care and the issues that require consideration by those responsible for the development of nurse-led models in acute and chronic pain.
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Specialist training in pediatric anesthesia
DEFF Research Database (Denmark)
Hansen, Tom G
2009-01-01
There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society of Anaesth......There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society...... of Anaesthesiology and Intensive Care Medicine has coordinated an advanced Inter-Nordic educational program in pediatric anesthesia and intensive care. The training program is managed by a Steering Committee. This program is intended for physicians who recently have received their specialist degree in anesthesiology...... and intensive care. The training period is 12 months of which 9 months are dedicated to pediatric anesthesia and 3 months to pediatric intensive care. During the 1-year training period, the candidates are designated a Scandinavian host clinic (at a tertiary pediatric center in Scandinavia approved...
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[Databases for surgical specialists in Cancún, Quintana Roo].
Contla-Hosking, Jorge Eduardo; Ceballos-Martínez, Zoila Inés; Peralta-Bahena, Mónica Esther
2004-01-01
Our aim was to identify the level of knowledge of surgical health-area specialists in Cancún, Quintana Roo, Mexico, from the personal productivity database. We carried out an investigation of 37 surgical specialists: 24 belonged to the Mexican Social Security Institute (IMSS), while 13 belonged to the Mexican Health Secretariat (SSA). In our research, we found that 61% of surgical health-area specialist physicians were familiar with some aspects of the institutional surgical registry, including the following: 54% knew of the existence of a personal registry of surgeries carried out, and 43% keep a record of their personal activities. From the latter percentage, 69% of surgical health-area specialist physicians mentioned keeping their records manually, while 44% used the computer. Results of the research suggest that these physicians would like to have some kind of record of the surgeries carried out by each. An important percentage of these specialists do not keep a personal record on a database; due to this lack of knowledge, we obtain incorrect information in institutional records of the reality of what is actually done. We consider it important to inform surgical specialists concerning the existence of personal institutional records in database form or even of record done manually, as well as correct terminology for the International Codification (CIE-9 & 10). We inform here of the need to encourage a culture in records and databases in the formative stage of surgeon specialists.
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The evolution of resource adaptation: how generalist and specialist consumers evolve.
Ma, Junling; Levin, Simon A
2006-07-01
Why and how specialist and generalist strategies evolve are important questions in evolutionary ecology. In this paper, with the method of adaptive dynamics and evolutionary branching, we identify conditions that select for specialist and generalist strategies. Generally, generalist strategies evolve if there is a switching benefit; specialists evolve if there is a switching cost. If the switching cost is large, specialists always evolve. If the switching cost is small, even though the consumer will first evolve toward a generalist strategy, it will eventually branch into two specialists.
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Does the specialist nurse enhance or deskill the general nurse?
Marshall, Z; Luffingham, N
Much conflict and confusion surrounds the title and role of the specialist nurse, leading in some instances to disharmony between general and specialist nurses. It has been suggested that too many highly specialized nurses in a general area may lead to a deskilled workforce and fragmented care. Attempts to define the key concepts of specialist practice as described by the UKCC has resulted in elitism, conflict and abuse of the title. One suggestion to eliminate this conflict is for specialist nurses to achieve key competencies that encompass the role of the clinical expert. These key competencies should be devised by specialist nurses, in the absence of national guidelines, and be agreed by employers. They should incorporate the key roles of: change agent, expert clinician, educator, researcher and coordinator. It is contended that if all concerned have a clearer definition of the title, role and what is expected from the specialist nurse then this will result in reduced conflict and improved quality of care.
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Brazilian infectious diseases specialists: who and where are they?
Directory of Open Access Journals (Sweden)
Alex Jones Flores Cassenote
2016-03-01
Conclusion: Our study shows that Brazilian infectious diseases specialists are predominantly young and female doctors. Most have concluded a medical residency training program. The absolute majority practice in the Southeastern region. However, some states from the Northern, Northeastern and Southeastern regions exhibit specialist rates above the national average. In these areas, nonetheless, there is a strong concentration of infectious diseases specialists in state capitals and in metropolitan areas.
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Handbook of Research on Environmental Taxation
DEFF Research Database (Denmark)
, their environmental and economic impact and, finally, the larger question of the role of taxation among other policy approaches to environmental protection. Intermixing theory with case studies, the Handbook offers readers lessons that can be applied around the world. It identifies key bodies of research for people......The Handbook of Research on Environmental Taxation captures the state of the art of research on environmental taxation. Written by 36 specialists in environmental taxation from 16 countries, it takes an interdisciplinary and international approach, focusing on issues that are universal to using...... taxation to achieve environmental goals. The Handbook explores the conceptual foundations of environmental taxation, essential elements for designing environmental tax measures, factors that influence the acceptance of environmental taxation, the variety of ways to implement environmental taxes...
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'The use of technical specialists in quality assurance audits'
International Nuclear Information System (INIS)
Higgins, T.J.; Diaz, M.R.
1993-01-01
This paper provides a nontechnical discussion of the use of Technical Specialists in quality assurance audits by the Office of Civilian Radioactive Waste Management's Office of Quality Assurance. The purpose is to describe one successful solution to the problem that arises when a quality assurance organization is responsible for conducting audits of many, diverse, highly technical activities. The solution is the conduct of audits that combine both horizontal and vertical sample selection strategies and which employ Technical Specialists in the vertical portion of the audit. The Technical Specialist is paired with a programmatic auditor who perform as a dedicated team in their conduct of the audit. This paper focuses on the Technical Specialist
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Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care
McCann-Stone, Nancy; Robinson, Sherry B.; Rull, Gary; Rosher, Richard B.
2009-01-01
This paper describes an Elder Specialist Program developed by one school of medicine to sensitize medical students to geriatric psychosocial issues. Elder Specialists participate in panel discussions as part of each geriatric session. As an alternative to traditional senior mentoring programs, the Elder Specialist Program provides all students a…
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Occupational medicine specialist referral triggers: Mixed-methods analysis of teleconsult cases.
Eaton, J L; Mohammad, A; Mohr, D C; Brustein, D J; Kirkhorn, S R
2017-12-30
Qualitative analyses can yield critical lessons for learning organizations in healthcare. Few studies have applied these techniques in the field of occupational and environmental medicine (OEM). To describe the characteristics of complex cases referred for OEM subspecialty evaluation and variation by referring provider's training. Using a mixed methods approach, we conducted a content analysis of clinical cases submitted to a national OEM teleconsult service. Consecutive cases entered between April 2014 and July 2015 were screened, coded and analysed. 108 cases were available for analysis. Local Veterans Health Administration (VHA) non-specialist providers entered a primary medical diagnosis in 96% of cases at the time of intake. OEM speciality physicians coded significant medical conditions based on free text comments. Coder inter-rater reliability was 84%. The most frequent medical diagnosis types associated with tertiary OEM referral by non-specialists were endocrine (19%), cardiovascular (18%) and mental health (16%). Concern for usage of controlled and/or sedating medications was cited in 1% of cases. Compared to referring non-specialists, OEM physicians were more likely to attribute case complexity to musculoskeletal (OR: 2.3, 1.68-3.14) or neurological (OR: 1.69, 1.28-2.24) conditions. Medication usage (OR: 2.2, 1.49-2.26) was more likely to be a source of clinical concern among referring providers. The findings highlight the range of triggers for OEM physician subspecialty referral in clinical practice with employee patients. The results of this study can be used to inform development of provider education, standardized clinical practice pathways, and quality review activities for occupational medicine practitioners. Published by Oxford University Press on behalf of The Society of Occupational Medicine 2017.
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Directory of Open Access Journals (Sweden)
Alan Raybould
2018-04-01
Full Text Available We describe two contrasting methods of comparative environmental risk assessment for genetically modified (GM crops. Both are science-based, in the sense that they use science to help make decisions, but they differ in the relationship between science and policy. Policy-led comparative risk assessment begins by defining what would be regarded as unacceptable changes when the use a particular GM crop replaces an accepted use of another crop. Hypotheses that these changes will not occur are tested using existing or new data, and corroboration or falsification of the hypotheses is used to inform decision-making. Science-led comparative risk assessment, on the other hand, tends to test null hypotheses of no difference between a GM crop and a comparator. The variables that are compared may have little or no relevance to any previously stated policy objective and hence decision-making tends to be ad hoc in response to possibly spurious statistical significance. We argue that policy-led comparative risk assessment is the far more effective method. With this in mind, we caution that phenotypic profiling of GM crops, particularly with omics methods, is potentially detrimental to risk assessment.
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Bracun Sova, Rajka
2015-01-01
Since Bourdieu, it has been argued that art appreciation requires "knowledge". The focus of this qualitative study was to examine art appreciation as a learned competence by exploring two different groups of museum visitors: art specialists and art non-specialists. The research was conducted at Moderna galerija in Ljubljana. Twenty-three…
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National conference on radiation safety of nuclear power plants and their environmental impacts
International Nuclear Information System (INIS)
Moravek, J.
1989-01-01
The first national conference on radiation safety of nuclear power plants and their environmental impacts was held in Tale (CS), 12 to 15 October, 1987 with the participation of 201 Czechoslovak specialists representing central authorities, research institutes, institutions of higher education, power plants in operation and under construction, water management and hygiene inspection and some production sectors, specialists from Hungary, Poland and the GDR. The participants heard 110 papers. The conference agenda comprised keynote papers presented in plenary session and five specialist sessions: 1. Radiation control of discharges and their surroundings. 2. Monitoring and evaluation of the radiation situation in nuclear power plants. 3. Equipment for monitoring the nuclear power plant and its environs. 4. Mathematical modelling and assessment of the nuclear power plant radiation environmental impact. 5. Evaluation of sources and of the transport of radioactive materials inside the power plant and the minimization of the nuclear power plant's environmental impact. (Z.M.)
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Design of an Oximeter Based on LED-LED Configuration and FPGA Technology
Stojanovic, Radovan; Karadaglic, Dejan
2013-01-01
A fully digital photoplethysmographic (PPG) sensor and actuator has been developed. The sensing circuit uses one Light Emitting Diode (LED) for emitting light into human tissue and one LED for detecting the reflectance light from human tissue. A Field Programmable Gate Array (FPGA) is used to control the LEDs and determine the PPG and Blood Oxygen Saturation (SpO2). The configurations with two LEDs and four LEDs are developed for measuring PPG signal and Blood Oxygen Saturation (SpO2). N-LEDs...
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Stress, satisfaction and burnout among Dutch medical specialists
Visser, Mechteld R. M.; Smets, Ellen M. A.; Oort, Frans J.; de Haes, Hanneke C. J. M.
2003-01-01
Background: Stress and stress-related illnesses are increasing among medical specialists. This threatens the quality of patient care. in this study we investigated (a) levels of job stress and job satisfaction among medical specialists, (b) factors contributing to stress and satisfaction and (c) the
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Understanding practice patterns of glaucoma sub-specialists in India
Directory of Open Access Journals (Sweden)
Nikhil S. Choudhari
2017-10-01
Full Text Available AIM: To obtain information on the prevailing practice patterns of glaucoma specialists in India. METHODS: Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India (GSI were surveyed. This survey, conducted in 2013, was based on an interactive audience response system. RESULTS: The information was obtained from 146 glaucoma specialists. Approximately half (n=83; 57% had ≥10y of experience in managing glaucoma and were in institutional practice (n=74, 51%. Goldmann applanation tonometry was preferred by 103 (72% specialists whilst n=25 (17.4% used non-contact tonometer. Indentation gonioscopy was favoured by two-thirds (n=90, 66% whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed (n=115, 86% and n=114; 83% respectively. Nearly three quarter specialists (n=96; 72% preferred optical coherence tomography for imaging. The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser (iridotomy, n=117; 93% and medical management (prostaglandin analogue, n=104; 78%, respectively. Approximately only a third of the specialists surveyed (n=37; 28% were performing both trabeculectomy and implantation of a glaucoma drainage device and about half (n=64; 47% were not operating on congenital glaucoma at all. CONCLUSION: This survey has found conformance with preferred practice patterns in several areas of diagnosis and management of glaucoma, but there was diversity in a few areas. The information is a significant step towards improvement of glaucoma care in India, including planning for future strategies.
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Exploring the situational motivation of medical specialists: a qualitative study.
van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Croiset, Gerda; Peerdeman, Saskia M
2018-02-26
The aim was to obtain insight into the factors in the work environment that motivate or demotivate a medical specialist during his/her working day. A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus. Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists' motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one's planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists' motivation. Regarding the design of the study, we found that situational motivation is indeed observable. The basic psychological needs autonomy, competence, and relatedness are important for specialists' motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research.
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Qvist, Ina; Hendriks, Jeroen M L; Møller, Dorthe S; Albertsen, Andi E; Mogensen, Helle M; Oddershede, Gitte D; Odgaard, Annette; Mortensen, Leif Spange; Johnsen, Søren Paaske; Frost, Lars
2016-01-01
A previous randomised trial showed that structured, nurse-led atrial fibrillation (AF) care is superior to conventional AF care, although further research is needed to determine the outcomes of such care in a real-world setting. We compared the outcomes of patients in real-world, nurse-led, structured hospital AF clinics with the outcomes of a randomised trial of the efficacy of a nurse-led AF clinic, with respect to a composite outcome of cardiovascular-related hospitalisation and death. All patients were referred to the AF nurse specialist by cardiologists. The AF nurse specialist provided patient education, risk-factor control and stimulated empowerment and compliance. During follow-up, treatment was adjusted according to clinical guidelines. Patient education was repeated, and compliance with medical treatment was controlled. The study size was powered as a non-inferiority study. Outcome measures were adjudicated by the same principles in both cohorts. A total of 596 patients from the real world and 356 patients from a clinical trial were included in this study. No significant difference between groups with respect to age, type of AF or CHA2DS2VASc score was found. The composite primary end point occurred with an incidence rate of 8.0 (95% CI 6.1 to 10.4) per 100 person-years in the real-world population and 8.3 (95% CI 6.3 to 10.9) per 100 person-years in the clinical trial, with a crude HR of 0.83 (95% CI 0.56 to 1.23). Structured, nurse-led, hospital-based AF care appears to be effective, and patient outcomes in an actual, hospital-based, structured AF care are as least as good as those in trial settings.
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Design and Manufacture of a Novel LED Table Lamp with Flower Decoration
Directory of Open Access Journals (Sweden)
Tzer-Ming Jeng
2014-08-01
Full Text Available This work involved the design and manufacture of a novel LED table lamp that provides for flower decoration. It is a combination of a normal LED table lamp and attachments holding flower arrangement frogs. In this application the frogs, as used for traditional flower arrangements, became heat sinks for the LED units. They are made of an aluminum alloy to give good heat transfer and dissipation. In any case since they are fixed to the unit they do not need to be very heavy. The design features of this novel flower-arrangement LED table lamp are: (1 the use of a light aluminum alloy flower decoration frog as a heat sink which gives both high heat dissipation and allows decorative flower arrangement; (2 the installation of LED lamps at three points of the same plate above a cylinder covered with a glass lampshade to achieve a beautiful effect; (3 to provide three different lighting modes for reading, use as a night light and for flower decoration. This novel LED table lamp meets all the energy-saving and environmental protection requirements. It has commercial potential in the market for LED lamps.
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Glaucoma Medication Preferences among Glaucoma Specialists in Mexico.
Lazcano-Gomez, Gabriel; Alvarez-Ascencio, Daniela; Haro-Zuno, Cindy; Turati-Acosta, Mauricio; Garcia-Huerta, Magdalena; Jimenez-Arroyo, Jesus; Castañeda-Diez, Rafael; Castillejos-Chevez, Armando; Gonzalez-Salinas, Roberto; Dominguez-Dueñas, Francisca; Jimenez-Roman, Jesus
2017-01-01
To determine the glaucoma specialists' preferences for the different brands of topical glaucoma medications available in Mexico. A web-based survey was sent to 150 board-certified glaucoma specialists in Mexico, with 14 questions related to brand preferences for all glaucoma medications available in Mexico. Participants were asked to select each glaucoma medication class by brand and to state the factors leading to their choice. Data from 111 (74%) glaucoma specialists were collected. Imot (timolol 0.5%; Sophia, Mexico) was the preferred brand for the beta-blockers (BB) class by 71% (n = 79) of the participants. Azopt (brinzolamide 1%; Alcon Lab, US) was the preferred carbonic anhydrase inhibitor (CAI) by 54% (n = 60) of the glaucoma specialists. Lumigan (bimatoprost 0.01% and 0.03%; Allergan Inc., U.S.) was the first choice for the prostaglandin analogues (PGAs) in 62% (n = 70) of the answers. The most frequently prescribed alpha-agonist (AA) was Agglad (brimonidine 0.2%; Sophia Lab, Mexico) in 44% (n = 49) of the answers. Medication accessibility (31%), cost (29%), and recommended dose (23%) were the three main factors influencing the glaucoma specialists' preferences. Medication cost and accessibility, as well as posology, remain the main factors influencing brand preferences among glaucoma doctors. In our professional opinion, the therapeutic effect must be the leading factor when prescribing topical medications in the daily practice, so that patients receive the best treatment option. This survey provides an understanding of the decision-making process when prescribing glaucoma medications by glaucoma specialists in a Latin American developing country. Ideally, patient treatment should be individualized and aimed to achieve the best results possible for their specific condition. How to cite this article: Lazcano-Gomez G, Alvarez-Ascencio D, Haro-Zuno C, Turati-Acosta M, Garcia-Huerta M, Jimenez-Arroyo J, Castañeda-Diez R, Castillejos-Chevez A, Gonzalez
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STS-95 Mission Specialist Duque suits up during TCDT
1998-01-01
STS-95 Mission Specialist Pedro Duque of Spain, representing the European Space Agency, suits up in the Operations and Checkout Building prior to his trip to Launch Pad 39-B. Duque and the rest of the STS-95 crew are at KSC to participate in the Terminal Countdown Demonstration Test (TCDT) which includes mission familiarization activities, emergency egress training, and a simulated main engine cutoff. The other crew members are Payload Specialist Chiaki Mukai (M.D., Ph.D.), representing the National Space Development Agency of Japan (NASDA), Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, and Mission Commander Curtis L. Brown. The STS-95 mission, targeted for liftoff on Oct. 29, includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Following the TCDT, the crew will be returning to Houston for final flight preparations.
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Performance objectives and criteria for conducting DOE environmental audits
Energy Technology Data Exchange (ETDEWEB)
NONE
1994-01-01
This document contains the Performance Objectives and Criteria (POC) that have been developed for environmental audits and assessments conducted by the Office of the Assistant Secretary for Environment, Safety and Health. The Environmental POC can serve multiple purposes. Primarily, they are to serve as guidelines for the technical specialists conducted the audits and assessments, and for the team management. The POC can also serve as supporting documents for training of technical discipline specialists and Team Leaders and as bases for DOE programs and field offices and contractors conducting audit or assessment activities or improving environmental protection programs. It must be recognized that not all of the POC will necessarily apply to all DOE facilities. The users of this document must rely upon their knowledge of the facility and their professional judgment, or the judgment of qualified environmental professionals to determine the applicability of each POC. The POC cover eleven technical disciplines: air; surface water and drinking water quality; groundwater; waste management; toxic and chemical materials; radiation; quality assurance; inactive waste sites and releases; ecological and cultural resources; the National Environmental Policy Act (NEPA); and environmental management systems.
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Performance objectives and criteria for conducting DOE environmental audits
International Nuclear Information System (INIS)
1994-01-01
This document contains the Performance Objectives and Criteria (POC) that have been developed for environmental audits and assessments conducted by the Office of the Assistant Secretary for Environment, Safety and Health. The Environmental POC can serve multiple purposes. Primarily, they are to serve as guidelines for the technical specialists conducted the audits and assessments, and for the team management. The POC can also serve as supporting documents for training of technical discipline specialists and Team Leaders and as bases for DOE programs and field offices and contractors conducting audit or assessment activities or improving environmental protection programs. It must be recognized that not all of the POC will necessarily apply to all DOE facilities. The users of this document must rely upon their knowledge of the facility and their professional judgment, or the judgment of qualified environmental professionals to determine the applicability of each POC. The POC cover eleven technical disciplines: air; surface water and drinking water quality; groundwater; waste management; toxic and chemical materials; radiation; quality assurance; inactive waste sites and releases; ecological and cultural resources; the National Environmental Policy Act (NEPA); and environmental management systems
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Bridging the care continuum: patient information needs for specialist referrals
Directory of Open Access Journals (Sweden)
Steltenkamp Carol L
2009-09-01
Full Text Available Abstract Background Information transfer is critical in the primary care to specialist referral process and has been examined extensively in the US and other countries, yet there has been little attention to the patient's perspective of the information transfer process. This cross-sectional study examined the quality of the information received by patients with a chronic condition from the referring and specialist physician in the specialist referral process and the relationship of the quality of information received to trust in the physicians. Methods Structured telephone interviews were conducted with a random sample of 250 patients who had experienced a referral to a specialist for the first visit for a chronic condition within the prior six months. The sample was selected from the patients who visited specialist physicians at any of the 500 hospitals from the National Research Corporation client base. Results Most patients (85% received a good explanation about the reason for the specialist visit from the referring physician yet 26% felt unprepared about what to expect. Trust in the referring physician was highly associated with the preparatory information patients received. Specialists gave good explanations about diagnosis and treatment, but 26% of patients got no information about follow-up. Trust in the specialist correlated highly with good explanations of diagnosis, treatment, and self-management. Conclusion Preparatory information from referring physicians influences the quality of the referral process, the subsequent coordination of care, and trust in the physician. Changes in the health care system can improve the information transfer process and improve coordination of care for patients.
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Specialist participation in healthcare delivery transformation: influence of patient self-referral.
Aliu, Oluseyi; Sun, Gordon; Burke, James; Chung, Kevin C; Davis, Matthew M
2014-01-01
Improving coordination of care and containing healthcare costs are prominent goals of healthcare reform. Specialist involvement in healthcare delivery transformation efforts like Accountable Care Organizations (ACOs) is necessary to achieve these goals. However, patients’ self-referrals to specialists may undermine care coordination and incur unnecessary costs if patients frequently receive care from specialists not engaged in such healthcare delivery transformation efforts. Additionally, frequent self-referrals may also diminish the incentive for specialist participation in reform endeavors like ACOs to get access to a referral base. To examine recent national trends in self-referred new visits to specialists. A descriptive cross-sectional study of new ambulatory visits to specialists from 2000 to 2009 using data from the National Ambulatory Medical Care Survey. We calculated nationally representative estimates of the proportion of new specialist visits through self-referrals among Medicare and private insurance beneficiaries. We also estimated the nationally representative absolute number of self-referred new specialist visits among both groups of beneficiaries. Among Medicare and private insurance beneficiaries, self-referred visits declined from 32.2% (95% confidence interval [CI], 24.0%-40.4%) to 19.6% (95% CI, 13.9%-23.3%) and from 32.4% (95% CI, 27.9%-36.8%) to 24.1% (95% CI,18.8%-29.4%), respectively. Hence, at least 1 in 5 and 1 in 4 new visits to specialists among Medicare and private insurance beneficiaries, respectively, are self-referred. The current considerable rate of self-referred new specialist visits among both Medicare and private insurance beneficiaries may have adverse implications for organizations attempting to transform healthcare delivery with improved care coordination.
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Methodological bases of innovative training of specialists in nanotechnology field
Directory of Open Access Journals (Sweden)
FIGOVSKY Oleg Lvovich
2016-10-01
Full Text Available The performance of innovative training system aimed at highly intellectual specialists in the area of nanotechnologies for Kazakhstan’s economy demands establishment and development of nanotechnological market in the country, teaching of innovative engineering combined with consistent research, integration of trained specialists with latest technologies and sciences at the international level. Methodological aspects of training competitive specialists for nanotechnological field are specific. The paper presents methodological principles of innovative training of specialists for science-intensive industry that were realized according to grant given by the Ministry of Education and Science of the Republic of Kazakhstan.
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Reliable LED Lighting Technologies: Key Factors and Procurement Guidance
Energy Technology Data Exchange (ETDEWEB)
Davis, Lynn; Arquit Niederberger, Anne
2015-10-08
Abstract— Lighting systems have the ability to transform the economic and educational infrastructure of disadvantaged communities, and eradicating “light poverty” has become one of the primary goals of the International Year of Light 2015. Solid-state lighting (SSL) technology, based on light-emitting diode (LED) light sources, has emerged as the next generation of lighting technology, with a current global market penetration of roughly 5%. This paper will report on recent research on understanding SSL lighting system reliability (failure modes, environmental stressors, electrical power quality); discuss the implications of SSL technology reliability for providing lighting services; and suggest practical approaches to ensure SSL reliability to benefit humanity. Among the key findings from this work is that LED sources can be extremely reliable, withstanding a broad range of environmental stresses without failure. Nonetheless, SSL lighting systems can have a negative impact on electrical power reliability, as well as on the affordability of lighting services, without attention to the quality of the accompanying power infrastructure. It is therefore critical to ensure that the performance of the power supply electronics used in lighting systems is matched to the quality of the power source, when evaluating energy efficient lighting choices.
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National Target for South Asia Specialists. A Report.
National Council on Foreign Language and International Studies, New York, NY.
The South Asia Panel of the National Council on Foreign Languages and International Studies reports on the need for specialists in the languages and cultures of Afghanistan, Bangladesh, India, Nepal, Pakistan, Sri Lanka, Bhutan, and the Maldives. Two categories of specialists are discussed: (1) individuals in government, mission, etc., in…
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Directory of Open Access Journals (Sweden)
Yeo Chay Leng
2012-11-01
Full Text Available Abstract Our prospective-audit-and-feedback antimicrobial stewardship (AS program for hematology and oncology inpatients was switched from one led by dedicated clinicians to a rotating team of infectious diseases trainees in order to provide learning opportunities and attempt a “de-escalation” of specialist input towards a more protocol-driven implementation. However, process indicators including the number of recommendations and recommendation acceptance rates fell significantly during the year, with accompanying increases in broad-spectrum antibiotic prescription. The trends were reversed only upon reverting to the original setup. Dedicated clinicians play a crucial role in AS programs involving immunocompromised patients. Structured training and adequate succession/contingency planning is critical for sustainability.
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Optometry Specialist (AFSC 91255).
Kille, Michael O.
This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for optometry specialists. Covered in the individual volumes are optometry clinic administration (optometry career and field training, ethical relationships and professionalism, eligibility for optometric care and appointment…
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International Nuclear Information System (INIS)
Milyutin, A.A.
2002-05-01
The present publication represents the collection of materials of a scientific conference of the leading specialists, young scientists and students, which was organized by Ministry for Education of the Republic of Belarus on the basis of International A. Sakharov Environmental University (Minsk, Republic of Belarus). The ecological problems were viewed on the following directions: ecology, radioecology, ecological monitoring, ecological information systems, eco priority power engineering, eco biology, medical ecology, molecular medicine, social ecology
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A qualitative evaluation of the Scottish Staff and Associate Specialist Development Programme.
Cleland, Jennifer; Burr, Jacqueline; Johnston, Peter
2016-05-01
The continued professional development of staff and associate specialist doctors in the UK was ill served prior to the introduction of the new staff and associate specialist doctor's contract in 2008. The aim of this study was to independently evaluate NHS Education for Scotland's approach to improving professional development for staff and associate specialist doctors, the staff and associate specialist Professional Development Fund. Semi-structured telephone interviews with key stakeholders, framed by a realistic approach to evaluate what works, for whom and in how and under what circumstances. An inductive and data-driven thematic analysis was carried out and then the realist framework was applied to the data. We interviewed 22 key stakeholders: staff and associate specialist doctors, staff and associate specialist educational advisors, programme architects and clinical directors, between end February and May 2014. The resultant data indicated five broad themes: organisational barriers to continued professional development for staff and associate specialist doctors, the purpose of funding, gains from funding, the need for better communication about the staff and associate specialist Programme Development Fund, and the interplay between individual and systems factors. The staff and associate specialist Programme Development Fund has changed the opportunities available to staff and associate specialist doctors in Scotland and, in that sense, has changed the context for this group - or at least those who have realised the opportunities. © The Author(s) 2016.
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Analyzing Thermal Module Developments and Trends in High-Power LED
Directory of Open Access Journals (Sweden)
Jung-Chang Wang
2014-01-01
Full Text Available The solid-state light emitting diode (SSLED has been verified as consumer-electronic products and attracts attention to indoor and outdoor lighting lamp, which has a great benefit in saving energy and environmental protection. However, LED junction temperature will influence the luminous efficiency, spectral color, life cycle, and stability. This study utilizes thermal performance experiments with the illumination-analysis method and window program (vapour chamber thermal module, VCTM V1.0 to investigate and analyze the high-power LED (Hi-LED lighting thermal module, in order to achieve the best solution of the fin parameters under the natural convection. The computing core of the VCTM program employs the theoretical thermal resistance analytical approach with iterative convergence stated in this study to obtain a numerical solution. Results showed that the best geometry of thermal module is 4.4 mm fin thickness, 9.4 mm fin pitch, and 37 mm fin height with the LED junction temperature of 58.8°C. And the experimental thermal resistances are in good agreement with the theoretical thermal resistances; calculating error between measured data and simulation results is no more than ±7%. Thus, the Hi-LED illumination lamp has high life cycle and reliability.
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Impacts of UVB radiation on food consumption of forest specialist tadpoles.
Londero, James Eduardo Lago; Dos Santos, Caroline Peripolli; Segatto, Ana Lúcia Anversa; Passaglia Schuch, André
2017-09-01
Solar ultraviolet radiation B (UVB) is an important environmental stressor for amphibian populations due to its genotoxicity, especially in early developmental stages. Nonetheless, there is an absence of works focused on the UVB effects on tadpoles' food consumption efficiency. In this work, we investigated the effects of the exposure to a low environmental-simulated dose of UVB radiation on food consumption of tadpoles of the forest specialist Hypsiboas curupi [Hylidae, Anura] species. After UVB treatment tadpoles were divided and exposed to a visible light source or kept in the dark, in order to indirectly evaluate the efficiency of DNA repair performed by photolyases and nucleotide excision repair (NER), respectively. The body mass and the amount of food in tadpoles' guts were verified in both conditions and these data were complemented by the micronuclei frequency in blood cells. Furthermore, the keratinized labial tooth rows were analyzed in order to check for possible UVB-induced damage in this structure. Our results clearly show that the body weight decrease induced by UVB radiation occurs due to the reduction of tadpoles' food consumption. This behavior is directly correlated with the genotoxic impact of UVB light, since the micronuclei frequency significantly increased after treatments. Surprisingly, the results indicate that photoreactivation treatment was ineffective to restore the food consumption activity and body weight values, suggesting a low efficiency of photolyases enzymes in this species. In addition, UVB treatments induced a higher number of breaks in the keratinized labial tooth rows, which could be also associated with the decrease of food consumption. This work contributes to better understand the process of weight loss observed in tadpoles exposed to UVB radiation and emphasizes the susceptibility of forest specialist amphibian species to sunlight-induced genotoxicity. Copyright © 2017 Elsevier Inc. All rights reserved.
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UK HSE Training of HM Radiation Specialist Inspectors
International Nuclear Information System (INIS)
Nattres, E.; Barrett, J. A.
2004-01-01
HSE's mission is to ensure that risks to people's health and safety from work activities are properly controlled. Radiation Specialist Inspectors make an essential contribution to HSE's objectives through the application of their professional skills and knowledge. The role of the Radiation Specialist Inspector includes inspection work in the field to ensure compliance by employers with the Health and Safety at Work etc Act 1974, Ionising Radiations Regulations 1999 and associated legislation. They also contribute to research, and the development of technical policy, legislation, standards, and guidance on protection against the possible harm from exposure to electromagnetic fields, optical or ionizing radiation. This paper explains how Radiation Specialist Inspectors are trained. It starts with the recruitment process, with an emphasis on recruiting people who have already gained relevant experience from radiation work practices in previous employments. The interview process is explored, which includes both technical and behavioural interviews, making a presentation and completing a personality questionnaire. The initial twelve months training is then discussed in detail, including the six months as a general Health and Safety Inspector where inspector' skills and techniques' are developed by practical involvement in inspection, followed by a challenging six months with a Radiation Specialist group. The programme for this period is designed to broaden and develop skills and knowledge within the radiation protection specialist. After the initial twelve months probationary period, new Inspectors are expected to confirm and establish themselves in their role of Radiation Specialist Inspectors. However, it does not end there, continuing professional development to ensure that Inspectors have cutting edge knowledge of the latest advances within the radiation field and health and safety as a whole is essential and will be discussed in more detail. (Author) 6 refs
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Management Matters: The Library Media Specialist's Management Toolbox
Pappas, Marjorie L.
2004-01-01
Library media specialists need tools to help them manage the school library media program. The Internet includes a vast array of tools that a library media specialist might find useful. The websites and electronic resources included in this article are only a representative sample and future columns may explore additional tools. All the tools are…
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Design of an Oximeter Based on LED-LED Configuration and FPGA Technology
Directory of Open Access Journals (Sweden)
Radovan Stojanovic
2013-01-01
Full Text Available A fully digital photoplethysmographic (PPG sensor and actuator has been developed. The sensing circuit uses one Light Emitting Diode (LED for emitting light into human tissue and one LED for detecting the reflectance light from human tissue. A Field Programmable Gate Array (FPGA is used to control the LEDs and determine the PPG and Blood Oxygen Saturation (SpO2. The configurations with two LEDs and four LEDs are developed for measuring PPG signal and Blood Oxygen Saturation (SpO2. N-LEDs configuration is proposed for multichannel SpO2 measurements. The approach resulted in better spectral sensitivity, increased and adjustable resolution, reduced noise, small size, low cost and low power consumption.
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Design of an oximeter based on LED-LED configuration and FPGA technology.
Stojanovic, Radovan; Karadaglic, Dejan
2013-01-04
A fully digital photoplethysmographic (PPG) sensor and actuator has been developed. The sensing circuit uses one Light Emitting Diode (LED) for emitting light into human tissue and one LED for detecting the reflectance light from human tissue. A Field Programmable Gate Array (FPGA) is used to control the LEDs and determine the PPG and Blood Oxygen Saturation (S(p)O(2)). The configurations with two LEDs and four LEDs are developed for measuring PPG signal and Blood Oxygen Saturation (S(p)O(2)). N-LEDs configuration is proposed for multichannel S(p)O(2) measurements. The approach resulted in better spectral sensitivity, increased and adjustable resolution, reduced noise, small size, low cost and low power consumption.
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The clinical nurse specialist: leadership in quality improvement.
Finkelman, Anita
2013-01-01
Healthcare delivery is in a crisis, requiring improvement. How to improve and who should assume more leadership are not clear. At the same time, the nursing profession struggles with a weak education system, graduating students who require major support for an extended time. There is also confusion related to nursing roles, particularly with nurses who have a graduate degree. The Institute of Medicine has published a series of reports about the healthcare system and need for improvement and describes a structure for improvement. The clinical nurse specialist is particularly suited to assume a major role in nursing leadership to guide staff and the healthcare system to better ensure improved care. There is great need to communicate that the clinical nurse specialist can and should assume this role. This will require a review and development of more quality improvement content and experiences in clinical nurse specialist educational programs, but much of the content is already in programs. The clinical nurse specialist works in systems, impacts systems, works with staff, and can thus reach more patients with improvement approaches.
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TRAINING SYSTEM OF FUTURE SPECIALISTS: QUALITY CONTROL
Directory of Open Access Journals (Sweden)
Vladimir A. Romanov
2015-01-01
Full Text Available The aim of the investigation is development of innovative strategy of quality control training of engineers and skilled workers (hereinafter – future specialists in educational professional organizations on the principles of social partnership.Methods. Theoretic: theoretic and methodological analysis, polytheoretic synthesis, modeling. Empirical: research and generalization of the system, process and competence – based approaches experience, experiment, observation, surveys, expert evaluation, SWOT-analysis as a method of strategic planning which is to identify the internal and external factors (socio-cultural of the organization surrounding.Results. The strategy of the development of the process of quality control training in educational professional organizations and a predictive model of the system of quality control training for future engineers and workers have been created on the analysis and synthesis of a quantitative specification of the quality, the obtained experience and success in control training of future specialists in educational professional organizations in recent economic and educational conditions.Scientific novelty. There has been built a predicative model of quality control training of future specialists to meet modern standards and the principles of social partnership; the control algorithm of the learning process, developed in accordance with the standards (international of quality ISO in the implementation of the quality control systems of the process approach (matrix-based responsibility, competence and remit of those responsible for the education process in the educational organization, the «problem» terms and diagnostic tools for assessing the quality of professional training of future specialists. The perspective directions of innovation in the control of the quality of future professionals training have been determined; the parameters of a comprehensive analysis of the state of the system to ensure the
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Outstanding environmental issues. A review of the EU's environmental agenda
Netherlands Environmental Assessment Agency =; Netherlands Environmental; European Environmental Agency EEA
2004-01-01
EU environmental policy has led to economic investments that have clearly benefited the health of people and ecosystems. But there are still important unresolved environmental issues in Europe, in particular climate change, loss of biodiversity and air pollution in urban areas. Appropriate
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Fuselage mounted anti-collision lights utilizing high power LEDs
Lundberg, John; Machi, Nicolo; Mangum, Scott; Singer, Jeffrey
2005-09-01
As LEDs continue to improve in efficacy and total light output, they are increasingly finding their way in to new applications in the aviation industry as well as adjacent markets. One function that is particularly challenging and may reap substantial benefits from this new technology is the fuselage mounted anti-collision light. Anti-collision lights provide conspicuity for the aircraft by periodically emitting bright flashes of light. The color, light distribution and intensity levels for these lights are all closely regulated through Federal Aviation Regulation (FAR) documents. These lighting requirements, along with thermal, environmental and aerodynamic requirements, drive the overall design. In this paper, we will discuss the existing technologies used in anti-collision lights and the advantages and challenges associated with an LED solution. Particular attention will be given to the optical, thermal, electrical and aerodynamic aspects associated with an LED approach. A specific case study will be presented along with some of the challenges that have arisen during the design process. These challenges include the addition of an integrated covert anti-collision lighting.
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Application of high-brightness LEDs in aircraft position lights
Machi, Nicolo; Mangum, Scott; Singer, Jeffrey M.
2004-10-01
Solid state lighting devices have made their way into a number of niche markets and continue to make inroads into other markets as their price / performance ratios improve. One of these markets is aviation lighting. Although this paper will focus on the use of LEDs for aircraft position lights, much of the discussion is applicable to other installations on the interior and exterior of the aircraft. The color, light distribution and intensity levels for a position light are all closely regulated through Code of Federal Regulation (CFR; formerly Federal Aviation Regulation (FAR)) documents. These lighting requirements, along with harsh thermal and environmental requirements, drive the design. In this paper, we will look at these requirements and discuss what is required in order to use LEDs for this type of application. We will explore the optical, thermal and electrical issues associated with the use of LEDs for position lights and examine the specific case study of the Astreon forward position lights. Finally, we will discuss some of the challenges that we see with solid state lighting in current and future aircraft applications.
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Find an Endocrinology - Thyroid Specialist
... History Resource Center Patients Thyroid Information Find an Endocrinology – Thyroid Specialist Patient Support Links Clinical Thyroidology for ... Access Thyroid Online Access Clinical Thyroidology Online Video Endocrinology Donate Give Online Research Accomplishments Ridgway Legacy Fund ...
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WATERSHED SELECTION FOR ENVIRONMENTAL REHABILITATION USING MULTICRITERIA ANALYSIS
Directory of Open Access Journals (Sweden)
Carlos Eduardo da Silva Francisco
2009-10-01
Full Text Available The Anhumas creek watershed, in the region of Campinas, São Paulo State, Brazil, is degraded also as a result of unplanned land use of its riparian zones, considered Permanent Preservation Areas (APP. Therefore, river flow is unstable, promoting frequent flood damages, besides the lack of several environmental functions of its APPs. Environmental recovery of a degraded area requires a comprehensive effort, often multidisciplinary. Multicriterial analysis is a tool which allows gathering a diversity of attributes of the studied subject, weighing and valuating them, helping in the decision making effort. This work aims to apply two methods of multicriteria analysis to optimize the selection of a watershed for an environmental recovery study of APPs in the Anhumas watershed. The Anhumas watershed was divided in 7 sub-basins aiming the selection of one of those to implement an environmental planning study and to establish and rank areas that should be prioritized for recovery. Thirteen environmental criteria were selected for application of multicriteria analysis using the methods of Compromise Programming (PC and Cooperative Game Theory (CGT. Relevance of each criterion to the analysis was given by a questionnaire answered by specialists. Basin selection results showed no difference neither between PC and CGT nor between mean or mode used to standardize weights given by specialists. Multicriteria analysis was effective, but allowed enough flexibility for the decision maker (DM to adjust undesired analysis distortions. After DM adjustments, the priority basins were ranked as basins 4 > 7 > 5 > 6 > 2 > 3 > 1. Important procedures when carrying out such an analysis were to avoid conceptual overlapping among different criteria, to implement appropriate value judgment for each criterion and to use decision maker expertise to supplement weights obtained with specialists.
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Doing HOF work in NPP - an internal specialist point of view
International Nuclear Information System (INIS)
Koistinen, Petri
2011-01-01
Organisational learning has been identified as one success factor both in general business literature and also in nuclear industry. One part of organisational learning is routines that support organisational learning. In nuclear industry learning from events is an important process of organisational learning. The other building blocks of learning organisation are climate that supports learning and leadership that encourages learning. These have also been identified in nuclear industry as being important issues. Learning from events relies on the validity of the investigation process. Investigation process and report has simply three parts: what happened (facts), why it happened (analysis) and how to prevent reoccurrence (corrective actions, CA). In RCA analysis part is highlighted, however it cannot be done correctly unless the facts have not been collected well. In a good learning process there must also be a follow up and feedback system for CA's. The following are the key points from this presentation: - Koistinen has been an internal HOF specialist since 2004; still the only HOF specialist at TVO. - Main duties are event investigations (including RCA), operating experience, safety culture improvement, human performance and organisational development issues. - Human error is typically the end point of an investigation - Koistinen's job is to find out what has led a good professional to make an error (organisational factors). - A blame-free or just culture is required to identify the organisational issues in an event. - RCA is used for the most serious events - about 5 RCA like investigations are conducted at the two TVO units per year. - Finland does not have RCA training available and so staff must go elsewhere. Those working in event investigations are usually new in the nuclear business and therefore lack experience. - The author presents a number of guidelines from STUK, the Finnish regulatory body. There are requirements for competence of investigators
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Thermal management for LED applications
Poppe, András
2014-01-01
Thermal Management for LED Applications provides state-of-the-art information on recent developments in thermal management as it relates to LEDs and LED-based systems and their applications. Coverage begins with an overview of the basics of thermal management including thermal design for LEDs, thermal characterization and testing of LEDs, and issues related to failure mechanisms and reliability and performance in harsh environments. Advances and recent developments in thermal management round out the book with discussions on advances in TIMs (thermal interface materials) for LED applications, advances in forced convection cooling of LEDs, and advances in heat sinks for LED assemblies. This book also: Presents a comprehensive overview of the basics of thermal management as it relates to LEDs and LED-based systems Discusses both design and thermal management considerations when manufacturing LEDs and LED-based systems Covers reliability and performance of LEDs in harsh environments Has a hands-on applications a...
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Expected roles and utilization of specialist nurses in Japan: the nurse administrators' perspective.
Onishi, Mami; Kanda, Katsuya
2010-04-01
This study explored (1) expected roles for specialist nurses in Japan and (2) nurse administrators' experience-based management strategies for effective implementation of these roles. Background In Japan, specialist nurses have begun to be recognized as valuable human resources. However, managerial issues in utilizing specialist nurses, including unclear roles and lack of reports on effective management strategies, remain. Three focus-group discussions were conducted. Nine nurse administrators participated. Data were analysed using qualitative content analysis techniques. The expected roles for specialist nurses were: (1) facilitating general nurses' learning; (2) monitoring and improving the patient care standard; and (3) developing new roles for nursing. Two management strategies were: (1) enhancing specialist nurses' influence, and (2) enhancing specialist nurses' motivation. Specialist nurses are important human resources able to assume responsibility for process improvement in nursing care. Effective ways to enhance specialist nurses' influence and motivation include developing their management and communication skills, and coordinating their workload and relationships with other health care professionals. Process improvement indicators may be useful for evaluating specialist nurses' work. Nurse administrators can contribute to effective implementation of specialist nurses' roles not only by clarifying their roles but also by empowering them to keep up with changing organizational needs.
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75 FR 1010 - Environmental Impact Statement: Sherburne and Stearns Counties, MN
2010-01-07
... Tier I Environmental Impact Statement (EIS) process for a proposed east/west minor arterial connection..., Environmental and Civil Rights Specialist, Federal Highway Administration, Galtier Plaza, Suite 500, 380 Jackson... process begun in 2002 to address the need for improved east/west minor arterial continuity, land use and...
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CooLED - efficient LED bulbs with custrom optics - final report
DEFF Research Database (Denmark)
Wolff, Jesper; Corell, Dennis Dan; Dam-Hansen, Carsten
Denne rapport indeholder en beskrivelse af arbejdet udført i og resultaterne af forsknings- og udviklingsprojektet EUDP 64012-0226, CooLED – en ny generation LED Lyskilde for det tidsløse high-end marked....
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Professional training of future specialists with the use of information technologies
Directory of Open Access Journals (Sweden)
Виктор Семенович Корнилов
2013-12-01
Full Text Available This paper deals with implementation of information technologies within different levels of professional training of the future specialists at A. Yassawi International Kazakh-Turkish University. Information technologies enable the future specialists to engage in online exchanges and it gives great good opportunity in learning the subject efficiently; thereby expanding their study and learning community during the classroom activity. The results obtained by the use of the information technologies show improvements in professional training of the future specialists in teaching foreign language. The use of information technology in teaching is increasing, which should lead to a significant improvement of the training quality of future specialists. Improvements also are observed in the experimental groups of higher levels, which indicates the efficiency of the use of information technologies in the professional training of future specialists.
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Ahmed Hersi, Afra; Horan, Deborah A.; Lewis, Mark A.
2016-01-01
This article explores the development of a professional learning community through a case study of three teachers--an ESOL specialist, a literacy specialist, and a fifth-grade teacher--who engaged in co-teaching and collaboration. The emerging community of practice offered these teachers a space to learn and problem-solve by utilizing their…
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The School Librarian as Information Specialist: A Vibrant Species
Harris, Frances Jacobson
2011-01-01
In this article, the author talks about the school librarian as information specialist. She stresses that the school librarian's information specialist role is more important than ever. She offers her personal toolkit that consists of four strategies in helping and teaching students to use content responsibly.
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Broadband radiometric LED measurements
Eppeldauer, G. P.; Cooksey, C. C.; Yoon, H. W.; Hanssen, L. M.; Podobedov, V. B.; Vest, R. E.; Arp, U.; Miller, C. C.
2016-09-01
At present, broadband radiometric LED measurements with uniform and low-uncertainty results are not available. Currently, either complicated and expensive spectral radiometric measurements or broadband photometric LED measurements are used. The broadband photometric measurements are based on the CIE standardized V(λ) function, which cannot be used in the UV range and leads to large errors when blue or red LEDs are measured in its wings, where the realization is always poor. Reference irradiance meters with spectrally constant response and high-intensity LED irradiance sources were developed here to implement the previously suggested broadband radiometric LED measurement procedure [1, 2]. Using a detector with spectrally constant response, the broadband radiometric quantities of any LEDs or LED groups can be simply measured with low uncertainty without using any source standard. The spectral flatness of filtered-Si detectors and low-noise pyroelectric radiometers are compared. Examples are given for integrated irradiance measurement of UV and blue LED sources using the here introduced reference (standard) pyroelectric irradiance meters. For validation, the broadband measured integrated irradiance of several LED-365 sources were compared with the spectrally determined integrated irradiance derived from an FEL spectral irradiance lamp-standard. Integrated responsivity transfer from the reference irradiance meter to transfer standard and field UV irradiance meters is discussed.
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Are nurse-led chemotherapy clinics really nurse-led? An ethnographic study.
Farrell, Carole; Walshe, Catherine; Molassiotis, Alex
2017-04-01
The number of patients requiring ambulatory chemotherapy is increasing year on year, creating problems with capacity in outpatient clinics and chemotherapy units. Although nurse-led chemotherapy clinics have been set up to address this, there is a lack of evaluation of their effectiveness. Despite a rapid expansion in the development of nursing roles and responsibilities in oncology, there is little understanding of the operational aspects of nurses' roles in nurse-led clinics. To explore nurses' roles within nurse-led chemotherapy clinics. A focused ethnographic study of nurses' roles in nurse-led chemotherapy clinics, including semi-structured interviews with nurses. Four chemotherapy units/cancer centres in the UK PARTICIPANTS: Purposive sampling was used to select four cancer centres/units in different geographical areas within the UK operating nurse-led chemotherapy clinics. Participants were 13 nurses working within nurse-led chemotherapy clinics at the chosen locations. Non-participant observation of nurse-led chemotherapy clinics, semi-structured interviews with nurse participants, review of clinic protocols and associated documentation. 61 nurse-patient consultations were observed with 13 nurses; of these 13, interviews were conducted with 11 nurses. Despite similarities in clinical skills training and prescribing, there were great disparities between clinics run by chemotherapy nurses and those run by advanced nurse practitioners. This included the number of patients seen within each clinic, operational aspects, nurses' autonomy, scope of practice and clinical decision-making abilities. The differences highlighted four different levels of nurse-led chemotherapy clinics, based on nurses' autonomy and scope of clinical practice. However, this was heavily influenced by medical consultants. Several nurses perceived they were undertaking holistic assessments, however they were using medical models/consultation styles, indicating medicalization of nurses' roles
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Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin
2016-01-01
Objective This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Design Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Setting Champlain health region in Eastern Ontario, Canada. Population Primary care providers and specialists registered to use the eConsult service. Main outcome measures Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. Results A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Conclusions Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. PMID:27338880
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Heurkens, E.W.T.M.
2016-01-01
Across the globe sustainable private sector-led urban development projects (SPUDPs) in the built environment rarely commence as real estate developers face several institutional barriers which limit their capacity to develop economic-viable, social-responsible, environmental-friendly urban places.
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Nuclear criticality safety specialist training and qualification programs
International Nuclear Information System (INIS)
Hopper, C.M.
1993-01-01
Since the beginning of the Nuclear Criticality Safety Division of the American Nuclear Society (ANS) in 1967, the nuclear criticality safety (NCS) community has sought to provide an exchange of information at a national level to facilitate the education and development of NCS specialists. In addition, individual criticality safety organizations within government contractor and licensed commercial nonreactor facilities have developed training and qualification programs for their NCS specialists. However, there has been substantial variability in the content and quality of these program requirements and personnel qualifications, at least as measured within the government contractor community. The purpose of this paper is to provide a brief, general history of staff training and to describe the current direction and focus of US DOE guidance for the content of training and qualification programs designed to develop NCS specialists
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Becoming a Specialist Nurse in Psychiatric Mental Health Care
Södergren, Ulrika; Benjaminson, Carin; Mattsson, Janet
2017-01-01
Background: Specialist nurse students are upon graduation certified to have increased their professional competence to an advanced level. But how do specialist nurse students themselves experience and understand their professional competence and its development upon graduation? This is what this study aims at describing. Method: This study has a…
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Doctors applying for Danish postgraduate medical specialist training are getting younger
DEFF Research Database (Denmark)
Kjaer, N. K.; Clausen, L. W.; Qvesel, D.
2012-01-01
was 58 months. 6% of the recruited doctors had a PhD. 61% of the doctors were graduates from the University of Southern Denmark. 14% graduated from the University of Copenhagen and 12% from Aarhus University. Finally, 13% graduated from a foreign university. CONCLUSION: Applicants accepted for specialist......INTRODUCTION: It was previously shown that applicants for postgraduate medical specialist training in Denmark were old. In order to prevent potential shortage of specialists, the Danish health authorities have passed legislation to speed up the output of new specialists. The aim of this study...... was to highlight the present characteristics of young doctors who entered specialist training. MATERIAL AND METHODS: Data include 443 doctors who were enrolled in a formalized postgraduate medical training programme in the Region of Southern Denmark from 2009 to 2011. RESULTS: 41% of the recruited young doctors...
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The changing role of the subject specialist
Directory of Open Access Journals (Sweden)
Michael Cotta-Schønberg
2007-11-01
Full Text Available As we all know, libraries are these years rapidly undergoing change on unparalleled scale. Evidently, this applies to librarians, too, and not the least to that important category of library staff, the subject specialist. As recruiting and education of library workers differ from country to country it is difficult to give a detailed, generally valid description of the subject librarian in libraries, but I believe that you can describe an ideal model of subject librarianship as follows: Within each of the major subject disciplines covered by the library, the library should have a subject specialist preferably with a master degree or at least a bachelor degree in the particular subject discipline. The role of the subject specialist is to perform four basic functions where extensive subject knowledge is considered to be necessary: selecting and classifying books, assisting users with advanced subject inquiries, giving subject-specific courses in information retrieval, and maintaining liaison with relevant academic departments and centres. Personally, I know this system very well since I got employment in the Royal Library in Copenhagen as a subject specialist in psychology in the very month I finished my degree in psychology from the University of Copenhagen, back in 1973. The subject librarian system at the Royal Library in Copenhagen was patterned on the ideal model, as I just described it, and it was closely paralleled in the other academic libraries in Denmark, also the new university libraries which were founded in the seventies.
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Polish Code of Ethics of a Medical Laboratory Specialist.
Elżbieta, Puacz; Waldemar, Glusiec; Barbara, Madej-Czerwonka
2014-09-01
Along with the development of medicine, increasingly significant role has been played by the laboratory diagnostics. For over ten years the profession of the medical laboratory specialist has been regarded in Poland as the autonomous medical profession and has enjoyed a status of one of public trust. The process of education of medical laboratory specialists consists of a five-year degree in laboratory medicine, offered at Medical Universities, and of a five-year Vocational Specialization in one of the fields of laboratory medicine such as clinical biochemistry, medical microbiology, medical laboratory toxicology, medical laboratory cytomorphology and medical laboratory transfusiology. An important component of medical laboratory specialists' identity is awareness of inherited ethos obtained from bygone generations of workers in this particular profession and the need to continue its further development. An expression of this awareness is among others Polish Code of Ethics of a Medical Laboratory Specialist (CEMLS) containing a set of values and a moral standpoint characteristic of this type of professional environment. Presenting the ethos of the medical laboratory specialist is a purpose of this article. Authors focus on the role CEMLS plays in areas of professional ethics and law. Next, they reconstruct the Polish model of ethos of medical diagnostic laboratory personnel. An overall picture consists of a presentation of the general moral principles concerning execution of this profession and rules of conduct in relations with the patient, own professional environment and the rest of the society. Polish model of ethical conduct, which is rooted in Hippocratic medical tradition, harmonizes with the ethos of medical laboratory specialists of other European countries and the world.
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Certification of the instructional competence of nuclear training specialists
International Nuclear Information System (INIS)
Wollert, T.N.
1990-01-01
This study was designed to identify the qualification requirements and the means to assess the unique knowledge and skills necessary to perform the instructional activities needed by nuclear training specialist at Fort Saint Vrain Nuclear Generating Station. A survey questionnaire with 233 task statements categorized into eleven duty areas was distributed to twenty-three nuclear training specialists at Fort Saint Vrain Nuclear Generating Station. On the basis of the data accumulated for this study, the researcher identified the following findings. A list of 158 task statements were identified as being relevant; this list was considered a core knowledge, skills, and abilities needed as a nuclear training specialist. The list consisted of ten duty areas which were relevant to the effective performance of a nuclear training specialist. Thirty-three task statements were identified as being relevant for the duty area Conductive Training. These were considered the core of knowledge, skills, and abilities needed in the development of the initial test instrument and the instructor classroom skills observation checklist. The significant correlation between the results of these two instruments, using a rank-order correlation coefficient, was interpreted by the researcher as indicating that the initial test instrument possessed concurrent validity. The researcher interpreted the reliability value as a positive indicator that the initial test instrument demonstrated internal consistency. It was concluded that it could be determined whether personnel possessed the level of competence needed to perform the instructional duties of a nuclear training specialist by using a written test. Data from this research supported the use of the initial test developed for this study as a valid means to certify nuclear training specialists for the duty area Conducting Training
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Energy Technology Data Exchange (ETDEWEB)
NONE
2010-04-15
This report examines if and how LED can be used for public lighting on a large scale. Pilot projects in 29 municipalities were assessed to test the usefulness of LED lighting. This final report provides answers to the questions that relate to the feasibility of the deployment of LED in public lighting and provides some practical pointers. [Dutch] Er is onderzocht of, en zo ja op welke wijze, LED grootschalig toegepast kan worden in de openbare verlichting (OVL). In 29 gemeenten in Nederland zijn proefprojecten geevalueerd om LED verlichting te toetsen op bruikbaarheid. Deze eindrapportage geeft antwoord op vragen die betrekking hebben op de haalbaarheid van de toepassing van LED binnen de OVL en geeft wat praktische aandachtspunten.
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Maguire, Martin C
2013-11-01
The EU EuroClim project developed a system to monitor and record climate change indicator data based on satellite observations of snow cover, sea ice and glaciers in Northern Europe and the Arctic. It also contained projection data for temperature, rainfall and average wind speed for Europe. These were all stored as data sets in a GIS database for users to download. The process of gathering requirements for a user population including scientists, researchers, policy makers, educationalists and the general public is described. Using an iterative design methodology, a user survey was administered to obtain initial feedback on the system concept followed by panel sessions where users were presented with the system concept and a demonstrator to interact with it. The requirements of both specialist and non-specialist users is summarised together with strategies for the effective communication of geographic climate change information. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.
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Nurse specialists in adult congenital heart disease: The current status in Europe
Moons, P.; Scholte op Reimer, W.; De Geest, S.; Fridlund, B.; Heikkila, J.; Jaarsma, Trijntje (Tiny); Martensson, J.; Smith, K; Stewart, S.; Stromberg, A; Thompson, D.R.
2006-01-01
Aim: Recommendations for the management of adults with congenital heart disease indicate that specialist referral centres should employ nurse specialists who are trained and educated in the care for these patients. We surveyed the involvement, education and activities of nurse specialists in the
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LED-roulette : LED's vervangen balletje
Goossens, P.
2007-01-01
Iedereen waagt wel eens een gokje, in een loterij of misschien ook in een casino. Wie droomt er immers niet van om op een gemakkelijke manier rijk te worden? Met de hier beschreven LED-roulette valt weliswaar weinig te winnen, maar het is wel een uitstekende manier om het roulettespel thuis te
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Payload specialist Reinhard Furrer show evidence of previous blood sampling
1985-01-01
Payload specialist Reinhard Furrer shows evidence of previous blood sampling while Wubbo J. Ockels, Dutch payload specialist (only partially visible), extends his right arm after a sample has been taken. Both men show bruises on their arms.
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Motivational Profiles and Motivation for Lifelong Learning of Medical Specialists.
van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Wilschut, Janneke A; Tjin A Tsoi, Sharon L N M; Croiset, Gerda; Peerdeman, Saskia M
2018-05-22
Medical specialists face the challenge of maintaining their knowledge and skills and continuing professional development, that is, lifelong learning. Motivation may play an integral role in many of the challenges facing the physician workforce today including maintenance of a high performance. The aim of this study was to determine whether medical specialists show different motivational profiles and if these profiles predict differences in motivation for lifelong learning. An online questionnaire was sent to every medical specialist working in five hospitals in the Netherlands. The questionnaire included the validated Multidimensional Work Motivation Scale and the Jefferson Scale of Physician Lifelong Learning together with background questions like age, gender, and type of hospital. Respondents were grouped into different motivational profiles by using a two-step clustering approach. Four motivational profiles were identified: (1) HAMC profile (for High Autonomous and Moderate Controlled motivation), (2) MAMC profile (for Moderate Autonomous and Moderate Controlled motivation), (3) MALC profile (for Moderate Autonomous and Low Controlled motivation), and (4) HALC profile (for High Autonomous and Low Controlled motivation). Most of the female specialists that work in an academic hospital and specialists with a surgical specialty were represented in the HALC profile. Four motivational profiles were found among medical specialists, differing in gender, experience and type of specialization. The profiles are based on the combination of autonomous motivation (AM) and controlled motivation (CM) in the specialists. The profiles that have a high score on autonomous motivation have a positive association with lifelong learning.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work
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Nurse-led primary health care for homeless men: a multimethods descriptive study.
Roche, M A; Duffield, C; Smith, J; Kelly, D; Cook, R; Bichel-Findlay, J; Saunders, C; Carter, D J
2017-12-21
To explore the primary healthcare needs and health service use of homeless men in inner Sydney. People experiencing homelessness have greater health needs than the general population and place high demands on tertiary care, which is expensive and may not be the optimum service for their needs. Accessible, approachable and affordable primary healthcare services could improve the health of homeless persons and potentially decrease costs to the healthcare system. A multimethod design using a cross-sectional survey (n = 40) and administrative data (n = 2 707 daily summaries) collected from a nurse-led primary healthcare clinic for homeless men in Sydney. Survey respondents were aged 27-76 years. Health problems reflected multimorbidity, with mental health issues present in almost all respondents. The majority had attended the clinic more than 20 times in the past year and said the services, treatments and referrals helped them avoid the emergency department. Administrative data indicated that medication administration was the most frequent service provided. Referrals to other health services doubled over the 7-year period. Multiple morbidities, particularly mental health issues, are associated with homelessness. A proactive approach by nurses including preventative services appeared to overcome barriers to health service use. This nurse-led primary healthcare clinic highlights the importance of providing services to homeless men with multiple comorbidities. Respect and trust in addition to easy access to health services appear to be important facilitators of health service use. A greater number of primary health services that collaborate with specialist services, including nurse-led clinics, may facilitate health care for persons who are homeless, reducing the burden on acute services. © 2017 International Council of Nurses.
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Addressing cultural diversity: the hepatitis B clinical specialist perspective.
Wallace, Jack; Smith, Elizabeth; Hajarizadeh, Behzad; Richmond, Jacqueline; Lucke, Jayne
2017-08-31
Hepatitis B is a viral infection primarily affecting people from culturally diverse communities in Australia. While vaccination prevents infection, there is increasing mortality resulting from liver damage associated with chronic infection. Deficits in the national policy and clinical response to hepatitis B result in a low diagnosis rate, inadequate testing and diagnosis processes, and poor access to hepatitis B treatment services. While research identifies inadequate hepatitis B knowledge among people with the virus and primary health care workers, this project sought to identify how specialist clinicians in Australia negotiate cultural diversity, and provide often complex clinical information to people with hepatitis B. A vignette was developed and presented to thirteen viral hepatitis specialist clinicians prior to an electronically recorded interview. Recruitment continued until saturation of themes was reached. Data were thematically coded into themes outlined in the interview schedule. Ethical approval for the research was provided by the La Trobe University Human Research Ethics Committee. Key messages provided to patients with hepatitis B by clinical specialists were identified. These messages were not consistently provided to all patients with hepatitis B, but were determined on perceptions of patient knowledge, age and highest educational level. While the vignette stated that English was not an issue for the patient, most specialists identified the need for an interpreter. Combating stigma related to hepatitis B was seen as important by the specialists and this was done through normalising the virus. Having an awareness of different cultural understandings about hepatitis B specifically, and health and well-being generally, was noted as a communication strategy. Key core competencies need to be developed to deliver educational messages to people with hepatitis B within clinical encounters. The provision of adequate resources to specialist clinics will
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Wildlife Private Lands Specialist Support Areas
Minnesota Department of Natural Resources — This layer represents the areas of Minnesota that MNDNR Wildlife Private Lands Specialists cover. These boundaries are provided for support mapping and to show...
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O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U
2017-01-07
The purpose of the study is to explore the reasons why specialist doctors travel to provide regular rural outreach services, and whether reasons relate to (1) salaried or private fee-for-service practice and (2) providing rural outreach services in more remote locations. A national cross-sectional study of specialist doctors from the Medicine in Australia: Balancing Employment and Life (MABEL) survey in 2014 was implemented. Specialists providing rural outreach services self-reported on a 5-point scale their level of agreement with five reasons for participating. Chi-squared analysis tested association between agreement and variables of interest. Of 567 specialists undertaking rural outreach services, reasons for participating include to grow the practice (54%), maintain a regional connection (26%), provide complex healthcare (18%), healthcare for disadvantaged people (12%) and support rural staff (6%). Salaried specialists more commonly participated to grow the practice compared with specialists in fee-for-service practice (68 vs 49%). This reason was also related to travelling further and providing outreach services in outer regional/remote locations. Private fee-for-service specialists more commonly undertook outreach services to provide complex healthcare (22 vs 14%). Specialist doctors undertake rural outreach services for a range of reasons, mainly to complement the growth and diversity of their main practice or maintain a regional connection. Structuring rural outreach around the specialist's main practice is likely to support participation and improve service distribution.
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2011-04-15
... to Prepare a Tiered Environmental Impact Statement AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice to Rescind a Notice of Intent to Prepare a Tiered Environmental Impact Statement. SUMMARY... Heitmann, Environmental Specialist, Federal Highway Administration, New Mexico Division Office, 4001 Office...
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Directory of Open Access Journals (Sweden)
Bailey, Wayne
2011-01-01
Full Text Available This short article explores whether using a mentoring model supports our Subject Specialist Mentors (SSMs with their role of mentoring trainees on Initial Teacher Training (ITT courses. Although there are many mentoring models to choose from, our model is based around mentoring within the Lifelong Learning Sector (LLS where trainees need support for their subject specialism as well as their generic teaching skills. The main focus is the use of coaching and mentoring skills taking into consideration guiding, supporting and challenging the trainee during the lifetime of the mentor/trainee relationship. The SSMs found that using our model as a tool helped to structure meetings and to ensure that the trainee had the necessary support to enable them to become proficient, competent subject specialist teachers. In conclusion, it was found that there is a need for the use of a model or a framework to help the Subject Specialist Mentor (SSM with such an important role.
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STS-9 payload specialists and backup in training session
1983-01-01
Two Spacelab 1 payload specialists and a backup for that flight prepare for a training session in the JSC mockup and integration laboratory. Fully decked out in the Shuttle constant wear garments (foreground) are Ulf Merbold, left, and Byron K. Licktenberg, prime crewmembers on the STS-9 team. In civilian clothes is payload specialist backup Michael L. Lampton.
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Exploration of Environmental Management
Li Shushu; Li Ruilong; Chen Rui
2012-01-01
On the basis of domestic and international research, this article takes research on peasant household and agricultural managements as base points, aims to build environmental management model, establish government-led, an effective environmental management mechanism between the government and peasant household. Analyzes the role of peasant household’ environmental management in the regional environmental improvement from the aspect of theoretical analysis and analyze significant factors affec...
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IMPROVEMENT OF INNOVATIVE TRAINING OF ROAD SPECIALISTS
Directory of Open Access Journals (Sweden)
I. I. Leonovich
2007-01-01
Full Text Available Complicated conditions, under which road enterprises of the Republic are forced to operate, put forward and reveal the necessity to innovative way of development. In order to fulfill this task it is necessary to have specialists who are capable and ready to realize this endeavour. The most acceptable variant is to train specialists who will be able to introduce innovations and who are presently involved in the production process. Such training should be carried out within the framework of post-graduate education. Authors have provide a number of reasons in favour of quick development of such education.
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Collaboration with general practitioners: preferences of medical specialists – a qualitative study
Directory of Open Access Journals (Sweden)
Slaets Joris PJ
2006-12-01
Full Text Available Abstract Background Collaboration between general practitioners (GPs and specialists has been the focus of many collaborative care projects during the past decade. Unfortunately, quite a number of these projects failed. This raises the question of what motivates medical specialists to initiate and continue participating with GPs in new collaborative care models. The following question is addressed in this study: What motivates medical specialists to initiate and sustain new models for collaborating with GPs? Methods We conducted semi-structured interviews with eighteen medical specialists in the province of Groningen, in the North of The Netherlands. The sampling criteria were age, gender, type of hospital in which they were practicing, and specialty. The interviews were recorded, fully transcribed, and analysed by three researchers working independently. The resulting motivational factors were grouped into categories. Results 'Teaching GPs' and 'regulating patient flow' (referrals appeared to dominate when the motivational factors were considered. In addition, specialists want to develop relationships with the GPs on a more personal level. Most specialists believe that there is not much they can learn from GPs. 'Lack of time', 'no financial compensation', and 'no support from colleagues' were considered to be the main concerns to establishing collaborative care practices. Additionally, projects were often experienced as too complex and time consuming whereas guidelines were experienced as too restrictive. Conclusion Specialists are particularly interested in collaborating because the GP is the gatekeeper for access to secondary health care resources. Specialists feel that they are able to teach the GPs something, but they do not feel that they have anything to learn from the GPs. With respect to professional expertise, therefore, specialists do not consider GPs as equals. Once personal relationships with the GPs have been established, an
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The Perception of Teachers and School Library Media Specialist on ...
African Journals Online (AJOL)
The Perception of Teachers and School Library Media Specialist on the Role of School Library Media Specialists in Selected Secondary Schools in Ogun State. ... Journal Home > Vol 9, No 1 (2012) >. Log in or Register to get access to full text ...
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Pharmacovigilance training for specialist oncology nurses-a two way evaluation
Schutte, T.; Van Eekeren, R.; Richir, M.; Van Staveren, J.; Van Puijenbroek, E.P.; Tichelaar, J.; Van Agtmael, M.A.
2017-01-01
Background: In a new prescribing qualifcation course for specialist oncology nurses, we thought it important to emphasize pharma-covigilance and adverse drug reaction (ADR)-reporting. To this end, our aim was to develop and evaluate an ADR reporting assignment for specialist oncology nurses.
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International Nuclear Information System (INIS)
Verma, R.; Treasure, P.; Hughes, R.
2015-01-01
Radiotherapy for localised prostate cancer is an effective and well tolerated treatment. Following radiotherapy, most men are followed up either in doctor or specialist nurse led hospital outpatient clinics. Attending clinics may be of little personal benefit as the majority of patients have few ongoing symptoms post radiotherapy and have very good cancer prognoses. Recognising the limitations outpatient clinic follow up, we developed a radiographer led model of remote telephone follow up of patients completing radiotherapy for low to intermediate risk prostate cancer. Standardised toxicity assessments were performed and patient satisfaction assessed. Radiographer led follow up detected similar levels of post radiotherapy GI, GU and sexual toxicity as outpatient clinic appointments, with a very high level of patient satisfaction compared to routine outpatient clinics. We believe that radiographer led telephone follow up provides an alternative model for long term follow up of men after prostate radiotherapy
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Stronger communities? Changing prospects for community-led strategic planning in New Zealand
Directory of Open Access Journals (Sweden)
Bruno Brosnan
2010-12-01
Full Text Available New Zealand’s Local Government Act 2002 ushered in a new phase in local government, a phase that is best characterised by the term ‘empowerment’. Not only were councils empowered to promote social, economic, environmental and cultural well-being, in contrast with previous more prescriptive legislation, but citizens were empowered to engage in community-led strategic planning. In many respects the new statute reflected contemporary international public management trends in which governance is increasingly being conducted via networks of public and private actors. However, with the change of government from a centre-left Labour-led coalition to a centre-right National-led government following the November 2008 general election, it is less certain that local government and communities will continue to experience a strengthening of the pluralisation of governance that has been a feature of the past decade. This article argues that the potential disempowerment of local government, and possible attenuation of community-led strategic planning in New Zealand, comes at a time when the momentum for devolution to local government and other communities is increasing elsewhere.
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Operating experience relating to on-site electric power sources. Proceedings of a Specialist Meeting
International Nuclear Information System (INIS)
1986-02-01
The reliability of on-site electric power sources of nuclear power plants usually consisting of diesel generators, gas turbine generators and DC power sources, has been a matter of concern during reactor operations. The frequent recurrence and the important consequences of failures relating to on-site electric power sources have led to a general consensus that they form one of the most significant features influencing the total performance of the safety Systems. This has also been confirmed by surveys performed on the incidents reported through the NEA Incident Reporting System (IRS). Accordingly, a recommendation to organise a Specialist Meeting on the subject was made at the third annual meeting of CSNI Principal Working Group No. 1 (Operating Experience and Human Factors). At the 12. meeting of the CSNI held in November 1984. the Committee endorsed the proposal and accepted an offer by the United Kingdom to host and organise the Specialist Meeting. The Specialist Meeting, sponsored by the CSNI, was held in London, United Kingdom from 16 to 18 October 1985. It was hosted by H.M. Nuclear Installations Inspectorate of the Health and Safety Executive. The purpose of the meeting was to promote the exchange of Information on operating experience relating to on-site electric power sources and to look for measures to further improve their reliability In the areas of design, operation and licensing. The meeting was organised by a Programme Group which included nominated members of CSNI PWG No. 1. the Programme Group met in May and June 1985 in Paris to agree on the programme and practical arrangements for the meeting. As a result of the review of the abstracts which had been contributed in response to the Call for Papers, 28 papers were accepted for presentation during the meeting. Approximately 60 delegates from 13 Member countries, and the NEA Secretariat, attended the meeting. Session summaries prepared by the respective session chairmen are Included prior to the
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Operating experience relating to on-site electric power sources. Proceedings of a Specialist Meeting
Energy Technology Data Exchange (ETDEWEB)
NONE
1986-02-15
The reliability of on-site electric power sources of nuclear power plants usually consisting of diesel generators, gas turbine generators and DC power sources, has been a matter of concern during reactor operations. The frequent recurrence and the important consequences of failures relating to on-site electric power sources have led to a general consensus that they form one of the most significant features influencing the total performance of the safety Systems. This has also been confirmed by surveys performed on the incidents reported through the NEA Incident Reporting System (IRS). Accordingly, a recommendation to organise a Specialist Meeting on the subject was made at the third annual meeting of CSNI Principal Working Group No. 1 (Operating Experience and Human Factors). At the 12. meeting of the CSNI held in November 1984. the Committee endorsed the proposal and accepted an offer by the United Kingdom to host and organise the Specialist Meeting. The Specialist Meeting, sponsored by the CSNI, was held in London, United Kingdom from 16 to 18 October 1985. It was hosted by H.M. Nuclear Installations Inspectorate of the Health and Safety Executive. The purpose of the meeting was to promote the exchange of Information on operating experience relating to on-site electric power sources and to look for measures to further improve their reliability In the areas of design, operation and licensing. The meeting was organised by a Programme Group which included nominated members of CSNI PWG No. 1. the Programme Group met in May and June 1985 in Paris to agree on the programme and practical arrangements for the meeting. As a result of the review of the abstracts which had been contributed in response to the Call for Papers, 28 papers were accepted for presentation during the meeting. Approximately 60 delegates from 13 Member countries, and the NEA Secretariat, attended the meeting. Session summaries prepared by the respective session chairmen are Included prior to the
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Pest Management Specialist (AFSC 56650).
Air Univ., Gunter AFS, Ala. Extension Course Inst.
This eight-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for pest management specialists. Covered in the individual volumes are civil engineering; pest management (entomology, pest management planning and coordination, and safety and protective equipment); pest management chemicals and…
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Doody, Owen; Slevin, Eamonn; Taggart, Laurence
2018-01-01
To explore families' perceptions of the contribution of clinical nurse specialists in intellectual disability nursing in Ireland. Clinical nurse specialists roles have developed over the years and are seen as complex and multifaceted, causing confusion, frustration and controversy. 2001 saw the formal introduction of clinical nurse specialists roles in Ireland across nursing including intellectual disability. A exploratory qualitative approach using semistructured one-to-one interviews with 10 family members regarding their perceptions of the clinical nurse specialists in intellectual disability. Data were audio-recorded, transcribed and analysed using Burnard's framework. Ethical approval was gained and access granted by service providers. The study highlights that intellectual disability clinical nurse specialists contribute and support care deliver across a range of areas, including personal caring, supporting and empowering families, liaison, education and leadership. Clinical nurse specialists have an important role and contribution in supporting families and clients, and Ireland is in a unique position to develop knowledge regarding specialist care for people with intellectual disability that can be shared nationally and internationally. Ireland is in a unique position to develop knowledge regarding specialist care for people with intellectual disability that can be shared and adapted by other healthcare professionals in other countries that do not have a specialised intellectual disability nurses. © 2017 John Wiley & Sons Ltd.
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22 CFR 11.20 - Foreign Service specialist career candidate appointments.
2010-04-01
..., background investigation, and final review process required of career candidates, but normally they will not... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Foreign Service specialist career candidate... SERVICE OFFICERS § 11.20 Foreign Service specialist career candidate appointments. (a) General...
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POSTGRADUATE EDUCATION FUNCTIONING PATTERNS OF TOURISM SPHERE SPECIALISTS IN SWITZERLAND
Directory of Open Access Journals (Sweden)
Наталія Закордонець
2014-04-01
Full Text Available Functioning patterns of postgraduate education of tourism sphere specialists in Switzerland have been established. The competences of tourism sphere specialist, the formation of which programs of postgraduate education are focused on have been considered. The benefits of educational qualification of Masters in Business Administration with a major specialization in tourism have been outlined. The characteristics of the core curriculum of the Doctor of Management of leading universities in the field of tourism education have been determined. The performance criteria of postgraduate education system functioning of tourism sphere specialists in Switzerland have been revealed.
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Burns education for non-burn specialist clinicians in Western Australia.
McWilliams, Tania; Hendricks, Joyce; Twigg, Di; Wood, Fiona
2015-03-01
Burn patients often receive their initial care by non-burn specialist clinicians, with increasingly collaborative burn models of care. The provision of relevant and accessible education for these clinicians is therefore vital for optimal patient care. A two phase design was used. A state-wide survey of multidisciplinary non-burn specialist clinicians throughout Western Australia identified learning needs related to paediatric burn care. A targeted education programme was developed and delivered live via videoconference. Pre-post-test analysis evaluated changes in knowledge as a result of attendance at each education session. Non-burn specialist clinicians identified numerous areas of burn care relevant to their practice. Statistically significant differences between perceived relevance of care and confidence in care provision were reported for aspects of acute burn care. Following attendance at the education sessions, statistically significant increases in knowledge were noted for most areas of acute burn care. Identification of learning needs facilitated the development of a targeted education programme for non-burn specialist clinicians. Increased non-burn specialist clinician knowledge following attendance at most education sessions supports the use of videoconferencing as an acceptable and effective method of delivering burns education in Western Australia. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.
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Saraçli, Sinan; Yilmaz, Veysel; Arslan, Talha
2014-01-01
Problem Statement: The damage caused by recent environmental problems has led to increased environmental concerns and the development of environment-friendly consumption behaviours in almost every society. Environment-friendly consumption involves the consideration of environmental benefits by minimizing any damage done to the environment at all…
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Chinman, Matthew; McInnes, D Keith; Eisen, Susan; Ellison, Marsha; Farkas, Marianne; Armstrong, Moe; Resnick, Sandra G
2017-09-01
Mental health peer specialists are individuals with serious mental illnesses who receive training to use their lived experiences to help others with serious mental illnesses in clinical settings. This Open Forum discusses the state of the research for mental health peer specialists and suggests a research agenda to advance the field. Studies have suggested that peer specialists vary widely in their roles, settings, and theoretical orientations. Theories of action have been proposed, but none have been tested. Outcome studies have shown benefits of peer specialists; however, many studies have methodological shortcomings. Qualitative descriptions of peer specialists are plentiful but lack grounding in implementation science frameworks. A research agenda advancing the field could include empirically testing theoretical mechanisms of peer specialists, developing a measure of peer specialist fidelity, conducting more rigorous outcomes studies, involving peer specialists in executing the research, and assessing various factors that influence implementing peer specialist services and testing strategies that could address those factors.
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Does a specialist unit improve outcomes for hospitalized patients with Parkinson's disease?
Skelly, Rob; Brown, Lisa; Fakis, Apostolos; Kimber, Lindsey; Downes, Charlotte; Lindop, Fiona; Johnson, Clare; Bartliff, Caroline; Bajaj, Nin
2014-01-01
Objective Suboptimal management of Parkinson's disease (PD) medication in hospital may lead to avoidable complications. We introduced an in-patient PD unit for those admitted urgently with general medical problems. We explored the effect of the unit on medication management, length of stay and patient experience. Methods We conducted a single-center prospective feasibility study. The unit's core features were defined following consultation with patients and professionals: specially trained staff, ready availability of PD drugs, guidelines, and care led by a geriatrician with specialty PD training. Mandatory staff training comprised four 1 h sessions: PD symptoms; medications; therapy; communication and swallowing. Most medication was prescribed using an electronic Prescribing and Administration system (iSOFT) which provided accurate data on time of administration. We compared patient outcomes before and after introduction of the unit. Results The general ward care (n = 20) and the Specialist Parkinson's Unit care (n = 24) groups had similar baseline characteristics. On the specialist unit: less Parkinson's medication was omitted (13% vs 20%, p < 0.001); of the medication that was given, more was given on time (64% vs 50%, p < 0.001); median length of stay was shorter (9 days vs 13 days, p = 0.043) and patients' experience of care was better (p = 0.01). Discussion If replicated and generalizable to other hospitals, reductions in length of stay would lead to significant cost savings. The apparent improved outcomes with Parkinson's unit care merit further investigation. We hope to test the hypothesis that specialized units are cost-effective and improve patient care using a randomized controlled trial design. PMID:25264022
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The Role of the Technical Specialist in Disaster Response and Recovery
Curtis, J. C.
2017-12-01
Technical Specialists provide scientific expertise for making operational decisions during natural hazards emergencies. Technical Specialists are important members of any Incident Management Team (IMT) as is described in in the National Incident Management System (NIMS) that has been designed to respond to emergencies. Safety for the responders and the threatened population is the foremost consideration in command decisions and objectives, and the Technical Specialist is on scene and in the command post to support and promote safety while aiding decisions for incident objectives. The Technical Specialist's expertise can also support plans, logistics, and even finance as well as operations. This presentation will provide actual examples of the value of on-scene Technical Specialists, using National Weather Service "Decision Support Meteorologists" and "Incident Meteorologists". These examples will demonstrate the critical role of scientists that are trained in advising and presenting life-critical analysis and forecasts during emergencies. A case will be made for local, state, and/or a national registry of trained and deployment-ready scientists that can support emergency response.
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Directory of Open Access Journals (Sweden)
van Eijk Jacques
2007-09-01
Full Text Available Abstract Background The prevalence of cardiovascular disease is increasing. Improved treatment options increase survival after an acute myocardial infarction or sudden cardiac arrest, although patients often have difficulty adjusting and regaining control in daily life. In particular, patients who received an implantable cardioverter defibrillator (ICD experience physical and psychological problems. Interventions to enhance perceived control and acceptance of the device are therefore necessary. This paper describes a small-scale study to explore the feasibility and the possible benefits of a structured nurse- and peer-led self-management programme ('Chronic Disease Self-Management Program' – CDSMP among ICD patients. Methods Ten male ICD patients (mean age = 65.5 years participated in a group programme, consisting of six sessions, led by a team consisting of a nurse specialist and a patient with cardiovascular disease. Programme feasibility was evaluated among patients and leaders by measuring performance of the intervention according to protocol, attendance and adherence of the participating ICD patients, and patients' and leaders' opinions about the programme. In addition, before and directly after attending the intervention, programme benefits (e.g. perceived control, symptoms of anxiety and depression, and quality of life were assessed. Results The programme was conducted largely according to protocol. Eight patients attended at least four sessions, and adherence ranged from good to very good. On average, the patients reported to have benefited very much from the programme, which they gave an overall report mark of 8.4. The leaders considered the programme feasible as well. Furthermore, improvements were identified for general self-efficacy expectancies, symptoms of anxiety, physical functioning, social functioning, role limitations due to physical problems, and pain. Conclusion This study suggests that a self-management programme led by a
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Neurofibromatosis and the role of the specialist adviser.
Redman, Carolyn
2017-09-11
Neurofibromatosis (NF) is a genetic condition that mainly involves the nervous system. There are two types: NF1 affects about one in 2,500 of the population worldwide and NF2 affects one in 35,000. Both types result in complex health problems for patients and can pose significant challenges for all those involved in their management. Established in 1981, The Neuro Foundation is a patient-focused charity that funds a network of specialist advisers who work in partnership with the NHS to offer support and advice for families affected by NF and the professionals who care for them. With a significant level of autonomy, the specialist adviser role is flexible in matching the needs of those affected while working cooperatively alongside the national specialist services for NF1 and NF2. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.
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One Point of View: Elementary School Mathematics Specialists: Where Are They?
Dossey, John A.
1984-01-01
A plea is made for the mathematics education community to support the need for elementary school mathematics specialists. Roles of such specialists in primary as well as intermediate grades are listed. (MNS)
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DEFF Research Database (Denmark)
Poulsen, Peter Behrensdorff; Dam-Hansen, Carsten; Thorseth, Anders
Projektet har til formål at anvende dansk forskning inden for optik og lys til at realisere innovative energieffektive LED lyssystemer til museumsbranchen.......Projektet har til formål at anvende dansk forskning inden for optik og lys til at realisere innovative energieffektive LED lyssystemer til museumsbranchen....
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Linked environmental data. The next step for environmental information systems
International Nuclear Information System (INIS)
Menger, Matthias; Ackermann, Patrick; Linse, Andreas; Bandholtz, Thomas
2013-01-01
The Federal Environment Agency (UBA) in Germany as one Competent Authority of the European Member States involved with the assessment and authorisation of chemicals, pesticides, biozides and medicals, has a wide expertise of complex information systems. Having timely, comprehensive and reliable information on the environmental relevant properties (e.g. of chemical substances and preparations) is of immense importance for all sections dealing with environmental protection issues. Regarding the reality of available information systems in each environmental section, and moreover in each section itself, there has been developed several specific approaches to gather, store and search its relevant data. This makes sense due to each section has its own requirements, different user groups (industry and authorities or just authorities or scientific partners etc.), different budgets to bring technology 'on the road', and different (legally obligatory) procedures to handle the data and information of such systems. Nevertheless, there several strong reasons to look for a Linked Environmental Data infrastructure - at least internally in one authority itself: - Overcome the mostly separated systems; - Explore the potential of data silos in several environmental sections; - Efficiency/effectiveness in data gathering, assessment, results, budgets..; - sharing of knowledge, i.e. use of specific prepared information of specially intended information systems; - timelyness of data/information; - best data/information from most competent partner/section; - gain from already available systems and their data/information; - speed up developments and availability of data/information. Of course there are also several points which might be a huge obstacle to Linked Environmental Data (LED), e.g. confidential business data. This leads already to the distinction between 'Open LED' and 'Non-Open LED'. Nevertheless, the potential benefits and the possibilities offered via the modern information
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Individual prey choices of octopuses: Are they generalist or specialist?
Directory of Open Access Journals (Sweden)
Jennifer A. MATHER, Tatiana S. LEITE, Allan T. BATISTA
2012-08-01
Full Text Available Prey choice is often evaluated at the species or population level. Here, we analyzed the diet of octopuses of different populations with the aim to assess the importance of individual feeding habits as a factor affecting prey choice. Two methods were used, an assessment of the extent to which an individual octopus made choices of species representative of those population (PSi and IS and 25% cutoff values for number of choices and percentage intake of individual on their prey. In one population of Octopus cf vulgaris in Bermuda individuals were generalist by IS=0.77, but most chose many prey of the same species, and were specialists on it by >75% intake. Another population had a wider prey selection, still generalist with PSi=0.66, but two individuals specialized by choices. In Bonaire, there was a wide range of prey species chosen, and the population was specialists by IS= 0.42. Individual choices revealed seven specialists and four generalists. A population of Octopus cyanea in Hawaii all had similar choices of crustaceans, so the population was generalist by IS with 0.74. But by individual choices, three were considered a specialist. A population of Enteroctopus dofleini from Puget Sound had a wide range of preferences, in which seven were also specialists, IS=0.53. By individual choices, thirteen were also specialists. Given the octopus specialty of learning during foraging, we hypothesize that both localized prey availability and individual personality differences could influence the exploration for prey and this translates into different prey choices across individuals and populations showed in this study [Current Zoology 58 (4: 597-603, 2012].
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The Changing Role of the Reading Specialist: A Case Study
Ginsburg, Victoria Elaine
2012-01-01
This descriptive qualitative case study explored the changing role of the reading specialist through various perceptions of professionals in the Neon Shadow School District. The purpose of the study was to explore what, how, and why the duties and responsibilities of the reading specialist have changed since first employed as an…
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A lifetime prediction method for LEDs considering mission profiles
DEFF Research Database (Denmark)
Qu, Xiaohui; Wang, Huai; Zhan, Xiaoqing
2016-01-01
and to benchmark the cost-competitiveness of different lighting technologies. The existing lifetime data released by LED manufacturers or standard organizations are usually applicable only for specific temperature and current levels. Significant lifetime discrepancies may be observed in field operations due...... to the varying operational and environmental conditions during the entire service time (i.e., mission profiles). To overcome the challenge, this paper proposes an advanced lifetime prediction method, which takes into account the field operation mission profiles and the statistical properties of the life data...
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Color homogeneity in LED spotlights
Prins, C.R.
2013-01-01
Color variation in the light output of white LEDs is a common problem in LED lighting. We aim to design LED spotlights with a uniform color output while keeping the cost of the system low and the energy efficiency high. Therefore we design a special optic to eliminate the color variation of the LED.
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CAUSES FOR INEFFECTIVE COMMUNICATION BETWEEN MEDICAL SPECIALISTS
Directory of Open Access Journals (Sweden)
Stayko I. Spiridonov
2017-07-01
Full Text Available Purpose: In the resent years the healthcare system has moved to inter-professional, cross-disciplinary, multi-person approach where the communications are very important for ensuring patient safety. Communication in health organisations needs to be studied and analysed deeply and comprehensively because the future of an organisation often depends on good communication. The purpose of this study is to investigate and analyse the reasons for ineffective communication between medical specialists in the teams they work in. Materials and Methods: A questionnaire method is used. Through a survey over a period of 12 months (from 01. 12. 2014 to 01. 12. 2015 at the Escullap Hospital in Pazardzhik, DCC 18 - Sofia, St. Mina Hospital in Plovdiv, MHAT – Plovdiv, DCC 1 in Haskovo, UMHAT in Stara Zagora, DCC 3 in Varna and MHAT – Parvomay, was studied and analyzed the opinion of medical specialists on the effectiveness of communication within the team they work in. The survey includes 477 medical specialists. Results and conclusions: According to 41.1% of the respondents, the communication in the team they work in is insufficiently effective. Most of the respondents (39.8% find their colleagues responsible for the ineffective communication, followed by those who seek the cause for poor communication in the management of the health care facility (27.6%. The leading cause of poor communication in the team according to the study participants is the inequality between the characters of the colleagues (41.9%. According to the majority of respondents (28.3%, improvements in facilities and wage increases (27.3% would be essential to improve communication within the team they work in. Recommendations have been formulated to improve communication among medical specialists.
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Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin
2016-06-23
This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Champlain health region in Eastern Ontario, Canada. Primary care providers and specialists registered to use the eConsult service. Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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Impact of a Clinical Pharmacy Specialist in an Emergency Department for Seniors.
Shaw, Paul B; Delate, Thomas; Lyman, Alfred; Adams, Jody; Kreutz, Heather; Sanchez, Julia K; Dowd, Mary Beth; Gozansky, Wendolyn
2016-02-01
This study assesses outcomes associated with the implementation of an emergency department (ED) for seniors in which a clinical pharmacy specialist, with specialized geriatric training that included medication management training, is a key member of the ED care team. This was a retrospective cohort analysis of patients aged 65 years or older who presented at an ED between November 1, 2012, and May 31, 2013. Three groups of seniors were assessed: treated by the clinical pharmacy specialist in the ED for seniors, treated in the ED for seniors but not by the clinical pharmacy specialist, and not treated in the ED for seniors. Outcomes included rates of an ED return visit, mortality and hospital admissions, and follow-up total health care costs. Multivariable regression modeling was used to adjust for any potential confounders in the associations between groups and outcomes. A total of 4,103 patients were included, with 872 (21%) treated in the ED for seniors and 342 (39%) of these treated by the clinical pharmacy specialist. Groups were well matched overall in patient characteristics. Patients who received medication review and management by the clinical pharmacy specialist did not experience a reduction in ED return visits, mortality, cost of follow-up care, or hospital admissions compared with the other groups. Of the patients treated by the clinical pharmacy specialist, 154 (45.0%) were identified as having at least 1 medication-related problem. Although at least 1 medication-related problem was identified in almost half of patients treated by the clinical pharmacy specialist in the ED for seniors, incorporation of a clinical pharmacy specialist into the ED staff did not improve clinical outcomes. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
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Contracting in specialists for emergency obstetric care- does it work in rural India?
Directory of Open Access Journals (Sweden)
Randive Bharat
2012-12-01
Full Text Available Abstract Background Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC in rural India. Methods Facility survey was conducted in all secondary and tertiary public health facilities (44 in three heterogeneous districts in Maharashtra state of India. Interviews (42 were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Results Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month. The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Conclusions Density and geographic distribution of private specialists are important
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Contracting in specialists for emergency obstetric care- does it work in rural India?
Randive, Bharat; Chaturvedi, Sarika; Mistry, Nerges
2012-12-31
Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Density and geographic distribution of private specialists are important influencing factors in determining feasibility and use of
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Integrating HCI Specialists into Open Source Software Development Projects
Hedberg, Henrik; Iivari, Netta
Typical open source software (OSS) development projects are organized around technically talented developers, whose communication is based on technical aspects and source code. Decision-making power is gained through proven competence and activity in the project, and non-technical end-user opinions are too many times neglected. In addition, also human-computer interaction (HCI) specialists have encountered difficulties in trying to participate in OSS projects, because there seems to be no clear authority and responsibility for them. In this paper, based on HCI and OSS literature, we introduce an extended OSS development project organization model that adds a new level of communication and roles for attending human aspects of software. The proposed model makes the existence of HCI specialists visible in the projects, and promotes interaction between developers and the HCI specialists in the course of a project.
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Struggling doctors in specialist training: a case control study
DEFF Research Database (Denmark)
O'Neill, Lotte; Norberg, Karen; Thomsen, Maria
), or transferred (i.e. had unplanned changes in place of training/ward due to failure to thrive or due to inadequate development of competences), or dropped out (i.e. were dismissed from, had resigned from, or changed their speciality). Controls were a random sample of doctors in the source population, who were......Abstract summary The aim of this cummulative incidence case-control study was to examine: if struggling trainees in medical specialist training (cases) tended to struggle already in medical school or not compared to non-struggling controls, and which performance indicators during medical school...... seemed to predict struggling in postgraduate education if any. The study design is rooted in epidemiological methodology. Struggling doctors in specialist training: a case-control study. It has been reported in the international literature, that around 3-10% of doctors in post-garduate specialist...
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ISD Designed Medical Specialist Training.
Rock, Samuel K., Jr.; Chagalis, George P.
The Basic Medical Specialist course has one of the largest enrollments of the U.S. Army's Academy of Health Sciences; 11,000 soldiers were trained in this course in 1977 and 1978. Training encompasses both emergency first aid (for field medics) and basic nursing skills. A task force working to improve Army training developed this course, in…
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Noble, B; King, N; Woolmore, A; Hughes, P; Winslow, M; Melvin, J; Brooks, J; Bravington, A; Ingleton, C; Bath, P A
2015-03-01
The Midhurst Macmillan Specialist Palliative Care Service (MMSPCS) is a UK, medical consultant-led, multidisciplinary team aiming to provide round-the-clock advice and care, including specialist interventions, in the home, community hospitals and care homes. Of 389 referrals in 2010/11, about 85% were for cancer, from a population of about 155 000. Using a mixed method approach, the evaluation comprised: a retrospective analysis of secondary-care use in the last year of life; financial evaluation of the MMSPCS using an Activity Based Costing approach; qualitative interviews with patients, carers, health and social care staff and MMSPCS staff and volunteers; a postal survey of General Practices; and a postal survey of bereaved caregivers using the MMSPCS. The mean cost is about 3000 GBP (3461 EUR) per patient with mean cost of interventions for cancer patients in the last year of life 1900 GBP (2192 EUR). Post-referral, overall costs to the system are similar for MMSPCS and hospice-led models; however, earlier referral avoided around 20% of total costs in the last year of life. Patients and carers reported positive experiences of support, linked to the flexible way the service worked. Seventy-one per cent of patients died at home. This model may have application elsewhere. © 2014 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.
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Caring for cancer patients on non-specialist wards.
LENUS (Irish Health Repository)
Gill, Finola
2012-02-01
As cancer is the leading cause of death worldwide, every nurse will be required to care for patients with the condition at some point in his\\/her career. However, non-specialized oncology nurses are often ill-prepared to nurse patients suffering from cancer. This literature review aims to provide an overview of current trends and developments in cancer care nursing in an attempt to identify the range of previous research pertaining to caring for patients with cancer on non-specialist wards. The review finds that non-specialized cancer nurses report a lack of education and training with regard to cancer care and cancer treatments, which acts as a barrier to providing quality nursing care. Emotional and communication issues with patients and their families can also cause non-specialist nurses significant distress. International research has shown that specialist oncology nurses make a considerable difference to physical and psychosocial patient care. It is therefore paramount that non-speciality nurses\\' educational needs are met to develop clinical competence and to provide supportive holistic care for both patients and their families.
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International symposium and field seminar on karst waters and environmental impacts. Abstracts
Energy Technology Data Exchange (ETDEWEB)
Gunay, G; Tezcan, L; Atilla, A O [comps.
1996-12-31
The international symposium and field seminar on karst waters and environmental impacts was held on 10-20 September 1995 in Beldibi,Antalya, Turkey. The specialists discussed COST Action 65, Environmental Impact sand Legal Aspects, Engineering and Environmental Impacts of Karst, Research Methods, Tracing Techniques, Hydro chemistry, Environmental Isotopes in Karst, Transport Processing, Modeling and Flow Systems, Karst Morphology and Paleoenvironment, Regional Karst Systems, James F. Quinlay Pollution Control and Karst Water Protection Session and Hydrology. Almost 140 papers were presented in the meeting.
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International symposium and field seminar on karst waters and environmental impacts. Abstracts
International Nuclear Information System (INIS)
Gunay, G.; Tezcan, L.; Atilla, A.O.
1995-01-01
The international symposium and field seminar on karst waters and environmental impacts was held on 10-20 September 1995 in Beldibi,Antalya, Turkey. The specialists discussed COST Action 65, Environmental Impact sand Legal Aspects, Engineering and Environmental Impacts of Karst, Research Methods, Tracing Techniques, Hydro chemistry, Environmental Isotopes in Karst, Transport Processing, Modeling and Flow Systems, Karst Morphology and Paleoenvironment, Regional Karst Systems, James F. Quinlay Pollution Control and Karst Water Protection Session and Hydrology. Almost 140 papers were presented in the meeting
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Inequalities in utilisation of general practitioner and specialist services in 9 European countries
Directory of Open Access Journals (Sweden)
Mielck Andreas
2011-10-01
Full Text Available Abstract Background The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the gap in knowledge we pay a special attention to the magnitude of inequalities among patients with chronic conditions. Methods Data on the use of GP and specialist services were derived from national health surveys of Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands and Norway. For each country and education level we calculated the absolute prevalence and relative inequalities in utilisation of GP and specialist services. In order to account for the need for care, the results were adjusted by the measure of self-assessed health. Results People with lower education used GP services equally often in most countries (except Belgium and Germany compared with those with a higher level of education. At the same time people with a higher education used specialist care services significantly more often in all countries, except in the Netherlands. The general pattern of educational inequalities in utilisation of specialist care was similar for both men and women. Inequalities in utilisation of specialist care were equally large in Eastern European and in Western European countries, except for Latvia where the inequalities were somewhat larger. Similarly, large inequalities were found in the utilisation of specialist care among patients with chronic diseases, diabetes, and hypertension. Conclusions We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases.
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Inequalities in utilisation of general practitioner and specialist services in 9 European countries.
Stirbu, Irina; Kunst, Anton E; Mielck, Andreas; Mackenbach, Johan P
2011-10-31
The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the gap in knowledge we pay a special attention to the magnitude of inequalities among patients with chronic conditions. Data on the use of GP and specialist services were derived from national health surveys of Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands and Norway. For each country and education level we calculated the absolute prevalence and relative inequalities in utilisation of GP and specialist services. In order to account for the need for care, the results were adjusted by the measure of self-assessed health. People with lower education used GP services equally often in most countries (except Belgium and Germany) compared with those with a higher level of education. At the same time people with a higher education used specialist care services significantly more often in all countries, except in the Netherlands. The general pattern of educational inequalities in utilisation of specialist care was similar for both men and women. Inequalities in utilisation of specialist care were equally large in Eastern European and in Western European countries, except for Latvia where the inequalities were somewhat larger. Similarly, large inequalities were found in the utilisation of specialist care among patients with chronic diseases, diabetes, and hypertension. We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases. © 2011 Stirbu et al; licensee BioMed Central Ltd.
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Work-based assessment within Malta’s specialist training programme in family medicine
Sammut, Mario R.; Abela, Gunther
2014-01-01
The Specialist Training Programme in Family Medicine (STPFM) – Malta was drawn up by the Malta College of Family Doctors in 2006, approved by Malta’s Specialist Accreditation Committee, and launched in 2007 by the Primary Health Care Department and the Malta College of Family Doctors. This article regarding the work-based assessment of specialist training in family medicine in Malta was prepared by consulting various local / international documents and publications tha...
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Investigation of structure in the modular light pipe component for LED automotive lamp
Chen, Hsi-Chao; Zhou, Yang; Huang, Chien-Sheng; Jhong, Wan-Ling; Cheng, Bo-Wei; Jhang, Jhe-Ming
2014-09-01
Light-Emitting Diodes (LEDs) have the advantages of small length, long lifetime, fast response time (μs), low voltage, good mechanical properties and environmental protection. Furthermore, LEDs could replace the halogen lamps to avoid the mercury pollution and economize the use of energy. Therefore, the LEDs could instead of the traditional lamp in the future and became an important light source. The proposal of this study was to investigate the effects of the structure and length of the reflector component for a LED automotive lamp. The novel LED automotive lamp was assembled by several different modularization columnar. The optimized design of the different structure and the length to the reflector was simulated by software TracePro. The design result must met the vehicle regulation of United Nations Economic Commission for Europe (UNECE) such as ECE-R19 etc. The structure of the light pipe could be designed by two steps structure. Then constitute the proper structure and choose different power LED to meet the luminous intensity of the vehicle regulation. The simulation result shows the proper structure and length has the best total luminous flux and a high luminous efficiency for the system. Also, the stray light could meet the vehicle regulation of ECE R19. Finally, the experimental result of the selected structure and length of the light pipe could match the simulation result above 80%.
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Collaboration with general practitioners : preferences of medical specialists - a qualitative study
Berendsen, Annette J.; Benneker, Wim H. G. M.; Schuling, Jan; Rijkers-Koorn, Nienke; Slaets, Joris P. J.; Meyboom-de Jong, Betty
2006-01-01
Background: Collaboration between general practitioners (GPs) and specialists has been the focus of many collaborative care projects during the past decade. Unfortunately, quite a number of these projects failed. This raises the question of what motivates medical specialists to initiate and continue
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Mountain Warfare: The Need for Specialist Training
National Research Council Canada - National Science Library
Malik, Muhammad
2003-01-01
This study focuses on the need for specialist training for mountain warfare. It analyzes the special characteristics of mountain and high altitude terrain which affect conduct of military operations...
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LED Technology for Dental Applications
DEFF Research Database (Denmark)
Argyraki, Aikaterini; Ou, Yiyu; Soerensen, L. H.
LEDs have a large potential in many dental and oral applications. Areas such as photo polymerization, fluorescence imaging, photodynamic therapy, and photoactivated disinfection are important future candidates for LED based diagnostics and treatment in dentistry.......LEDs have a large potential in many dental and oral applications. Areas such as photo polymerization, fluorescence imaging, photodynamic therapy, and photoactivated disinfection are important future candidates for LED based diagnostics and treatment in dentistry....
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Broadband Radiometric LED Measurements
Eppeldauer, G. P.; Cooksey, C. C.; Yoon, H. W.; Hanssen, L. M.; Podobedov, V. B.; Vest, R. E.; Arp, U.; Miller, C. C.
2016-01-01
At present, broadband radiometric measurements of LEDs with uniform and low-uncertainty results are not available. Currently, either complicated and expensive spectral radiometric measurements or broadband photometric LED measurements are used. The broadband photometric measurements are based on the CIE standardized V(��) function, which cannot be used in the UV range and leads to large errors when blue or red LEDs are measured in its wings, where the realization is always poor. Reference irr...
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The Peer Specialist : Opportunities for the Recovery of Suicidal Care Consumers
van Bergen, Diana; Huisman, Annemiek
2017-01-01
The emergence of peer specialists with a history of suicidality who work with suicidal care consumers is a recent phenomenon that increasingly receives attention in the field of suicide prevention. Peer specialists aim at: 1) Establishing a more open discussion of suicidality; 2) Enabling attempt
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Modeling fraud detection and the incorporation of forensic specialists in the audit process
DEFF Research Database (Denmark)
Sakalauskaite, Dominyka
Financial statement audits are still comparatively poor in fraud detection. Forensic specialists can play a significant role in increasing audit quality. In this paper, based on prior academic research, I develop a model of fraud detection and the incorporation of forensic specialists in the audit...... process. The intention of the model is to identify the reasons why the audit is weak in fraud detection and to provide the analytical framework to assess whether the incorporation of forensic specialists can help to improve it. The results show that such specialists can potentially improve the fraud...... detection in the audit, but might also cause some negative implications. Overall, even though fraud detection is one of the main topics in research there are very few studies done on the subject of how auditors co-operate with forensic specialists. Thus, the paper concludes with suggestions for further...
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Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Donald, Faith; Martin-Misener, Ruth; Kilpatrick, Kelley; Harbman, Patricia; Kaasalainen, Sharon; Marshall, Deborah; Charbonneau-Smith, Renee; DiCenso, Alba
2015-10-01
Clinical nurse specialists (CNSs) are major providers of transitional care. This paper describes a systematic review of randomized controlled trials (RCTs) evaluating the clinical effectiveness and cost-effectiveness of CNS transitional care. We searched 10 electronic databases, 1980 to July 2013, and hand-searched reference lists and key journals for RCTs that evaluated health system outcomes of CNS transitional care. Study quality was assessed using the Cochrane Risk of Bias and Quality of Health Economic Studies tools. The quality of evidence for individual outcomes was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. We pooled data for similar outcomes. Thirteen RCTs of CNS transitional care were identified (n = 2463 participants). The studies had low (n = 3), moderate (n = 8) and high (n = 2) risk of bias and weak economic analyses. Post-cancer surgery, CNS care was superior in reducing patient mortality. For patients with heart failure, CNS care delayed time to and reduced death or re-hospitalization, improved treatment adherence and patient satisfaction, and reduced costs and length of re-hospitalization stay. For elderly patients and caregivers, CNS care improved caregiver depression and reduced re-hospitalization, re-hospitalization length of stay and costs. For high-risk pregnant women and very low birthweight infants, CNS care improved infant immunization rates and maternal satisfaction with care and reduced maternal and infant length of hospital stay and costs. There is low-quality evidence that CNS transitional care improves patient health outcomes, delays re-hospitalization and reduces hospital length of stay, re-hospitalization rates and costs. Further research incorporating robust economic evaluation is needed. © 2015 John Wiley & Sons, Ltd.
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Impact of specialist palliative care on coping with Parkinson's disease: patients and carers.
Badger, Nathan J; Frizelle, Dorothy; Adams, Debi; Johnson, Miriam J
2018-01-09
UK guidelines recommend palliative care access for people with Parkinson's disease; however, this remains sporadic, and it is unknown whether specialist palliative care helps patients and carers cope with this distressing condition. This study aimed to explore whether, and how, access to specialist palliative care services affected patients' and carers' coping with Parkinson's disease. Semistructured interviews were conducted, audio-recorded and verbatim transcribed. Data were analysed using interpretative phenomenological analysis. Participants were patients with advanced idiopathic Parkinson's disease (n=3), and carers of people with Parkinson's disease (n=5, however, one diagnosis was reviewed) receiving care from an integrated specialist palliative care and Parkinson's disease service in North East England. Access to specialist palliative care helped participants cope with some aspects of advanced Parkinson's disease. Three superordinate themes were developed:' managing uncertainty', 'impacts on the self' and 'specialist palliative care maintaining a positive outlook'. Specialist palliative care helped patients and carers cope with advanced Parkinson's disease. Specialist palliative care is a complex intervention that acknowledges the complex and holistic nature of Parkinson's disease, enabling health in some domains despite continued presence of pathology. These exploratory findings support the utility of this approach for people living with Parkinson's disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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The specialist physician's approach to rheumatoid arthritis in South Africa.
Bester, Frederik C J; Bosch, Fredricka J; van Rensburg, Barend J Jansen
2016-03-01
Rheumatoid arthritis (RA) is expected to increase in Africa and South Africa. Due to the low numbers of rheumatologists in South Africa, specialist physicians also have to care for patients with RA. Furthermore several new developments have taken place in recent years which improved the management and outcome of RA. Classification criteria were updated, assessment follow-up tools were refined and above all, several new biological disease-modifying anti-rheumatic drugs were developed. Therefore it is imperative for specialist physicians to update themselves with the newest developments in the management of RA. This article provides an overview of the newest developments in the management of RA in the South African context. This approach may well apply to countries with similar specialist to patient ratios and disease profiles.
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Training Nuclear Power Specialists
International Nuclear Information System (INIS)
Paulikas, V.
2003-01-01
Situation of preparation of nuclear energy specialists in Lithuania is presented. Nuclear engineers are being prepared at Kaunas University of Technology. In view with decision to decommission Unit 1, the Ignalina NPP is limiting the number of new personnel to fill in vacancies. The main attention is given to the training courses for improvement skills of existing Ignalina NPP, VATESI personnel. Main topics of the training courses are listed. Comparison with previous years on personnel hired and dismissed in Ignalina NPP is made
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LED lamp color control system and method
Gaines, James; Clauberg, Bernd; Van Erp, Josephus A.M.
2013-02-05
An LED lamp color control system and method including an LED lamp having an LED controller 58; and a plurality of LED channels 60 operably connected to the LED controller 58, each of the plurality of LED channels 60 having a channel switch 62 in series with at least one shunted LED circuit 83, the shunted LED circuit 83 having a shunt switch 68 in parallel with an LED source 80. The LED controller 58 determines whether the LED source 80 is in a feedback controllable range, stores measured optical flux for the LED source 80 when the LED source 80 is in the feedback controllable range, and bypasses storing the measured optical flux when the LED source 80 is not in the feedback controllable range.
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Barr, Nigel; Holmes, Mark; Roiko, Anne; Dunn, Peter; Lord, Bill
2018-06-01
This study explored the self-reported behaviors and perceptions of Australian paramedics in relation to their environmental hygiene practices. A national online survey was conducted with Paramedics Australasia members (N = 417). Participants reported working in ambulances often contaminated with body fluids. Widespread noncompliance with routine and deep cleaning of ambulances, and misunderstandings about environmental hygiene practices were apparent. Improvements to environmental hygiene practices of Australian paramedics are recommended to avoid pathogen transmission and ensure patient safety. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
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Linked environmental data. The next step for environmental information systems
Energy Technology Data Exchange (ETDEWEB)
Menger, Matthias; Ackermann, Patrick; Linse, Andreas [Federal Environemnt Agency, Dessau (Germany); Bandholtz, Thomas [innoQ GmbH, Monheim (Germany)
2013-07-01
The Federal Environment Agency (UBA) in Germany as one Competent Authority of the European Member States involved with the assessment and authorisation of chemicals, pesticides, biozides and medicals, has a wide expertise of complex information systems. Having timely, comprehensive and reliable information on the environmental relevant properties (e.g. of chemical substances and preparations) is of immense importance for all sections dealing with environmental protection issues. Regarding the reality of available information systems in each environmental section, and moreover in each section itself, there has been developed several specific approaches to gather, store and search its relevant data. This makes sense due to each section has its own requirements, different user groups (industry and authorities or just authorities or scientific partners etc.), different budgets to bring technology 'on the road', and different (legally obligatory) procedures to handle the data and information of such systems. Nevertheless, there several strong reasons to look for a Linked Environmental Data infrastructure - at least internally in one authority itself: - Overcome the mostly separated systems; - Explore the potential of data silos in several environmental sections; - Efficiency/effectiveness in data gathering, assessment, results, budgets..; - sharing of knowledge, i.e. use of specific prepared information of specially intended information systems; - timelyness of data/information; - best data/information from most competent partner/section; - gain from already available systems and their data/information; - speed up developments and availability of data/information. Of course there are also several points which might be a huge obstacle to Linked Environmental Data (LED), e.g. confidential business data. This leads already to the distinction between 'Open LED' and 'Non-Open LED'. Nevertheless, the potential benefits and the possibilities
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Environmental management strategies: The 21st century perspective
Energy Technology Data Exchange (ETDEWEB)
Crognale, G.
1999-07-01
This book provides a look at how to integrate EH and S issues throughout your organization. Specialists in the field have contributed their first-hand accounts and actual case studies to give a balanced overview of how environmental management issues affect everyone in an organization. Moving away from a regulations-driven viewpoint, a proactive view is taken that integrates environmental issues into the fabric of the organization at every level. Issues covered in the book include federal regulations from OSHA, EC, and EPA; meeting ISO 14001; assessing the value of EH and S as a management tool; progressive environmental stewardship and effective communications; risk management; EH and S software and other resources; and future trends in environmental management.
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[What is parents' and medical health care specialists knowledge about vaccinations?].
Tarczoń, Izabela; Domaradzka, Ewa; Czajka, Hanna
2009-01-01
The aim of the study was to become familiar with parents' and Medical Health Care specialists knowledge and attitude towards vaccinations. The influence of information, provided to patients from various sources, on general opinion about immunization and its coverage within the last year were evaluated. Analysis of questionnaires about vaccinations performed among 151 parents and 180 Medical Health Care specialists. Medical Health Care specialists knowledge was considerably higher in comparison to questioned parents. Surprisingly enough, only approximately 90% of Medical Health Care workers knew about prophylaxis of Hib infections. A doctor is the main and the most reliable source of information for parents. Significant impact on parents' attitude to vaccinations is made not only by campaigns promoting vaccinations, but also by widespread opinions about their harmfulness. The doctor is the major source of reliable information about vaccinations for parents. Therefore, there is the need of continuous improvement of Medical Health Care specialists knowledge, but also the ability of successfully communicating it to parents.
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The role of rehabilitation specialists in Canadian NICUs: a national survey.
Limperopoulos, Catherine; Majnemer, Annette
2002-01-01
Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). A national survey was conducted to elucidate the current roles of rehabilitation specialists. Occupational therapy (OT), physical therapy (PT), and speech and language pathology (SLP) departments in all Canadian health care institutions with tertiary level NICUs (n = 38) were surveyed by telephone. Results indicate that 16% have no rehabilitation coverage, while 11% receive very limited external services (< 1/month). Over half of the OT and PT departments provide weekly services whereas only 5/38 provide SLP coverage. Service delivery includes assessment and a number of therapeutic interventions. Splinting and feeding are predominantly performed by OT, whereas chest physiotherapy and ROM are carried out primarily by PT. Rehabilitation specialists are actively involved in education and case management. The extent of involvement of rehabilitation specialists was discrepant, and highly associated with the type of facility. Rehabilitation services, when provided, are comprehensive and include evaluation, treatment, teaching, decision-making, and family support.
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An LED Approach for Measuring the Photocatalytic Breakdown of Crystal Violet Dye
Ryan, Robert E.; Underwood, Lauren W.; ONeal, Duane; Pagnutti, Mary; Davis, Bruce A.
2009-01-01
A simple technique to assess the reactivity of photocatalytic coatings sprayed onto transmissive glass surfaces was developed. This new method uses ultraviolet (UV) gallium nitride (GaN) light-emitting diodes (LEDs) to drive a photocatalytic reaction (the photocatalytic breakdown of a UV-resistant dye applied to a surface coated with the semiconductor titanium dioxide); and then a combination of a stabilized white light LED and a spectrometer to track the dye degradation as a function of time. Simple, standardized evaluation techniques that assess photocatalytic materials over a variety of environmental conditions, including illumination level, are not generally available and are greatly needed prior to in situ application of photocatalytic technologies. To date, much research pertaining to this aspect of photocatalysis has been limited and has focused primarily on laboratory experiments using mercury lamps. Mercury lamp illumination levels are difficult to control over large ranges and are temporally modulated by line power, limiting their use in helping to understand and predict how photocatalytic materials will behave in natural environmental settings and conditions. The methodology described here, using steady-state LEDs and time series spectroradiometric techniques, is a novel approach to explore the effect of UV light on the photocatalytic degradation of a UV resistant dye (crystal violet). GaN UV LED arrays, centered around 365 nm with an adjustable DC power supply, are used to create a small, spatially uniform light field where the steady state light level can be varied over three to four orders of magnitude. For this study, a set of glass microscope slides was custom coated with a thinly sprayed layer of photocatalytic titanium dioxide. Crystal violet was then applied to these titanium-dioxide coated slides and to uncoated control slides. The slides were then illuminated at various light levels from the dye side of the slide by the UV LED array. To monitor
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A Survey of Headache Medicine Specialists on Career Satisfaction and Burnout.
Evans, Randolph W; Ghosh, Kamalika
2015-01-01
Physicians report increasing rates of career dissatisfaction and professional burnout, which may be related to the practice environment and subspecialty. There has never been a survey of professional burnout among headache medicine specialists. The aim of the present survey was to learn more about how headache medicine physicians are affected by these issues. An email survey was sent to 749 physician members of the American Headache Society with questions or statements about demographics, professional quality of life and satisfaction, future practice plans, and professional burnout using the Maslach Burnout Inventory. In a sample of 127 headache medicine specialists, 66 (57.4%) physicians reported symptoms of professional burnout reflected by high Emotional Exhaustion and/or high Depersonalization. There is widespread dissatisfaction with work schedules, government regulations, implementation of the Affordable Care Act, insurance company policies, malpractice concerns, patient telephone calls, and compensation. Sixty-two percent of respondents concur that headache medicine is becoming more complicated without patient benefit, 14% concur that headache medicine specialists are fairly compensated, and 59% would go into headache medicine again if they were fourth year medical students. In the next 1 to 3 years, 21.3% plan to cut back on hours, 14.2% plan to cut back on patients seen, and 12.6% plan to switch to a cash practice. Medicine and healthcare are changing in such a way that 33.9% concur that they will accelerate their retirement plans. Headache medicine specialists have one of the highest rates of burnout compared to other physician specialists, which is twice the rate of working adults. Physicians' age and practice environment and experience are related with their career satisfaction and professional burnout. Some attributes of career satisfaction can decrease burnout by reducing emotional exhaustion and depersonalization and by enhancing personal
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Plant growth regulation by the light of LEDs; LED ko wo tsukatta shokubutsu saibai gijutsu
Energy Technology Data Exchange (ETDEWEB)
Watanabe, H. [Mitsubishi Chemical Co., Tokyo (Japan). Yokohama Research Center
1996-03-01
Light Emitting Diode (LED) has not only an excellent display function for the luminescent device but also a superior feature without other lamps as light source for plant growth. It was National Aeronautics and Space Administration (NASA) to find out such merit for this light source for plant growth and try at first to use for plant growth at the space. They began to examine the LED application to the light source for the plant growth at the space since a stage at high cost of the LED, to develop some researches centered at cultivation of lettuce, wheat, and others. Finding out future possibility of cost-down of the LEDs on the cost/performance and large merits of the LEDs for control of the plant growth and plant physiology, authors have conducted some cultivation experiments of the plants using the LEDs for light source some years ago. In this papers, characterizations, actual possibility, and future developments of the LEDs for the light sources of the plant growth, are introduced. 5 refs., 4 figs.
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DEFF Research Database (Denmark)
Ashton, Toni; Brown, Paul M.; Sopina, Elizaveta (Liza)
2013-01-01
and professional development, key sources of dissatisfaction are workload pressures, mentally demanding work and managerial interference. In the private sector specialists value the opportunity to work independently and apply their own ideas in the workplace. Conclusion Sources of job satisfaction...... and dissatisfaction amongst specialists are different for the public and private sectors. Allowing specialists more freedom to work independently and to apply their own ideas in the workplace may enhance recruitment and retention of specialists in the public health system....
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Payload specialist Ronald Parise using SAREX
1995-01-01
ASTRO-2 payload specialist Ronald A. Parise reminisces on his inspace amateur radio experience of five years ago in the ASTRO-1 mission. Using the Shuttle Amateur Radio Experiment (SAREX), Parise talks to students on Earth from the flight deck of the Earth orbiting Space Shuttle Endeavour.
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International Nuclear Information System (INIS)
Iskandarov, T.I.; Kamil'dzhanov, A.Kh.
2000-01-01
The VII congress of hygienists, sanitarians, epidemiologists and infectious diseases specialists of the republic of Uzbekistan 'Actual problems of hygiene, toxicology, epidemiology and infectious diseases in the republic of Uzbekistan' was held on 2000 in Tashkent, Uzbekistan. Specialists discussed various aspects of actual problems of hygiene, toxicology, epidemiology and infectious diseases . They discussed also some aspects of radiology and nuclear medicine, radiation protection and dosimetry, radiation and other environmental pollutant effect on living organisms and biological materials. More than 100 talks were presented in the meeting. (k.m.)
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Motivation and stimulation of employment specialists in the sphere of information technologies
Directory of Open Access Journals (Sweden)
S. Bazhenov
2015-01-01
Full Text Available The article discusses the concept of "Information and communication technologies." The characteristic of the labor specialists in the sphere of information technologies, namely the characteristics of the object, means and product of their labor. The author of the article deals with the specifics of specialists of the topic. We study the needs and motivations of IT professionals. A method for evaluating the effectiveness of labor specialists in the sphere of information technologies and offered rates for calculating the efficiency of workers, including factors: timeliness; the number of completed tasks; detected errors; the cost of bug fixes. Purpose of the article – to reveal the specifics of working IT professionals, and especially to justify the incentives and motivation of specialists in this field. The objectives of the article: to characterize the concept of "Information and communications technologies"; identify the main needs and motivations of IT professionals; develop a method for evaluating the effectiveness of specialists in this field.Methodology. In conducting this study the main sources of raw data served as the information contained in scientific, reference, periodical literature on the subject in question, including the sources of information and telecommunications network "Internet". The basis of methodological developments put the comparative methods of analysis and synthesis of existing data.Results. The characteristic of the concept of "Information and communication technologies." It is proved that the work of specialists in the sphere of information technologies is intellectual work, and that the subject, the means and the product of this kind of work – are special types of information in digital form. Emphasize that as part of the system of social production, work in the field of software development (software performs a task and a number of specific functions: creative, integration, stimulating, consumer
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Administrative Perceptions on the Role of the School Library Media Specialist
Page, Kayla
2013-01-01
Despite the efforts of local school library media specialists to promote their programming, many administrators do not understand the roles and responsibilities of the school library media specialist. Using a constructivist theoretical framework, this study was designed to examine the local school administrators' perceptions of the role of the…
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Health Education Specialist Practice Analysis 2015 (HESPA 2015): Process and Outcomes
McKenzie, James F.; Dennis, Dixie; Auld, M. Elaine; Lysoby, Linda; Doyle, Eva; Muenzen, Patricia M.; Caro, Carla M.; Kusorgbor-Narh, Cynthia S.
2016-01-01
The Health Education Specialist Practice Analysis 2015 (HESPA 2015) was conducted to update and validate the Areas of Responsibilities, Competencies, and Sub-competencies for Entry- and Advanced-Level Health Education Specialists. Two data collection instruments were developed--one was focused on Sub-competencies and the other on knowledge items…
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Directory of Open Access Journals (Sweden)
Ming-Hsin Phoebe Chiu
2009-12-01
Full Text Available Subject specialists are important assets in academic and research libraries. They possess not only the specialized knowledge of a particular subject field, but also the skills in library and information services. Looming shortage of qualified subject specialists resulting from the retirement of current professionals, most likely the baby-boomer generation, persuasively suggests that education and training are in urgent need of rethinking. This empirical study was conducted within the context of Library and Information Science education and academic librarianship in North America. Survey, content analysis, and focus group were employed as data collection methods. This study aims to analyze the status of LIS education for subject specialists, education needs and personal attributes of subject specialists, and the qualifications and responsibilities of becoming subject specialists. The goal of the study is to understand the knowledge, skills, and attitude of becoming subject specialists. Results of the study may provide insight into planning of formal curriculum and on-the-job training. [Article content in Chinese
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Environmental information in Colombia
International Nuclear Information System (INIS)
Velez S, Andres
2005-01-01
This article is a chapter from the paper, Elements for the description of an environmental information system, which was written by the author as a requirement for the degree of specialist on environment and Geoinformatics at the school of engineering. Universidad de Antioquia. The original paper attempted a description of the context and development of a particular environmental information system, built at the eastern region of Antioquia by CORNARE (a regional autonomous corporation for the environment and the natural resources). This article refers to the Colombian institutional context for environmental information. With particular emphasis laid on the strategic character that must be conceded to the administration of information. Towards the construction of equitable and sustainable development models under autonomous orientation an efficient and transparent environmental administration as is needed by such models is only attainable through the design and application of environmental information systems committed to the pursuit of collective interests. Here a balance is sought between accomplishments and failures reached during the long standing discussion held in Colombia around the formulation of public policies that acknowledge and strengthen the role of information as a cornerstone of environmental administration, and a contribution towards the goal of human sustainable development
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O'Sullivan, Belinda; McGrail, Matthew; Russell, Deborah
2017-12-01
Systematically describe the characteristics of rural specialists, their work and job satisfaction by geographical location of work. Cross-sectional. Three thousand, four hundred and seventy-nine medical specialists participating in the 2014 Medicine in Australia: Balancing Employment and Life (MABEL) survey of doctors. Location of practice, whether metropolitan, large (>50 000 population) or small regional centres (Rural specialists had more on-call requirements and poorer professional development opportunities. However, satisfaction with work hours, remuneration, variety of work, level of responsibility, opportunities to use abilities and overall satisfaction did not differ. Specialists in general medicine and general surgery were significantly more likely to work rurally compared with anaesthetists, particularly in small regional centres, whereas a range of other relevant specialists had lower than the average rural distribution and paediatricians and endocrinologists were significantly less likely to work in large regional centres. Rural specialists are just as satisfied as metropolitan counterparts reporting equivalent variety and responsibility at work. Better support for on-call demands and access to professional development could attract more specialists to rural practice. Increased rural training opportunities and regional workforce planning is needed to develop and recruit relevant specialties. Specifically, targeted support is warranted for training and development of specialists in general medicine and general surgery and overseas-trained specialists, who provide essential services in smaller regional centres. © 2017 National Rural Health Alliance Inc.
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Color homogeneity in LED spotlights
Prins, C.R.; Tukker, T.W.; IJzerman, W.L.; Thije Boonkkamp, ten J.H.M.
2014-01-01
LED is a rising technology in the field of lighting. Halogen spotlights are nowadays replaced by LED spotlights because of their energy efficiency and long lifetime. However, color variation in the light output is a common problem. Poorly designed LED spotlights tend to have yellowish or bluish
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LED lamp power management system and method
Gaines, James; Clauberg, Bernd; Van Erp, Josephus A. M.
2013-03-19
An LED lamp power management system and method including an LED lamp having an LED controller 58; a plurality of LED channels 60 operably connected to the LED controller 58, each of the plurality of LED channels 60 having a channel switch 62 in series with at least one shunted LED circuit 83, the shunted LED circuit 83 having a shunt switch 68 in parallel with an LED source 80. The LED controller 58 reduces power loss in one of the channel switch 62 and the shunt switch 68 when LED lamp electronics power loss (P.sub.loss) exceeds an LED lamp electronics power loss limit (P.sub.lim); and each of the channel switches 62 receives a channel switch control signal 63 from the LED controller 58 and each of the shunt switches 68 receives a shunt switch control signal 69 from the LED controller 58.
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Think Stoma Nurse: a tool to trigger referral to specialist care.
Hanley, Judy; Adams, Jane
This article describes the initial development and subsequent evolution of a simple referral assessment tool for stoma care. The first author's personal experience identified that there was widespread inconsistency in perceptions of local multidisciplinary teams as to when it was appropriate to refer to specific specialist nursing teams. This resulted in both inappropriate and delayed referrals. A 'Think Specialist Nurse' initiative was developed across the author's trust, building on the traffic light template from the 'ThinkGlucose' tool, to facilitate referrals to clinical nurse specialists. The stoma-care specific tool, 'Think Stoma Nurse', has subsequently evolved beyond its initial audience, and has been adapted into materials aimed at patients and carers.
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International Nuclear Information System (INIS)
1997-01-01
Design and management of nuclear fuel has undergone a strong evolution process during past years. The increase of the operating cycle length and of the discharge burnup has led to the use of more advanced fuel designs, as well as to the adoption of fuel efficient operational strategies. The analysis of recent operational experience highlighted a number of issues related to nuclear fuel and control rod events raising concerns about the safety aspects of these new designs and operational strategies, which led to the organisation of this Specialists Meeting on fuel and control rod issues. The meeting was intended to provide a forum for the exchange of information on lessons learned and safety concern related to operating experience with fuel and control rods (degradation, reliability, experience with high burnup fuel, and others). After an opening session 6 papers), this meeting was subdivided into four sessions: Operating experience and safety concern (technical session I - 6 papers), Fuel performance and operational issues (technical session II - 7 papers), Control rod issues (technical session III - 9 papers), Improvement of fuel design (technical session IV.A - 4 papers), Improvement on fuel fabrication and core management (technical session IV.B - 6 papers)
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The Specialist Court for Kosovo: continuity or departure from the hybrid courts model?
Directory of Open Access Journals (Sweden)
Shkёlzen Selimi
2016-01-01
Full Text Available The issue of whether to establish Specialist Chambers within the Kosovo justice system for alleged war crimes committed in Kosovo has been, arguably, one of the most heated debates not only from a political and social point of view, but also from a legal one. While the required amendments in the Constitution and several laws of Kosovo necessary to establish the Specialist Chambers in furtherance of the agreement dated 14 April 2014 between the Republic of Kosovo and the European Union on the Mission of the European Union Rule of Law Mission in Kosovo (“EULEX” will certainly create heated debates in the political level, one may argue that the legal issues that are expected to be encountered when the Specialist Chambers will be operational, may be even more pressing. This is in consideration of the peculiar nature of the Specialist Chambers, which are meant to have their basis within the laws of Kosovo, but at the same time, be independent from them and from control of Kosovo authorities. The purpose of this article is to delineate the possible legal issues that might confront the Specialist Chambers of Kosovo. Its main argument is that, while the Specialist Chambers seem to follow the experience of other hybrid internationalised courts, it still differs from them in some aspects. The challenges that the new Specialist Chambers may need to tackle deal with its jurisdiction and position within the Kosovo Judicial system, and its legitimacy and legal basis.
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Few older people in New Zealand who commit suicide receive specialist psychogeriatric services.
Cheung, Gary; Casey, Jane
2014-08-01
Suicide in older people is a growing public health concern in many parts of the world. The literature on this issue is lacking in New Zealand. The aim of this study is to ascertain whether this group is accessing specialist psychogeriatric services. A retrospective case series study of completed suicides in older people (≥65 years) during a three-year period from January 2010 to December 2012 was performed. An online survey detailing demographic and clinical information was completed by psychiatrists in 15 of the 20 District Health Boards in New Zealand. Only about 15% of older people who committed suicide were accessing specialist psychogeriatric services and the group with the highest suicide rate (men≥85 years) did not feature in specialist services. Depression (61%) was the most common diagnosis and nearly half (35%) had had contact with specialist services within three days prior to the suicide. Over half (52%) had a history of past suicide attempt(s). Older people who complete suicide are infrequently accessing specialist services. In those that do, there are questions to be answered regarding suicide prediction and prevention for this high-risk group of vulnerable individuals. More research is required targeting those not accessing specialist services, in particular the high risk group of older men. The role of general practitioner, community care, the assessment and management of depression and whether there is any access issue to specialist psychogeriatric services require elucidation. © The Royal Australian and New Zealand College of Psychiatrists 2014.
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Part-time and full-time medical specialists, are there differences in allocation of time?
Directory of Open Access Journals (Sweden)
Groenewegen Peter P
2006-03-01
Full Text Available Abstract Background An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and continuity of care. People tend to think that physicians working part-time are less devoted to their work, implying that full-time physicians complete a greater number of tasks. The central question in this article is whether part-time medical specialists allocate their time differently to their tasks than full-time medical specialists. Methods A questionnaire was sent by mail to all internists (N = 817, surgeons (N = 693 and radiologists (N = 621 working in general hospitals in the Netherlands. Questions were asked about the actual situation, such as hours worked and night and weekend shifts. The response was 53% (n = 411 for internists, 52% (n = 359 for surgeons, and 36% (n = 213 for radiologists. Due to non-response on specific questions there were 367 internists, 316 surgeons, and 71 radiologists included in the analyses. Multilevel analyses were used to analyze the data. Results Part-time medical specialists do not spend proportionally more time on direct patient care. With respect to night and weekend shifts, part-time medical specialists account for proportionally more or an equal share of these shifts. The number of hours worked per FTE is higher for part-time than for full-time medical specialists, although this difference is only significant for surgeons. Conclusion In general, part-time medical specialists do their share of the job. However, we focussed on input only. Besides input, output like the numbers of services provided deserves attention as well. The trend in medicine towards more part-time work has an important consequence: more medical specialists are needed to get the work done. Therefore, a greater number of medical specialists
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Foster-Turley, Pat
This discussion paper is intended for policy makers, program managers, technical specialists, and others seeking new tools and ideas with which to achieve environmentally sustainable development. Effective techniques from the field of environmental education and communication (EE&C) that can help biodiversity conservationists and program managers…
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Operative training in otolaryngology in the United Kingdom: a specialist registrar survey
Georgalas, Christos; Hadjihannas, Edward; Ghufoor, Khalid; Pracy, Paul; Papesch, Michael
2005-01-01
OBJECTIVE: To assess the current status of operative training for otolaryngology specialist registrars in the United Kingdom. DESIGN: Web-based questionnaire survey. PARTICIPANTS: All otolaryngology specialist registrars in the United Kingdom. MAIN OUTCOME MEASURES: The overall satisfaction with
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What influences the job satisfaction of staff and associate specialist hospital doctors?
French, Fiona; Ikenwilo, Divine; Scott, Anthony
2007-08-01
Despite their rising numbers in the National Health Service (NHS), the recruitment, retention, morale and educational needs of staff and associate specialist hospital doctors have traditionally not been the focus of attention. A postal survey of all staff grades and associate specialists in NHS Scotland was conducted to investigate the determinants of their job satisfaction. Doctors in both grades were least satisfied with their pay. They were more satisfied if they were treated as equal members of the clinical team, but less satisfied if their workload adversely affected the quality of patient care. With the exception of female associate specialists, respondents who wished to become a consultant were less satisfied with all aspects of their jobs. Associate specialists who worked more sessions also had lower job satisfaction. Non-white staff grades were less satisfied with their job compared with their white counterparts. It is important that associate specialists and staff grades are promoted to consultant posts, where this is desired. It is also important that job satisfaction is enhanced for doctors who do not desire promotion, thereby improving retention. This could be achieved through improved pay, additional clinical training, more flexible working hours and improved status.
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Are nurse-led chemotherapy clinics really nurse-led? : an ethnographic study
Farrell, Carole; Walshe, Catherine Elizabeth; Molassiotis, Alex
2017-01-01
Background: The number of patients requiring ambulatory chemotherapy is increasing year on year, creating problems with capacity in outpatient clinics and chemotherapy units. Although nurse-led chemotherapy clinics have been set up to address this, there is a lack of evaluation of their effectiveness. Despite a rapid expansion in the development of nursing roles and responsibilities in oncology, there is little understanding of the operational aspects of nurses’ roles in nurse-led clinics. Ob...
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Specialist Teams Needed to Support Youth.
Mellin, Laurel M.
1991-01-01
Presents seven reasons why it is important for health specialist teams to take action supporting the prevention and treatment of childhood obesity. The article offers guidelines to help parents assist their children in maintaining positive eating, exercise, and self-esteem patterns, noting sensitive intervention is preferable to imposed diets. (SM)
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Jabiluka project - Draft Environmental Impact Statement. Appendices
International Nuclear Information System (INIS)
1996-01-01
The Appendices provide various technical data in support of studies presented in the Main Report, including the guidelines for an EIS at Jabiluka, environmental requirements, waste management plan, water management system criteria, water quality data, transport licensing and security procedures, rehabilitation plus specialist studies into ore characteristics, noise issues and haulage risk assessment. Copyright (1996) Energy Resources of Australia Limited
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Semper, Julie; Halvorson, Betty; Hersh, Mary; Torres, Clare; Lillington, Linda
2016-01-01
The aim of the study was to describe the clinical nurse specialist role in developing and implementing a staff nurse education program to promote practice accountability using peer review principles. Peer review is essential for professional nursing practice demanding a significant culture change. Clinical nurse specialists in a Magnet-designated community hospital were charged with developing a staff nurse peer review education program. Peer review is a recognized mechanism of professional self-regulation to ensure delivery of quality care. The American Nurses Association strongly urges incorporating peer review in professional nursing practice models. Clinical nurse specialists play a critical role in educating staff nurses about practice accountability. Clinical nurse specialists developed an education program guided by the American Nurses Association's principles of peer review. A baseline needs assessment identified potential barriers and learning needs. Content incorporated tools and strategies to build communication skills, collaboration, practice change, and peer accountability. The education program resulted in increased staff nurse knowledge about peer review and application of peer review principles in practice. Clinical nurse specialists played a critical role in helping staff nurses understand peer review and its application to practice. The clinical nurse specialist role will continue to be important in sustaining the application of peer review principles in practice.
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The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.
Schoonover, Heather
The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.
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Directory of Open Access Journals (Sweden)
Federica Branchi
2015-01-01
Full Text Available Background and Aim. Nonceliac gluten sensitivity is syndrome characterized by symptoms disappearing after a gluten-free diet. Its existence is still argument of discussion among specialists. Our aim was to evaluate the knowledge about nonceliac gluten sensitivity among gastroenterology specialists. Methods. During October 2013 a questionnaire was sent through a medical newsletter to Italian gastroenterologists. Twelve questions investigated their knowledge on nonceliac gluten sensitivity, including their diagnostic and therapeutic approach. Results. A total of 212 gastroenterologists filled in the questionnaire. The 98.6% were aware of the existence of a syndrome called “nonceliac gluten sensitivity” and 77% believe in its existence. However, only 56% gave a correct definition of the term. The majority of specialists diagnosed gluten sensitive patients and the number of diagnoses was not statistically different from that of celiac disease. Moreover, a gluten-free diet was prescribed by 64% of the specialists and among them the 73% noted an increase of gluten sensitive patients attending their outpatient services. Conclusions. Our study indicated that most of the specialists recognize nonceliac gluten sensitivity and prescribe gluten-free diet, although 44% of the specialists are not able to give its correct definition; underlining the necessity of medical education on this topic is needed.
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Schneider, H
2018-05-16
In all phases, patients are entitled to receive medical treatment according to medical specialist standards. This does not mean that patients necessarily have to be treated by a medical specialist. Operations performed by "beginners", e. g. assistant physicians, are permitted. However, there are increased liability risks, both for the specialist and the assistant physician. Furthermore, there are risks of criminal responsibility for causing bodily harm by negligence or negligent manslaughter. This article portrays the requirements of civil liability and criminal responsibility concerning beginners' operations on the basis of cases and judgments of the Federal Court and the Higher Regional Courts in Germany. Additionally, the reception of the jurisprudence by the relevant legal literature will be discussed. Jurisprudence and legal literature categorize breaches of duty of care. Assistant physicians can be subject to contributory negligence liabilities, while specialists can bear liabilities for negligent selection, organization or supervision. Responsible specialist and assistant physicians can protect themselves (and the patient) and avoid legal risks by only performing operations adequate to their educational level or by delegating operations to beginners and ensuring intervention by a specialist by supervision of the operation which is suitable to the assistant physician's level of education.
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Advances in LEDs for automotive applications
Bhardwaj, Jy; Peddada, Rao; Spinger, Benno
2016-03-01
High power LEDs were introduced in automotive headlights in 2006-2007, for example as full LED headlights in the Audi R8 or low beam in Lexus. Since then, LED headlighting has become established in premium and volume automotive segments and beginning to enable new compact form factors such as distributed low beam and new functions such as adaptive driving beam. New generations of highly versatile high power LEDs are emerging to meet these application needs. In this paper, we will detail ongoing advances in LED technology that enable revolutionary styling, performance and adaptive control in automotive headlights. As the standards which govern the necessary lumens on the road are well established, increasing luminance enables not only more design freedom but also headlight cost reduction with space and weight saving through more compact optics. Adaptive headlighting is based on LED pixelation and requires high contrast, high luminance, smaller LEDs with high-packing density for pixelated Matrix Lighting sources. Matrix applications require an extremely tight tolerance on not only the X, Y placement accuracy, but also on the Z height of the LEDs given the precision optics used to image the LEDs onto the road. A new generation of chip scale packaged (CSP) LEDs based on Wafer Level Packaging (WLP) have been developed to meet these needs, offering a form factor less than 20% increase over the LED emitter surface footprint. These miniature LEDs are surface mount devices compatible with automated tools for L2 board direct attach (without the need for an interposer or L1 substrate), meeting the high position accuracy as well as the optical and thermal performance. To illustrate the versatility of the CSP LEDs, we will show the results of, firstly, a reflector-based distributed low beam using multiple individual cavities each with only 20mm height and secondly 3x4 to 3x28 Matrix arrays for adaptive full beam. Also a few key trends in rear lighting and impact on LED light
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Do specialists exit the firm outsourcing its R&D?
DEFF Research Database (Denmark)
Wang, Wenjing
Do specialists exit the firm increasingly outsourcing its research and development (R&D) work? Although this question is critical in understanding how R&D outsourcing links to innovation performance, the answer is not yet clear. This paper proposes that the optimal level of firm's internal...... employment of R&D specialists decreases with the deepening of R&D outsourcing but increases with the broadening of R&D outsourcing. These relations can be inferred from previous empirical studies as well as our theoretical analysis, and are supported by the empirical evidence from estimations of correlated...
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IT Security Specialist | IDRC - International Development Research ...
International Development Research Centre (IDRC) Digital Library (Canada)
The IT Security Specialist takes a strategic role in the delivery of Infrastructure ... on IT Security to project managers, business clients and senior management. ... as a team member or a team leader by undertaking research, investigations, ...
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Thorne, Amanda L; Mercer, Stuart J; Harris, Guy JC; Simson, Jay NL
2006-01-01
INTRODUCTION An audit of patients presenting with colorectal cancer to our district general hospital during a 2-year period from November 1994 found that 12.1% of cases were diagnosed later than 6 months after initial presentation to a physician. This audit was repeated for a 2-year period from December 2001, to determine whether the introduction of a specialist coloproctology surgery service had led to a reduction in late diagnosis of colorectal cancer. PATIENTS AND METHODS Case notes were reviewed of all patients presenting with colorectal cancer between December 2001 and November 2003. Late diagnosis was defined as diagnosis of colorectal cancer more than 6 months after their first attendance to either their general practitioner or district general hospital. The results were compared with those of the previous study. RESULTS Of a total of 218 patients presenting with colorectal cancer during the study period, 14 (6.4%; 10 men and 4 women) satisfied the criteria for late diagnosis, with the longest delay being 12.5 months. Reasons for late diagnosis were false-negative reporting of barium studies (n = 3), inaccurate tumour biopsy (n = 2), concurrent pathology causing anaemia (n = 4), inappropriate delay in definitive investigation (n = 3), and refusal of investigation by patients (n = 2). CONCLUSIONS There has been a reduction of nearly 50% (12.1% to 6.4%) in the proportion of patients with a late diagnosis of colorectal cancer compared with our previous audit. It is suggested that an important factor in this improvement in diagnosis has been the introduction of a specialist coloproctology surgery service. PMID:17059718
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Economic and Environmental Effects of Airline Deregulation
Schipper, Youdi; Rietveld, Piet
1997-01-01
This paper deals with the issue of regulatory reform in the airline industry, in connection with environmental externalities. Deregulation has led to shorter routes, higher frequencies, probably larger aircraft sizes and more intense peak traffic at airports. In addition, deregulation has led to
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Nakajima, Masahiro; Nakamura, Masato; Hiroshige, Yutaka
This paper aims to analyze the formative processes and the current state of a collaboration between ‘outsiders’ and local residents in a System of Rural Regional Environmental management from the view point of human networks. The system seeks to solve the problem of abandoned farmlands led by a group of university students (outsiders). We chronologically classified a total of eighty-nine activities addressing the issue of abandoned farmlands by utilizing three concepts: ‘calculated devices’ (e.g. the making of relations between a group of university students and local residents and strengthening these relations), ‘assistance/participation’, and ‘voluntary interaction/desire’. Based on this analysis, we: 1) developed an understanding of the formative processes as well as the current state of the collaboration between a group of university students and twenty seven local residents from an individual perspective; 2) identified ten key individuals who played a significant role in the activities examined and revealed their characteristics and motivations; 3) suggest that an existing NPO and informal relations between the local residents played a major role in the formation of collaborative networks; 4) argue that the perceived characteristics of the students (e.g. ‘youthful’, ‘inexperienced’) and the Mori-Mori club (e.g. unstable) contributed to the maintenance and expansion of the collaboration between ‘outsiders’ and local residents.
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2011-04-27
...-7945, [email protected] or Rachel Bennett, Environmental Protection Specialist, P.O. Box 129, Grand Canyon, Arizona 86023, 928-638-7326, Rachel[email protected] . SUPPLEMENTARY INFORMATION: If you wish to...
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A novel statistical method for classifying habitat generalists and specialists
DEFF Research Database (Denmark)
Chazdon, Robin L; Chao, Anne; Colwell, Robert K
2011-01-01
in second-growth (SG) and old-growth (OG) rain forests in the Caribbean lowlands of northeastern Costa Rica. We evaluate the multinomial model in detail for the tree data set. Our results for birds were highly concordant with a previous nonstatistical classification, but our method classified a higher......: (1) generalist; (2) habitat A specialist; (3) habitat B specialist; and (4) too rare to classify with confidence. We illustrate our multinomial classification method using two contrasting data sets: (1) bird abundance in woodland and heath habitats in southeastern Australia and (2) tree abundance...... fraction (57.7%) of bird species with statistical confidence. Based on a conservative specialization threshold and adjustment for multiple comparisons, 64.4% of tree species in the full sample were too rare to classify with confidence. Among the species classified, OG specialists constituted the largest...
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Environmental Design Pedagogy in Leningrad in the 1980s
DEFF Research Database (Denmark)
Karpova, Yulia
2019-01-01
of America with the support of the U.S. Environmental Protection Agency, and held in San Jose, California, in August 1992. At this event, young Leningrad designers demonstrated the tendency to de-centre the consumer in their picture of environmental design, and, arguably, took a step towards a post...... awareness. In cooperation with environmentalists, philosophers, historians and other specialists, industrial designers sought for specific methods of environmentally affirmative design. In line with this, they also called for a corresponding reconsideration of design pedagogy: no adding “environmental...... design” as an extra discipline to design departments, but orienting the whole curriculum towards solving environmental issues. This chapter highlights tensions and contradictions of late Soviet design environmentalism by considering the case of a design workshop run by Vladimir Kirpichev at Mukhina...
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Ashton, Toni; Brown, Paul; Sopina, Elizaveta; Cameron, Linda; Tenbensel, Timothy; Windsor, John
2013-09-27
As in many countries, medical and surgical specialists in New Zealand have the opportunity of working in the public sector, the private sector or both. This study aimed to explore the level and sources of satisfaction and dissatisfaction of specialists in New Zealand with working in the two sectors. Such information can assist workforce planning, management and policy and may inform the wider debate about the relationship between the two sectors. A postal survey was conducted of 1983 registered specialists throughout New Zealand. Respondents were asked to assess 14 sources of satisfaction and 9 sources of dissatisfaction according to a 5-point Likert scale. Means and standard deviations were calculated for the total sample, and for procedural and non-procedural specialties. Differences between the means of each source of satisfaction and dissatisfaction were also calculated. Completed surveys were received from 943 specialists (47% response rate). Overall mean levels of satisfaction were higher in the private sector than the public sector while levels of dissatisfaction were lower. While the public system is valued for its opportunities for further education and professional development, key sources of dissatisfaction are workload pressures, mentally demanding work and managerial interference. In the private sector specialists value the opportunity to work independently and apply their own ideas in the workplace. Sources of job satisfaction and dissatisfaction amongst specialists are different for the public and private sectors. Allowing specialists more freedom to work independently and to apply their own ideas in the workplace may enhance recruitment and retention of specialists in the public health system.
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Commissioning of specialist palliative care services in England.
Lancaster, Harriet; Finlay, Ilora; Downman, Maxwell; Dumas, James
2018-03-01
Some failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise. We sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services. 29 CCGs provided information about the number of patients with some form of palliative care needs in their population. For specialist palliative care services, CCGs allocated budgets ranging from £51.83 to £2329.19 per patient per annum. 163 CCGs (77.90%) currently commission 7-day admission to their specialist palliative care beds. 82.84% of CCGs commission 7-day specialist palliative care services in patients' own homes and out-of-hours services rely heavily on hospice provision. 64 CCGs (31.37%) commission pain control teams, the majority of whom only operate in regular working hours. 68.14% of CCGs reported commissioning palliative care education of any sort for healthcare professionals and 44.85% of CCGs had no plans to update or review their palliative care services. The most important finding from this exercise is that the information CCGs hold about their population and services is not standardised. However, information based on data that are more objective, for example, population and total budget for palliative care, demonstrate wide variations in commissioning. 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/.
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Environmental consequences of energy production: Proceedings
Energy Technology Data Exchange (ETDEWEB)
none,
1989-01-01
The Seventeenth Annual Illinois Energy conference entitled Environmental consequences of Energy Production was held in Chicago, Illinois on October 19-20, 1989. The purpose of the meeting was to provide a forum for exchange of information on the technical, economic and institutional issues surrounding energy production and related environmental problems. The conference program was developed by a planning committee which included Illinois energy and environmental specialists from the major sectors including energy industries, environmental organizations, research universities, utility companies, federal, state and local government agencies, and public interest groups. The conference included presentations on four major topic areas. The issue areas were: urban pollution: where are we now and what needs to be done in the future; the acid rain problem: implications of proposed federal legislation on the Midwest; global warming: an update on the scientific debate; and strategies to minimize environmental damage. Separate abstracts have been prepared for the individual presentations. (FL)
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DEFF Research Database (Denmark)
Ou, Haiyan; Corell, Dennis Dan; Dam-Hansen, Carsten
2010-01-01
This paper explored the feasibility of making a white LED light source by color mixing method without using the blue color. This ‘no blue’ white LED has potential applications in photolithography room illumination, medical treatment and biophotonics research. A no-blue LED was designed......-2005. Even after 15 days of illumination, no effect was observed. So this LED-based solution was demonstrated to be a very promising light source for photolithography room illumination due to its better color rendering in addition to energy efficiency, long life time and design flexibility. Additionally......, and the prototype was fabricated. The spectral power distribution of both the LED bulb and the yellow fluorescent tube was measured. Based on that, colorimetric values were calculated and compared on terms of chromatic coordinates, correlated color temperature, color rendering index, and chromatic deviation...
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Virdee, Mandeep S; Stewart, Derek
2017-02-01
Background Updated evidence-based guidelines for the management of atrial fibrillation (AF) necessitate patient review, particularly with respect to oral anticoagulants, to ensure maximum health gain around stroke prophylaxis. Objective To quantify the level of anticoagulation utilisation in patients with a CHA 2 DS 2 -VASc ≥1/≥2 (male/female) according to evidence-based guidelines and to assess the impact of a pharmacist-led intervention to optimise therapy. Setting Fifteen general medical practices in Liverpool, North-West England with a practice population of 99,129. Method GRASP-AF software was employed to interrogate patient electronic medical records to identify and risk stratify AF patients (using CHA 2 DS 2 -VASc). A pharmacist then reviewed the medical records of those of patients not anticoagulated and with a CHA 2 DS 2 -VASc ≥1/≥2 (male/female). Recommendations were discussed with a general practitioner (GP) and those patients in whom the need for anticoagulation was agreed were invited for a consultation with either the pharmacist or GP and therapy optimised where appropriate. The GPs were responsible for managing those patients referred for diagnosis confirmation or further specialist opinion. Main outcome measure Proportion of patients eligible/not eligible for anticoagulation; proportions in whom anticoagulants initiated, refused, antiplatelets discontinued. Results Five hundred and twenty-three patients (31% of patients identified with AF and a CHA 2 DS 2 -VASc ≥1/≥2 (male/female)) were not receiving an anticoagulant (26 subsequently died or left the practice leaving 497). Three hundred and eighty-two (77%) pharmacist recommendations to a GP were agreed without modification. Following outcomes of diagnostic investigations and specialist referrals, 202 (41%) patients were candidates for anticoagulation, 251 (51%) were not eligible for anticoagulation, 103 (21%) were anticoagulated (56 warfarin, 47 DOAC). Conclusion A pharmacist-led
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Plant growth with Led lighting systems
International Nuclear Information System (INIS)
Campiotti, C.A.; Bernardini, A.; Di Carlo, F.; Scoccianti, M.; Alonzo, G.; Carlino, M.; Dondi, F.; Bibbiani, C.
2009-01-01
Leds lighting is highly relevant for the horticultural industry. Compared to other light sources used for plant production, leds have several properties which are potentially useful in relation to horticulture. However, although LEDs technology has raised strong interest in research for extraterrestrial agriculture, current LEDs panel costs are still too high for commercial adoption in greenhouse sector, and their electrical efficacies do not compete with those of high-pressure sodium lamps, but several manufactures are working to address these issues. When LEDs become practical, their ability to based light sources specifically suitable for photosynthesis and other horticulturally relevant plant properties (i.e. low radiated heat; lighting from within the canopy) will render the narrow band spectrum of LEDs of particular interest for providing light to greenhouse horticulture. A general description of LEDs application and their technical characteristics is briefly reported. [it
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Promoting Renewable Energy or Environmental Problems?
DEFF Research Database (Denmark)
Raftopoulos, Malayna; Riethof, Marieke
2016-01-01
emissions and their vulnerability to climate change and environmental disasters such as droughts, floods, deforestation, landslides and pollution. In environmental terms, Brazil’s exports to China have led to changes in land use focused on export agriculture, the construction of infrastructure in vulnerable...
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Perceived learning effectiveness of a course Facebook page: teacher-led versus student-led approach
Directory of Open Access Journals (Sweden)
Tugba Orten Tugrul
2017-01-01
Full Text Available This research aims to compare the perceived effectiveness of teacher -led and student-led content management approaches embraced in a course Facebook page designed to enhance traditional classroom learning. Eighty-five undergraduate marketing course students voluntarily completed a questionnaire composed of two parts; a depiction of a course Facebook page where both teacher and students can share instructional contents, and questions about perceived learning effectiveness. The findings indicate that students have more favorable evaluations of a student-led approach in sharing instructional contents on a course Facebook Page than a teacher-led approach. Additionally, it is shown that instructional contents posted by both teacher and students enhance the overall learning effectiveness of a course Facebook page incorporated into a traditional classroom teaching.
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Education of radiation safety specialists at Faculty of Medicine of Vilnius University
International Nuclear Information System (INIS)
Urbelis, A.; Surkiene, G.
2004-01-01
Vilnius University is the first institution of higher education in Lithuania that began to teach students on radiation safety. The special course of radiation hygiene was delivered to students in 1962-1992. In 1992 it was introduced residency of radiation hygiene and graduated students qualified for title of radiation hygiene specialist. The residency lasted one year and included six cycles: fundamentals of nuclear physics, statistics and noninfectious epidemiology, radiobiology, radiological research methods, controls of radiation safety and hygienic analysis of radiation safety. From 1994 Vilnius University has been educating and training professionals of public health. The specialists of radiation safety aren't been training as isolated branch. All courses is divided into two parts. The first one is included into bachelor, the second part - into master study. The bachelor study consists of 2 credits (16 hours for lectures and 32 hours for practical studies). The future bachelors study introduction of radiation safety, elements of nuclear physics, dose limit values, fundamentals of radiological protection, natural radiation. The master study consists of 2 credits (8 hours for lectures and 48 hours for practical studies). The future masters study specific problems of radiation safety in medicine and industry, the safety problems of nuclear power - stations, the problems of radioactive wastes, radiation biology, radiation risk. Radiation safety study model in Faculty of medicine of Vilnius University differs from study model in most European countries as it makes great play of radiation safety while usual model includes radiation safety as insignificant part of environmental health. (author)
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The role of specialist nurses in multiple sclerosis: a rapid and systematic review.
De Broe, S; Christopher, F; Waugh, N
2001-01-01
Multiple sclerosis (MS) is a disease of the central nervous system. The cause is unknown. There are about 80-160 people with MS per 100,000 population, with twice as many women affected as men. The management of individuals with MS includes treatment of acute relapses and chronic symptoms. The care of MS patients is provided by various healthcare professionals, such as general practitioners (GPs), neurologists, physiotherapists, occupational therapists and nurses. Some MS patients have access to an MS specialist nurse, although this provision varies geographically. The aim of this report is to assess the effectiveness and relative cost-effectiveness of MS specialist nurses in improving care and outcomes for patients with MS. A systematic review of the literature, involving a range of databases, was performed. Full details are described in the main report. Only one study was identified that tried to evaluate the benefit of MS specialist nurses. The study concluded that MS patients and their carers found the MS specialist nurse to be helpful, particularly in improving their knowledge of MS, ability to cope, mood and confidence about the future. GPs also reported finding the nurse to be helpful with their MS patients, and 40% of the GPs stated they would purchase the services of an MS specialist nurse if their practices became fundholding. However, there were considerable methodological weaknesses inherent in the study design, and it was unclear whether the results of the study could be extrapolated to other settings or to other MS patient groups. RESULTS - ONGOING RESEARCH: There are two ongoing research studies regarding MS specialist nurses. One of these studies involves the provision of MS nurses to several areas, but also has two control populations to allow evaluation of the health benefits of the nurses to MS patients and their carers. This study will help to fill the evidence gap. RESULTS - COSTS: The costs of providing MS specialist nurses consist of their
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Directory of Open Access Journals (Sweden)
Mochamad Arief Sofijanto
2015-03-01
mengetahui perbedaan jumlah hasil tangkapan pada bagan tancap akibat perlakuan warna lampu LED yang berbeda. Metode penelitian yang digunakan adalah deskriptif dan experimental fishing dimana rancangan penelitiannya adalah Rancangan Acak Lengkap (RAL dengan perlakuan warna lampu LED sebanyak 5 jenis warna yaitu merah (A, kuning (B, hijau (C, biru (D, dan putih (E dengan 6 kali ulangan. Secara deskriptif hasil penelitian menunjukkan lampu LED dapat digunakan untuk menggantikan lampu petromaks dan lampu LHE. Diperoleh 17 jenis ikan laut yang tertarik pada cahaya lampu LED yang digunakan. Hasil analisis statistik menunjukkan terdapat perbedaan nyata terhadap hasil tangkapan bagan dengan perlakuan warna lampu LED. Berdasarkan Uji Nyata Terkecil dinyatakan bahwa bagan yang menggunakan warna lampu LED biru mendapatkan hasil tangkapan tertinggi kemudian diikuti oleh warna kuning, hijau, putih dan merah. The set ‘bagan’ (liftnet fishing gear is a kind of fishing gears which using atificial light as fishes gathering. This fishing gear uses an electric generator to turn on the energy saving lamp which hang on under the set ‘bagan’. The price of gasoline more expensive due to the Indonesia government’s fuel subsidy reduced and this make fishing operation costs more expensive for fishermen. This research using the LED lamps that do not use gasoline as fuel because the LED lamps can use the photovoltaic technology (solar cell system. The purposes of this study were: 1 to find out whether the LED lamps can replace the kerosene lamps and saving energy lamps, 2 to know the different in cath using different colours of LED lamps. The reserach methods are descriptive and experimental fishing which used Completely Randomized Design with LED lamps colour treatments i.e: red (A, yellow (B, green (C, blue (D, and white (E, the number of replications are 6 times. LED lamps can be used to replace the kerosene and saving energy lamps. There were 17 species of
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Adult orthodontics in the Republic of Ireland: specialist orthodontists' opinions.
McMorrow, Siobhán Mary; Millett, Declan T
2017-12-01
To report the opinions of specialist orthodontists regarding the profile, characteristics and treatment of adults currently undergoing orthodontic treatment in the Republic of Ireland (ROI) Design/setting: A national cross-sectional questionnaire study in the ROI. A pilot-tested questionnaire was distributed to 122 specialist orthodontists in the ROI. Questions addressed general and treatment information for current adult orthodontic patients. Those whose treatment involved orthognathic surgery were not excluded. A response of 83% was obtained. Ninety-five per cent of specialists reported treating adults, most of whom were self-referred and were typically professional, female and aged 25-35 years. The overall ratio quoted of professionals to non-professionals was almost 3:2. For 50% of specialists, males were estimated to account for 20-40% of their adult cases and for 23%, this increased to an estimated 40-60%. Class II division 1 malocclusion and skeletal II were considered the most common dentofacial characteristics. Occlusal features encountered in decreasing frequency were generalised crowding, increased overjet, deep overbite, late lower incisor crowding, spacing and impacted teeth. Fifteen per cent reported that at least 10% of their adult cases required orthodontics with maxillofacial surgery but 8% reported that this was at least 50%. Treatment challenges commonly acknowledged were overbite reduction, anchorage management, 'black triangles' and overjet reduction. Tooth whitening was reckoned to be used by 19% of specialists. Aesthetic upper and stainless steel lower brackets were indicated to be used most often whereas only 19% used clear aligners and 10% used lingual appliances often. The profile and characteristics of adults currently undergoing orthodontic treatment in the ROI were diverse. Higher estimates were quoted for self- than for general dental practitioner-referral. A high percentage of treatment was reported to be undertaken for non
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The impact of specialist trauma service on major trauma mortality.
Wong, Ting Hway; Lumsdaine, William; Hardy, Benjamin M; Lee, Keegan; Balogh, Zsolt J
2013-03-01
Trauma services throughout the world have had positive effects on trauma-related mortality. Australian trauma services are generally more consultative in nature rather than the North American model of full trauma admission service. We hypothesized that the introduction of a consultative specialist trauma service in a Level I Australian trauma center would reduce mortality of the severely injured. A 10-year retrospective study (January 1, 2002-December 31, 2011) was performed on all trauma patients admitted with an Injury Severity Score (ISS) > 15. Patients were identified from the trauma registry, and data for age, sex, mechanism of injury, ISS, survival to discharge, and length of stay were collected. Mortality was examined for patients with severe injury (ISS > 15) and patients with critical injury (ISS > 24) and compared for the three periods: 2002-2004 (without trauma specialist), 2005-2007 (with trauma specialist), and 2008-2011 (with specialist trauma service). A total of 3,869 severely injured (ISS > 15) trauma patients were identified during the 10-year period. Of these, 2,826 (73%) were male, 1,513 (39%) were critically injured (ISS > 24), and more than 97% (3,754) were the victim of blunt trauma. Overall mortality decreased from 12.4% to 9.3% (relative risk, 0.75) from period one to period three and from 25.4% to 20.3% (relative risk, 0.80) for patients with critical injury. A 0.46% per year decrease (p = 0.018) in mortality was detected (odds ratio, 0.63; p 24), the trend was (0.61% per year; odds ratio, 0.68; p = 0.039). The introduction of a specialist trauma service decreased the mortality of patients with severe injury, the model of care should be considered to implement state- and nationwide in Australia. Epidemiologic study, level III.
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Entomology Specialist 1-1. Military Curriculum Materials for Vocational and Technical Education.
Jones, Jimmie L.
This individualized, self-paced course for training an entomology specialist was adapted from military curriculum materials for use in vocational and technical education. Completion of the course should provide students with basic information needed to accomplish the following duties of an entomology specialist: perform entomological work, apply…
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The Association for Educational Communications and Technology: Division of School Media Specialists.
Miller, Mary Mock
1993-01-01
Reports on the Division of School Media Specialists of the Association for Educational Communications and Technology (AECT). Highlights include the mission statement; publications; board members and committee chairs; activities at the AECT conferences; and future concerns, including public relations and marketing plans for media specialists and…
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Asthma management in a specialist setting: Results of an Italian Respiratory Society survey.
Braido, Fulvio; Baiardini, Ilaria; Alleri, Pietro; Bacci, Elena; Barbetta, Carlo; Bellocchia, Michela; Benfante, Alida; Blasi, Francesco; Bucca, Caterina; Busceti, Maria Teresa; Centanni, Stefano; Colanardi, Maria Cristina; Contoli, Marco; Corsico, Angelo; D'Amato, Maria; Di Marco, Fabiano; Marco, Dottorini; Ferrari, Marta; Florio, Giovanni; Fois, Alessandro Giuseppe; Foschino Barbaro, Maria Pia; Silvia, Garuti; Girbino, Giuseppe; Grosso, Amelia; Latorre, Manuela; Maniscalco, Sara; Mazza, Francesco; Mereu, Carlo; Molinengo, Giorgia; Ora, Josuel; Paggiaro, Pierluigi; Patella, Vincenzo; Pelaia, Girolamo; Pirina, Pietro; Proietto, Alfio; Rogliani, Paola; Santus, Pierachille; Scichilone, Nicola; Simioli, Francesca; Solidoro, Paolo; Terraneo, Silvia; Zuccon, Umberto; Canonica, Giorgio Walter
2017-06-01
Asthma considerably impairs patients' quality of life and increases healthcare costs. Severity, morbidity, and degree of disease control are the major drivers of its clinical and economic impact. National scientific societies are required to monitor the application of international guidelines and to adopt strategies to improve disease control and better allocate resources. to provide a detailed picture of the characteristics of asthma patients and modalities of asthma management by specialists in Italy and to develop recommendations for the daily management of asthma in a specialist setting. A quantitative research program was implemented. Data were collected using an ad hoc questionnaire developed by a group of specialists selected by the Italian Pneumology Society/Italian Respiratory Society. The records of 557 patients were analyzed. In the next few years, specialists are expected to focus their activity patients with more severe disease and will be responsible for selection of patients for personalized biological therapy; however, only 20% of patients attending Italian specialist surgery can be considered severe. In 84.4% of cases, the visit was a follow-up visit requested in 82.2% of cases by the specialist him/herself. The Asthma Control Test is used only in 65% of patients. When available, a significant association has been observed between the test score and asthma control as judged by the physician, although concordance was only moderate (κ = 0.68). Asthma was considered uncontrolled by the specialist managing the case in 29.1% of patients; nevertheless, treatment was not stepped up in uncontrolled or partly controlled patients (modified in only 37.2% of patients). The results of this survey support re-evaluation of asthma management by Italian specialists. More resources should be made available for the initial visit and for more severely ill patients. In addition, more extensive use should be made of validated tools, and available drugs should be used
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Directory of Open Access Journals (Sweden)
Zotova-Sadylo Yelena Yurievna
2013-05-01
Full Text Available Purpose The structural-functional model of professional business communication development of future economic specialists is presented by the author. Its basic components, purpose, function, principles, methods of its practical realization are characterized in the article. Methodology The considered model is aimed at providing advanced and competent levels of professional business communication / cross-cultural business communication of future specialists in economics by means of relevant to the problem special course within a system of humanitarian cycle disciplines, and integrated class hours and extracurricular activity. The main feature of the special course is its integrated character determined by the necessity to synthesize contents of humanitarian cycle disciplines for the purpose of training material comprehensive awareness. Results In this context focused professional extracurricular activity carried out in strict accordance with an overall objective of young specialist training is effective. Successful implementation of structural functional model is possible providing that integrated approach to creative specialists training by means of entire educational and extracurricular activity system.
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Baghianimoghadam, M H; Forghani, H; Zolghadr, R; Rahaei, Z; Khani, P
2012-04-01
Peer-led programmes on AIDS prevention have shown a good level of effectiveness when tested among high-risk populations. This study compared peer-led and teacher-led methods of education about HIV/AIDS among female high-school students in Yazd city, Islamic Republic of Iran. In 2009 students in 3 high schools were trained by their classmates (peer-led), by the research team (teacher-led) or had no education (controls); 180 students completed a specially designed questionnaire based on the health belief model, before and after the intervention. Post-intervention mean knowledge scores increased 2-fold in the peer-led group, and this was significantly higher than the increase in the teacher-led group scores (1.5-fold). Control group scores were unchanged. In the peer-led programme all of the components of the model were significantly improved whereas in the teacher-led programme, only perceived severity and perceived barriers scored significantly higher after the intervention.
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Treatment Algorithm of a Hypertension Specialist
Czech Academy of Sciences Publication Activity Database
Peleška, Jan; Anger, Z.; Buchtela, David; Tomečková, Marie; Veselý, Arnošt; Zvárová, Jana
2007-01-01
Roč. 25, Suppl. 2 (2007), S 383-S 383 ISSN 0952-1178. [European Meeting on Hypertension /17./. 15.06.2007-19.06.2007, Milan] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : treatment algorithm for hypertension * hypertension specialist Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery
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STS-87 Mission Specialist Winston E. Scott suits up
1997-01-01
STS-87 Mission Specialist Winston Scott dons his launch and entry suit with the assistance of a suit technician in the Operations and Checkout Building. This is Scotts second space flight. He and the five other crew members will depart shortly for Launch Pad 39B, where the Space Shuttle Columbia awaits liftoff on a 16-day mission to perform microgravity and solar research. Scott is scheduled to perform an extravehicular activity spacewalk with Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan, during STS-87. He also performed a spacewalk on STS-72.
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Evaluating the outcomes of a podiatry-led assessment service in a public hospital orthopaedic unit.
Bonanno, Daniel R; Medica, Virginia G; Tan, Daphne S; Spring, Anita A; Bird, Adam R; Gazarek, Jana
2014-01-01
list without requiring an orthopaedic consultation. Two-thirds of patients who had an appointment at the podiatry-led assessment service were discharged without requiring a surgical consultation. The introduction of a podiatry-led service assists with timely provision of patient care and ensures those with the greatest need for orthopaedic surgery have improved access to specialist care.
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The role and organisation of community palliative specialist nursing teams in rural England.
Leadbeater, Maria; Staton, Wendy
2014-11-01
This article describes a study that used a qualitative approach, purposive sampling and semi-structured telephone interviews conducted with specialist palliative care nurses from six rural community teams in England. The study investigated how services were organised and the issues of delivering specialist palliative nursing care in a rural area. Qualitative content analysis was used to analyse the data. The findings showed many similarities in that the majority of patients in rural areas were not accessing hospice services and there was a greater reliance on care at home. However, the challenges in delivering care ranged from managing patient expectations, geographical distance, lack of technology to support remote working and education for the specialist palliative care teams. The study makes specific recommendations for rural community specialist palliative care teams.
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A qualitative study of work-life balance amongst specialist orthodontists in the United Kingdom
Cunningham, S. J.; Bateman, L. E.; Collins, J. M.
2016-01-01
Objective: To identify factors affecting work-life balance amongst male and female orthodontists in the United Kingdom. Design: A qualitative interview-based study with a cross-sectional design. Subjects: Specialist orthodontists working in specialist practice and the hospital service in the United Kingdom were selected by purposive sampling. Methods: In-depth semi-structured interviews were conducted with eighteen orthodontic specialists. Interview transcripts were analysed using Framework A...
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A new approach to preparation of standard LEDs for luminous intensity and flux measurement of LEDs
Park, Seung-Nam; Park, Seongchong; Lee, Dong-Hoon
2006-09-01
This work presents an alternative approach for preparing photometric standard LEDs, which is based on a novel functional seasoning method. The main idea of our seasoning method is simultaneously monitoring the light output and the junction voltage to obtain quantitative information on the temperature dependence and the aging effect of the LED emission. We suggested a general model describing the seasoning process by taking junction temperature variation and aging effect into account and implemented a fully automated seasoning facility, which is capable of seasoning 12 LEDs at the same time. By independent measurements of the temperature dependence, we confirmed the discrepancy of the theoretical model to be less than 0.5 % and evaluate the uncertainty contribution of the functional seasoning to be less than 0.5 % for all the seasoned samples. To demonstrate assigning the reference value to a standard LED, the CIE averaged LED intensity (ALI) of the seasoned LEDs was measured with a spectroradiometer-based instrument and the measurement uncertainty was analyzed. The expanded uncertainty of the standard LED prepared by the new approach amounts to be 4 % ~ 5 % (k=2) depending on color without correction of spectral stray light in the spectroradiometer.
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Evaluation of specialist referrals at a rural health care clinic.
Biggerstaff, Mary Ellen; Short, Nancy
2017-07-01
Transition to a value-based care system involves reducing costs improving population health and enhancing the patient experience. Many rural hospitals must rely on specialist referrals because of a lack of an internal system of specialists on staff. This evaluation of the existing specialist referrals from primary care was conducted to better understand and improve the referral process and address costs, population health, and the patient experience. A 6-month retrospective chart review was conducted to evaluate quality and outcomes of specialty referrals submitted by 10 primary care providers. During a 6-month period in 2015, there was a total of 13,601 primary care patient visits and 3814 referrals, a referral rate of approximately 27%. The most striking result of this review was that nearly 50% of referred patients were not making the prescribed specialist appointment. Rather than finding a large number of unnecessary referrals, we found overall referral rates higher than expected, and a large percentage of our patients were not completing their referrals. The data and patterns emerging from this investigation would guide the development of referral protocols for a newly formed accountable care organization and lead to further quality improvement projects: a LEAN effort, dissemination of results to clinical and executive staff, protocols for orthopedic and neurosurgical referrals, and recommendations for future process improvements. ©2017 American Association of Nurse Practitioners.
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Wilson-Sands, Cathy; Brahn, Pamela; Graves, Kristal
2015-01-01
Validating participants' ability to correctly perform cardiopulmonary resuscitation (CPR) skills during basic life support courses can be a challenge for nursing professional development specialists. This study compares two methods of basic life support training, instructor-led and computer-based learning with voice-activated manikins, to identify if one method is more effective for performance of CPR skills. The findings suggest that a computer-based learning course with voice-activated manikins is a more effective method of training for improved CPR performance.
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Trying To Reduce Your Technostress?: Helpful Activities for Teachers and Library Media Specialists.
McKenzie, Barbara K.; And Others
1997-01-01
As pressure increases to integrate technology into instruction, many teachers and library media specialists are having difficulty coping with "technostress." Presents suggestions and activities for teachers and library media specialists designed to reduce "technostress." (PEN)
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Development of the Role Scenario of the Personnel Management Specialist Activity
Directory of Open Access Journals (Sweden)
Stolyaruk Khrystyna S.
2013-12-01
Full Text Available The article is devoted of the issues of development of classification and content of role, which are performed by personnel management specialists in their professional activity. It proves a necessity of development of role scenarios under conditions of application of the competence approach in training and practical activity. Thus, the author offers five key roles in activity of a personnel management specialist, which reflect different vectors of directions of the scenario of professional activity regardless of the performed function and position. The article specifies the following roles in the offered classification: partner, expert, communicator, consultant and curator. It presents results of a sociological study, which demonstrate the degree of co-ordination of opinions of employers and practicing personnel managers with respect to performance of roles in the sphere by their professional activity by the latter. This helps to identify a number of problems, which include the problem of availability of reserves of increase of the level of competence of personnel management specialists. This issue, in its turn, closely deals with main aspects of formation of competitiveness of the said specialists, since the degree of formation of competences is the key condition of formation of competitive advantages.
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The Generalist versus the Specialist: The New Oxford Dictionary Reveals a Gap.
Levine, Martin Lyon
1981-01-01
There is a gap, it is suggested, separating the generally cultured person, not just from the scientist, but from specialists in many fields. Dictionary definitions are seen as one means of seeing the extent to which specialists and those in the general culture speak the same language. (MLW)
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Proceedings of fuel safety research specialists' meeting
International Nuclear Information System (INIS)
Suzuki, Motoe
2002-08-01
Fuel Safety Research Specialists' Meeting, which was organized by Japan Atomic Energy Research Institute, was held on March 4-5, 2002 at JAERI in Tokai Establishment. Purposes of the Meeting are to exchange information and views on LWR fuel safety topics among the specialist participants from domestic and foreign organizations, and to discuss the recent and future fuel research activities in JAERI. In the Meeting, presentations were given and discussions were made on general report of fuel safety research activities, fuel behaviors in normal operation and accident conditions, FP release behaviors in severe accident conditions, and JAERI's ''Advanced LWR Fuel Performance and Safety Research Program''. A poster exhibition was also carried out. The Meeting significantly contributed to planning future program and cooperation in fuel research. This proceeding integrates all the pictures and papers presented in the Meeting. The 10 of the presented papers are indexed individually. (J.P.N.)
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Landscape structure affects specialists but not generalists in naturally fragmented grasslands
Miller, Jesse E.D.; Damschen, Ellen Ingman; Harrison, Susan P.; Grace, James B.
2015-01-01
Understanding how biotic communities respond to landscape spatial structure is critically important for conservation management as natural landscapes become increasingly fragmented. However, empirical studies of the effects of spatial structure on plant species richness have found inconsistent results, suggesting that more comprehensive approaches are needed. In this study, we asked how landscape structure affects total plant species richness and the richness of a guild of specialized plants in a multivariate context. We sampled herbaceous plant communities at 56 dolomite glades (insular, fire-adapted grasslands) across the Missouri Ozarks, and used structural equation modeling (SEM) to analyze the relative importance of landscape structure, soil resource availability, and fire history for plant communities. We found that landscape spatial structure-defined as the area-weighted proximity of glade habitat surrounding study sites (proximity index)-had a significant effect on total plant species richness, but only after we controlled for environmental covariates. Richness of specialist species, but not generalists, was positively related to landscape spatial structure. Our results highlight that local environmental filters must be considered to understand the influence of landscape structure on communities, and that unique species guilds may respond differently to landscape structure than the community as a whole. These findings suggest that both local environment and landscape context should be considered when developing management strategies for species of conservation concern in fragmented habitats.
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Energy Technology Data Exchange (ETDEWEB)
Goehler, Tino
2010-12-17
The external quantum efficiency of light-emitting diodes (LEDs) based on Al- GaAs/InGaAlP is limited by total internal reflection because of the high refractive index (typically between 3 and 4) of the semiconductor. Metal nanoparticles (MNP) deposited on the surface of the LED can be used as dipole scatterers in order to enhance the emission of the LED. In this thesis, first, single gold nanoparticles of various sizes deposited on such an LED were investigated. A clear enhancement is detected as long as the dipole plasmon resonance of the particle is at a shorter wavelength than the LED emission. If the plasmon resonance coincides with the LED emission or is at a larger wavelength, the enhancement turns into suppression. Numerical simulations indicate that this latter effect is mainly caused by the particle quadrupole resonance producing extra absorption. Arrays of MNPs can be produced by a special mask technique called ''Fischer pattern nanolithography'' and manipulated in shape and size by additional steps. Originally, the MNPs produced by this technique are triangular in shape and turn out to suppress the LED emission. After transformation of the particles to spheres, a clear enhancement was detected. Light that would otherwise remain trapped inside the substrate is coupled out by resonant plasmonic scattering. Investigations on analogous structures on a transparent high-index material (GaP) indicate a stronger coupling between the particles than expected on the basis of literature data. (orig.)
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Monitoring stream temperatures—A guide for non-specialists
Heck, Michael P.; Schultz, Luke D.; Hockman-Wert, David; Dinger, Eric C.; Dunham, Jason B.
2018-04-19
Executive SummaryWater temperature influences most physical and biological processes in streams, and along with streamflows is a major driver of ecosystem processes. Collecting data to measure water temperature is therefore imperative, and relatively straightforward. Several protocols exist for collecting stream temperature data, but these are frequently directed towards specialists. This document was developed to address the need for a protocol intended for non-specialists (non-aquatic) staff. It provides specific step-by-step procedures on (1) how to launch data loggers, (2) check the factory calibration of data loggers prior to field use, (3) how to install data loggers in streams for year-round monitoring, (4) how to download and retrieve data loggers from the field, and (5) how to input project data into organizational databases.
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American specialists and SAP project
International Nuclear Information System (INIS)
Andrlova, Z.
2008-01-01
Within the past days of November the project teams of SAP Nuclear in Slovenske elektrarne, a. s. incorporated the specialists from PSEG from New Jersey, U.S.A. The goal of their stay here was to pass on the professional experience and good practice from the implementation of quite demanding project in the nuclear power plants. We have learned more about the company and the objectives from an interview with Clay Warren, SAP Nuclear Project Manager in SE. (author)
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Ensemble modeling to predict habitat suitability for a large-scale disturbance specialist
Quresh S. Latif; Victoria A. Saab; Jonathan G. Dudley; Jeff P. Hollenbeck
2013-01-01
To conserve habitat for disturbance specialist species, ecologists must identify where individuals will likely settle in newly disturbed areas. Habitat suitability models can predict which sites at new disturbances will most likely attract specialists. Without validation data from newly disturbed areas, however, the best approach for maximizing predictive accuracy can...
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Brooks, Caroline; DinanThompson, Maree
2013-01-01
This paper provides a context for exploring the positioning of Physical Education specialist teachers (PE specialist teachers) in primary schools in Queensland in the discourses of teacher professionalism. A critical analysis of literature on the history and status of the subject and its practitioners aims to contextualize discourses in and about…
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Variation of fee-for-service specialist direct care work effort with patient overall illness burden.
Goodman, Robert
2011-08-01
To explore whether a common industry measure of overall patient illness burden, used to assess the total costs of members in a health plan, would be suitable to describe variation in a summary metric of utilization that assesses specialist physician direct patient care services not grouped into clinical episodes, but with exclusion criteria applied to reduce any bias in the data. Data sources/study setting Calendar year 2006 administrative data on 153,557 commercial members enrolled in a non-profit single-state statewide Health Maintenance Organization (HMO) and treated by 4356 specialists in 11 specialties. The health plan's global referral process and specialist fee-for-service reimbursement likely makes these results applicable to the non-managed care setting, as once a global referral was authorized there was no required intervention by the HMO or referring primary care provider for the majority of any subsequent specialist direct clinical care. Study design Specialty-specific correlations and ordinary least-squares regression models to assess variations in specialist direct patient care work effort with patient overall illness burden, after the application of exclusion criteria to reduce potential bias in the data. Principle findings Statistically significant positive correlations exist between specialist direct patient care work effort and patient overall illness burden for all studied specialties. Regression models revealed a generally monotonic increasing relationship between illness burden categories and aggregate specialist direct patient care work effort. Almost all regression model differences from the reference category across specialties are statistically significant (P ≤ 0.012). Assessment of additional results demonstrates the relationship has more substantive significance in some specialties and less in others. The most substantive relationships in this study were found in the specialties of orthopaedic surgery, general surgery and interventional
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O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U
2017-07-01
Objective Targeting rural outreach services to areas of highest relative need is challenging because of the higher costs it imposes on health workers to travel longer distances. This paper studied whether subsidies have the potential to support the provision of specialist outreach services into more remote locations. Methods National data about subsidies for medical specialist outreach providers as part of the Wave 7 Medicine in Australia: Balancing Employment and Life (MABEL) Survey in 2014. Results Nearly half received subsidies: 19% (n=110) from a formal policy, namely the Australian Government Rural Health Outreach Fund (RHOF), and 27% (n=154) from other sources. Subsidised specialists travelled for longer and visited more remote locations relative to the non-subsidised group. In addition, compared with non-subsidised specialists, RHOF-subsidised specialists worked in priority areas and provided equally regular services they intended to continue, despite visiting more remote locations. Conclusion This suggests the RHOF, although limited to one in five specialist outreach providers, is important to increase targeted and stable outreach services in areas of highest relative need. Other subsidies also play a role in facilitating remote service distribution, but may need to be more structured to promote regular, sustained outreach practice. What is known about this topic? There are no studies describing subsidies for specialist doctors to undertake rural outreach work and whether subsidies, including formal and structured subsidies via the Australian Government RHOF, support targeted outreach services compared with no financial support. What does this paper add? Using national data from Australia, we describe subsidisation among specialist outreach providers and show that specialists subsidised via the RHOF or another source are more likely to provide remote outreach services. What are the implications for practitioners? Subsidised specialist outreach providers are
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An accelerated test method of luminous flux depreciation for LED luminaires and lamps
International Nuclear Information System (INIS)
Qian, C.; Fan, X.J.; Fan, J.J.; Yuan, C.A.; Zhang, G.Q.
2016-01-01
Light Emitting Diode (LED) luminaires and lamps are energy-saving and environmental friendly alternatives to traditional lighting products. However, current luminous flux depreciation test at luminaire and lamp level requires a minimum of 6000 h testing, which is even longer than the product development cycle time. This paper develops an accelerated test method for luminous flux depreciation to reduce the test time within 2000 h at an elevated temperature. The method is based on lumen maintenance boundary curve, obtained from a collection of LED source lumen depreciation data, known as LM-80 data. The exponential decay model and Arrhenius acceleration relationship are used to determine the new threshold of lumen maintenance and acceleration factor. The proposed method has been verified by a number of simulation studies and experimental data for a wide range of LED luminaire and lamp types from both internal and external experiments. The qualification results obtained by the accelerated test method agree well with traditional 6000 h tests. - Highlights: • We develop an accelerated test method for LED luminaires and lamps. • The method is proposed based on a “Boundary Curve” concept. • The parameters of the boundary curve are extracted from LM-80 test reports. • Qualification results from the proposed method agree with ES requirements.
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Environmental performance evaluation of Beijing's energy use planning
International Nuclear Information System (INIS)
Wang Lei; Xu Linyu; Song Huimin
2011-01-01
In line with rapid economic development, urban energy consumption is increasing rapidly, resulting in environmental problems. After considering several methods to evaluate the environmental performance of energy use, including: energy ecological footprint, input-output analysis, emergy-exergy analysis, and multi-criteria decision-making, an environmental performance evaluation model is proposed, which combines the analytical hierarchy process, fuzzy extent analysis, and membership degree analysis. In the model, 18 sub-indicators of environmental performance from energy use planning are classified into four categories: structure of energy use and industry, technology and efficiency of energy use, environmental impacts caused by energy use, and the socio-economic benefits of energy use. Membership degree analysis is applied to each indicator. Three energy use scenarios which are, respectively, environment-friendly, technology-led, and economic policy-led are evaluated. The results show that the technology-led energy use planning is best. The sustainable energy use policies are proposed from three aspects, including optimizing the energy use and industrial structure, encouraging development of energy-saving and air pollution control technologies, and enhancing legislation on energy use management. The policies are helpful to optimize the trade-offs between economic growth and environmental protection in Beijing. - Highlights: → Our paper establishes a system of indicators according to the structure of urban energy use planning. → We have created a comprehensive environmental performance evaluation model in the research. → The model and results can serve as an important basis for decision-making to guide local government.
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Generation of solar spectrum by using LEDs
Lu, Pengzhi; Yang, Hua; Pei, Yanrong; Li, Jing; Xue, Bin; Wang, Junxi; Li, Jinmin
2016-09-01
Light emitting diode (LED) has been recognized as an applicable light source for indoor and outdoor lighting, city beautifying, landscape facilities, and municipal engineering etc. Conventional LED has superior characteristics such as long life time, low power consumption, high contrast, and wide viewing angle. Recently, LED with high color-rendering index and special spectral characteristics has received more and more attention. This paper is intended to report a solar spectrum simulated by multichip LED light source. The typical solar spectrum of 5500k released by CIE was simulated as a reference. Four types of LEDs with different spectral power distributions would be used in the LED light source, which included a 430nm LED, a 480nm LED, a 500nm LED and a white LED. In order to obtain better simulation results, the white LED was achieved by a 450nm LED chip with the mixture of phosphor. The phosphor combination was prepared by mixing green phosphor, yellow phosphor and red phosphor in a certain proportion. The multichip LED light source could provide a high fidelity spectral match with the typical solar spectrum of 5500k by adjusting injection current to each device. The luminous flux, CIE chromaticity coordinate x, y, CCT, and Ra were 104.7 lm, 0.3337, 0.3681, 5460K, and 88.6, respectively. Because of high color-rendering index and highly match to the solar spectrum, the multichip LED light source is a competitive candidate for applications where special spectral is required, such as colorimetric measurements, visual inspection, gemstone identification and agriculture.
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Orienting and Onboarding Clinical Nurse Specialists: A Process Improvement Project.
Garcia, Mayra G; Watt, Jennifer L; Falder-Saeed, Karie; Lewis, Brennan; Patton, Lindsey
Clinical nurse specialists (CNSs) have a unique advanced practice role. This article describes a process useful in establishing a comprehensive orientation and onboarding program for a newly hired CNS. The project team used the National Association of Clinical Nurse Specialists core competencies as a guide to construct a process for effectively onboarding and orienting newly hired CNSs. Standardized documents were created for the orientation process including a competency checklist, needs assessment template, and professional evaluation goals. In addition, other documents were revised to streamline the orientation process. Standardizing the onboarding and orientation process has demonstrated favorable results. As of 2016, 3 CNSs have successfully been oriented and onboarded using the new process. Unique healthcare roles require special focus when onboarding and orienting into a healthcare system. The use of the National Association of Clinical Nurse Specialists core competencies guided the project in establishing a successful orientation and onboarding process for newly hired CNSs.
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ICT SPECIALIST SKILLS AND KNOWLEDGE – BUSINESS REQUIREMENTS AND EDUCATION
Directory of Open Access Journals (Sweden)
Miloš Maryška
2012-09-01
Full Text Available This paper describes partial results of surveys realized amongCzech universities and business units which aim has been to analyzecurrent situation in demand and supply side of ICT (Informationand Communication Technologies specialists at the labor marketin the Czech Republic. The demand and supply side are comparedthrough their requirements on knowledge of ICT specialists. Theresults present typical “product” of Czech education system inICT competencies. General conclusions show that majority ofundergraduates do not have appropriate knowledge profile to enterICT corporate business as qualified employees - ICT specialist -without further additional training. The same fact is valid for a littleless than a half of graduates at master level. During quantitativeanalysis, we have identified that at about 60 per cent of ICTspecialists did not pass a formal ICT education. These facts showlacks in ICT oriented study programs and provoke requirementon further development of ICT oriented curricula in accordance tobusiness requirements and needs.
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Tests and measures used by specialist physical therapists when examining patients with stroke.
Andrews, A Williams; Folger, Stephen E; Norbet, Shannon E; Swift, Lindsay C
2008-09-01
Examination procedures preferred by physical therapists have not been documented either specifically or comprehensively. The purpose of this study was to determine which tests and measures are used most frequently by specialists in the examination of adults with stroke. Physical therapy specialists were identified as having geriatric or neurologic certification through the American Board of Physical Therapy Specialties. A request to participate in a Web-based survey was sent to 471 individuals in the American Physical Therapy Association's Directory of Certified Specialists. A comprehensive list of tests and measures was first derived from the Interactive Guide to Physical Therapist Practice. The list was finalized based on several exclusion criteria and the results of a pilot study. Subjects rated the frequency of use of 294 tests and measures with patients post-stroke on a Likert scale. The survey response rate was 31.7% (n = 128). The 50 most frequently used tests and measures were identified. The results of this study do not identify the tests and measures that clinicians should use, only those that the specialists use. Nevertheless, clinicians may want to consider tests and measurements frequently used by specialists when examining adults with stroke.
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2013-03-05
... Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA; Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Tampa, Florida; Amended Certification Regarding... should [[Page 14360
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Nõgisto, Jaanus, 1956-
2007-01-01
Rockansambli Led Zeppelini muusikast, ansamblist Led R ja heliplaadist "Led the R Out" räägib kitarrist Jaanus Nõgisto. Led R ja Narva Linna Sümfooniaorkestri kontserdid: 22. juunil Pärnus ja 14. juulil Haapsalu lossihoovis, ansambli Led R kontsert koos Havana Blackiga 3. aug. Sõru sadamas Hiiumaal
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Industry-led program recycles used oil materials
International Nuclear Information System (INIS)
Anon.
1997-01-01
The Alberta Used Oil Management Association (AUOMA) is running an industry-led program for recycling used oil filters, containers and used oil. The objective of the program is to help develop an infrastructure that will make recycling simple and convenient for consumers of oil materials. It was estimated that millions of litres of used oil are improperly discarded into the Alberta environment. The program is also aimed at increasing public awareness of the importance of recycling used oil materials, particularly to those consumers who change their own motor oil. By the end of 1997 AUOMA expects to open about 50 recycling centres called EcoCentres. An environmental handling charge (EHC) will be paid to AUOMA by wholesale suppliers on the first sale of oil materials in Alberta. The EHC will be the only funds used to support the program
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Clinical nurse specialist education: actualizing the systems leadership competency.
Thompson, Cathy J; Nelson-Marten, Paula
2011-01-01
The purpose of this article was to show how sequenced educational strategies aid in the acquisition of systems leadership and change agent skills, as well as other essential skills for professional clinical nurse specialist (CNS) practice. Clinical nurse specialist education offers the graduate student both didactic and clinical experiences to help the student transition into the CNS role. Clinical nurse specialist faculty have a responsibility to prepare students for the realities of advanced practice. Systems leadership is an integral competency of CNS practice. The contemporary CNS is to be a leader in the translation of evidence into practice. To assist students to acquire this competency, all CNS students are expected to use research and other sources of evidence to identify, design, implement, and evaluate a specific practice change. Anecdotal comments from students completing the projects are offered. Student projects have been focused in acute and critical care, palliative care, and adult/gerontologic health clinical settings; community outreach has been the focus of a few change projects. Examples of student projects related to the systems leadership competency and correlated to the spheres of influence impacted are presented.
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Entrustable professional activity (EPA) reshapes the practice of specialist training.
Niemi-Murola, Leila
In addition to medical expertise, competence-based medical training comprises communication and collaboration skills, professionalism, and leadership skills. Continuous feedback is essential for learning and development, and feedback only from the medical specialist examination taken in the end of training does not ensure thorough specialist training. Entrustable professional activity (EPA) is a unit of professional practice, defined as tasks or responsibilities typical of the specialty. EPA translates competence-based training into manageable and meaningful entities and provides tools for the evaluation of medical competence.
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Schmidt-Erfurth, Ursula; Chong, Victor; Loewenstein, Anat; Larsen, Michael; Souied, Eric; Schlingemann, Reinier; Eldem, Bora; Monés, Jordi; Richard, Gisbert; Bandello, Francesco
2014-01-01
Age-related macular degeneration (AMD) is still referred to as the leading cause of severe and irreversible visual loss world-wide. The disease has a profound effect on quality of life of affected individuals and represents a major socioeconomic challenge for societies due to the exponential increase in life expectancy and environmental risks. Advances in medical research have identified vascular endothelial growth factor (VEGF) as an important pathophysiological player in neovascular AMD and intraocular inhibition of VEGF as one of the most efficient therapies in medicine. The wide introduction of anti-VEGF therapy has led to an overwhelming improvement in the prognosis of patients affected by neovascular AMD, allowing recovery and maintenance of visual function in the vast majority of patients. However, the therapeutic benefit is accompanied by significant economic investments, unresolved medicolegal debates about the use of off-label substances and overwhelming problems in large population management. The burden of disease has turned into a burden of care with a dissociation of scientific advances and real-world clinical performance. Simultaneously, ground-breaking innovations in diagnostic technologies, such as optical coherence tomography, allows unprecedented high-resolution visualisation of disease morphology and provides a promising horizon for early disease detection and efficient therapeutic follow-up. However, definite conclusions from morphologic parameters are still lacking, and valid biomarkers have yet to be identified to provide a practical base for disease management. The European Society of Retina Specialists offers expert guidance for diagnostic and therapeutic management of neovascular AMD supporting healthcare givers and doctors in providing the best state-of-the-art care to their patients. Trial registration number NCT01318941. PMID:25136079
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Brouwers, Melissa C; Vukmirovic, Marija; Tomasone, Jennifer R; Grunfeld, Eva; Urquhart, Robin; O'Brien, Mary Ann; Walker, Melanie; Webster, Fiona; Fitch, Margaret
2016-10-01
To report on the findings of the CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum) Casebook project, which systematically documented Canadian initiatives (ie, programs and projects) designed to improve or support coordination and continuity of cancer care between primary care providers (PCPs) and oncology specialists. Pan-Canadian environmental scan. Canada. Individuals representing the various initiatives provided data for the analysis. Initiatives included in the Casebook met the following criteria: they supported coordination and collaboration between PCPs and oncology specialists; they were related to diagnosis, treatment, survivorship, or personalized medicine; and they included breast or colorectal cancer or both. Data were collected on forms that were compiled into summaries (ie, profiles) for each initiative. Casebook initiatives were organized based on the targeted stage of the cancer care continuum, jurisdiction, and strategy (ie, model of care or type of intervention) employed. Thematic analysis identified similarities and differences among employed strategies, the level of primary care engagement, implementation barriers and facilitators, and initiative evaluation. The CanIMPACT Casebook profiles 24 initiatives. Eleven initiatives targeted the survivorship stage of the cancer care continuum and 15 focused specifically on breast or colorectal cancer or both. Initiative teams implemented the following strategies: nurse patient navigation, multidisciplinary care teams, electronic communication or information systems, PCP education, and multicomponent initiatives. Initiatives engaged PCPs at various levels. Implementation barriers included lack of care standardization across jurisdictions and incompatibility among electronic communication systems. Implementation facilitators included having clinical and program leaders publicly support the initiative, repurposing existing resources, receiving financial support, and
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An Analysis of the Alteration Specialist Occupation.
Buerkel, Elaine; Rehling, Joseph H.
The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the textile service occupation. The industry needs properly trained alteration specialists, bushelmen and dressmakers, in the repairing, remodeling, altering or renovating of garments. Their personal…
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Gregg, Emma
2017-04-12
Aim The aim of this literature review was to explore the development of the role of specialist ophthalmic nurses in delivering ranibizumab intravitreal injections to patients with wet age-related macular degeneration (AMD), and to evaluate their contribution to reducing capacity pressures in medical retina services, while maintaining safe and effective standards of care. Method A systematic literature search was undertaken to identify relevant articles published between January 2000 and June 2015. A search of electronic databases was undertaken, and selected relevant journals were searched manually. A free text and subject heading search strategy was conducted, in which the abstracts of publications identified for review were assessed for relevance. Inclusion criteria were: nurses delivering ranibizumab intravitreal treatment; studies performed in the UK and other countries; and patients with AMD, diabetic macular oedema or central retinal vein occlusion receiving nurse-led ranibizumab (Lucentis) intravitreal treatment. Findings Five studies were identified from the literature search, which audited a total of 31,303 injections delivered by nurse practitioners between January 2007 and November 2013. The visual outcomes and the rate of complications from intravitreal injections delivered by trained ophthalmic nurse practitioners were comparable to intravitreal injections delivered by ophthalmologists. Four of the five studies reported increased patient satisfaction, patients consenting to nurse-delivered intravitreal injections, favourable pain experience, and absence of complaints. Conclusion Practice innovation is an example of a quality, innovation, productivity and prevention process. Role expansion, in which specialist ophthalmic nurses deliver intravitreal injections, has been shown to be economical, safe and effective. It enables timely delivery of the service, thereby preventing irreversible blindness for individuals with wet AMD.
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2010-07-01
... sharing agreements, contracts for scarce medical specialist services and contracts for other medical... medical specialist services and contracts for other medical services. The Under Secretary for Health is... specialist services at Department of Veterans Affairs health care facilities (including, but not limited to...
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Peculiarities of self-regulation of extreme profile specialists
Directory of Open Access Journals (Sweden)
Kabanova T.N.
2017-04-01
Full Text Available Individually-psychological characteristics were studied and profiles of the styles of self-regulation of the employees engaged in hazardous were determined. The mainly group consisted of 30 men aged 21 to 60 years, who are specialists of dangerous professions. The comparison group included 30 men from 22 to 60 years, whose professional activity was not associated with risk. The following methods were used: questionnaire "Style of self-regulation of behavior" by V. I. Morosanova; questionnaire of self-control (H. Grasmik, 1993, adaptation Bulygina V. G., Abdrazakova A. M., 2009; the questionnaire BIS/BAS, used to study the sensitivity to punishment and reward; the questionnaire formal-dynamic properties of individuality by V. M. Rusalov; the aggression questionnaire by A. Buss and M. Perry (adaptation Enikolopov S. N., Cybulski N. P., 2007; the scale of anxiety Charles D. Spielberger (State-Trait Anxiety Inventory – STAI; personal questionnaire of the G. and S. Eysenck – EPQ. It was found that specialists hazardous professions are distinguished by: a higher level of development of the regulatory flexibility and individual system of conscious self-regulation activity; higher levels of extroversion, communication activity, the total adaptability; a lower level of reactive anxiety, trait anxiety and general emotional. Moreover, impulsiveness, egocentrism, lack of restraint and physical activity in the structure of self-monitoring specialists of dangerous professions associated with high levels of affective component of aggression and incoherence of parts of the process of self-regulation. There were allocated a 3 profile of self-regulation in specialists of dangerous professions: a a high level of self-regulation – coupled with a high intellectual and physical development, the highest level of adaptability and general activity; b medium – rapid response to emerging changes in the situation, the successful production alternatives, greater
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DEFF Research Database (Denmark)
Alfarog, Azzarn Orner; Qu, Xiaohui; Wang, Huai
2017-01-01
and accelerate the failure. In this paper, a new thermal model concerning the thermal coupling is proposed with Finite Element Method (FEM) simulation for parameter acquirement. The proposed model has a better estimation of the thermal stresses of key components in the LED lamps and therefore an improved...... separately, and then the thermal design is also optimized independently. In practice, the LED source and driver are usually compacted in a single fixture. The heat dissipated from LED source and driver will be coupled together and affect the heat transfer performance, which may degrade the whole system...
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International Nuclear Information System (INIS)
Anon.
1979-01-01
The programme of work of the OECD Nuclear Energy Agency includes topics relating to radiation and environmental protection matters in mining and milling operations. A first Specialist Meeting on Personal Dosimetry and Area Monitoring suitable for Radon and Daughter Products was organised in October 1976 at Elliot Lake, Canada. The proceedings were published by NEA some months later. Following an enquiry among interested persons, NEA decided to organise a new meeting on the same subject in Paris from 20th to 22nd November 1978. The meeting dealt with questions relating to personal dosimetry techniques, the monitoring of the atmosphere in mines and their neighbourhood, as well as in buildings
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Broaddus, Michelle R; Owczarzak, Jill; Schumann, Casey; Koester, Kimberly A
2017-10-01
To address barriers to adequate engagement in medical care among people living with HIV, Wisconsin's AIDS/HIV Program created a new position, the Linkage to Care (LTC) Specialist. Specialists provide intensive, short-term case management and patient navigation services for small caseloads of individuals at high risk of disengaging with medical care. Clients are eligible if they are newly diagnosed with HIV or new to medical care, recently released from incarceration, recently out of care, nonadherent to scheduled medical care visits, or have detectable viral load while in care. Interviews with 30 clients of Specialists were conducted to understand experiences with the program and medical care. Common themes included the ability of Specialists to navigate complex systems of care and support services, the unique role Specialists played in their clients' lives, and the challenges of transitioning out of the program. Although the primary goal of Specialists is to address barriers to medical care, they often adopted a holistic approach that also included housing, financial assistance, and other social determinants of health. Descriptions of the Specialist's role in implementation manuals focus on their functional roles and the services provided. However, clients often discussed the emotional support they received, especially for clients without strong social support networks. Many clients also desired an ongoing relationship with their Specialists even after discharge, but had been able to establish independence and self-efficacy. The LTC Specialists are resource-intensive considering their small caseloads, but fill an important gap in existing, often overtaxed case management systems.
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Physical perfection of future specialists to the management.
Directory of Open Access Journals (Sweden)
Dolinnyj U.A.
2012-12-01
Full Text Available The process of leadthrough of practical employments is considered on physical education on an experimental model, which are directed on the increase of reserve possibilities of organism of future specialists of management. In an experiment took part 30 students of 2 and 3 courses. It is set that management specialists for high-quality implementation of work need a high mental capacity, enhanceable psychoemotional firmness, general endurance. Directions of prophylaxis of emotional and physical overstrain are recommended, increases of level of positive motivation to systematic employments by physical exercises. It is marked that an experimental model in combination with the fixed form of leadthrough of employments on a body-conditioning and employments on specialization of the chosen type of sport is one the stages of alteration organizationally of methodical aspects of physical culture.
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The consent process in interventional radiology: the role of specialist nurses
International Nuclear Information System (INIS)
Davies, L.; Laasch, H.-U.; Wilbraham, L.; Marriott, A.; England, R.E.; Martin, D.F.
2004-01-01
AIMS: To evaluate the impact of patient education by specialist nurses on patients' understanding of interventional procedures, their anxiety levels and satisfaction with the given information. MATERIALS AND METHODS: Sixty patients attending the radiology department for gastrointestinal interventional procedures were interviewed. Patients were assessed using a combination of categorical and visual analogue scales. Parameters were assessed on admission and after additional information had been given by specialist nurses. After the procedure patients were asked to rate the quality of information given and their overall satisfaction. RESULTS: Four of the 60 patients were excluded due to a Mini Mental Test score of <7. Only 35 (62.5%) claimed to have been given information by the referring consultant. Fifty-three patients received additional information before formally giving consent, 50 (96.2%) from the specialist nurses. Patient anxiety before and after information did not significantly change (p=0.52), but there was significant improvement in levels of satisfaction (p=0.001) and perceived understanding (p<0.001). Patients rated overall quality of information at an average of 9.2/10 and overall satisfaction was high (median=9.1/10). CONCLUSION: The use of specialist nurses to educate patients greatly increases patient understanding. The process of informed consent is improved and patient satisfaction is increased
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The consent process in interventional radiology: the role of specialist nurses
Energy Technology Data Exchange (ETDEWEB)
Davies, L.; Laasch, H.-U.; Wilbraham, L.; Marriott, A.; England, R.E.; Martin, D.F. E-mail: derrick.martin@smtr.nhs.uk
2004-03-01
AIMS: To evaluate the impact of patient education by specialist nurses on patients' understanding of interventional procedures, their anxiety levels and satisfaction with the given information. MATERIALS AND METHODS: Sixty patients attending the radiology department for gastrointestinal interventional procedures were interviewed. Patients were assessed using a combination of categorical and visual analogue scales. Parameters were assessed on admission and after additional information had been given by specialist nurses. After the procedure patients were asked to rate the quality of information given and their overall satisfaction. RESULTS: Four of the 60 patients were excluded due to a Mini Mental Test score of <7. Only 35 (62.5%) claimed to have been given information by the referring consultant. Fifty-three patients received additional information before formally giving consent, 50 (96.2%) from the specialist nurses. Patient anxiety before and after information did not significantly change (p=0.52), but there was significant improvement in levels of satisfaction (p=0.001) and perceived understanding (p<0.001). Patients rated overall quality of information at an average of 9.2/10 and overall satisfaction was high (median=9.1/10). CONCLUSION: The use of specialist nurses to educate patients greatly increases patient understanding. The process of informed consent is improved and patient satisfaction is increased.
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Brakes Specialist. Teacher Edition. Automotive Service Series.
Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.
This document contains teacher's materials for a course on becoming an automotive brakes specialist, based on the National Institute of Automotive Service Excellence task lists. The course consists of three instructional units: service brake hydraulic system and wheel bearings, service drum brakes, and service disc brakes. Depending on the…
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Learning Mathematics for Teaching Mathematics: Non-Specialist Teachers' Mathematics Teacher Identity
Crisan, Cosette; Rodd, Melissa
2017-01-01
A non-specialist teacher of mathematics is a school teacher who qualified to teach in a subject other than mathematics yet teaches mathematics to students in secondary school. There is an emerging interest internationally in this population, a brief report of which is given in the paper. Because of concerns about the quality of non-specialists'…
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Insideness and Outsideness: An Autoethnography of a Primary Physical Education Specialist Teacher
Brooks, Caroline; Thompson, Maree Dinan
2015-01-01
The purpose of this study is to provide an authentic and legitimate voice to the physical education (PE) specialist teacher in the primary school and to give an insight into professional knowledge. An autoethnographic approach has been used to invite readers to enter my world of the primary PE specialist teacher and observe and respond to its…
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Active methods of teaching in the system of preparation of specialists on physical education
Directory of Open Access Journals (Sweden)
Pechko O.M.
2010-03-01
Full Text Available The uses of simulation games given about directions are resulted in pedagogical practice. Practice is conducted during the increase of professional qualification of specialists. Possibilities of the use of pedagogical situations are considered in the system of preparation of specialist. Pedagogical situations are an aggregate of facilities and methods of becoming of professional specialist. The prospects of the use of simulation games are indicated in an educational process. Acquisition of the proper qualities options are rotined.
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Survey of the labour market for information specialists in Lithuania
Directory of Open Access Journals (Sweden)
Elena Maceviciute
1998-01-01
Full Text Available This paper reports on the results of surveys carried out in Lithuania and Estonia in 1995 and 1996, the main aim of which was to provide a basis for planning the development of information management courses in the Baltic States. In the course of the project it was necessary to resolve certain methodological difficulties in the identification of the concept 'information specialist' and in the process of data collection. The results show the recruitment rates needed over the next three years and the qualities and skills needed by information specialists.
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Dossett, Lesly A; Kauffmann, Rondi M; Lee, Jay S; Singh, Harkamal; Lee, M Catherine; Morris, Arden M; Jagsi, Reshma; Quinn, Gwendolyn P; Dimick, Justin B
2018-06-01
Our objective was to determine specialist physicians' attitudes and practices regarding disclosure of pre-referral errors. Physicians are encouraged to disclose their own errors to patients. However, no clear professional norms exist regarding disclosure when physicians discover errors in diagnosis or treatment that occurred at other institutions before referral. We conducted semistructured interviews of cancer specialists from 2 National Cancer Institute-designated Cancer Centers. We purposively sampled specialists by discipline, sex, and experience-level who self-described a >50% reliance on external referrals (n = 30). Thematic analysis of verbatim interview transcripts was performed to determine physician attitudes regarding disclosure of pre-referral medical errors; whether and how physicians disclose these errors; and barriers to providing full disclosure. Participants described their experiences identifying different types of pre-referral errors including errors of diagnosis, staging and treatment resulting in adverse events ranging from decreased quality of life to premature death. The majority of specialists expressed the belief that disclosure provided no benefit to patients, and might unnecessarily add to their anxiety about their diagnoses or prognoses. Specialists had varying practices of disclosure including none, non-verbal, partial, event-dependent, and full disclosure. They identified a number of barriers to disclosure, including medicolegal implications and damage to referral relationships, the profession's reputation, and to patient-physician relationships. Specialist physicians identify pre-referral errors but struggle with whether and how to provide disclosure, even when clinical circumstances force disclosure. Education- or communication-based interventions that overcome barriers to disclosing pre-referral errors warrant development.
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Projecting LED product life based on application
Narendran, Nadarajah; Liu, Yi-wei; Mou, Xi; Thotagamuwa, Dinusha R.; Eshwarage, Oshadhi V. Madihe
2016-09-01
LED products have started to displace traditional light sources in many lighting applications. One of the commonly claimed benefits for LED lighting products is their long useful lifetime in applications. Today there are many replacement lamp products using LEDs in the marketplace. Typically, lifetime claims of these replacement lamps are in the 25,000-hour range. According to current industry practice, the time for the LED light output to reach the 70% value is estimated according to IESNA LM-80 and TM-21 procedures and the resulting value is reported as the whole system life. LED products generally experience different thermal environments and switching (on-off cycling) patterns when used in applications. Current industry test methods often do not produce accurate lifetime estimates for LED systems because only one component of the system, namely the LED, is tested under a continuous-on burning condition without switching on and off, and because they estimate for only one failure type, lumen depreciation. The objective of the study presented in this manuscript was to develop a test method that could help predict LED system life in any application by testing the whole LED system, including on-off power cycling with sufficient dwell time, and considering both failure types, catastrophic and parametric. The study results showed for the LED A-lamps tested in this study, both failure types, catastrophic and parametric, exist. The on-off cycling encourages catastrophic failure, and maximum operating temperature influences the lumen depreciation rate and parametric failure time. It was also clear that LED system life is negatively affected by on-off switching, contrary to commonly held belief. In addition, the study results showed that most of the LED systems failed catastrophically much ahead of the LED light output reaching the 70% value. This emphasizes the fact that life testing of LED systems must consider catastrophic failure in addition to lumen depreciation, and
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STS-95 Payload Specialist Glenn participates in a media briefing before returning to JSC
1998-01-01
STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, participates in a media briefing at the Kennedy Space Center Press Site Auditorium before returning to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. Also participating in the briefing were the other STS-95 crew members: Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist and Payload Commander Stephen K. Robinson; Mission Specialist Scott E. Parazynski; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process.
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Perceived Learning Effectiveness of a Course Facebook Page: Teacher-Led versus Student-Led Approach
Tugrul, Tugba Orten
2017-01-01
This research aims to compare the perceived effectiveness of teacher-led and student-led content management approaches embraced in a course Facebook page designed to enhance traditional classroom learning. Eighty-five undergraduate marketing course students voluntarily completed a questionnaire composed of two parts; a depiction of a course…
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Development of the Role Scenario of the Personnel Management Specialist Activity
Stolyaruk Khrystyna S.
2013-01-01
The article is devoted of the issues of development of classification and content of role, which are performed by personnel management specialists in their professional activity. It proves a necessity of development of role scenarios under conditions of application of the competence approach in training and practical activity. Thus, the author offers five key roles in activity of a personnel management specialist, which reflect different vectors of directions of the scenario of professional a...
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Harmonics Monitoring Survey on LED Lamps
Directory of Open Access Journals (Sweden)
Abdelrahman Ahmed Akila
2017-03-01
Full Text Available Light Emitting Diode (LED lamps are being increasingly used in many applications. These LED lamps operate using a driver, which is a switching device. Hence, LED lamps will be a source of harmonics in the power system. These harmonics if not well treated, may cause severe performance and operational problems. In this paper, harmonics (amplitude and phase angles generated by both LED lamps and conventional fluorescent lamps will be studied practically. Then they will be analyzed and evaluated. Compared to each other harmonics generated by both LED and conventional florescent lamps, self mitigation may occur based on the phase angle of these harmonics. All data will be measured using power analyzer and will be done on a sample of actual lamps.
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Impact of the Pharmacy Practice Model Initiative on Clinical Pharmacy Specialist Practice.
Jacobi, Judith; Ray, Shaunta'; Danelich, Ilya; Dodds Ashley, Elizabeth; Eckel, Stephen; Guharoy, Roy; Militello, Michael; O'Donnell, Paul; Sam, Teena; Crist, Stephanie M; Smidt, Danielle
2016-05-01
This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role of pharmacists as patient care providers. PPMI envisions a future in which pharmacists have greater responsibility for medication-related outcomes and technicians assume greater responsibility for product-related activities. Although the PPMI recommendations have elevated the level of practice in many settings, they also potentially affect existing clinical pharmacists, in general, and clinical pharmacy specialists, in particular. Moreover, although more consistent patient care can be achieved with an expanded team of pharmacist providers, the role of clinical pharmacy specialists must not be diminished, especially in the care of complex patients and populations. Specialist practitioners with advanced training and credentials must be available to model and train pharmacists in generalist positions, residents, and students. Indeed, specialist practitioners are often the innovators and practice leaders. Negotiation between hospitals and pharmacy schools is needed to ensure a continuing role for academic clinical pharmacists and their contributions as educators and researchers. Lessons can be applied from disciplines such as nursing and medicine, which have developed new models of care involving effective collaboration between generalists and specialists. Several different pharmacy practice models have been described to meet the PPMI goals, based on available personnel and local goals. Studies measuring the impact of these new practice models are needed. © 2016 Pharmacotherapy Publications, Inc.
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Standardization of UV LED measurements
Eppeldauer, G. P.; Larason, T. C.; Yoon, H. W.
2015-09-01
Traditionally used source spectral-distribution or detector spectral-response based standards cannot be applied for accurate UV LED measurements. Since the CIE standardized rectangular-shape spectral response function for UV measurements cannot be realized with small spectral mismatch when using filtered detectors, the UV measurement errors can be several times ten percent or larger. The UV LEDs produce broadband radiation and both their peaks or spectral bandwidths can change significantly. The detectors used for the measurement of these LEDs also have different spectral bandwidths. In the discussed example, where LEDs with 365 nm peak are applied for fluorescent crack-recognition using liquid penetrant (non-destructive) inspection, the broadband radiometric LED (signal) measurement procedure is standardized. A UV LED irradiance-source was calibrated against an FEL lamp standard to determine its spectral irradiance. The spectral irradiance responsivity of a reference UV meter was also calibrated. The output signal of the reference UV meter was calculated from the spectral irradiance of the UV source and the spectral irradiance responsivity of the reference UV meter. From the output signal, both the integrated irradiance (in the reference plane of the reference meter) and the integrated responsivity of the reference meter were determined. Test UV meters calibrated for integrated responsivity against the reference UV meter, can be used to determine the integrated irradiance from a field UV source. The obtained 5 % (k=2) measurement uncertainty can be decreased when meters with spectral response close to a constant value are selected.
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Doody, Owen; Slevin, Eamonn; Taggart, Laurence
2017-10-01
To explore the contribution of clinical nurse specialists in intellectual disability nursing in Ireland. While clinical nurse specialists exist since the 1940s, they have only been a reality in Ireland since 2001. While the role of clinical nurse specialist has developed over the years, it still however is often seen as a complex multifaceted role that causes confusion, frustration and controversy. A exploratory qualitative approach using focus groups with Irish intellectual disability clinical nurse specialists (n = 31). Five focus group interviews were conducted to gather qualitative data to gain insight into the attitudes, perceptions and opinions of the participants. Data were audio-recorded, transcribed and analysed using Burnard's (Vital Notes for Nurses: Research for Evidence-Based Practice in Healthcare, 2011, Blackwell Publishing, Oxford) framework. Ethical approval was gained from the researcher's university and access granted by the national council for the professional development of nursing/midwifery in Ireland. The study highlights that intellectual disability clinical nurse specialists contribute to and support care delivery across a range of areas including client-focused and family-centred care, staff support, organisation support, community support and supporting other agencies. Overall, the study shows the importance of intellectual disability clinical nurse specialists and their contribution across a range of services, care environments and the support they offer to clients/families/staff/multidisciplinary team members and outside agencies. Ireland is in a unique position to develop knowledge regarding specialist care for people with intellectual disability that can be shared and adapted by other healthcare professionals in other countries that do not have specialised intellectual disability nurses. © 2016 John Wiley & Sons Ltd.
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CONCEPTUAL BASES OF TRAINING OF TOURISM SPECIALISTS IN UKRAINE (BY THE EXAMPLE OF KRYVYI RIH
Directory of Open Access Journals (Sweden)
Вікторія Пацюк
2015-05-01
Full Text Available Relevance and importance of training of tourism specialists on the regional level have been revealed. General principles of training of tourism services specialists in Ukraine have been found out. The structure and professional specialization of Ukrainian universities, where the “Tourism” specialists are trained have been analyzed. Pofessional requirements for future employees of tourism industry have been defined. Relevance of training of tourism specialists in Kryvyi Rih in the context of the implementation of the Program of Industrial Tourism Development has been revealed. Potential scope of employment of tourism graduates has been defined. Main tasks of tourism education in Ukraine have been generalized.
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Professional Training of Marketing Specialists: Foreign Experience
Zakharchenko, Yuliia
2017-01-01
Due to content-based analysis of marketing specialists' professional training and approaches to development of their educational trajectory, it has been revealed that curricula and their content are given much attention by employers whose demands are focused on meeting current labour market conditions. It has been justified that despite the…
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Achieving environmental excellence through a multidisciplinary grassroots movement.
Herechuk, Bryan; Gosse, Carolyn; Woods, John N
2010-01-01
St. Joseph's Healthcare Hamilton (SJHH) supports a grassroots green team, called Environmental Vision and Action (EVA). Since the creation of EVA, a healthy balance between corporate projects led by corporate leaders and grassroots initiatives led by informal leaders has resulted in many successful environmental initiatives. Over a relatively short period of time, environmental successes at SJHH have included waste diversion programs, energy efficiency and reduction initiatives, alternative commuting programs, green purchasing practices, clinical and pharmacy greening and increased staff engagement and awareness. Knowledge of social movements theory helped EVA leaders to understand the internal processes of a grassroots movement and helped to guide it. Social movements theory may also have broader applicability in health care by understanding the passionate engagement that people bring to a common cause and how to evolve sources of opposition into engines for positive change. After early successes, as the limitations of a grassroots movement began to surface, the EVA team revived the concept of evolving the grassroots green program into a corporate program for environmental stewardship. It is hard to quantify the importance of allowing our staff, physicians, volunteers and patients to engage in changes that they feel passionately about. However, at SJHH, the transformation of a group of people unsatisfied with the organization's environmental performance into an 'engine for change' has led to a rapid improvement in environmental stewardship at SJHH that is now regarded as a success.
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Keskin, Yusuf
2014-01-01
This study aimed to analyse reports prepared by American education specialists visiting Turkey from the Proclamation of the Republic till the end of the 1950's to inspect Turkey's education system. In accordance with this purpose, first, the foreign specialists' reports are briefly introduced chronologically and then American specialist reports…
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Chiarchiaro, Jared; White, Douglas B; Ernecoff, Natalie C; Buddadhumaruk, Praewpannarai; Schuster, Rachel A; Arnold, Robert M
2016-05-01
Conflict is common between physicians and surrogate decision makers around end-of-life care in ICU. Involving experts in conflict management improve outcomes, but little is known about what differences in conflict management styles may explain the benefit. We used simulation to examine potential differences in how palliative care specialists manage conflict with surrogates about end-of-life treatment decisions in ICUs compared with intensivists. Subjects participated in a high-fidelity simulation of conflict with a surrogate in an ICU. In this simulation, a medical actor portrayed a surrogate decision maker during an ICU family meeting who refuses to follow an advance directive that clearly declines advanced life-sustaining therapies. We audiorecorded the simulation encounters and applied a coding framework to quantify conflict management behaviors, which was organized into two categories: task-focused communication and relationship building. We used negative binomial modeling to determine whether there were differences between palliative care specialists' and intensivists' use of task-focused communication and relationship building. Single academic medical center ICU. Palliative care specialists and intensivists. None. We enrolled 11 palliative care specialists and 25 intensivists. The palliative care specialists were all attending physicians. The intensivist group consisted of 11 attending physicians, 9 pulmonary and critical care fellows, and 5 internal medicine residents rotating in the ICU. We excluded five residents from the primary analysis in order to reduce confounding due to training level. Physicians' mean age was 37 years with a mean of 8 years in practice. Palliative care specialists used 55% fewer task-focused communication statements (incidence rate ratio, 0.55; 95% CI, 0.36-0.83; p = 0.005) and 48% more relationship-building statements (incidence rate ratio, 1.48; 95% CI, 0.89-2.46; p = 0.13) compared with intensivists. We found that palliative care
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Black, Bruce J.; Haynes, Cynthia; Schrock, Denny; Duerfeldt, Kevin; Litchfield, Ruth
2016-01-01
Gardening and nutrition lessons for children can affect knowledge, actions, and behaviors that support more healthful lifestyles. The objective of the study described in this article was to determine the effectiveness of a master gardener--led education program for youth at a week-long summer camp in Iowa. Garden knowledge was assessed via a…
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Specialist services for older people : issues of negative and positive ageism
Reed, Jan; Cook, Glenda; Cook, Margaret; Inglis, Pamela; Clarke, Charlotte
2006-01-01
This paper reports findings of a study in 2004 of the development of specialist services for older people in the National Health Service (NHS) in England, as recommended in the Department of Health's National Service Framework for Older People (NSF-OP). The study was funded by the Department of Health as part of a programme of research to explore the Framework's implementation. Information was collected through a questionnaire survey about the nature of specialist developments at three levels...
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BPA/PGE transmission support project: Final environmental assessment
International Nuclear Information System (INIS)
1996-12-01
This Mitigation Action Plan describes the mitigation measures identified in the BPA/PGE Transmission Support Project Environmental Assessment. These measures commit to actions that will reduce the environmental impacts that could occur by constructing, operating and maintaining the transmission line and related facilities. They have been developed in coordination with environmental specialists, design and construction engineers and maintenance personnel. The measures will be written into the construction specifications for the project, which is expected to be constructed by contract personnel. Unless noted in the plan, the construction inspector or the line foreman would be responsible for carrying out the mitigation; environmental staff would also monitor the area for mitigation effectiveness. The right-of-way would be cleared in 1997 or 1998, and construction would begin in the spring of 1998 and be completed later that fall
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Scholarly Productivity of School Psychology Faculty Members in Specialist-Level Programs: 2002-2011
Laurent, Jeff; Runia, Elizabeth
2016-01-01
The scholarly productivity of school psychology faculty members in specialist-level only programs was examined. Information was gathered from the School Psychology Program Information portion of the website for the National Association of School Psychologists. A total of 137 specialist-level only school psychology programs were identified.…
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LENUS (Irish Health Repository)
Carroll, A
2018-03-01
The successful implementation of an integrated care pathway (ICP) for any given condition is a challenge. Even more challenging is successful ICP implementation for individuals who have multiple co-morbidities. This is further compounded when there are dual mental health and physical disabilities that require integrated working across multiple disciplines, specialties, institutions and organisations. Anti-NMDA-Receptor encephalitis (aNMDARe) is a relatively new diagnostic entity with patients typically presenting with significant psychiatric symptoms followed by progressive neurological deterioration. In this case series, we describe 3 cases of females with aNMDARe who were referred for complex specialist rehabilitation (CSR) to The National Rehabilitation Hospital. CSR is the total active care of patients with a disabling condition, and their families, by a multi-professional team who have undergone recognised specialist training in rehabilitation, led \\/supported by a consultant trained and accredited in rehabilitation medicine (RM). These services provide for patients with highly complex rehabilitation needs that are beyond the scope of local services. In these cases, referral to CSR resulted in the construction of a bespoke integrated care pathway (ICP) that transcended the barriers between primary, secondary and tertiary care and across the boundaries of physical and mental health. A care pathway is a complex intervention for the mutual decision-making and organisation of care processes Rehabilitation services acted as the coordinator of services in these cases to ensure implementation of the care plan and to ensure successful transitions of care and supported local specialist and general teams in the management of these complex cases.
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STS-95 Payload Specialist Glenn and his wife pose before their return flight to JSC
1998-01-01
At the Skid Strip at Cape Canaveral Air Station, STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, poses with his wife Annie before their return flight to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The STS-95 crew also includes Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process.
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Host plant invests in growth rather than chemical defense when attacked by a specialist herbivore.
Arab, Alberto; Trigo, José Roberto
2011-05-01
Plant defensive compounds may be a cost rather than a benefit when plants are attacked by specialist insects that may overcome chemical barriers by strategies such as sequestering plant compounds. Plants may respond to specialist herbivores by compensatory growth rather than chemical defense. To explore the use of defensive chemistry vs. compensatory growth we studied Brugmansia suaveolens (Solanaceae) and the specialist larvae of the ithomiine butterfly Placidina euryanassa, which sequester defensive tropane alkaloids (TAs) from this host plant. We investigated whether the concentration of TAs in B. suaveolens was changed by P. euryanassa damage, and whether plants invest in growth, when damaged by the specialist. Larvae feeding during 24 hr significantly decreased TAs in damaged plants, but they returned to control levels after 15 days without damage. Damaged and undamaged plants did not differ significantly in leaf area after 15 days, indicating compensatory growth. Our results suggest that B. suaveolens responds to herbivory by the specialist P. euryanassa by investing in growth rather than chemical defense.
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Education of specialists-cartographers in Lviv Polytechnic National University
Directory of Open Access Journals (Sweden)
Наталія Ярема
2017-09-01
Full Text Available This paper describes the system of future specialists-cartographers education in Lviv polytechnic national university. Main targets of the department of cartography and geospatial modelling are listed. Key research areas of the department, the educational specifics of students at «Bachelor» and «Master‘s» levels are described. At present, the main task of the department is to train specialists with good knowledge of cartographic investigation method, GIS technologies, because digital cartography, web-mapping, web-portal are things of the future. Cartography specialists must know how to create traditional maps (topographic, thematic, tourist using computer technologies and electronic maps that can be used in the creation of GIS systems, informational resources in navigation, military affairs and so on. The main scientific direction of the department is general geographic and thematic mapping, GIS mapping and development of GIS, history of the cartography, mathematic modelling in geodesy, astronomy and geophysics. The department trains bachelors on specialty 103 «Earth sciences», specialization 103.02 «Cartography». The feature of master’s education is maximum approach to education content for future employment. Master degree students are improving their professional knowledge and skills received during their study for the bachelor’s degree. They are deeply studying modern methods of cartographic digital terrain models with GIS technologies, combining their work with development of cartographic databases. They get acquainted with the principles of base sets of geospatial data, conduct thematic evaluation and forecast maps, using GIS. The students also study methods and order of design, edition, and maps development in detail. Modern mapping needs to be more efficient in the use of both natural and human resources, reflect a complex system man - society - environment. Such problem can be solved using various modeling techniques with
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FORMATION OF PROFESSIONAL MOBILITY SPECIALIST WITHIN THE COMPETENCE APPROACH
Directory of Open Access Journals (Sweden)
M. L. Gruzdeva
2013-01-01
Full Text Available In the article discussed the question of formation of professional mobility specialist through the formation of professional competencies within the educational process in high school.
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White LEDs with limit luminous efficacy
Energy Technology Data Exchange (ETDEWEB)
Lisitsyn, V. M.; Stepanov, S. A., E-mail: stepanovsa@tpu.ru; Yangyang, Ju [National Research Tomsk Polytechnic University, 30 Lenin Av., Tomsk, 634050 (Russian Federation); Lukash, V. S. [JSC Research Institute of Semiconductor Devices, 99a Krasnoarmeyskaja St., Tomsk, 634050 (Russian Federation)
2016-01-15
In most promising widespread gallium nitride based LEDs emission is generated in the blue spectral region with a maximum at about 450 nm which is converted to visible light with the desired spectrum by means of phosphor. The thermal energy in the conversion is determined by the difference in the energies of excitation and emission quanta and the phosphor quantum yield. Heat losses manifest themselves as decrease in the luminous efficacy. LED heating significantly reduces its efficiency and life. In addition, while heating, the emission generation output and the efficiency of the emission conversion decrease. Therefore, the reduction of the energy losses caused by heating is crucial for LED development. In this paper, heat losses in phosphor-converted LEDs (hereinafter chips) during spectrum conversion are estimated. The limit values of the luminous efficacy for white LEDs are evaluated.
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Paediatric conscious sedation: views and experience of specialists in paediatric dentistry.
Woolley, S M; Hingston, E J; Shah, J; Chadwick, B L
2009-09-26
The objectives were three-fold: to investigate the level of conscious sedation training received prior to and during specialist training in paediatric dentistry; to establish the use of conscious sedation during and following specialisation; and to determine the attitudes of specialists in paediatric dentistry to conscious sedation. A self-administered postal questionnaire was sent to all specialists in paediatric dentistry registered with the General Dental Council in January 2008. Non-responders were contacted again after a four-week period. A response rate of 60% was achieved. Of the 122 respondents, 67 (55%) had received sedation training as an undergraduate; 89 (75%) had been trained during specialisation. All respondents performed dental treatment under sedation as a trainee and the majority used nitrous oxide inhalation sedation (NOIS). Over 90% of respondents felt that NOIS should be available to all children, both in appropriate primary care settings and in hospitals. One hundred and twenty-one (99%) respondents thought that all trainees in paediatric dentistry should have sedation training. The most popular form of sedation amongst specialists in paediatric dentistry was NOIS. However, some of the respondents felt that children should have access to other forms of sedation in both the primary care and hospital settings. Additional research on other forms of sedation is required to evaluate their effectiveness and safety.
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BUSINESS GAMES IN PROFESSIONAL TRAINING OF FUTURE FIRE SAFETY SPECIALISTS
Directory of Open Access Journals (Sweden)
Лариса Маладика
2014-12-01
Full Text Available Special features of professional training of future specialists in extraordinary (emergency situations, increasing its quality with the use of interactive technologies have been considered in this article. The paper presents a research of modern interactive educational technologies, most widely used at higher educational institutions, promoting modernization of education as well as training of competitive future specialists. The article grounds possibility of formation and development of the culture of professional communication by interactive methods of learning, and business games, in particular. The research deals with kinds of business games as active methods of learning, their structural levels and features of use.
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Lopatina, Elena; Donald, Faith; DiCenso, Alba; Martin-Misener, Ruth; Kilpatrick, Kelley; Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Marshall, Deborah A
2017-07-01
Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic
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Elementary School Math Instruction: Can Reading Specialists Assist?
Heinrichs, Audrey S.
1987-01-01
Discusses the contradictions found in recommendations for direction instruction or informal math language development, and some suggestions for practical resolution of disagreements, to enable school reading specialists to provide both background and practical help to classroom instructors teaching math. (HTH)
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Why are some medical specialists working part-time, while others work full-time?
Jong, Judith D. de; Heiligers, Phil; Groenewegen, Peter P.; Hingstman, Lammert
2006-01-01
Although medical specialists primarily work full-time, part-time work is on the increase, a trend that can be found worldwide. This article seeks to answer the question why some medical specialists work part-time, while others do not although they are willing to work part-time. Two approaches are
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EDITORIAL: LED light sources (light for the future) LED light sources (light for the future)
Grandjean, N.
2010-09-01
Generating white light from electricity with maximum efficacy has been a long quest since the first incandescent lamp was invented by Edison at the end of the 19th century. Nowadays, semiconductors are making reality the holy grail of converting electrons into photons with 100% efficiency and with colours that can be mixed for white light illumination. The revolution in solid-state lighting (SSL) dates to 1994 when Nakamura reported the first high-brightness blue LED based on GaN semiconductors. Then, white light was produced by simply combining a blue dye with a yellow phosphor. After more than a decade of intensive research the performance of white LEDs is quite impressive, beating by far the luminous efficacy of compact fluorescent lamps. We are likely close to replacing our current lighting devices by SSL lamps. However, there are still technological and fabrication cost issues that could delay large market penetration of white LEDs. Interestingly, SSL may create novel ways of using light that could potentially limit electricity saving. Whatever the impact of SSL, it will be significant on our daily life. The purpose of this special cluster issue is to produce a snapshot of the current situation of SSL from different viewing angles. In an introductory paper, Tsao and co-workers from Sandia National Laboratories, present an energy-economics perspective of SSL considering societal changes and SSL technology evolution. In a second article, Narukawa et al working at Nichia Corporation—the pioneer and still the leading company in SSL—describe the state of the art of current research products. They demonstrate record performance with white LEDs exhibiting luminous efficacy of 183 lm W-1 at high-current injection. Then, a series of topical papers discuss in detail various aspects of the physics and technology of white LEDs Carrier localization in InGaN quantum wells has been considered the key to white LEDs' success despite the huge density of defects. A
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Gosden, C A; Barnard, K; Williams, D R R; Tinati, T; Turner, B; Holt, R I G
2015-12-01
To assess the impact of continual major National Health Service reorganization on commissioning, organizational and delivery arrangements for secondary care diabetes services. To explore how consultant diabetologists and diabetes specialist nurses perceive the issues facing diabetes specialist services in 2011 and how these have changed in the preceding decade. We used a longitudinal case study approach that combined quantitative and qualitative methods. Five locations in England were purposively selected to represent the wider diabetes specialist community, and seven semi-structured interviews were conducted. Interviews were recorded, transcribed verbatim and analysed using Framework analysis. Findings were compared with and contrasted to results from national quantitative surveys of diabetes specialist services undertaken in 2000 and 2006. Clinicians viewed positively the expertise and commitment of multidisciplinary teams and their ability to adapt to new situations. Negative perceptions persisted throughout the decade, relating to the continual change that threatens to dismantle relationships and services which had taken many years to establish. Lack of resources, inadequate manpower planning and poor access to psychological support for people with diabetes remained constant themes from 2000 to 2011. A willingness to innovate and work differently to improve services was identified; however, clinicians must be supported through organizational changes to ensure people with diabetes receive high-quality care. The disruptive nature of organizational change was a recurrent theme throughout the decade. Periods of stability must exist within commissioning to allow relationships, which are key to integration, to be maintained and permit service improvements to develop. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.
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Preparation, Endorsement, and Employment of Mathematics Specialists
Cicmanec, Karen B. Mauck
2008-01-01
For over 30 years, educators have recommended that mathematics specialists be placed in schools to provide teachers with the resources they need to assist their students. To assess whether these recommendations have been realized, a survey was used to gather data from large school districts, the 50 states, and District of Columbia. The outcome of…
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About a competence and professional trade of specialists in the field of physical culture
Directory of Open Access Journals (Sweden)
F.I. Sobyanin
2013-02-01
Full Text Available Correlation of concepts «competence» and «professional trade» is examined. More than 200 sources are studied. The necessity of account for training of athletic personnels of professional fitness and value of professional trade becomes firmly established as to the ultimate goal of forming of specialist in the field of physical culture. Negative tendencies are exposed in maintenance of preparation of specialists and higher professional athletic education in the higher institutes. Culturological and acmeological approach is offered for further strategy of perfection of professional pedagogical preparation of specialists. The stages of forming of specialist are presented on the basis of application of this approach. A necessity is marked at training of personnels oriented on the exposure of features of professional fitness of young people to the professions in the field of physical culture, its initial state and dynamics.
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Test and Control System for Chlorophyll Fluorescence Parameters Using LED as Excitation Source
Directory of Open Access Journals (Sweden)
Zou Qiuying
2014-05-01
Full Text Available A new scheme on test and control system for chlorophyll fluorescence is presented in this work, which uses light-emitting diode (LED excitation by means of measuring the fluorescence parameter fpsII. The system takes programmable power supply as LEDs illumination drive power with high sensitivity and signal-to-noise ratio. MINIPAM is used to measure fluorescence parameter fpsII and keeps communication with upper PC by serial port. The upper PC can control the power supply and process the data received from MINIPAM by software which is programmed in VB6. The results show that the system has a lot of advantages such as high accuracy and convenience. The effect of environmental factors on fluorescence parameters is analyzed comprehensively. It will be a practical measurement and control system for photosynthetic ability and have wide application foreground.
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King, Anna; Boyd, Michal; Dagley, Lynelle
2017-02-01
To describe implementation of an innovative gerontology nurse specialist role within one primary health organisation in Auckland, New Zealand. Quantitative outcomes of the screening tool as well as the nurse specialist assessment will be presented. The intervention involved use of the Brief Risk Identification for Geriatric Health Tool (BRIGHT) to identify high-needs older people with subsequent comprehensive geriatric assessment (CGA) performed by the gerontology nurse specialist. A total 384 of the 416 BRIGHTs were completed (92% response rate) and 15% of these were identified as high risk (n = 57). The BRIGHTs for high-risk older people revealed the highest scoring question was 'needing help with housework' (26%). The most frequent intervention by the gerontology nurse specialist was education (30%). The primary health care gerontology nurse specialist model delivers a proactive case finding and specialist gerontology intervention for older people at high risk of functional or health decline.
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A portable inspection system to estimate direct glare of various LED modules
Chen, Po-Li; Liao, Chun-Hsiang; Li, Hung-Chung; Jou, Shyh-Jye; Chen, Han-Ting; Lin, Yu-Hsin; Tang, Yu-Hsiang; Peng, Wei-Jei; Kuo, Hui-Jean; Sun, Pei-Li; Lee, Tsung-Xian
2015-07-01
Glare is caused by both direct and indirect light sources and discomfort glare produces visual discomfort, annoyance, or loss in visual performance and visibility. Direct glare is caused by light sources in the field of view whereas reflected glare is caused by bright reflections from polished or glossy surfaces that are reflected toward an individual. To improve visual comfort of our living environment, a portable inspection system to estimate direct glare of various commercial LED modules with the range of color temperature from 3100 K to 5300 K was developed in this study. The system utilized HDR images to obtain the illumination distribution of LED modules and was first calibrated for brightness and chromaticity and corrected with flat field, dark-corner and curvature by the installed algorithm. The index of direct glare was then automatically estimated after image capturing, and the operator can recognize the performance of LED modules and the possible effects on human being once the index was out of expecting range. In the future, we expect that the quick-response smart inspection system can be applied in several new fields and market, such as home energy diagnostics, environmental lighting and UGR monitoring and popularize it in several new fields.
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DEFF Research Database (Denmark)
Gils, Charlotte; Pottegård, Anton; Ennis, Zandra Nymand
2016-01-01
the perception of the teratogenic risk of 9 commonly and 3 rarely prescribed drugs among general practitioners and specialists in obstetrics/gynecology. METHODS: All 811 general practitioners in the Region of Southern Denmark and all 502 specialist obstetricians/gynecologists in Denmark as a whole were invited...... to participate in the study based on an online questionnaire. Medians and interpercentile ranges of the perceived background risk and perceived risks for each of the drugs were included in the questionnaire. RESULTS: One hundred forty three (18 %) general practitioners and 138 (27 %) obstetricians...... by a dermatologist, and warfarin treatment is only rarely initiated in women of the fertile age without involvement of specialists in internal medicine. Hence, the active knowledge on the teratogenic potential of these drugs is likely to be less accurate among general practitioners and obstetricians...
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Gu, Feishi; Gu, Lingyuan
2016-01-01
This study examines how mathematics teaching research specialists mentor practicing teachers during post-lesson debriefs of a lesson study in China. Based on a systematic, fine-grained analysis of 107 h of videotaped mentoring meetings of 20 groups of teachers and teaching research specialists from different elementary schools, this study reveals…
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Freedom of choice of specialist physicians is important to Swiss resident: a cross-sectional study.
Peytremann-Bridevaux, Isabelle; Ruffieux, Christiane; Burnand, Bernard
2011-12-19
To assess how important the possibility to choose specialist physicians is for Swiss residents and to determine which variables are associated with this opinion. This cross-sectional study used data from the 2007 Swiss population-based health survey and included 13,642 non-institutionalised adults who responded to the telephone and paper questionnaires. The dependent variable included answers to the question "How important is it for you to be able to choose the specialist you would like to visit?" Independent variables included socio-demographics, health and past year healthcare use measures. Crude and adjusted logistic regressions for the importance of being able to choose specialist physicians were performed, accounting for the survey design. 45% of participants found it very important to be able to choose the specialist physician they wanted to visit. The answers "rather important", "rather not important" and "not important" were reported by 28%, 20% and 7% of respondents. Women, individuals in middle/high executive position, those with an ordinary insurance scheme, those reporting ≥2 chronic conditions or poorer subjective health, or those who had had ≥2 outpatient visits in the preceding year were more likely to find this choice very important. In 2007, almost half of all Swiss residents found it very important to be able to choose his/her specialist physician. The further development of physician networks or other chronic disease management initiatives in Switzerland, towards integrated care, need to pay attention to the freedom of choice of specialist physicians that Swiss residents value. Future surveys should provide information on access and consultations with specialist physicians.
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[History of training and certification programs of medical specialists in Peru].
Burstein Alva, Zuño
2014-01-01
In this paper, historical reference is made about legal provisions for recognition of the training and certification of medical specialists in Peru through university programs provided since 1928 and culminating in 1973 with the legal authorization by the relevant state authority to implement the Second Specialization Program in Human Medicine and to grant the Certification of Specialist in the Name of the Nation upon completion of a university residency program and specialized training by the regular modality, and the recognition by the university with the non-regular modality. In Peru it has been established to the present that the Professional Certifications of Specialists in Human Medicine in the Name of the Nation, both in regular modality as well as in non-regular modality, can only be granted by public or private universities authorized for this mission and, besides, no other public or private institution can claim this role that corresponds exclusively for the Peruvian University.
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Efficacy of embedded nurse-led versus conventional physician-led follow-up in rheumatoid arthritis
DEFF Research Database (Denmark)
de Thurah, Annette; Esbensen, Bente Appel; Roelsgaard, Ida Kristiane
2017-01-01
difference (SMD) -0.17 (95 % CI -1.0 to 0.67), whereas a statistical significant difference in favour of nurse-led follow-up was seen after 2 years (SMD: 0.6 (95% CI -0.00 to 1.20)). CONCLUSION: After 1 year no difference in disease activity, indicated by DAS-28, were found between embedded nurse-led follow...
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Noé, C; Pelletier-Aouizerate, M; Cartier, H
2017-04-01
The use in dermatology of light-emitting diodes (LEDs) continues to be surrounded by controversy. This is due mainly to poor knowledge of the physicochemical phases of a wide range of devices that are difficult to compare to one another, and also to divergences between irrefutable published evidence either at the level of in vitro studies or at the cellular level, and discordant clinical results in a variety of different indications: rejuvenation, acne, wound healing, leg ulcers, and cutaneous inflammatory or autoimmune processes. Therapeutic LEDs can emit wavelengths ranging from the ultraviolet, through visible light, to the near infrared (247-1300 nm), but only certain bands have so far demonstrated any real value. We feel certain that if this article remains factual, then readers will have a different, or at least more nuanced, opinion concerning the use of such LED devices in dermatology. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
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Celebrity-led development organisations
DEFF Research Database (Denmark)
Budabin, Alexandra Cosima; Rasmussen, Louise Mubanda; Richey, Lisa Ann
2017-01-01
The past decade has seen a frontier open up in international development engagement with the entrance of new actors such as celebrity-led organisations. We explore how such organisations earn legitimacy with a focus on Madonna’s Raising Malawi and Ben Affleck’s Eastern Congo Initiative. The study...... for funding, endorsements, and expertise. We argue that the ways in which celebrity-led organisations establish themselves as legitimate development actors illustrate broader dynamics of the machinery of development.......The past decade has seen a frontier open up in international development engagement with the entrance of new actors such as celebrity-led organisations. We explore how such organisations earn legitimacy with a focus on Madonna’s Raising Malawi and Ben Affleck’s Eastern Congo Initiative. The study...... draws from organisational materials, interviews, mainstream news coverage, and the texts of the celebrities themselves to investigate the construction of authenticity, credibility, and accountability. We find these organisations earn legitimacy and flourish rapidly amid supportive elite networks...
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LENUS (Irish Health Repository)
Pope, George
2012-01-31
OBJECTIVES: to evaluate specialist geriatric input and medication review in patients in high-dependency continuing care. DESIGN: prospective, randomised, controlled trial. SETTING: two residential continuing care hospitals. PARTICIPANTS: two hundred and twenty-five permanent patients. INTERVENTION: patients were randomised to either specialist geriatric input or regular input. The specialist group had a medical assessment by a geriatrician and medication review by a multidisciplinary expert panel. Regular input consisted of review as required by a medical officer attached to each ward. Reassessment occurred after 6 months. RESULTS: one hundred and ten patients were randomised to specialist input and 115 to regular input. These were comparable for age, gender, dependency levels and cognition. After 6 months, the total number of medications per patient per day fell from 11.64 to 11.09 in the specialist group (P = 0.0364) and increased from 11.07 to 11.5 in the regular group (P = 0.094). There was no significant difference in mortality or frequency of acute hospital transfers (11 versus 6 in the specialist versus regular group, P = 0.213). CONCLUSION: specialist geriatric assessment and medication review in hospital continuing care resulted in a reduction in medication use, but at a significant cost. No benefits in hard clinical outcomes were demonstrated. However, qualitative benefits and lower costs may become evident over longer periods.
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Preceptor development. Use a staff development specialist.
Schneller, S; Hoeppner, M
1994-01-01
Preceptor orientation is a well identified need. Less often identified is the critical role the staff development specialist plays in the ongoing support and development of preceptors. In this article, the authors explain activities of coaching, facilitating, mentoring, and consulting. These role components are essential in the ongoing development of preceptors. This support also may help retain preceptors.
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LED-driven backlights for automotive displays
Strauch, Frank
2007-09-01
As a light source the LED has some advantage over the traditionally used fluorescence tube such as longer life or lower space consumption. Consequently customers are asking for the LED lighting design in their products. We introduced in a company owned backlight the white LED technology. This step opens the possibility to have access to the components in the display market. Instead of having a finalized display product which needs to be integrated in the head unit of a car we assemble the backlight, the glass, own electronics and the housing. A major advantage of this concept is the better control of the heat flow generated by the LEDs to the outer side because only a common housing is used for all the components. Also the requirement for slim products can be fulfilled. As always a new technology doesn't come with advantages only. An LED represents a point source compared to the well-known tube thus requiring a mixing zone for the multiple point sources when they enter a light guide. This zone can't be used in displays because of the lack of homogeneity. It's a design goal to minimize this zone which can be helped by the right choice of the LED in terms of slimness. A step ahead is the implementation of RGB LEDs because of their higher color rendering abilities. This allows for the control of the chromaticity point under temperature change but as a drawback needs a larger mixing zone.
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Environmental Protection Versus Foundry Engineering Practice
Directory of Open Access Journals (Sweden)
Maj M.
2017-06-01
Full Text Available • Theory and practice of environmental protection in the case of foundries in Europe and Asia • Experience resulting from the cooperation with the foundries in a few European countries, China and India • Phenomena and factors affecting the pollution of the natural environment and the implementation of measures aiming at the environmental protection. Every specialist dealing with foundry processes and their impact on environmental pollution must have encountered in their professional careers numerous situations in which the theory of environmental protection confronts the stark reality. The discrepancy between theory and practice can particularly be noticed in foundry engineering in developing countries where the contrasts between different countries and casting plants are extremely striking. The comparison of working conditions in European and Asian foundries provides a vast scope for further observations and analyses. Environmental protection seems not only a concern of manufacturers of castings, but also of their customers whose opinion exerts a significant influence on both the acceptability of working conditions and on the approach to environmental pollution adopted in metal casting industry. The article presents a number of examples of various outlooks on environmental issues in foundries manufacturing a wide range of cast steel and cast iron castings, where different technologies and production processes are applied.
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Cryogenic characterization of LEDs for space application
Carron, Jérôme; Philippon, Anne; How, Lip Sun; Delbergue, Audrey; Hassanzadeh, Sahar; Cillierre, David; Danto, Pascale; Boutillier, Mathieu
2017-09-01
In the frame of EUCLID project, the Calibration Unit of the VIS (VISible Imager) instrument must provide an accurate and well characterized light source for in-flight instrument calibration without noise when it is switched off. The Calibration Unit consists of a set of LEDs emitting at various wavelengths in the visible towards an integrating sphere. The sphere's output provides a uniform illumination over the entire focal plane. Nine references of LEDs from different manufacturers were selected, screened and qualified under cryogenic conditions. Testing this large quantity of samples led to the implementation of automated testing equipment with complete in-situ monitoring of optoelectronic parameters as well as temperature and vacuum values. All the electrical and optical parameters of the LED have been monitored and recorded at ambient and cryogenic temperatures. These results have been compiled in order to show the total deviation of the LED electrical and electro-optical properties in the whole mission and to select the best suitable LED references for the mission. This qualification has demonstrated the robustness of COTS LEDs to operate at low cryogenic temperatures and in the space environment. Then 6 wavelengths were selected and submitted to an EMC sensitivity test at room and cold temperature by counting the number of photons when LEDs drivers are OFF. Characterizations were conducted in the full frequency spectrum in order to implement solutions at system level to suppress the emission of photons when the LED drivers are OFF. LEDs impedance was also characterized at room temperature and cold temperature.
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Measurement of the photometric characteristics of LEDs
International Nuclear Information System (INIS)
Nazarenko, L.A.; Zubkov, D.P.
2015-01-01
Proposed and implemented a method for measuring LEDs, which is based on self-calibration of the LED goniophotometer facility by using a trap-detector. Designed and manufactured automated goniophotometer, which provides a measurement of high power LEDs at a specified junction temperature. Designed and experimentally researched the photometer with a photometric sphere based diffuser, which meets all requirements of CIE for photometric measurements of LEDs
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It's more than money: policy options to secure medical specialist workforce for regional centres.
May, Jennifer; Walker, Judi; McGrail, Mathew; Rolley, Fran
2017-12-01
Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills
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Lebovits, Allen
2012-09-01
There are many external influences in today's market force that impair the relationship between the pain medicine specialist and the patient, and ultimately prevent optimal quality of care. This article explores the ethical challenges facing the pain medicine specialist in today's increasingly "business" environment and will offer solutions for maintaining the professionalism of pain medicine. Four commonly encountered bioethical principles in the practice of pain medicine are reviewed: beneficence, nonmaleficence, justice, and autonomy. The following ethical challenges of the pain medicine specialist are reviewed: practicing outside ones specialty area, practice characteristics, the consultant role, the economic lure of aggressive intervention, not evaluating for and treating comorbid psychopathology, reimbursement pressures, workers' compensation, and use of unproven methods. Solutions offered include collegial associations, social responsibility, legislative initiatives, pain education, interdisciplinary evaluation and treatment, improved relationships with third-party payers, reduced racial disparities, and ethics education. Ethics is the "roadmap" that enables the pain medicine specialist to navigate the increasingly murky waters of practicing pain management today by maintaining the professionalism necessary to combat today's "business" pressures. Wiley Periodicals, Inc.
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System Reliability for LED-Based Products
Energy Technology Data Exchange (ETDEWEB)
Davis, J Lynn; Mills, Karmann; Lamvik, Michael; Yaga, Robert; Shepherd, Sarah D; Bittle, James; Baldasaro, Nick; Solano, Eric; Bobashev, Georgiy; Johnson, Cortina; Evans, Amy
2014-04-07
Results from accelerated life tests (ALT) on mass-produced commercially available 6” downlights are reported along with results from commercial LEDs. The luminaires capture many of the design features found in modern luminaires. In general, a systems perspective is required to understand the reliability of these devices since LED failure is rare. In contrast, components such as drivers, lenses, and reflector are more likely to impact luminaire reliability than LEDs.
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Mission Specialist Pedro Duque smiles at camera while at Launch Pad 39B
1998-01-01
STS-95 Mission Specialist Pedro Duque of Spain, with the European Space Agency (ESA), smiles for the camera from Launch Pad 39B. The STS-95 crew were making final preparations for launch, targeted for liftoff at 2 p.m. on Oct. 29. Other crew members not shown are Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialists Scott E. Parazynski, Stephen K. Robinsion, and and Payload Specialists John H. Glenn Jr., senator from Ohio, and Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The STS-95 mission is expected to last 8 days, 21 hours and 49 minutes, returning to KSC at 11:49 a.m. EST on Nov. 7.
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Proceedings of the cross-over symposium 'new approaches for studies on environmental radioactivity'
International Nuclear Information System (INIS)
Matsumoto, Shiro; Uchida, Shigeo; Yamazawa, Hiromi; Amano, Hikaru
1999-03-01
This conference was organized by the Promotion Committee on Nuclear Cross-Over Research and the Specialist Committee on Assessment and Reduction of Radiation Risks, and co-organized by Microbial Toxicology Lab., RIKEN and Environmental Chemistry Lab., JAERI. In 1991, a project on transfer models and parameters of radionuclides in terrestrial environment was started in the Specialist Committee on Assessment and Reduction of Radiation Risks. This project was finished successfully to have active cooperation of different organizations which were Japan Atomic Energy Research Institute (JAERI), Meteorological Research Institute (MRI), National Institute of Radiological Sciences (NIRS), the Institute of Physical and Chemical Research (RIKEN) and Power Reactor and Nuclear Fuel Development Corporation (PNC). Subsequently, we started a new project named 'Development of dynamic models of transfer of radionuclides in the terrestrial environment' with adding a new member, Institute for Environmental Sciences (IES) from 1996. The results we obtained so far were presented in this conference. The 20 of the presented papers are indexed individually. (J.P.N.)
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Proceedings of the cross-over symposium `new approaches for studies on environmental radioactivity`
Energy Technology Data Exchange (ETDEWEB)
Matsumoto, Shiro [Saitama Univ., Urawa (Japan); Uchida, Shigeo; Yamazawa, Hiromi; Amano, Hikaru [eds.
1999-03-01
This conference was organized by the Promotion Committee on Nuclear Cross-Over Research and the Specialist Committee on Assessment and Reduction of Radiation Risks, and co-organized by Microbial Toxicology Lab., RIKEN and Environmental Chemistry Lab., JAERI. In 1991, a project on transfer models and parameters of radionuclides in terrestrial environment was started in the Specialist Committee on Assessment and Reduction of Radiation Risks. This project was finished successfully to have active cooperation of different organizations which were Japan Atomic Energy Research Institute (JAERI), Meteorological Research Institute (MRI), National Institute of Radiological Sciences (NIRS), the Institute of Physical and Chemical Research (RIKEN) and Power Reactor and Nuclear Fuel Development Corporation (PNC). Subsequently, we started a new project named `Development of dynamic models of transfer of radionuclides in the terrestrial environment` with adding a new member, Institute for Environmental Sciences (IES) from 1996. The results we obtained so far were presented in this conference. The 20 of the presented papers are indexed individually. (J.P.N.)
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From Humanizing the Educational Process to Professionally Mobile Specialists Training
Directory of Open Access Journals (Sweden)
T. A. Fugelova
2012-01-01
Full Text Available Training professional mobile specialists capable of responding flexibly to dynamic changes in society is considered to be the most important issue of the modern educational system. The paper justifies the idea that technical universities should take responsibility for solving this problem by means of humanization of technical education, which implies reconsidering its values and general notions. For overcoming the technocratic trends, the author recommends to cultivate the value of professionalism in the humanization context.Professionalism is defined by using the «professional service» idea as a «purpose acknowledgment, supertask, even a mission». The main components of the above attitude lie in finding the harmony with the world and its basic values. Therefore, technical universities face the challenge of training people of intelligence with a high moral and business responsibility. The basic value of such a person is regarded as «dedication to the cause» - the constant desire to improve the world and leave behind them- selves something of value to society. For training such specialists, the educational process should provide teachers dialogue and collaboration with students to facilitate the process of self-determination and self-development of the prospective specialists.
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What are the roles of clinical nurses and midwife specialists?
Wickham, Sheelagh
Research shows the increasing part the Clinical Nurse Specialist (CNS) plays in healthcare today. But what does a CNS actually do in their day-to day-work? This study, set in the Republic of Ireland, aimed to explore the CNS and clinical midwife specialist (CMS) roles in practice. Quantitative methodology was used to explore the roles and activities of the CNS and CMS. Following ethics approval, a valid and reliable questionnaire was circulated to the total population of CNS/CMS in Ireland. The data were analysed using SPSS. This study articulates the individual role elements and activity level. The findings show the CNS/CMS to be active in the roles of researcher, educator, communicator, change agent, leader and clinical specialist, but the level of activity varies between different roles and individual role elements. The CNS/CMS is seen as a valuable resource in health care today and has potential to have a positive effect on patient care. The majority of CNS/CMSs are active in varying roles but the analysis shows lesser activity in some areas, such as research. The findings merit further study on role activity and possible variables that influence role activity.
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Applying research to practice: generalist and specialist (visual ergonomics) consultancy.
Long, Jennifer; Long, Airdrie
2012-01-01
Ergonomics is a holistic discipline encompassing a wide range of special interest groups. The role of an ergonomics consultant is to provide integrated solutions to improve comfort, safety and productivity. In Australia, there are two types of consultants--generalists and specialists. Both have training in ergonomics but specialist knowledge may be the result of previous education or work experience. This paper presents three projects illustrating generalist and specialist (visual ergonomics) consultancy: development of a vision screening protocol, solving visual discomfort in an office environment and solving postural discomfort in heavy industry. These case studies demonstrate how multiple ergonomics consultants may work together to solve ergonomics problems. It also describes some of the challenges for consultants, for those engaging their services and for the ergonomics profession, e.g. recognizing the boundaries of expertise, sharing information with business competitors, the costs-benefits of engaging multiple consultants and the risk of fragmentation of ergonomics knowledge and solutions. Since ergonomics problems are often multifaceted, ergonomics consultants should have a solid grounding in all domains of ergonomics, even if they ultimately only practice in one specialty or domain. This will benefit the profession and ensure that ergonomics remains a holistic discipline.
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O'Sullivan, Belinda G; Joyce, Catherine M; McGrail, Matthew R
2014-09-04
Outreach has been endorsed as an important global strategy to promote universal access to health care but it depends on health workers who are willing to travel. In Australia, rural outreach is commonly provided by specialist doctors who periodically visit the same community over time. However information about the level of participation and the distribution of these services nationally is limited. This paper outlines the proportion of Australian specialist doctors who participate in rural outreach, describes their characteristics and assesses how these characteristics influence remote outreach provision. We used data from the Medicine in Australia: Balancing Employment and Life (MABEL) survey, collected between June and November 2008. Weighted logistic regression analyses examined the effect of covariates: sex, age, specialist residential location, rural background, practice arrangements and specialist group on rural outreach. A separate logistic regression analysis studied the effect of covariates on remote outreach compared with other rural outreach. Of 4,596 specialist doctors, 19% (n = 909) provided outreach; of which, 16% (n = 149) provided remote outreach. Most (75%) outreach providers were metropolitan specialists. In multivariate analysis, outreach was associated with being male (OR 1.38, 1.12 to 1.69), having a rural residence (both inner regional: OR 2.07, 1.68 to 2.54; and outer regional/remote: OR 3.40, 2.38 to 4.87) and working in private consulting rooms (OR 1.24, 1.01 to 1.53). Remote outreach was associated with increasing 5-year age (OR1.17, 1.05 to 1.31) and residing in an outer regional/remote location (OR 10.84, 5.82 to 20.19). Specialists based in inner regional areas were less likely than metropolitan-based specialists to provide remote outreach (OR 0.35, 0.17 to 0.70). There is a healthy level of interest in rural outreach work, but remote outreach is less common. Whilst most providers are metropolitan-based, rural doctors are more
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International Nuclear Information System (INIS)
2011-01-01
Reference Materials are an important requirement for any sort of quantitative chemical and radiochemical analysis. Laboratories need them for calibration and quality control throughout their analytical work. The IAEA started to produce reference materials in the early 1960's to meet the needs of the analytical laboratories in its Member States that required reference materials for quality control of their measurements. The initial efforts were focused on the preparation of environmental reference materials containing anthropogenic radionuclides for use by those laboratories employing nuclear analytical techniques. These reference materials were characterized for their radionuclide content through interlaboratory comparison involving a core group of some 10 to 20 specialist laboratories. The success of these early exercises led the IAEA to extend its activities to encompass both terrestrial and marine reference materials containing primordial radionuclides and trace elements. Within the frame of IAEA activities in production and certification of reference materials, this report describes the certification of the IAEA-444 and IAEA-445: soil and water spiked with gamma emitting radionuclides respectively. Details are given on methodologies and data evaluation
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Supporting smoking cessation in the medical specialist practice
Schippers, G. M.
2004-01-01
Although smoking cessation reduces the cardiovascular risk of smoking, why this is so is still uncertain. Nevertheless, because they are strongly and authoritatively involved in much of the serious health damage caused by smoking, medical specialists should do all they can to support their patients
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Health and environmental aspects of nuclear fuel cycle facilities
International Nuclear Information System (INIS)
1996-11-01
The purpose of the present publication is to give a generic description of health and environmental aspects of nuclear fuel cycle facilities. Primarily the report is meant to stand alone; however, because of the content of the publication and in the context of the DECADES project, it may serve as a means of introducing specialists in other fuel cycles to the nuclear fuel cycle. Refs, figs, tabs
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Schmidt-Erfurth, Ursula; Chong, Victor; Loewenstein, Anat; Larsen, Michael; Souied, Eric; Schlingemann, Reinier; Eldem, Bora; Monés, Jordi; Richard, Gisbert; Bandello, Francesco
2014-09-01
Age-related macular degeneration (AMD) is still referred to as the leading cause of severe and irreversible visual loss world-wide. The disease has a profound effect on quality of life of affected individuals and represents a major socioeconomic challenge for societies due to the exponential increase in life expectancy and environmental risks. Advances in medical research have identified vascular endothelial growth factor (VEGF) as an important pathophysiological player in neovascular AMD and intraocular inhibition of VEGF as one of the most efficient therapies in medicine. The wide introduction of anti-VEGF therapy has led to an overwhelming improvement in the prognosis of patients affected by neovascular AMD, allowing recovery and maintenance of visual function in the vast majority of patients. However, the therapeutic benefit is accompanied by significant economic investments, unresolved medicolegal debates about the use of off-label substances and overwhelming problems in large population management. The burden of disease has turned into a burden of care with a dissociation of scientific advances and real-world clinical performance. Simultaneously, ground-breaking innovations in diagnostic technologies, such as optical coherence tomography, allows unprecedented high-resolution visualisation of disease morphology and provides a promising horizon for early disease detection and efficient therapeutic follow-up. However, definite conclusions from morphologic parameters are still lacking, and valid biomarkers have yet to be identified to provide a practical base for disease management. The European Society of Retina Specialists offers expert guidance for diagnostic and therapeutic management of neovascular AMD supporting healthcare givers and doctors in providing the best state-of-the-art care to their patients. NCT01318941. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Maritime oil freight flows to 2050: Delphi perceptions of maritime specialists
International Nuclear Information System (INIS)
Dinwoodie, John; Tuck, Sarah; Rigot-Müller, Patrick
2013-01-01
This paper aims to synthesise maritime specialists' perceptions of changing patterns of maritime oil freight flows to 2050. Debate spans published maritime oil flows globally, diverse drivers of future flows including economic growth, shipping market changes and haul lengths. A classic Delphi study to explore the perceptions of likely trends and flows to 2050 recruited a panel of early career and established maritime specialists, many with long term career commitments to this industry. Underpinned by market volatility and legislative uncertainty, the perceptions of both groups coincided and were conservative. Local sourcing, new Arctic seaways and fossil fuel intolerance will tend to reduce oil freight work but perceptions of ship re-routing to avoid for example Emission Control Areas and piracy would tend to lengthen hauls. In advanced industrial nations, reducing energy intensities and diminishing social tolerance of fossil fuels imply gradually reducing maritime oil shipments. However, to achieve radical national commitments to carbon emissions reductions will necessitate specialist education for naturally conservative maritime professionals and vigorous oil import reduction policies to curtail domestic demand for oil shipments. - Highlights: • Local sourcing, Arctic seaways and fossil fuel intolerance lessen oil freight work. • Oil hauls lengthen if ships re-route to avoid Emission Control Areas and piracy. • Conservative perceptions of established specialists match early career views. • Carbon emission reduction policies imply significantly reduced oil shipments. • Attitude change in maritime professionals will require education and marketing
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2013-07-12
... DEPARTMENT OF TRANSPORTATION Surface Transportation Board [Docket No. FD 35726] Transport Handling Specialists, Inc.--Continuance in Control Exemption--RSL Railroad, LLC Transport Handling Specialists, Inc. (THS), has filed a verified notice of exemption (Notice) under 49 CFR 1180.2(d)(2) to continue in...
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Directory of Open Access Journals (Sweden)
Víctor Camañes
2014-08-01
Full Text Available This paper analyzes the high relevance of material selection for the sustainable development of an LED weatherproof light fitting. The research reveals how this choice modifies current and future end of life scenarios and can reduce the overall environmental impact. This life cycle assessment has been carried out with Ecotool, a software program especially developed for designers to assess the environmental performance of their designs at the same time that they are working on them. Results show that special attention can be put on the recycling and reusing of the product from the initial stages of development.
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Zhang, Zhijie; Pan, Xiaoyun; Blumenthal, Dana; van Kleunen, Mark; Liu, Mu; Li, Bo
2018-04-01
Invasive alien plants are likely to be released from specialist herbivores and at the same time encounter biotic resistance from resident generalist herbivores in their new ranges. The Shifting Defense hypothesis predicts that this will result in evolution of decreased defense against specialist herbivores and increased defense against generalist herbivores. To test this, we performed a comprehensive meta-analysis of 61 common garden studies that provide data on resistance and/or tolerance for both introduced and native populations of 32 invasive plant species. We demonstrate that introduced populations, relative to native populations, decreased their resistance against specialists, and increased their resistance against generalists. These differences were significant when resistance was measured in terms of damage caused by the herbivore, but not in terms of performance of the herbivore. Furthermore, we found the first evidence that the magnitude of resistance differences between introduced and native populations depended significantly on herbivore origin (i.e., whether the test herbivore was collected from the native or non-native range of the invasive plant). Finally, tolerance to generalists was found to be higher in introduced populations, while neither tolerance to specialists nor that to simulated herbivory differed between introduced and native plant populations. We conclude that enemy release from specialist herbivores and biotic resistance from generalist herbivores have contrasting effects on resistance evolution in invasive plants. Our results thus provide strong support for the Shifting Defense hypothesis. © 2018 by the Ecological Society of America.
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DEFF Research Database (Denmark)
Dam-Hansen, Carsten; Thorseth, Anders; Rosenqvist, Eva
2012-01-01
Den teknologiske udvikling indenfor Lys Emitterende Dioder (LED) går imod stadig større lysmængder og stadig større effektivitet. Kombineret med fordele som lang levetid, dæmpbarhed og ingen varmestråling gør det, at LED baserede lyskilder/lamper i stigende grad benyttes til belysningsformål og kan...
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Theoretical Aspects of the Building Professional Competences of the Hospitality Industry Specialists
Silicka, Inese; Ļubkina, Velta
2015-01-01
The theoretical aspects of the concept of the professional competences of future hospitality industry specialists are examined and analysed in the paper. The study is carried out within the framework of development of the doctoral thesis “Interrelation of the professional competence theories and the practice in the hospitality industry”. The components and constituent elements of the professional competences of the hospitality industry specialists are defined in the research; the concepts “pr...
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Integration of organic LEDs with inorganic LEDs for a hybrid lighting system
Kong, H. J.; Park, J. W.; Kim, Y. M.
2013-01-01
We demonstrate that a surface-emitting hybrid light source can be realized by a combination of organic and inorganic light-emitting devices (LEDs). To this end, a blue inorganic LED bar is deployed at one side of a transparent light guide plate (LGP), and a yellow organic LED (OLED) is in contact with the rear surface of the LGP. In such a configuration, it is found that the overall luminance is almost equivalent to the sum of the luminances measured from each light source, and the overall luminance uniformity is determined mainly by the luminance uniformity of the OLED panel at high luminances. We have achieved a white color showing the Commission Internationale d'Eclairage (CIE) chromaticity coordinates of (x = 0.34, y = 0.33), the power efficiency of 9.3 lm/W, the luminance uniformity of 63% at the luminance of 3100 cd m-2, the color rendering index as high as 89.3, and the correlated color temperature finely tunable within the range between 3000 and 8000 K. Such a system facilitates color tuning by adjusting their luminous intensities and hence the implementation of the emotional lighting system.
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Integration of organic LEDs with inorganic LEDs for a hybrid lighting system
International Nuclear Information System (INIS)
Kong, H J; Kim, Y M; Park, J W
2013-01-01
We demonstrate that a surface-emitting hybrid light source can be realized by a combination of organic and inorganic light-emitting devices (LEDs). To this end, a blue inorganic LED bar is deployed at one side of a transparent light guide plate (LGP), and a yellow organic LED (OLED) is in contact with the rear surface of the LGP. In such a configuration, it is found that the overall luminance is almost equivalent to the sum of the luminances measured from each light source, and the overall luminance uniformity is determined mainly by the luminance uniformity of the OLED panel at high luminances. We have achieved a white color showing the Commission Internationale d'Eclairage (CIE) chromaticity coordinates of (x = 0.34, y = 0.33), the power efficiency of 9.3 lm/W, the luminance uniformity of 63% at the luminance of 3100 cd m –2 , the color rendering index as high as 89.3, and the correlated color temperature finely tunable within the range between 3000 and 8000 K. Such a system facilitates color tuning by adjusting their luminous intensities and hence the implementation of the emotional lighting system. (paper)
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White LED with High Package Extraction Efficiency
International Nuclear Information System (INIS)
Yi Zheng; Stough, Matthew
2008-01-01
The goal of this project is to develop a high efficiency phosphor converting (white) Light Emitting Diode (pcLED) 1-Watt package through an increase in package extraction efficiency. A transparent/translucent monolithic phosphor is proposed to replace the powdered phosphor to reduce the scattering caused by phosphor particles. Additionally, a multi-layer thin film selectively reflecting filter is proposed between blue LED die and phosphor layer to recover inward yellow emission. At the end of the project we expect to recycle approximately 50% of the unrecovered backward light in current package construction, and develop a pcLED device with 80 lm/W e using our technology improvements and commercially available chip/package source. The success of the project will benefit luminous efficacy of white LEDs by increasing package extraction efficiency. In most phosphor-converting white LEDs, the white color is obtained by combining a blue LED die (or chip) with a powdered phosphor layer. The phosphor partially absorbs the blue light from the LED die and converts it into a broad green-yellow emission. The mixture of the transmitted blue light and green-yellow light emerging gives white light. There are two major drawbacks for current pcLEDs in terms of package extraction efficiency. The first is light scattering caused by phosphor particles. When the blue photons from the chip strike the phosphor particles, some blue light will be scattered by phosphor particles. Converted yellow emission photons are also scattered. A portion of scattered light is in the backward direction toward the die. The amount of this backward light varies and depends in part on the particle size of phosphors. The other drawback is that yellow emission from phosphor powders is isotropic. Although some backward light can be recovered by the reflector in current LED packages, there is still a portion of backward light that will be absorbed inside the package and further converted to heat. Heat generated
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Aldridge, Cassie; Bion, Julian; Boyal, Amunpreet; Chen, Yen-Fu; Clancy, Mike; Evans, Tim; Girling, Alan; Lord, Joanne; Mannion, Russell; Rees, Peter; Roseveare, Chris; Rudge, Gavin; Sun, Jianxia; Tarrant, Carolyn; Temple, Mark; Watson, Sam; Lilford, Richard
2016-07-09
Increased mortality rates associated with weekend hospital admission (the so-called weekend effect) have been attributed to suboptimum staffing levels of specialist consultants. However, evidence for a causal association is elusive, and the magnitude of the weekend specialist deficit remains unquantified. This uncertainty could hamper efforts by national health systems to introduce 7 day health services. We aimed to examine preliminary associations between specialist intensity and weekend admission mortality across the English National Health Service. Eligible hospital trusts were those in England receiving unselected emergency admissions. On Sunday June 15 and Wednesday June 18, 2014, we undertook a point prevalence survey of hospital specialists (consultants) to obtain data relating to the care of patients admitted as emergencies. We defined specialist intensity at each trust as the self-reported estimated number of specialist hours per ten emergency admissions between 0800 h and 2000 h on Sunday and Wednesday. With use of data for all adult emergency admissions for financial year 2013-14, we compared weekend to weekday admission risk of mortality with the Sunday to Wednesday specialist intensity ratio within each trust. We stratified trusts by size quintile. 127 of 141 eligible acute hospital trusts agreed to participate; 115 (91%) trusts contributed data to the point prevalence survey. Of 34,350 clinicians surveyed, 15,537 (45%) responded. Substantially fewer specialists were present providing care to emergency admissions on Sunday (1667 [11%]) than on Wednesday (6105 [42%]). Specialists present on Sunday spent 40% more time caring for emergency patients than did those present on Wednesday (mean 5·74 h [SD 3·39] vs 3·97 h [3·31]); however, the median specialist intensity on Sunday was only 48% (IQR 40-58) of that on Wednesday. The Sunday to Wednesday intensity ratio was less than 0·7 in 104 (90%) of the contributing trusts. Mortality risk among patients
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12. national conference of Czechoslovak power specialists
International Nuclear Information System (INIS)
1983-01-01
The XIIth national conference of Czechoslovak power specialists was held in Bratislava from October 5 to 7, 1983. Of the total number of 32 papers 12 were incorporated in the INIS system, i.e., such which dealt with the development of the nuclear power complex and the rationalization of sources and the use of heat in the Czechoslovak energy balance. (E.S.)
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Effective leadership within hospice and specialist palliative care units.
Barker, L
2000-01-01
In this study the Repertory Grid interview technique was used to investigate constructs of leadership held by a group of male and female senior managers from within hospice and Specialist Palliative Care Units (SPCUs) in the UK. The themes that emerged were compared with those from existing research models of leadership. Men and women in these roles describe different constructs of effective leadership. The women's constructs that emerged were predominantly transformational, whilst the men's were predominantly transactional. Themes were also identified in this study, which differed from previous studied, i.e. those of political and environment awareness and the valuing of others' views regardless of their status. These themes do not feature highly in other research, and may be in response to the environment within which hospice and specialist palliative care functions.
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The clinical nurse specialist in an Irish hospital.
Wickham, Sheelagh
2011-01-01
This study was set in an acute Irish health care setting and aimed to explore the activity of the clinical nurse specialist (CNS) in this setting. Quantitative methodology, using a valid and reliable questionnaire, provided descriptive statistics that gave accurate data on the total population of CNSs in the health care setting. The study was set in an acute-care 750-bed hospital that had 25 CNSs in practice. The sample consisted of all 25 CNSs who are the total population of CNSs working in the acute health care institution. The findings show the CNS to be active in the roles of researcher, educator, communicator, change agent, leader, and clinical specialist, but the level of activity varies between different roles. There is variety in the activity of CNSs in the various roles and to what extent they enact the role. The findings merit further study on CNS role activity and possible variables that influence role activity.
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Peer-led prenatal breast-feeding education: a viable alternative to nurse-led education.
Rempel, Lynn A; Moore, Katrina C J
2012-02-01
To evaluate a prenatal breast-feeding class developed and facilitated by peer Breast-feeding Buddies. Non-equivalent control group quasi-experimental study comparing participants of the peer-led class (PLC) to those attending an established hospital-based breast-feeding nurse-led class (NLC). A brief questionnaire was completed immediately prior to the class, and telephone interviews were conducted approximately one week following the class, and one and six months post partum. 54 expectant mothers who registered for the community PLC and 55 expectant mothers who registered for the NLC. Breast-feeding intentions were measured at all time-points. Class evaluations, breast-feeding experiences, and breast-feeding support were measured at all post-class interviews. Both classes were considered worthwhile, but the PLC class was rated as more helpful and participants appreciated learning from the peers' personal experiences. Mothers taught by peers were more likely to access peer breast-feeding support. PLC participants initially decreased their prenatal breast-feeding duration intentions but had significantly stronger intentions to continue breast feeding at six months than did NLC mothers. A peer-led prenatal breast-feeding class is as effective as a traditional model of breast-feeding education and is a valuable tool to promote and support successful breast feeding. RECOMMENDATIONS FOR PRACTICE: Peer-led breast-feeding classes should be provided to enhance the accessibility of breast-feeding education and support for expectant mothers. Copyright © 2010 Elsevier Ltd. All rights reserved.
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EC-LEDS Supports the Low-Carbon Transition
Energy Technology Data Exchange (ETDEWEB)
2016-09-01
EC-LEDS is a flagship U.S. government-led effort that assists countries to create and implement low emission development strategies, or LEDS -- development frameworks that promote sustainable social and economic development while reducing greenhouse gas emissions over the medium to long term.
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Energy Technology Data Exchange (ETDEWEB)
Peekstok, T.; Duyvesteijn, R.; Persoon, S.; Sanders, J.; De Jong, A. [Tuinbouw Techniek Ontwikkeling TTO, Honselersdijk (Netherlands)
2011-07-15
An overview is given of research results of the application of LED in the horticulture, focusing on high-growing vegetable crops. In this report LED illuminance research for tomatoes is outlined. The project has been carried out from October 2010 to May 2011 in the demonstration nursery Westland. Also, briefly attention is paid to LED lighting tests, performed by TTO (Horticulture Technology Development) in 2008 and 2009 [Dutch] Een overzicht wordt gegeven van de onderzoeksresultaten in de toepassing van LED belichting in de glastuinbouw, met nadruk op hoogopgaande groentegewassen. In dit verslag wordt het onderzoek met LED belichting in tomaat van telersvereniging 'Tuinbouw Techniek Ontwikkeling' (TTO) uiteengezet. Dit project heeft plaatsgevonden vanaf oktober 2010 tot mei 2011 in de Demokwekerij Westland. Hiernaast worden de proeven met LED belichting, welke uitgevoerd zijn door TTO in 2008 en 2009, kort samengevat.
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Energy Technology Data Exchange (ETDEWEB)
Mather, N.
2004-06-30
A lighting system using light-emitting diodes, and privately financed by a Canadian engineering professor at the University of Calgary, has been set up in a village in Nepal in 2000. Since then, through the efforts of the 'Light Up The World' Foundation, established by Dr. Irvine-Halliday, projects have lit up thousands of homes in the Philippines, India, Afghanistan, the Galapagos Islands, Mexico, Sri Lanka, and Angola. Although the goal of the project is primarily to provide lighting for reading and writing for school-children, the project has been the source of many other advantages; creation of enterprise, increased employment, enhanced income, gender equality, and improvements in health and safety among them. Since LED lamps in most cases replace kerosene lamps, the system also has significant environmental benefits. The system as originally envisioned creates electricity by pedal-powered generator, or by solar panels connected to a battery, depending on what is available at each home. Each home is connected to the power supply and supplied with low-energy diode lamps. The lights are extremely efficient and many homes can be equipped with them using less energy than it takes to power a single 100-watt light bulb. 5 photos.
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O'Connor, Laserina; Casey, Mary; Smith, Rita; Fealy, Gerard M; Brien, Denise O'; O'Leary, Denise; Stokes, Diarmuid; McNamara, Martin S; Glasgow, Mary Ellen; Cashin, Andrew
2018-03-01
To inform and guide the development of a future model of specialist and advanced nursing and midwifery practice. There is a sizable body of empirical literature supporting the unique contributions of specialist and advanced practice roles to health care. However, there is very little international evidence to inform the integration of a future model for advanced or specialist practice in the Irish healthcare system. A qualitative study was conducted to initiate this important area of inquiry. Purposive sampling was used to generate a sample of informants (n = 15) for the interviews. Nurses and midwives working in specialist and advanced practice and participants from other areas such as legislative, regulatory, policy, medicine and education were included in the sampling frame. Arguments for a new model of specialist and advanced practice were voiced. A number of participants proposed that flexibility within specialist and advanced practitioner career pathways was essential. Otherwise, there existed the possibility of being directed into specialised "silos," precluding movement to another area of integrated practice. Future specialist and advanced practice education programmes need to include topics such as the development of emotional and political intelligence. The contribution of specialist and advanced practice roles to the health service includes providing rapid access to care, seamless patient flow across services, early discharge and lead coordinator of the patient's care trajectory. There was a recommendation of moving towards a universal model to cultivate specialist and advanced nurse and midwife practitioners. The model design has Universal application in a range of contexts "U." It is Collaborative in its inclusivity of all key stakeholders "C." The model is Dynamic pertinent to accommodating movement of nurses and midwives across health continua rather than plateauing in very specialised "silos" "D." © 2017 John Wiley & Sons Ltd.
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Salander, Pär; Isaksson, Joakim; Granström, Brith; Laurell, Göran
2016-11-01
The purpose of this study is to systematically explore the motives for patients with head and neck cancer to contact a specialist nurse during two years postdiagnosis. Research focusing on the role of specialist nurses in cancer care almost exclusively concern cancers other than head and neck cancer. Qualitative, descriptive study based on the contacts between patients with head and neck cancer and a specialist nurse. Patients were invited to contact a specialist nurse by telephone. The specialist nurse took systematic field notes, that is, she registered who contacted her, the nature of the call and the outcome. Sixty patients were included. In descending order, the motives for contact were questions about practical and uncomplicated matters, consultations about medical troubles/worries, presenting a report of the patient's situation, requests for additional information about the treatment plan and requests for medical information. The pattern of the patients' motivations for calling was not related to medical or social factors, suggesting that the initiative to make contact is very much a question of the complexity of individual life circumstances. Very few referrals were sent from the specialist nurse to other professionals. The specialist nurse turned out to be more than just a coordinator of health-care resources. The findings bring up questions about the potential of the nurse's function as a coordinator, but also as a potential attachment figure, and questions about the nurse's relationships to other professionals. When implementing a specialist nurse function, it is important to decide whether the function should be inspired by a broader relational perspective. In addition to the indispensible competence and experience in the clinical field of head and neck cancer, training in counselling and acquaintance with object-relational psychology will then be desirable. © 2016 John Wiley & Sons Ltd.
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Directory of Open Access Journals (Sweden)
Kristina Ledauskaitė
2011-03-01
Full Text Available To develop knowledge, advanced technology and skilled labor-based economy in Lithuania, it is necessary to make an effective business interaction and practical training, and preparation of specialists to ensure the ability to compete in European labor markets, and general capacity building. Common started training for professionals is to consider raising questions as to develop people in constantly changing global context. Several years of the research done in Lithuania, Latvia and Estonia transport sectors, has allowed the evaluating of the general competencies of these area specialists, and showed that specialists working in transport/logistics area are faced with lack of practical skills. The eliminating of these lacks requires close cooperation between the educational institutions and transport and/or logistics sector cooperation.Article in Lithuanian
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Fokusgruppeinterview som led i en evalueringsproces
DEFF Research Database (Denmark)
Andersen-Mølgaard, Hanna; Harrit, Ole
2006-01-01
Teoretiske begrundelser og perspektiver, responsiv-konstruktivistisk evaluering, fokusgruppeinterview som led i BIKVAmodellen, eksempler, vurdering og perspektivering......Teoretiske begrundelser og perspektiver, responsiv-konstruktivistisk evaluering, fokusgruppeinterview som led i BIKVAmodellen, eksempler, vurdering og perspektivering...
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New dental applications with LEDs
DEFF Research Database (Denmark)
Argyraki, A.; Ou, Yiyu; Petersen, Paul Michael
Visible and ultraviolet LEDs will in the future give rise to new dental applications. Fluorescence imaging, photodynamic therapy and photoactivated disinfection are important future candidates for diagnostics and treatment in dentistry.......Visible and ultraviolet LEDs will in the future give rise to new dental applications. Fluorescence imaging, photodynamic therapy and photoactivated disinfection are important future candidates for diagnostics and treatment in dentistry....
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The rural pipeline to longer-term rural practice: General practitioners and specialists.
Directory of Open Access Journals (Sweden)
Marcella M S Kwan
Full Text Available Rural medical workforce shortage contributes to health disadvantage experienced by rural communities worldwide. This study aimed to determine the regional results of an Australian Government sponsored national program to enhance the Australian rural medical workforce by recruiting rural background students and establishing rural clinical schools (RCS. In particular, we wished to determine predictors of graduates' longer-term rural practice and whether the predictors differ between general practitioners (GPs and specialists.A cross-sectional cohort study, conducted in 2012, of 729 medical graduates of The University of Queensland 2002-2011. The outcome of interest was primary place of graduates' practice categorised as rural for at least 50% of time since graduation ('Longer-term Rural Practice', LTRP among GPs and medical specialists. The main exposures were rural background (RB or metropolitan background (MB, and attendance at a metropolitan clinical school (MCS or the Rural Clinical School for one year (RCS-1 or two years (RCS-2.Independent predictors of LTRP (odds ratio [95% confidence interval] were RB (2.10 [1.37-3.20], RCS-1 (2.85 [1.77-4.58], RCS-2 (5.38 [3.15-9.20], GP (3.40 [2.13-5.43], and bonded scholarship (2.11 [1.19-3.76]. Compared to being single, having a metropolitan background partner was a negative predictor (0.34 [0.21-0.57]. The effects of RB and RCS were additive-compared to MB and MCS (Reference group: RB and RCS-1 (6.58[3.32-13.04], RB and RCS-2 (10.36[4.89-21.93]. Although specialists were less likely than GPs to be in LTRP, the pattern of the effects of rural exposures was similar, although some significant differences in the effects of the duration of RCS attendance, bonded scholarships and partner's background were apparent.Among both specialists and GPs, rural background and rural clinical school attendance are independent, duration-dependent, and additive, predictors of longer-term rural practice. Metropolitan
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International Nuclear Information System (INIS)
Jin, D; Connally, R; Piper, J
2006-01-01
We report the results of a detailed study of the spectral and temporal properties of visible emission from three different GaN-based ultraviolet (UV) light emitting diodes (UV LEDs). The primary UV emission in the 360-380 nm band decays rapidly (less than 1 μs) following switch-off; however, visible luminescence (470-750 nm) with a decay lifetime of tens of microseconds was observed at approximately 10 -4 of the UV intensity. For applications of UV LEDs in time-resolved fluorescence (TRF) employing lanthanide chelates, the visible luminescence from the LEDs competes with the target Eu 3+ or Tb 3+ fluorescence in both spectral and temporal domains. A UV band-pass filter (Schott UG11 glass) was therefore used to reduce the visible luminescence of the UV LEDs by three orders of magnitude relative to UV output to yield a practical excitation source for TRF
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Optical characterization of ultrabright LEDs
International Nuclear Information System (INIS)
Benavides, Juan Manuel; Webb, Robert H.
2005-01-01
Ultrabright light emitting diodes (LEDs) are a new light source for visual psychophysics and microscopy. The new LEDs are intended primarily for room and exterior illumination, and the manufacturers' specifications are adequate for that. However, we use them as light sources in situations where a more complete characterization may be useful. For one set of LEDs we have measured the radiometric intensity and its distribution in space and wavelength, and we have tested for interactions of these variables and their dependence on driver configuration. We describe techniques for making these measurements and give a link to a simple calculator for converting among radiometric and photometric measures, as well as an evaluation of the safety considerations these very bright sources demand
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Causality Between Urban Concentration and Environmental Quality
Directory of Open Access Journals (Sweden)
Amin Pujiati
2015-08-01
Full Text Available Population is concentrated in urban areas can cause the external diseconomies on environment if it exceeds the carrying capacity of the space and the urban economy. Otherwise the quality of the environment is getting better, led to the concentration of population in urban areas are increasingly high. This study aims to analyze the relationship of causality between the urban concentration and environmental quality in urban agglomeration areas. The data used in the study of secondary data obtained from the Central Bureau of statistics and the City Government from 2000 to 2013. The analytical method used is the Granger causality and descriptive. Granger causality study results showed no pattern of reciprocal causality, between urban concentration and the quality of the environment, but there unidirectional relationship between the urban concentration and environmental quality. This means that increasing urban concentration led to decreased environmental quality.
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The marketer-a complex specialist, a man of concept, decision and action
Pop, Nicolae Al.; Vlădoi, Anca-Daniela
2009-01-01
Over the last fifty years, the theory and practice of contemporary marketing have been influenced by the focus of its applicative approach over a major landmark of the business world. A short characterization of its different orientations, from consumer oriented marketing to holistic marketing, can only lead to the conclusion regarding the formative complexity of the specialist working in this field. The profile of this specialist is to be understood in such a manner as to have a competitive ...
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STS-35 payload specialists perform balancing act on OV-102's middeck
1990-01-01
Aided by the microgravity environment aboard Columbia, Orbiter Vehicle (OV) 102, STS-35 Payload Specialist Ronald A. Parise balances Payload Specialist Samuel T. Durrance on his index finger in front of the middeck starboard wall. Durrance is wearing a blood pressure cuff and is holding a beverage container and food package during the microgravity performance. The waste management compartment (WMC), side hatch, and orbiter galley are seen behind the two crewmembers. Durrance's feet are at the forward lockers.
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White LED visible light communication technology research
Yang, Chao
2017-03-01
Visible light communication is a new type of wireless optical communication technology. White LED to the success of development, the LED lighting technology is facing a new revolution. Because the LED has high sensitivity, modulation, the advantages of good performance, large transmission power, can make it in light transmission light signal at the same time. Use white LED light-emitting characteristics, on the modulation signals to the visible light transmission, can constitute a LED visible light communication system. We built a small visible optical communication system. The system composition and structure has certain value in the field of practical application, and we also research the key technology of transmitters and receivers, the key problem has been resolved. By studying on the optical and LED the characteristics of a high speed modulation driving circuit and a high sensitive receiving circuit was designed. And information transmission through the single chip microcomputer test, a preliminary verification has realized the data transmission function.
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McGowan, E; Elliott, N; Stokes, E
2018-05-07
Investigation of the leadership capabilities of physiotherapy managers found that they report predominantly demonstrating capabilities associated with the human resource and structural frames. However, little is known about the leadership capabilities of clinical specialists and advanced physiotherapy practitioners (APPs) who also are identified as having responsibility for leadership. To explore clinical specialists´ and APPs' perceptions of their leadership capabilities and compare them with the reported leadership capabilities of physiotherapy managers. Semi-structured interviews were conducted with a purposive sample of 17 physiotherapy clinical specialists and APPs from a range of practice settings across Ireland. The interviews were analyzed using template analysis and the coding template was based on the Bolman and Deal Leadership framework. The participants described demonstrating leadership capabilities associated with each of the four leadership frames. However, the language used by the clinical specialists/APPs suggested that they work predominantly through the human resource frame. Structural frame capabilities were reported by the clinical specialists/APPs and there were some differences to those reported by the managers. In keeping with the reported leadership capabilities of the physiotherapy managers, the employment of capabilities associated with the political frame varied between participants and symbolic frame capabilities were underused. There are many similarities in the self-reported leadership capabilities of managers and clinical specialists/APPs. However, differences were also noted. Both cohorts of physiotherapy leaders may benefit from specific development programs to develop leadership capabilities associated with the political and symbolic frames.
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DEFF Research Database (Denmark)
Fabricius, Rasmus; Sillesen, Martin; Hansen, Morten Sejer
2017-01-01
not previously been studied. In the present study, we aim to investigate the role of supervision in the national surgical residency programme and the self-perceived readiness to undertake the role of a specialist doctor in gastrointestinal surgery in a cohort of gastrointestinal surgeons graduating in 2012......: A total of 30 graduated residents (55%) responded to the Danish survey. Among those, 14 (47%) felt ready to be a specialist in surgery. A total of 25 (83%) answered that increased supervision would have increased their selfperceived competencies to serve as a surgical specialist. Self -perceived readiness...... was significantly associated with level of supervision during surgical training (p = 0.02), whereas no association with operative volume could be established. CONCLUSIONS: A worryingly high number of graduates did not feel ready to undertake their role as a gastrointestinal surgical specialist. Adequate supervision...
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Development of high-performance solar LED lighting system
Huang, B.J.; Wu, M.S.; Hsu, P.C.; Chen, J.W.; Chen, K.Y.
2010-01-01
The present study developed a high-performance charge/discharge controller for stand-alone solar LED lighting system by incorporating an nMPPO system design, a PWM battery charge control, and a PWM battery discharge control to directly drive the LED. The MPPT controller can then be removed from the stand-alone solar system and the charged capacity of the battery increases 9.7%. For LED driven by PWM current directly from battery, a reliability test for the light decay of LED lamps was performed continuously for 13,200 h. It has shown that the light decay of PWM-driven LED is the same as that of constant-current driven LED. The switching energy loss of the MOSFET in the PWM battery discharge control is less than 1%. Three solar-powered LED lighting systems (18 W, 100 W and 150 W LED) were designed and built. The long-term outdoor field test results have shown that the system performance is satisfactory with the control system developed in the present study. The loss of load probability for the 18 W solar LED system is 14.1% in winter and zero in summer. For the 100 W solar LED system, the loss of load probability is 3.6% in spring. © 2009 Elsevier Ltd. All rights reserved.
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Development of high-performance solar LED lighting system
International Nuclear Information System (INIS)
Huang, B.J.; Wu, M.S.; Hsu, P.C.; Chen, J.W.; Chen, K.Y.
2010-01-01
The present study developed a high-performance charge/discharge controller for stand-alone solar LED lighting system by incorporating an nMPPO system design, a PWM battery charge control, and a PWM battery discharge control to directly drive the LED. The MPPT controller can then be removed from the stand-alone solar system and the charged capacity of the battery increases 9.7%. For LED driven by PWM current directly from battery, a reliability test for the light decay of LED lamps was performed continuously for 13,200 h. It has shown that the light decay of PWM-driven LED is the same as that of constant-current driven LED. The switching energy loss of the MOSFET in the PWM battery discharge control is less than 1%. Three solar-powered LED lighting systems (18 W, 100 W and 150 W LED) were designed and built. The long-term outdoor field test results have shown that the system performance is satisfactory with the control system developed in the present study. The loss of load probability for the 18 W solar LED system is 14.1% in winter and zero in summer. For the 100 W solar LED system, the loss of load probability is 3.6% in spring.
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Development of high-performance solar LED lighting system
Huang, B.J.
2010-08-01
The present study developed a high-performance charge/discharge controller for stand-alone solar LED lighting system by incorporating an nMPPO system design, a PWM battery charge control, and a PWM battery discharge control to directly drive the LED. The MPPT controller can then be removed from the stand-alone solar system and the charged capacity of the battery increases 9.7%. For LED driven by PWM current directly from battery, a reliability test for the light decay of LED lamps was performed continuously for 13,200 h. It has shown that the light decay of PWM-driven LED is the same as that of constant-current driven LED. The switching energy loss of the MOSFET in the PWM battery discharge control is less than 1%. Three solar-powered LED lighting systems (18 W, 100 W and 150 W LED) were designed and built. The long-term outdoor field test results have shown that the system performance is satisfactory with the control system developed in the present study. The loss of load probability for the 18 W solar LED system is 14.1% in winter and zero in summer. For the 100 W solar LED system, the loss of load probability is 3.6% in spring. © 2009 Elsevier Ltd. All rights reserved.
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Energy Technology Data Exchange (ETDEWEB)
Dietlein, M.; Schmidt, M.; Schicha, H. [Koeln Univ. (Germany). Dept. of Nuclear Medicine; Wegscheider, K. [Hamburg Univ. (Germany). Inst. of Statistics and Econometrics; Vaupel, R. [Sanofi-Aventis Deutschland GmbH, Berlin (Germany)
2007-07-01
Aim: Large-scale survey to focus on management of multinodular goiter and to compare the approaches of practitioners in primary care and thyroid specialists in Germany. Methods: Replies to a questionnaire were received from 2,191 practitioners and 297 thyroid specialists between June 1 and September 30, 2005. The hypothetical cases and their modifications described multinodular goiters of different sizes with and without toxic nodules. Results: In the workup, TSH determination and thyroid sonography were found to be standard procedures. Scintigraphy was selected by 80.2% of practitioners and 92.9% of specialists (p <0.001), in preference to fine needle aspiration cytology (17.9% of practitioners and 34.5% of the specialists, p <0.001). Only 6.1% of practitioners and 24.4% of specialists (p <0.001) advocated calcitonin screening. Euthyroid multinodular goiter (50-80 ml) was treated medically by 67.1% of practitioners and 65.6% of specialists, the combination of levothyroxine with iodine being clearly preferred (54.5% of practitioners, 52.3% of specialists). For toxic nodular goiter the preference for radioiodine therapy was significantly higher (p <0.001) among specialists (67.7%) than among practitioners (47.5%). Referral to surgery was recommended for cold nodules with negative cytology by 64.9% of practitioners and 73.5% of specialists (p = 0.004). Conclusions: Treatment and diagnostic procedures are used to nearly the same extent in primary care and specialist institutions, but the opinions diverge over the issues of calcitonin screening and referral for radioiodine therapy. (orig.)
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International Nuclear Information System (INIS)
Dietlein, M.; Schmidt, M.; Schicha, H.
2007-01-01
Aim: Large-scale survey to focus on management of multinodular goiter and to compare the approaches of practitioners in primary care and thyroid specialists in Germany. Methods: Replies to a questionnaire were received from 2,191 practitioners and 297 thyroid specialists between June 1 and September 30, 2005. The hypothetical cases and their modifications described multinodular goiters of different sizes with and without toxic nodules. Results: In the workup, TSH determination and thyroid sonography were found to be standard procedures. Scintigraphy was selected by 80.2% of practitioners and 92.9% of specialists (p <0.001), in preference to fine needle aspiration cytology (17.9% of practitioners and 34.5% of the specialists, p <0.001). Only 6.1% of practitioners and 24.4% of specialists (p <0.001) advocated calcitonin screening. Euthyroid multinodular goiter (50-80 ml) was treated medically by 67.1% of practitioners and 65.6% of specialists, the combination of levothyroxine with iodine being clearly preferred (54.5% of practitioners, 52.3% of specialists). For toxic nodular goiter the preference for radioiodine therapy was significantly higher (p <0.001) among specialists (67.7%) than among practitioners (47.5%). Referral to surgery was recommended for cold nodules with negative cytology by 64.9% of practitioners and 73.5% of specialists (p 0.004). Conclusions: Treatment and diagnostic procedures are used to nearly the same extent in primary care and specialist institutions, but the opinions diverge over the issues of calcitonin screening and referral for radioiodine therapy. (orig.)
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Evaluating UV-C LED disinfection performance and ...
This study evaluated ultraviolet (UV) light emitting diodes (LEDs) emitting at 260 nm, 280 nm, and the combination of 260|280 nm together for their efficacy at inactivating Escherichia. coli, MS2 coliphage, human adenovirus type 2 (HAdV2), and Bacillus pumilus spores; research included an evaluation of genomic damage. Inactivation by the LEDs was compared with the efficacy of conventional UV sources, the low-pressure (LP) and medium-pressure (MP) mercury vapor lamps. The work also calculated the electrical energy per order of reduction of the microorganisms by the five UV sources.For E. coli, all five UV sources yielded similar inactivation rates. For MS2 coliphage, the 260 nm LED was most effective. For HAdV2 and B. pumilus, the MP UV lamp was significantly more effective than the LP UV and UVC LED sources. When considering electrical energy per order of reduction, the LP UV lamp was the most efficient for E. coli and MS2, and the MPUV and LPUV were equally efficient for HAdV2 and B. pumilus spores. Among the UVC LEDs, the 280 nm LED unit required the least energy per log reduction of E. coli and HAdV2. The 280 nm and 260|280 nm LED units were equally efficient per log reduction of B. pumilus spores, and the 260 nm LED unit required the lowest energy per order of reduction of MS2 coliphage. The combination of the 260 nm and 280 nm UV LED wavelengths was also evaluated for potential synergistic effects. No dual-wavelength synergy was detected for inactivation of
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ZnO-nanorods: A possible white LED phosphor
Sarangi, Sachindra Nath; T., Arun; Ray, Dinseh K.; Sahoo, Pratap Kumar; Nozaki, Shinji; Sugiyama, Noriyuki; Uchida, Kazuo
2017-05-01
The white light-emitting diodes (LEDs) have drawn much attention to replace conventional lighting sources because of low energy consumption, high light efficiency and long lifetime. Although the most common approach to produce white light is to combine a blue LED chip and a yellow phosphor, such a white LED cannot be used for a general lighting application, which requires a broad luminescence spectrum in the visible wavelength range. We have successfully chemically synthesized the ZnO nanorods showing intense broad luminescence in the visible wavelength range and made a white LED using the ZnO nanorods as phosphor excited with a blue LED. Their lengths and diameters were 2 - 10 μm and 200 - 800 nm, respectively. The wurtzite structure was confirmed by the x-ray diffraction measurement. The PL spectrum obtained by exciting the ZnO nanorods with the He-Cd laser has two peaks, one associated with the near band-edge recombination and the other with recombination via defects. The peak intensity of the near band-edge luminescence at 388 nm is much weaker than that of the defect-related luminescence. The latter luminescence peak ranges from 450 to 850 nm and broad enough to be used as a phosphor for a white LED. A white LED has been fabricated using a blue LED with 450 nm emission and ZnO nanorod powders. The LED performances show a white light emission and the electroluminescence measurement shows a stiff increase in white light intensity with increasing blue LED current. The Commission International de1'Eclairage (CIE) chromaticity colour coordinates of 450 nm LED pumped white emission shows a coordinate of (0.31, 0.32) for white LED at 350 mA. These results indicate that ZnO nanorods provides an alternate and effective approach to achieve high-performance white LEDs and also other optoelectronic devices.
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Images of psychiatry: Attitude survey of teaching medical specialists of India
Directory of Open Access Journals (Sweden)
Suravi Patra
2017-01-01
Full Text Available Context: Attitude of teaching medical specialists shapes those of future doctors. Region-specific data on teaching medical specialists' attitudes toward psychiatry (ATP are lacking from India. Aims: This study aimed to assess the attitudes of teaching medical specialists toward psychiatry and its association with sociodemographic profile and career stage. Settings and Design: This is a cross-sectional descriptive survey. Materials and Methods: Attitude towards psychiatry (ATP was assessed from 188 specialists from All India Institute of Medical Sciences (AIIMS Bhubaneswar and AIIMS Jodhpur using modified ATP scale-30. Statistical Analysis: Descriptive statistical analysis was done using SPSS version 16.0. Associations of ATP with sociodemographic status, career stage, and family history of psychiatric illness were done using logistic regression analysis. Results: Overall response rate was 81.68%, and gender (confidence interval [C.I.]: 2.026–7.410, P = 0.000 and super-specialization (C.I.: 2.167–19.479, P = 0.021 were independent significant predictors for difference in attitudes. Female gender and super-specialization were associated with better attitudes. Ninety percent of participants had favorable attitude toward psychiatric illness. Four-fifth felt psychiatric patients to be as human as other patients and found psychiatric treatments effective. More than half felt that psychiatry does not stand among the three most exciting specialties and psychiatrists get less work satisfaction. Only one third said that they would have liked to be a psychiatrist. Conclusions: Attitudes were favorable toward patients and psychiatric interventions whereas unfavorable toward psychiatry as a discipline.
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LED Virtual Simulation based on Web3D
Lilan Liu; Liu Han; Zhiqi Lin; Manping Li; Tao Yu
2014-01-01
Regarding to the high price and low market popularity of current LED indoor lighting products, a LED indoor lighting platform is proposed based on Web3D technology. The internet virtual reality technology is integrated and applied into the LED collaborative e-commerce website with Virtools. According to the characteristics of the LED indoor lighting products, this paper introduced the method to build encapsulated model and three characteristics of LED lighting: geometrical, optical and behavi...
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Practical lighting design with LEDs
Lenk, Ron
2016-01-01
The second edition of Practical Lighting Design with LEDs has been revised and updated to provide the most current information for developing light-emitting diodes products. The authors, noted authorities in the field, offer a review of the most relevant topics including optical performance, materials, thermal design, and modeling and measurement. Comprehensive in scope, the text covers all the information needed to design LEDs into end products.
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Preparation of qualified specialists for the field of it from D-Link
Directory of Open Access Journals (Sweden)
Pavel V. Romasevich
2017-12-01
Full Text Available The article is devoted to the consideration of D-Link's experience in the development and implementation of educational programs for the training of qualified specialists for the field of IT. To remain competitive, a specialist needs to be constantly trained, especially in such a rapidly changing field as IT. The training programs developed by D-Link for IT professionals help to gain knowledge about new technologies and their application in industrial conditions. You can confirm the high level of professionalism by getting the D-Link certificate. To obtain a certificate, you must pass one or two certification exams, depending on the chosen training course. Training of specialists engaged in the development, implementation and support of solutions based on D-Link solutions, in addition to the company's specialists, is carried out by authorized training centers and academic partners of D-Link. On the D-Link’s distance learning and certification portal, distance learning courses are available for studying. The article focuses on various forms of cooperation between D-Link and higher education institutions: the development of original teaching materials, the organization of distance learning and its integration into the learning process, the creation of laboratories to support practical classes and research activities, the management of course and diploma work, the organization of industrial practice.
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Export Management Specialist. A Training Program. Instructor's Edition.
Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.
This publication provides instructors with materials for an export management specialist (EMS) training program. The objective of the training program is to assist companies in reaching their export goals by educating current and potential managers about the basics of exporting. It provides a foundation for considering international trade and for…
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A Review of Training Opportunities for Singing Voice Rehabilitation Specialists.
Gerhard, Julia
2016-05-01
Training opportunities for singing voice rehabilitation specialists are growing and changing. This is happening despite a lack of agreed-on guidelines or an accredited certification acknowledged by the governing bodies in the fields of speech-language pathology and vocal pedagogy, the American Speech-Language Hearing Association and the National Association of Teachers of Singing, respectively. The roles of the speech-language pathologist, the singing teacher, and the person who bridges this gap, the singing voice rehabilitation specialist, are now becoming better defined and more common among the voice care community. To that end, this article aims to review the current opportunities for training in the field of singing voice rehabilitation. A review of available university training programs, private training programs and mentorships, clinical fellowships, professional organizations, conferences, vocal training across genres, and self-study opportunities was conducted. All institutional listings are with permission from program leaders. Although many avenues are available for training of singing voice rehabilitation specialists, there is no accredited comprehensive training program at this point. This review gathers information on current training opportunities from across various modalities. The listings are not intended to be comprehensive but rather representative of possibilities for interested practitioners. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
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Training the non-specialist music teacher: insights from a ...
African Journals Online (AJOL)
Training the non-specialist music teacher: insights from a Zimbabwean case study. ... music education in primary schools is taught by general classroom teachers, who ... JOURNAL OF THE MUSICAL ARTS IN AFRICA VOLUME 7 2010, 1–15 ...
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Perioperative Clinical Nurse Specialist Role Delineation: A Systematic Review
National Research Council Canada - National Science Library
Cole, Lisa M; Walker, Theodore J; Nader, Kelly C; Glover, Dennis E; Newkirk, Laura E
2006-01-01
A clearly defined role of the Perioperative Clinical Nurse Specialist (PONS) is not identified. The purpose of this study was to provide recommendations for a delineated role of the PONS that will provide role clarity and practice guidance...
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Non-Music Specialist Trainee Primary School Teachers' Confidence in Teaching Music in the Classroom
Seddon, Frederick; Biasutti, Michele
2008-01-01
Prior research has revealed that non-music specialist trainee primary school teachers lack confidence in teaching music in spite of changes to teacher training and the introduction of music in the National Curriculum in England. The current study investigated the effects on non-music specialist trainee primary teachers' confidence to teach music…
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Vlasova, Vera K.; Vakhidova, Luycia V.
2016-01-01
Professional self-effectiveness is a key quality of a modern specialist together with cultural, general professional and professional competences, which are realized in his further activity. But in normative documents regulating preparation of a specialist, this quality is not present. The aim of the article is in working out a conception of…
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UV-LED Curing Efficiency of Wood Coatings
Véronic Landry; Pierre Blanchet; Gabrielle Boivin; Jean-François Bouffard; Mirela Vlad
2015-01-01
Ultraviolet light emitting diodes (UV-LEDs) have attracted great interest in recent years. They can be used to polymerize coatings, such as those used for prefinished wood flooring. In this project, two lamps were compared for their suitability to be used on a wood flooring finishing line: a UV-microwave and a UV-LED lamp. Low heat emission was found for the UV-LED lamp compared to the UV-microwave one. This study also reveals that the 4 W/cm2 UV-LED lamp used is not powerf...
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Led Zeppelin reklaamib Narvat / Anti Ronk
Ronk, Anti
2007-01-01
Ilmus Narva-teemaline kahest CD-st koosnev album, kus ühel plaadil on 60 minutit videot linna vaatamisväärsuste ja informatsiooniga, teisel - briti rockansambli Led Zeppelini teosed Narva sümfooniaorkestri ja rockansambli Led R esituses
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Disposition of Patients Before and After Establishment of Emergency Medicine Specialists
Directory of Open Access Journals (Sweden)
Payman Asadi
2014-09-01
Full Text Available Introduction: Emergency department (ED as the fundamental part of hospital has a specific importance due to admitting the most various and sensitive group of patients. The aim of the ED is presenting services with highest quality in the least time. To reach this goal establishment of an emergency medicine specialist who performs assessment, resuscitation, stabilization, detection, and maintenance of emergency patients is noteworthy. The aim of this study was evaluating the effect of establishing the emergency medicine specialists on the performance of ED in Poursina Hospital, Rasht, Iran. Methods: In this cross-sectional study files of all patients hospitalized in the ED of Poursina, Rasht, Iran, through 2005-2012 were evaluated. Variables such as age, gender, cause of refer and number of hospitalization, number of discharging from department, percentage of bed occupation and daily bed occupation, time of hospitalization, number of discharging under six hours, number of transportation to other wards or hospitals, and the rate of bed circulation in the ED were assessed, too. Data was gathered through hospital information system and analyzed using SPSS 20. Results: Through 2005 to 2012 number of admitted patients in the ED has increased so that the most admitted number was related to 2012 (p=0.0001. The present of discharged patients under six hours and the rate of direct discharging before the presence of emergency medicine specialists have increased from 15.5% and 58.9% to 23.4% and 61.2% in after their presence, respectively(p=0.001. Transporting to other wards and hospitals were also decreased from 41.1% to 38.8% (p=0.0001. The occupied beds percentage after presenting of emergency medicine specialists has noticeably decreased compared to the past, while bed turnover rate increased. In other words, the bed turnover mean has increased from 354.5±108.4 during 2005-2008 to 637.7±30.8 through 2009-2012 (p=0.002. Also, during 2005-2008 the
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Kamesh, Lavanya; Clapham, Mike; Foggensteiner, Lukas
2012-08-01
Renal specialty medical training in the UK was reformed in August 2007, with an emphasis placed on competency-based training and the publication of a new curriculum and assessment blueprint. This model of training places additional time demands on both trainees and trainers, with implications for job planning and service delivery. We evaluated the resource requirements and impact on service delivery of implementing a high-quality training programme in renal medicine. Each trainee maintained a portfolio containing details of workplace-based assessments. The change in educational environment led to improved trainee satisfaction. The mean total consultant time involved in implementing the training programme was 0.7 programmed activities (PAs) per trainee per week in the first year, which decreased to 0.5 PAs per trainee per week in the second year. This pilot study indicates that it is possible to integrate successful and high-quality specialty training in a busy clinical environment. The model outlined could form a template for postgraduate specialist training delivery in a variety of medical specialties.
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Perceived inequity: Does it explain burnout among medical specialists?
Smets, E. M. A.; Visser, M. R. M.; Oort, F. J.; Schaufeli, W. B.; de Haes, H. J. C. J. M.
2004-01-01
This study investigated, among medical specialists (N = 2,400), the association between perceived inequity in relationships at work (patients, colleagues, organization) and burn-out, and the moderating role of communal orientation. Intrapersonal inequity, involving an internal standard of reference,
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Proceedings of the IAEA specialists meeting on nuclear power plant lifetime assurance
International Nuclear Information System (INIS)
1990-12-01
The purpose of this Specialists meeting was to provide an international forum for a discussion on recent results in research and utility practice on: * methodologies to predetermine reactor key components lifetime (i.e. those components which are considered not replaceable or are replaceable but are costly in terms of capital expenditure and/or outage time to replace); * to measure parameters for estimating remaining life. The remaining life on each heavy component is determined using available data on: - original design documentation. - relevant degradation mechanisms (fracture, failure, broken structure, corrosion, erosion, etc). - degradation of key component materials. - operational and maintenance history. - present state deriving from inspection, surveillance and monitoring records. - component examination and long term behaviour research. The meeting was expected to provide a vehicle to allow a better understanding of ageing phenomena of key reactor components and the effect of environmental factors. This is, the meeting was expected to improve knowledge of the topic of plant lifetime management and, thusly, to give some directions for further investigations to achieve a higher level of NPP reliability, availability and safety. (au)