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Sample records for european experience provide

  1. Innovative treatment modalities for urinary incontinence: a European survey identifying experience and attitude of healthcare providers.

    Science.gov (United States)

    Kastelein, Arnoud W; Dicker, Maarten F A; Opmeer, Brent C; Angles, Sonia S; Raatikainen, Kaisa E; Alonso, Joan F; Tăut, Diana; Airaksinen, Olavi; Cardozo, Linda D; Roovers, Jan-Paul W R

    2017-11-01

    Urinary incontinence is a common condition in women, with a reported prevalence ranging from 25% to 51%. Of these women, an estimated 38% suffer from stress urinary incontinence (SUI). A European research consortium is investigating an innovative system based on information and communication technology for the conservative treatment of women with SUI. When introducing a new intervention, implementation barriers arise and need to be identified. Therefore, we investigated healthcare providers' experience with and attitude towards innovative care options. We performed an online survey to assess (1) the characteristics and practice of healthcare providers, (2) current protocols for SUI, (3) current use of biofeedback, and (4) knowledge about serious gaming. The survey was sent to members of professional societies in Europe (EUGA), UK (BSUG) and The Netherlands (DPFS). Of 341 questionnaires analyzed (response rate between 18% and 30%), 64% of the respondents had access to a protocol for the treatment of SUI, and 31% used biofeedback when treating patients with SUI. However, 92% considered that biofeedback has a clear or probable added value, and 97% of those who did not use biofeedback would change their practice if research evidence supported its use. Finally, 89% of respondents indicated that they had no experience of serious gaming, but 92% considered that it could be useful. Although inexperienced, European urogynecologists and physical therapists welcome innovative treatment options for the conservative treatment of SUI such as portable wireless biofeedback and serious gaming. Scientific evidence is considered a prerequisite to incorporate such innovations into clinical practice.

  2. Does the creative economy provide a sustainable urban form?: Some European experiences

    Directory of Open Access Journals (Sweden)

    Bajić-Brković Milica

    2009-01-01

    Full Text Available Three urban redevelopment projects recently undertaken in Europe-Ria 2000 in Bilbao, Spain; Emscher Park in Germany; and Gasometer in Vienna, Austria, are presented and discussed in the paper. All three innovate on three independent levels culture, economy and urban organization, and provide high quality places to assist their cities and regions to cope with a global competitive environment. All three were also designed to represent the best of the sustainable practice in Europe at the time. In the same time, the basic philosophy of all three is deeply rooted in creative economies and elaborate their basis principles. The paper explores their design solution in order to identify the points where creative industries and sustainability meet, and investigates if, and to what extent, they comply with the principles of sustainability. Urban design and physical space are in focus, while other areas are considered as long as they contribute to the design, or reflect a credo that architecture and urban design are among those that play a central role in building cities' reputation and character. The author argues that all three materialized some of the basic principles of sustainability, by elaborating ideas of genius loci and the relationship between identity and locality. Emscher Park has been the most successful in demonstrating how the Brownfield site and devastated area could be transformed into the cultural landscape. Ria 2000 brought in a new interpretation of balance between the man made and natural environments. Gasometer has been least successful, and rather its solutions go after the traditional redevelopment paradigm.

  3. A European experiment

    International Nuclear Information System (INIS)

    Willson, D.

    1981-01-01

    The Joint European Torus (JET) is an experiment in nuclear fusion research which was planned as a joint effort between national research laboratories and Euratom. Before approval was given for it to be built it became a political football in the European Communities. This book describes the background against which JET was conceived, designed and planned. It gives a chronological account of the political imbroglio which followed between 1975 and 1978 and indicates how close the project came to collapse at one point. In addition to the two years' delay caused by Ministerial conflicts over its siting, the project suffered many compromises in its financing, its staffing and its organisation. An account is given of the unique structure of the European Communities and its procedures, which shows how idealism constantly faces reality. The role of Euratom is discussed, taking into account the difference between its approach to applications of nuclear fission as opposed to those of nuclear fusion. (author)

  4. The European experience.

    Science.gov (United States)

    Bisgaard, N

    2001-06-01

    This article presents an overview of past and current experiences with time division multiple assess-based (Global System for Mobil Communication) mobile telephones in Europe as seen by the European Hearing Instrument Manufacturers Association. Initial fear of widespread interference problems for hearing aid users in general owing to use of a new generation of mobile telephones seems unjustified. The background for the International Electrotechnical Commission 118-13 standard for measuring interference is described. No solution to complete elimination of interference problems resulting from direct contact between hearing aids and mobile telephones has yet been found. Several reports on the subjects are cited, and new work on measurement standards for near-field situations is mentioned.

  5. European climate change experiments on precipitation change

    DEFF Research Database (Denmark)

    Beier, Claus

    Presentation of European activities and networks related to experiments and databases within precipitation change......Presentation of European activities and networks related to experiments and databases within precipitation change...

  6. Citizenship Education Development: European Experience

    Directory of Open Access Journals (Sweden)

    A. V. Suslov

    2012-01-01

    Full Text Available The paper considers the European experience of the citizenship education developmentan important aspect of internal policy in the most countries. The education in question is considered to be the democratic citizenship training aimed at developing the loyal attitude to different value priorities in society, social responsibility, active citizenship position, awareness of democratic rights, capability of using and protecting them.The author looks at the transformation of citizenship education concept in the last three decades from the civics education (i.e. history, political science, law, etc. to the democratic citizen education. The paper analyzes differ- ent approaches to citizenship education in several European countries including the post-soviet ones. It is emphasized that both in western and eastern Europe a lot of effort is made for spreading and supporting the education in question. The author recommends considering the foreign experience of integrating the democratic citizenship education into the state academic curricula at the primary, secondary and higher school levels. 

  7. Collection of european experiences in local investment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-07-01

    This booklet is realized within the framework of the european project called PREDAC. This objective of this project are to promote citizen participation in the financing of renewable energies projects in Europe, to make organizations, investor clubs and local government to be aware of this way of implication into renewable energies development. The first part presents a collection of european experiences, as discussions and perspectives are proposed in the second part. The last part gives a comparative table between Germany and Denmark in term of renewable energies development. (A.L.B.)

  8. European clearinghouse on nuclear power plants operational experience feedback

    International Nuclear Information System (INIS)

    Ranguelova, Vesselina; Bruynooghe, Christiane; Noel, Marc

    2010-01-01

    Learning from operational experience and applying this knowledge promptly and intelligently is one of the ways to improve the safety of Nuclear Power Plant (NPP). Recent reviews of the effectiveness of Operational Experience Feedback (OEF) systems have pointed to the need for further improvement, with importance being placed on tailoring the information to the needs of the regulators. In 2007, at the request of a number of nuclear safety regulatory authorities in Europe, the Institute for Energy of the European Commission's Joint Research Centre (EC JRC) initiated a project on Nuclear Power Plant operational experience feedback, which adopts an integrated approach to the research needed to strengthen the European capabilities for assessment of NPP operational events and to promote the development of tools and mechanisms for the improved application of the lessons learned. Consequently, a so-called ''European Clearinghouse'' on NPP OEF was established, which includes scientific officers from the EC JRC, a number of European nuclear safety regulatory authorities and some of their Technical Support Organizations (TSOs). The paper discusses the activities implemented in 2008 within the framework of the European Clearinghouse on NPP OEF (hereinafter called the European NPP Clearinghouse) and provides an overview of the main conclusions drawn from the safety studies performed. Outlook of the activities carried out in 2009 are given. (orig.)

  9. Experiences of healthcare providers managing sexual assault ...

    African Journals Online (AJOL)

    Experiences of healthcare providers managing sexual assault victims in the emergency unit Part 2: Discussion of results and literature control. ... It was recommended that members of the multidisciplinary team engage in community activities and that the community participate in matters pertaining to sexual assault.

  10. Transboundary brand: European and Ukrainian experiences

    Directory of Open Access Journals (Sweden)

    Tykhomyrova Yevheniya Borysivna

    2015-10-01

    Full Text Available The article presents a study of the concept "cross-border brand" and the analysis of the formation of cross-border branding practices in transboundary territory of Europe and Ukraine. Today the cross-border territories united by common economic, social, cultural and political life strive to be transformed into a brand. That is why the issues related to their positioning and branding are of great importance. According to the author cross-border / inter-regional brand, an intangible asset of cross-border cooperation, which provides the promotion of the interests of cross-border areas, both inside and outside the cross-border. In recent years, such brands as part of Euroregions are being formed with the participation of many European countries.

  11. EFEDA - European field experiment in a desertification-threatened area

    Science.gov (United States)

    Bolle, H.-J.; Andre, J.-C.; Arrue, J. L.; Barth, H. K.; Bessemoulin, P.; Brasa, A.; De Bruin, H. A. R.; Cruces, J.; Dugdale, G.; Engman, E. T.

    1993-01-01

    During June 1991 more than 30 scientific teams worked in Castilla-La Mancha, Spain, studying the energy and water transfer processes between soil, vegetation, and the atmosphere in semiarid conditions within the coordinated European research project EFEDA (European Field Experiment in Desertification-threatened Areas). Measurements were made from the microscale (e.g., measurements on single plants) up to a scale compatible with the grid size of global models. For this purpose three sites were selected 70 km apart and heavily instrumented at a scale in the order of 30 sq km. Aircraft missions, satellite data, and movable equipment were deployed to provide a bridge to the larger scale. This paper gives a description of the experimental design along with some of the preliminary results of this successful experiment.

  12. ETSON proposal on the European operational experience feedback system

    International Nuclear Information System (INIS)

    Maqua, Michael; Bertrand, Remy; Gelder, Pieter de

    2007-01-01

    The new IAEA Safety Fundamentals states regarding the operating experience feedback: The feedback of operating experience from facilities and activities - and, where relevant, from elsewhere - is a key means of enhancing safety. Processes must be put in place for the feedback and analysis of operating experience, including initiating events, accident precursors, near misses, accidents and unauthorized acts, so that lessons may be learned, shared and acted upon. This presentation deals with the proposal of the ETSON (European TSO Network) to optimize the European operating experiences feedback (OEF). It is generally recognized that the efficiency of nuclear safety supervision by public authorities is based on two key requirements: - the existence of a competent authority at national level, benefiting from an appropriate legislative and regulatory basis, from adequate (quantitatively and qualitatively) human resources, particularly for inspection purposes, - the availability of resources devoted to highly specialised independent technical expertise, in order to provide competent authorities with pertinent technical opinions on: -- the safety files provided by operators, for the purpose of licensing corresponding activities, -- the exploitation for regulatory purposes of the operating experience feed back from licensed nuclear installations. There are two worldwide systems intended to learn lessons from experience: the WANO (World Association of Nuclear Operators) system established by the licensees with access restricted to operating organizations and the IRS system jointly operated by IAEA and OECD/NEA accessible to regulators and to some other users nominated by the regulators in their countries. The IRS itself is dedicated to the analysis of safety significant operating events. NEA/CNRA runs a permanent working group on operating experience (WGOE). WGOE provides among other things also generic reports on safety concerns related to operating experiences and

  13. Chronic granulomatous disease: the European experience.

    Directory of Open Access Journals (Sweden)

    J Merlijn van den Berg

    Full Text Available CGD is an immunodeficiency caused by deletions or mutations in genes that encode subunits of the leukocyte NADPH oxidase complex. Normally, assembly of the NADPH oxidase complex in phagosomes of certain phagocytic cells leads to a "respiratory burst", essential for the clearance of phagocytosed micro-organisms. CGD patients lack this mechanism, which leads to life-threatening infections and granuloma formation. However, a clear picture of the clinical course of CGD is hampered by its low prevalence (approximately 1:250,000. Therefore, extensive clinical data from 429 European patients were collected and analyzed. Of these patients 351 were males and 78 were females. X-linked (XL CGD (gp91(phox deficient accounted for 67% of the cases, autosomal recessive (AR inheritance for 33%. AR-CGD was diagnosed later in life, and the mean survival time was significantly better in AR patients (49.6 years than in XL CGD (37.8 years, suggesting a milder disease course in AR patients. The disease manifested itself most frequently in the lungs (66% of patients, skin (53%, lymph nodes (50%, gastrointestinal tract (48% and liver (32%. The most frequently cultured micro-organisms per episode were Staphylococcus aureus (30%, Aspergillus spp. (26%, and Salmonella spp. (16%. Surprisingly, Pseudomonas spp. (2% and Burkholderia cepacia (<1% were found only sporadically. Lesions induced by inoculation with BCG occurred in 8% of the patients. Only 71% of the patients received antibiotic maintenance therapy, and 53% antifungal prophylaxis. 33% were treated with gamma-interferon. 24 patients (6% had received a stem cell transplantation. The most prominent reason of death was pneumonia and pulmonary abscess (18/84 cases, septicemia (16/84 and brain abscess (4/84. These data provide further insight in the clinical course of CGD in Europe and hopefully can help to increase awareness and optimize the treatment of these patients.

  14. The STOA experiment in the European Parliament

    International Nuclear Information System (INIS)

    Lake, G.

    1989-01-01

    The European Parliament, like the US Congress before it, has recognized a need for independent advice on scientific and technological policy issues, being hitherto over-dependent on Commission expertise in its examination of Commission proposals. Accordingly, it established the STOA Project (Scientific and Technological Options Assessment) in March 1987. The first major STOA study, Criteria for the Assessment of European Fusion Research, is described and analysed. A contrast is drawn between consensual and adversarial approaches to technology assessment and the importance of open, critical debate is stressed. In conclusion, it is the social character of technology which underlies the importance of parliamentary technology assessment. (author)

  15. Book Review: Airport Competition: The European Experience

    Directory of Open Access Journals (Sweden)

    Garry Gumelar Pratama

    2017-08-01

    Full Text Available The competitive business environment in aviation industry has changed since European Integration. Not only airlines become more competitive after s­uch integration, but also other main infrastructure of aviation, airports. At the first stage of regional development, competition in airport industry seems to be impossible since all countries in a region still have clear jurisdictional boundaries. The other side of the coin is that airport competition becomes an important issue in a more integrated region, such as European Union (EU. This occurs because an airport owner from another country can buy other airports outside its state jurisdiction, under the same region. Articles in this book prove the claim of the existence of airport competition. Under the introductory part, the editors outlined three cases from EU: UK Civil Aviation Authority action to Heathrow Airport in 2008, Blocked Takeover of Bratislava Airport 2006 and European Commission Prohibition on Subsidies to Ryanair by Brussels South Charleroi Airport 2004. All of the cases are inevitable proofs that airport competition undoubtedly exists in Europe.

  16. Satellite broadcasting - The European experience and perspective

    Science.gov (United States)

    Watson, Alan

    1991-11-01

    The use of satellites is considered as a means for developing a European transnational broadcasting system with attention given to the control of technology. A tension is described between maintaining technology as the property of one nation when the DBSs are developed for multinational program broadcasting. The simultaneous development of satellite systems is theorized to lead eventually to a single merged program for a particular nation, and the effect is considered of the regulation of cross-holding and cross-selling systems by investors.

  17. Local investment in renewable energies - European experiences

    International Nuclear Information System (INIS)

    Quantin, J.; Grepmeier, K.; Larsen, J.; Manolakaki, E.; Smith, M.

    2004-01-01

    This booklet is realized within the framework of the european commission called PREDAC. This document have been conceived by a working group specialized on the local investment into renewable energies thematic. The objectives of this project are: to promote citizen participation in the financing of renewable energies projects in Europe; to make organizations, investor clubs and local government to be aware of this way of implication into renewable energies development; to examine more especially three renewable energy sources: biomass, photovoltaic and wind in Denmark, France, Germany, Greece and United Kingdom. (author)

  18. WOLF REXUS EXPERIMENT - European Planetary Science Congress

    Science.gov (United States)

    Buzdugan, A.

    2017-09-01

    WOLF experiment is developing a reaction wheel-based control system, effectively functioning as active nutation damper. One reaction wheel is used to reduce the undesirable lateral rates of spinning cylindrically symmetric free falling units, ejected from a sounding rocket. Once validated in REXUS flight, the concept and the design developed during WOLF experiment can be used for other application which require a flat spin of the free falling units.

  19. European experience with spent fuel transport

    International Nuclear Information System (INIS)

    Hunter, I.A.

    1995-01-01

    Nuclear Transport Ltd has transported 5000 tonnes of spent fuel from 35 reactors in 8 European countries since 1972. Transport management is governed by the Quality Plan for: transport administration, packaging and shipment procedures at the shipping plant, operations at the power plant, and packaging and shipment organization at the power plant. Selection of a suitable carrier device is made with regard to the shipping plant requirements, physical limitations of the reactor, fuel characteristics, and transport route constraints. The transport plan is set up taking into account exploitation of the casks, reactor shut-down requirements, fuel acceptance plans at the reprocessing plant, and cask maintenance periods. A transport cycle involving spent fuel shipment to La Hague or to Sellafield takes typically two or four weeks, respectively. Most transports through Europe are by rail. A special-design railway ferry boat serves transports to the United Kingdom. Both wet or dry casks are employed. Modern casks are designed for high burnups and for oxide fuels. (J.B.)

  20. APPLICATION OF THE EUROPEAN EXPERIENCE IN FOREIGN LANGUAGE TEACHERS’ TRAINING

    Directory of Open Access Journals (Sweden)

    Victoria Barkasi

    2016-12-01

    Full Text Available The article defines the role of the European experience in the foreign language teachers` training in the modern society, the use of International relations in education. The concept of common European education is analyzed. Due to this concept teaching and learning standards, educational models, and teaching objectives are brought together with the aim to create the common all-European educational system. In order to join this all-European scheme Ukraine needs to make modifications in its educational system. The fundamental idea is to use blended learning as the dominant instructional mode in higher education. The authors examine how the study of the leading European powers` educational experience helps to approach the problems of education in Ukraine critically. English Language Department of Mykolaiv V. Sukhomlynsky National University as a part of the consortium, composed of ten higher education institutions, takes part in the TEMPUS-project «Improving teaching European languages through the introduction of on-line technology (blended learning to train teachers." Blended learning is a powerful technology to be implemented into the modern model of Ukrainian education in order to get the level of European educational system. The article highlights how participation in the implementation of TEMPUS-project can be an effective tool for improving the training of the foreign languages teachers.

  1. Complex terrain experiments in the New European Wind Atlas

    DEFF Research Database (Denmark)

    Mann, Jakob; Angelou, Nikolas; Arnqvist, Johan

    2017-01-01

    The New European Wind Atlas project will create a freely accessible wind atlas covering Europe and Turkey, develop the model chain to create the atlas and perform a series of experiments on flow in many different kinds of complex terrain to validate the models. This paper describes the experiment...

  2. Chronic granulomatous disease: the European experience

    DEFF Research Database (Denmark)

    van den Berg, J Merlijn; van Koppen, Elsbeth; Ahlin, Anders

    2009-01-01

    .6 years) than in XL CGD (37.8 years), suggesting a milder disease course in AR patients. The disease manifested itself most frequently in the lungs (66% of patients), skin (53%), lymph nodes (50%), gastrointestinal tract (48%) and liver (32%). The most frequently cultured micro-organisms per episode were......, and 53% antifungal prophylaxis. 33% were treated with gamma-interferon. 24 patients (6%) had received a stem cell transplantation. The most prominent reason of death was pneumonia and pulmonary abscess (18/84 cases), septicemia (16/84) and brain abscess (4/84). These data provide further insight...

  3. Sexual Harassment at Work: A European Experience

    Directory of Open Access Journals (Sweden)

    Artan Çela

    2015-03-01

    Full Text Available Unwelcome sexual advances, proposition or pressure for sexual activity, offensive flirtations, leering, whistling, making sexually suggestive gestures, sexual jokes, unwanted sexual looks, unwanted letters, telephone call, or materials of a sexual nature, unwanted physical contact, actual or attempting rape or sexual assault, this and more of this conduct if took place in the workplace would amount to a sexual harassment. The sexual harassment at work has become a serious issue of our time. It is an unjustified interference of integrity, dignity and well-being of workers, causing problems from headaches to depression, loss of confidence, panic attacks and perhaps suicide as the only way appearing to be the sole possible relief from the unremitting and frightening behavior. This article presents information concerning the sexual harassment at workplace, covering topics such as, the definitions for sexual harassment in both international and national context, a short history of sexual harassment, types of sexual harassment, effect of sexual harassment, measure to combat and prevent sexual harassment. It offers a short overview in sexual harassment legislation of some industrialized EU Member States and the legal remedies available against sexual harassment. The main purpose of this article is to provide a better understanding and prevention concerning the issue of sexual harassment in workplace.

  4. SPECIFICITIES OF COMPETENCY APPROACH IMPLEMENTATION: UKRAINIAN AND EUROPEAN EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Oksana V. Ovcharuk

    2010-08-01

    Full Text Available The article deals with the problems of competency approach implementation to the process of education content formation. The comparative analysis of European and Ukrainian experience of key competencies list discussion has done. Ukrainian perspectives of the competency approach integration to the content of education curricula are revealed.

  5. Professional Training of Junior Medical Staff: European Experience

    Science.gov (United States)

    Iliasova, Yuliia

    2017-01-01

    The article covers current problems of professional training of junior medical staff. The main disadvantages of Ukrainian system of medical education that impede the intention of improving quality of professional training of junior medical staff have been analyzed. European experience in organizing medical education, namely, in Great Britain,…

  6. Coping with Capital Inflows; Experiences of Selected European Countries

    OpenAIRE

    David Vávra; Inci Ötker; Barry Topf; Zbigniew Polanski

    2007-01-01

    This paper reviews the experiences of a number of European countries in coping with capital inflows. It describes the nature of the inflows, their implications for macroeconomic and financial stability, and the policy responses used to cope with them. The experiences suggest that as countries become more integrated with international financial markets, there is little room to regulate capital flows effectively. The most effective ways to deal with capital inflows would be to deepen the financ...

  7. Contributions of the European Operating Experience Feedback Project to Support Regulatory Bodies

    International Nuclear Information System (INIS)

    Heitsch, M.

    2016-01-01

    Operating Experience Feedback (OEF) is one of the ways of improving the nuclear safety of operating nuclear power plants. The EC-Clearinghouse initiative was set up in 2008 to support nuclear regulatory authorities of EU Member States, but also Technical Support Organizations, international organizations and the broader nuclear community, to enhance nuclear safety. The differing regulatory regimes in the EU member countries and a significant diversity of the nuclear power plant (NPP) designs have been a challenge in the establishment of the European Clearinghouse. The European Clearinghouse is organized as a Network operated by a Central Office located at the Institute for Energy and Transport (IET) which is part of Joint Research Centre (JRC) of the European Commission. It gathers 17 European regulatory authorities and 3 major European Technical Support organizations (TSO). The Clearinghouse aims at providing lessons learned, recommendations and best practices from operational experience of NPPs based on support and commitment from the EU nuclear regulatory authorities. One of the objectives of the European Clearinghouse is to establish European best practices for the assessment of unusual events in NPPs. The paper will present the main activities of the European Clearinghouse. These include: • Topical studies providing in-depth assessment of selected topics important for the safe operation of NPPs. Statistical tools help to identify interesting subjects for these studies; • Quarterly reports on operating experience; • Training courses in the field of root cause analysis and event investigation; • Development, maintenance and population of a database for storage of operating experience related information; • Collaboration with international organizations such as IAEA and OECD/NEA on all aspects of OEF. All activities of the Clearinghouse initiative focus on providing an added value for nuclear regulation. (author)

  8. European Clearinghouse for Nuclear Power Plants Operational Experience Feedback

    International Nuclear Information System (INIS)

    Martin Ramos, M.; Noel, M.

    2010-01-01

    In the European Union, in order to support the Community activities on operational experience, a centralized regional network on nuclear power plants operational experience feedback (European Clearinghouse on Operational Experience Feedback for Nuclear Power Plants) was established in 2008 at the EC JRC-IE, Petten (The Netherlands) on request of nuclear Safety Authorities of several Member States. Its main goal is to improve the communication and information sharing on OEF, to promote regional collaboration on analyses of operational experience and dissemination of the lessons learned. The enlarged EU Clearinghouse was launched in April 2010, and it is currently gathering the Regulatory Authorities of Finland, Hungary, Lithuania, the Netherlands, Romania, Slovenia, Switzerland, Bulgaria, Czec Republic, France, Germany, Slovak Republic, and Spain (these last six countries as observers). The OECD Nuclear Energy Agency, the IAEA, the EC Directorates General of the JRC and ENER are also part of the network. Recently, collaboration between some European Technical Support Organizations (such IRSN and GRS) and the EU Clearinghouse has been initiated. This paper explains in detail the objectives and organization of the EU Clearinghouse, as well as the most relevant activities carried out, like research work in trend analysis of events ocurred in NPP, topical reports on particular events, dissemination of the results, quarterly reports on events reported publicly and operational experience support to the members of the EU Clearinghouse. (Author)

  9. Providing Nuclear Criticality Safety Analysis Education through Benchmark Experiment Evaluation

    International Nuclear Information System (INIS)

    Bess, John D.; Briggs, J. Blair; Nigg, David W.

    2009-01-01

    One of the challenges that today's new workforce of nuclear criticality safety engineers face is the opportunity to provide assessment of nuclear systems and establish safety guidelines without having received significant experience or hands-on training prior to graduation. Participation in the International Criticality Safety Benchmark Evaluation Project (ICSBEP) and/or the International Reactor Physics Experiment Evaluation Project (IRPhEP) provides students and young professionals the opportunity to gain experience and enhance critical engineering skills.

  10. EMODNet Bathymetry - building and providing a high resolution digital bathymetry for European seas

    Science.gov (United States)

    Schaap, D.

    2016-12-01

    Access to marine data is a key issue for the EU Marine Strategy Framework Directive and the EU Marine Knowledge 2020 agenda and includes the European Marine Observation and Data Network (EMODnet) initiative. The EMODnet Bathymetry project develops and publishes Digital Terrain Models (DTM) for the European seas. These are produced from survey and aggregated data sets that are indexed with metadata by adopting from SeaDataNet the Common Data Index (CDI) data discovery and access service and the Sextant data products catalogue service. SeaDataNet is a network of major oceanographic data centres around the European seas that manage, operate and further develop a pan-European infrastructure for marine and ocean data management. SeaDataNet is also setting and governing marine data standards, and exploring and establishing interoperability solutions to connect to other e-infrastructures on the basis of standards such as ISO and OGC. The SeaDataNet portal provides users a number of interrelated meta directories, an extensive range of controlled vocabularies, and the various SeaDataNet standards and tools. SeaDataNet at present gives overview and access to more than 1.8 million data sets for physical oceanography, chemistry, geology, geophysics, bathymetry and biology from more than 100 connected data centres from 34 countries riparian to European seas. The latest EMODnet Bathymetry DTM has a resolution of 1/8 arcminute * 1/8 arcminute and covers all European sea regions. Use is made of available and gathered surveys and already more than 13.000 surveys have been indexed by 27 European data providers from 15 countries. Also use is made of composite DTMs as generated and maintained by several data providers for their areas of interest. Already 44 composite DTMs are included in the Sextant data products catalogue. For areas without coverage use is made of the latest global DTM of GEBCO who is partner in the EMODnet Bathymetry project. In return GEBCO integrates the EMODnet

  11. Experiences with Learning Management Systems in 113 European Institutions

    Directory of Open Access Journals (Sweden)

    Morten Flate Paulsen

    2003-10-01

    Full Text Available This article presents the major findings from six regional analyses conducted within the framework of the European Web-edu project (http://www.nettskolen.com/in_english/webedusite/index.html. It analyses the experiences of European institutions with the Learning Management Systems that they have purchased or developed themselves. Data was collected from in-depth interviews with 113 European experts, usually the systems managers in the institutions, in 17 countries. The analyses of the interviews revealed as many as 52 different commercial and 35 self-developed LMS systems. The article presents the data from these interviews and includes a series of important findings from the study. One conclusion is that there is a host of commercial and self-developed systems that seem to work satisfactorily in various educational institutions throughout Europe. The systems are not able to handle all the functions the institutions want, and they can be improved in many ways. But most systems encountered in the analyses seem to be good enough for handling online education successfully. Another conclusion is that the European market is not dominated by the American LMS systems. In countries that do not use English as the first language, locally developed LMS systems have successfully ousted the American products. Remarkably, a large number of the LMS systems used in Europe are commercial systems developed locally, or self-developed systems built by the institutions.

  12. Mapping ecosystem services provided by benthic habitats in the European North Atlantic Ocean

    Directory of Open Access Journals (Sweden)

    Ibon eGalparsoro

    2014-07-01

    Full Text Available Mapping and assessing the ecosystem services provided by benthic habitats are a highly valuable source of information for understanding their current and potential benefits to society. The main objective of this investigation is to assess and map the ecosystem services provided by benthic habitats of the European North Atlantic Ocean, in the context of Mapping and Assessment of Ecosystems and their Services (MAES programme, the European Biodiversity Strategy and the implementation of the Marine Strategy Framework Directive. In total, 62 habitats have been analysed in relation to 12 ecosystem services over 1.7 million km2. Results indicated that more than 90% of the mapped area provides biodiversity maintenance and food provision services; meanwhile grounds providing reproduction and nursery services are limited to half of the mapped area. Benthic habitats generally provide more services closer to shore than offshore and in shallower waters. This gradient is likely to be explained by difficult access (i.e. distance and depth and lack of scientific knowledge for most of the services provided by distant benthic habitats. This research has provided a first assessment of the benthic ecosystem services at Atlantic European scale, with the provision of ecosystem services maps and their general spatial distribution patterns. Related to the objectives of this research, the conclusions are: (i benthic habitats provide a diverse set of ecosystem services, being the food provision and biodiversity maintenance services the ones that are more extensively represented. In addition, other regulating and cultural services are provided in a more limited area; and (ii the ecosystem services assessment categories are significantly related to the distance to the coast and with depth (higher near the coast and in shallow waters.

  13. EMODNet Bathymetry - building and providing a high resolution digital bathymetry for European seas

    Science.gov (United States)

    Schaap, Dick M. A.

    2016-04-01

    Access to marine data is a key issue for the EU Marine Strategy Framework Directive and the EU Marine Knowledge 2020 agenda and includes the European Marine Observation and Data Network (EMODNet) initiative. EMODNet aims at assembling European marine data, data products and metadata from diverse sources in a uniform way. The EMODNet data infrastructure is developed through a stepwise approach in three major phases. Currently EMODNet is entering its 3rd phase with operational portals providing access to marine data for bathymetry, geology, physics, chemistry, biology, seabed habitats and human activities, complemented by checkpoint projects, analyzing the fitness for purpose of data provision. The EMODNet Bathymetry project develops and publishes Digital Terrain Models (DTM) for the European seas. These are produced from survey and aggregated data sets that are indexed with metadata by adopting from SeaDataNet the Common Data Index (CDI) data discovery and access service and the Sextant data products catalogue service. SeaDataNet is a network of major oceanographic data centers around the European seas that manage, operate and further develop a pan-European infrastructure for marine and ocean data management. SeaDataNet is also setting and governing marine data standards, and exploring and establishing interoperability solutions to connect to other e-infrastructures on the basis of standards such as ISO and OGC. The SeaDataNet portal provides users a number of interrelated meta directories, an extensive range of controlled vocabularies, and the various SeaDataNet standards and tools. SeaDataNet at present gives overview and access to more than 1.8 million data sets for physical oceanography, chemistry, geology, geophysics, bathymetry and biology from more than 100 connected data centers from 34 countries riparian to European seas. The latest EMODNet Bathymetry DTM has a resolution of 1/8 arc minute * 1/8 arc minute and covers all European sea regions. Use is made of

  14. Wind turbines and aviation interests - European experience and practice

    Energy Technology Data Exchange (ETDEWEB)

    Jago, P.; Taylor, N.

    2002-07-01

    The approach of other European countries to the effects of wind turbines on civil and military aviation has been studied in order to determine the applicability of these experiences to UK stakeholders. The background to the study is traced, and the restriction on the siting of turbines due to the hazards posed to aviation and defence interests, and the potential effects on radar for air traffic control, defence and low flying aircraft are examined. The planning and siting issues in different European countries, the planning system in the UK, and the safeguarding of aerodromes and military sites are discussed along with issues involved in low flying aircraft and search and rescue operations, and the marking and illumination of wind farms.

  15. Practical decommissioning experience with nuclear installations in the European Community

    International Nuclear Information System (INIS)

    Skupinski, E.

    1993-01-01

    Initiated by the Commission of the European Communities (CEC), this seminar was jointly organized by Kernkraftwerke RWE Bayernwerk GmbH (KRB) and the CEC at Gundremmingen-Guenzburg (D), where the former KRB-A BWR is presently being dismantled. The meeting aimed at gathering a limited number of European experts for the presentation and discussion of operations, the results and conclusions on techniques and procedures presently applied in the dismantling of large-scale nuclear installations in the European Community. Besides the four pilot dismantling projects of the presently running third R and D programme (1989-93) of the European Community on decommissioning of nuclear installations (WAGR, BR-3 PWR, KRB-A BWR and AT-1 FBR fuel reprocessing), the organizers selected the presentation of topics on the following facilities which have a significant scale and/or representative features and are presently being dismantled: the Magnox reprocessing pilot plant at Sellafield, the HWGCR EL4 at Monts d'Arree, the operation of an on-site melting furnace for G2/G3 GCR dismantling waste at Marcoule, an EdF confinement conception of shut-down LWRs for deferred dismantling, and the technical aspects of the Greifswald WWER type NPPs decommissioning. This was completed by a presentation on the decommissioning of material testing reactors in the United Kingdom and by an overview on the conception and implementation of two EC databases on tools, costs and job doses. The seminar concluded with a guided visit of the KRB-A dismantling site. This meeting was attended by managers concerned by the decommissioning of nuclear installations within the European Community, either by practical dismantling work or by decision-making functions. Thereby, the organizers expect to have contributed to the achievement of decommissioning tasks under optimal conditions - with respect to safety and economics - by making available a complete and updated insight into on-going dismantling projects and by

  16. The European Tracer Experiment - experimental results and database

    International Nuclear Information System (INIS)

    Nodop, K.; Connolly, R.; Girardi, F.

    1997-01-01

    As part of the European Tracer Experiment (ETEX) two successful atmospheric experiments were carried out in October and November, 1994. Perfluorocarbon (PFC) tracers were released into the atmosphere in Monterfil, Brittany, and air samples were taken at 168 stations in 17 European countries for 72 hours after the release. Upper air tracer measurements were made from three aircraft. During the first experiment a westerly air flow transported the tracer plume north-eastwards across Europe. During the second release the flow was eastwards. The results from the ground sampling network allowed the determination of the cloud evolution as far as Sweden, Poland and Bulgaria. Typical background concentrations of the tracer used are around 5 to 7 fl/l in ambient air. Concentrations in the plume ranged from 10 to above 200 fl/l. The tracer release characteristics, the tracer concentrations at the ground and in upper air, the routine and additional meteorological observations at the ground level and in upper air, trajectories derived from constant-level balloons and the meteorological input fields for long-range transport (LRT) models are assembled in the ETEX database. The ETEX database is accessible via the Internet

  17. The EIA Directive of the European Union - some experiences

    Energy Technology Data Exchange (ETDEWEB)

    Verheem, R. [EIA Commission (Netherlands)

    1995-12-01

    Information is presented on the provisions of the existing European Council Directive on EIA for projects 85/337, some of the main findings of the report from the European Commission of the implementation of the Directive, in particular as regards involvement of the public and a short discussion of the proposed modification of the Directive. The directive has the characteristics of a `framework law`. It establishes basic assessment principles and procedural requirements, and then allows Member States considerable discretion with regard to the transposition of their details into national legislation, provided that these basics are respected. The information in this article is solely intended to be an overview of the main provisions of the Directive.

  18. EMODNet Bathymetry - building and providing a high resolution digital bathymetry for European seas

    Science.gov (United States)

    Schaap, Dick M. A.

    2015-04-01

    Access to marine data is a key issue for the implementation of the EU Marine Strategy Framework Directive (MSFD). The EU communication 'Marine Knowledge 2020' underpins the importance of data availability and harmonising access to marine data from different sources. The European Marine Observation and Data Network (EMODnet) is a long term marine data initiative from the European Commission Directorate-General for Maritime Affairs and Fisheries (DG MARE) underpinning the Marine Knowledge 2020 strategy. EMODnet is a consortium of organisations assembling European marine data, data products and metadata from diverse sources in a uniform way. The main purpose of EMODnet is to unlock fragmented and hidden marine data resources and to make these available to individuals and organisations (public and private), and to facilitate investment in sustainable coastal and offshore activities through improved access to quality-assured, standardised and harmonised marine data which are interoperable and free of restrictions on use. The EMODnet data infrastructure is developed through a stepwise approach in three major phases. Currently EMODnet is in the 2nd phase of development with seven sub-portals in operation that provide access to marine data from the following themes: bathymetry, geology, physics, chemistry, biology, seabed habitats and human activities. EMODnet development is a dynamic process so new data, products and functionality are added regularly while portals are continuesly improved to make the service more fit for purpose and user friendly with the help of users and stakeholders. The EMODnet Bathymetry project develops and publishes Digital Terrain Models (DTM) for the European seas. These are produced from survey and aggregated data sets, that are indexed with metadata by adopting the SeaDataNet Common Data Index (CDI) data discovery and access service and the SeaDataNet Sextant data products catalogue service. The new EMODnet DTM will have a resolution of 1

  19. Complex terrain experiments in the New European Wind Atlas

    Science.gov (United States)

    Angelou, N.; Callies, D.; Cantero, E.; Arroyo, R. Chávez; Courtney, M.; Cuxart, J.; Dellwik, E.; Gottschall, J.; Ivanell, S.; Kühn, P.; Lea, G.; Matos, J. C.; Palma, J. M. L. M.; Peña, A.; Rodrigo, J. Sanz; Söderberg, S.; Vasiljevic, N.; Rodrigues, C. Veiga

    2017-01-01

    The New European Wind Atlas project will create a freely accessible wind atlas covering Europe and Turkey, develop the model chain to create the atlas and perform a series of experiments on flow in many different kinds of complex terrain to validate the models. This paper describes the experiments of which some are nearly completed while others are in the planning stage. All experiments focus on the flow properties that are relevant for wind turbines, so the main focus is the mean flow and the turbulence at heights between 40 and 300 m. Also extreme winds, wind shear and veer, and diurnal and seasonal variations of the wind are of interest. Common to all the experiments is the use of Doppler lidar systems to supplement and in some cases replace completely meteorological towers. Many of the lidars will be equipped with scan heads that will allow for arbitrary scan patterns by several synchronized systems. Two pilot experiments, one in Portugal and one in Germany, show the value of using multiple synchronized, scanning lidar, both in terms of the accuracy of the measurements and the atmospheric physical processes that can be studied. The experimental data will be used for validation of atmospheric flow models and will by the end of the project be freely available. This article is part of the themed issue ‘Wind energy in complex terrains’. PMID:28265025

  20. Parents\\' lived experience of providing kangaroo care to their ...

    African Journals Online (AJOL)

    Premature and low birthweight infants pose particular challenges to health services in South Africa. While there is good evidence to demonstrate the benefits of kangaroo care in low birthweight infants, limited research has been conducted locally on the experiences of parents who provide kangaroo care to their preterm ...

  1. Open architecture for health care systems: the European RICHE experience.

    Science.gov (United States)

    Frandji, B

    1997-01-01

    Groupe RICHE is bringing to the market of health IT the Open Systems approach allowing a new generation of health information systems to arise with benefit for patients, health care professionals, hospital managers, agencies and citizens. Groupe RICHE is a forum for exchanging information, expertise around open systems in health care. It is open to any organisation interested by open systems in health care and wanting to participate and influence the work done by its user, marketing and technical committees. The Technical Committee is in charge of the maintenance of the architecture and impact the results of industrial experiences on new releases. Any Groupe RICHE member is entitled to participate to this process. This unique approach in Europe allows health care professionals to benefit from applications supporting their business processes, including providing a cooperative working environment, a shared electronic record, in an integrated system where the information is entered only once, customised according to the user needs and available to the administrative applications. This allows Hospital managers to satisfy their health care professionals, to smoothly migrate from their existing environment (protecting their investment), to choose products in a competitive environment, being able to mix and match system components and services from different suppliers, being free to change suppliers without having to replace their existing system (minimising risk), in line with national and regional strategies. For suppliers, this means being able to commercialise products well fitted to their field of competence in a large market, reducing investments and increasing returns. The RICHE approach also allows agencies to define a strategy, allowing to create a supporting infrastructure, organising the market leaving enough freedom to health care organisations and suppliers. Such an approach is based on the definition of an open standard architecture. The RICHE esprit project

  2. E-CUSTOMS PROGRAMME - NEW QUALITY OF SERVICES PROVIDED BY CUSTOMS ADMINISTRATIONS TO EUROPEAN BUSINESS

    Directory of Open Access Journals (Sweden)

    Małgorzata Czermińska

    2016-09-01

    Full Text Available E-Customs initiative includes a number of IT projects, organizational and legal measures. They are designed to creation of a simple and paperless environment for trade and customs, to short the duration of customs clearance and to ensure an appropriate level of security of commercial transactions. Modern customs administration must operate on the basis of advanced infrastructure in the field of information and communication technologies. Only then will it be able to provide cheaper and more efficient customs services. Therefore, the greatest challenge and the main goal of the e-Customs programme is to harmonize customs procedures and systems in the 28 Member States. The article describes the assumptions and objectives of the e-Customs, presents its genesis and evolution. Particular attention was paid to the activities that are aimed at improving the quality of customs services provided to European companies.

  3. Loads Providing Ancillary Services: Review of International Experience

    Energy Technology Data Exchange (ETDEWEB)

    Heffner, Grayson; Goldman, Charles; Kintner-Meyer, Michael

    2007-05-01

    In this study, we examine the arrangements for and experiences of end-use loads providing ancillary services (AS) in five electricity markets: Australia, the United Kingdom (UK), the Nordic market, and the ERCOT and PJM markets in the United States. Our objective in undertaking this review of international experience was to identify specific approaches or market designs that have enabled customer loads to effectively deliver various ancillary services (AS) products. We hope that this report will contribute to the ongoing discussion in the U.S. and elsewhere regarding what institutional and technical developments are needed to ensure that customer loads can meaningfully participate in all wholesale electricity markets.

  4. European pharmacy students' experience with virtual patient technology.

    Science.gov (United States)

    Cavaco, Afonso Miguel; Madeira, Filipe

    2012-08-10

    To describe how virtual patients are being used to simulate real-life clinical scenarios in undergraduate pharmacy education in Europe. One hundred ninety-four participants at the 2011 Congress of the European Pharmaceutical Students Association (EPSA) completed an exploratory cross-sectional survey instrument. Of the 46 universities and 23 countries represented at the EPSA Congress, only 12 students from 6 universities in 6 different countries reported having experience with virtual patient technology. The students were satisfied with the virtual patient technology and considered it more useful as a teaching and learning tool than an assessment tool. Respondents who had not used virtual patient technology expressed support regarding its potential benefits in pharmacy education. French and Dutch students were significantly less interested in virtual patient technology than were their counterparts from other European countries. The limited use of virtual patients in pharmacy education in Europe suggests the need for initiatives to increase the use of virtual patient technology and the benefits of computer-assisted learning in pharmacy education.

  5. Male nurses' experiences of providing intimate care for women clients.

    Science.gov (United States)

    Inoue, Madoka; Chapman, Rose; Wynaden, Dianne

    2006-09-01

    This paper reports a study of male nurses' experiences of providing intimate care for women clients. The number of men entering the nursing profession has increased worldwide. As a consequence of the move to a more gender-balanced profession, debate has ensued over how intimate care should be performed when this requires male nurses to be physically close to women clients. As there was little previous work on this topic, we wished to provide nurses, clients and other healthcare professionals with a better understanding of male nurses' experiences of working with women clients and within a healthcare system where they often feel excluded. Semi-structured, open-ended interviews were conducted with male nurses working in various clinical settings in Western Australia. Latent content analysis was used to analyse the interviews, which were carried out between June and July 2004. Three themes were identified: the definition of intimate care, the emotional experience associated with providing intimate care and strategies used to assist in the delivery of intimate care for women clients. Providing intimate care for women clients was a challenging experience for male nurses. Participants described how it required them to invade these clients' personal space. Consequently, they often experienced various negative feelings and used several strategies to assist them during care delivery. Nurse educators should assist male nurses to be better prepared to interact with women clients in various settings. Furthermore, workplace environments need to provide additional support and guidance for male nurses to enable them to develop effective coping strategies to manage challenging situations.

  6. JNC's experience of complementary accesses provided by the additional protocol

    International Nuclear Information System (INIS)

    Miura, Yasushi

    2001-01-01

    JNC (Japan Nuclear Cycle Development Institute) examined problems on implementation of the Additional Protocol to Japan/IAEA Safeguards Agreement with the Government of Japan and International Atomic Energy Agency through trials performed at Oarai Engineering Center before it entered into force. On December 16th 1999, the Additional Protocol entered into force, and in last January JNC provided the first JNC site information to STA. Then our Government provided it of all Japan to IAEA in last June. Also in this January, we sent the additional information changed from old one to MEXT (Ministry of Education, Culture, Sports, Science and Technology). The first Complementary Access of not only JNC but also Japan was implemented on JNC Ningyo-Toge Environmental Engineering Center on the end of last November. Since then, we have had over 10 times experience of Complementary Accesses for about one year especially on Tokai works and Ningyo-Toge. JNC's experience of Complementary Accesses will be introduced. (author)

  7. CERN experiment provides first glimpse inside cold antihydrogen

    CERN Multimedia

    2002-01-01

    "The ATRAP experiment at the Antiproton Decelerator at CERN has detected and measured large numbers of cold antihydrogen atoms. Relying on ionization of the cold antiatoms when they pass through a strong electric field gradient, the ATRAP measurement provides the first glimpse inside an antiatom, and the first information about the physics of antihydrogen. The results have been accepted for publication in Physical Review Letters" (1 page).

  8. A decade of experience with the European Company

    NARCIS (Netherlands)

    Cremers, J.; Stollt, M.; Vitols, S.

    2013-01-01

    A little more than a decade ago one of the most significant developments in European company law and worker participation occurred: the European Union passed a Regulation and Directive on the European Company (or Societas Europaea, hereafter SE). This legislation is a major innovation in that it

  9. Business process integration between European manufacturers and transport and logistics service providers

    DEFF Research Database (Denmark)

    Mortensen, Ole; Lemoine, W

    2005-01-01

    The goal of the Supply Chain Management process is to create value for customers, stakeholders and all supply chain members, through the integration of disparate processes like manufacturing flow management, customer service and order fulfillment. However, many firms fail in the path of achieving...... a total integration. This study illustrates, from an empirical point of view, the problems associated to SC integration among European firms operating in global/international markets. The focus is on the relationship between two echelons in the supply chain: manufacturers and their transport and logistics...... service providers (TLSPs). The paper examines (1) the characteristics of the collaborative partnerships established between manufacturers and their TLSPs; (2) to what extent manufacturers and their TLSPs have integrated SC business processes; (3) the IT used to support the SC cooperation and integration...

  10. HIV testing and counseling: test providers' experiences of best practices.

    Science.gov (United States)

    Myers, Ted; Worthington, Catherine; Haubrich, Dennis J; Ryder, Karen; Calzavara, Liviana

    2003-08-01

    Although education is central to HIV testing and counseling, little is known about the educational processes within the testing experience. This study investigated test providers' understandings of testing and counseling best practices. Interviews with a purposive sample of 24 test providers were thematically analyzed. Analysis revealed five best practices specific to HIV education and public health--ensuring information and education for HIV risk reduction, individualization of risk assessment, ensuring test results are given in person, providing information and referrals, and facilitating partner notification--and six practices not specific to HIV counseling relationship building. The latter were building trust and rapport; maintaining professional boundaries; ensuring a comfortable, safe environment; ensuring confidentiality; imparting nonjudgmntal attitude; and self-determination. The identified best practices demonstrated remarkable consistency across respondent subgroups. Although counseling was seen as largely educational and with a preventive focus, it included individualized messages based on assessments of risk, knowledge, and social and cultural characteristics.

  11. OneGeology-Europe: architecture, portal and web services to provide a European geological map

    Science.gov (United States)

    Tellez-Arenas, Agnès.; Serrano, Jean-Jacques; Tertre, François; Laxton, John

    2010-05-01

    OneGeology-Europe is a large ambitious project to make geological spatial data further known and accessible. The OneGeology-Europe project develops an integrated system of data to create and make accessible for the first time through the internet the geological map of the whole of Europe. The architecture implemented by the project is web services oriented, based on the OGC standards: the geological map is not a centralized database but is composed by several web services, each of them hosted by a European country involved in the project. Since geological data are elaborated differently from country to country, they are difficult to share. OneGeology-Europe, while providing more detailed and complete information, will foster even beyond the geological community an easier exchange of data within Europe and globally. This implies an important work regarding the harmonization of the data, both model and the content. OneGeology-Europe is characterised by the high technological capacity of the EU Member States, and has the final goal to achieve the harmonisation of European geological survey data according to common standards. As a direct consequence Europe will make a further step in terms of innovation and information dissemination, continuing to play a world leading role in the development of geosciences information. The scope of the common harmonized data model was defined primarily by the requirements of the geological map of Europe, but in addition users were consulted and the requirements of both INSPIRE and ‘high-resolution' geological maps were considered. The data model is based on GeoSciML, developed since 2006 by a group of Geological Surveys. The data providers involved in the project implemented a new component that allows the web services to deliver the geological map expressed into GeoSciML. In order to capture the information describing the geological units of the map of Europe the scope of the data model needs to include lithology; age; genesis and

  12. Experience with Grid Expansion in a Northern European Perspective

    DEFF Research Database (Denmark)

    Ropenus, Stephanie; Kofoed-Wiuff, Anders; Hethey, János

    2016-01-01

    results from the differences in hourly wholesale electricity prices between regions or countries. The presentation given by Stephanie Ropenus at the 4. BNetzA Meets Science Dialogue provides some insights into increased integration of European electricity markets from a Nordic-German perspective. In doing......The power grid constitutes an essential flexibility option for integrating ever-greater shares of variable renewable energy, such as wind power and solar photovoltaics. The development of interconnectors between neighboring EU Member States enables cross-border balancing. The potential for trade...... so, it draws on the results of three reports commissioned by Agora Energiewende where Stephanie Ropenus acted as project leader, [1], [14] and [15], or co-author [2]. Increased integration between the Nordic countries and Germany will become ever more important as the share of renewables increases...

  13. Cardiac 82rubidium PET/CT: initial European experience

    International Nuclear Information System (INIS)

    Groves, Ashley M.; Dickson, John C.; Kayani, Irfan; Endozo, Raymondo; Blanchard, Patty; Shastry, Manu; Prvulovich, Elizabeth; Waddington, Wendy A.; Ben-Haim, Simona; Bomanji, Jamshed B.; Ell, Peter J.; Speechly-Dick, Marie-Elsya; McEwan, Jean R.

    2007-01-01

    Myocardial perfusion with PET/CT has advantages over conventional SPECT. We describe our initial European experience using 82 Rubidium-PET/CT, as part of a clinical myocardial perfusion service. We studied the first 100 patients (64 male; 36 female, mean age = 60: SD +/-12.5y, mean body mass index = 30: SD +/-6.9kg/m 2 ) who underwent 82 Rubidium cardiac PET/CT in our institution. Thirty patients had recently undergone coronary angiography. Patients underwent imaging during adenosine infusion and at rest. Images were acquired over 5 minutes using a GE-PET/CT instrument. Image quality was described as good, adequate or inadequate. Images were reported patient-by-patient by a minimum of five nuclear medicine physicians. A segment-by-segment analysis (17-segment model) was also performed. Image quality was good in 77%, adequate 23% and inadequate 0%. There was no statistical difference in image quality between obese and non-obese patients (Fisher's exact test, p = 0.2864). 59% had normal perfusion studies, 29% had inducible ischaemia, 12% had myocardial infarction (11% with super added ischaemia). There was reduced 82 Rubidium uptake in 132/1700 segments during stress. There was reduced 82 Rubidium uptake at rest in 42/1700 segments. The 82 Rubidium PET/CT findings were consistent with the angiographic findings in 28/30 cases. We show that, even from initial use of 82 Rubidium, it is possible to perform myocardial perfusion studies quickly with good image quality, even in the obese. The PET findings correlated well in the third of the cases where angiography was available. As such, 82 Rubidium cardiac PET/CT is likely to be an exciting addition to the European nuclear physician/ cardiologist's radionuclide imaging arsenal. (orig.)

  14. Laser-assisted lead extraction: the European experience.

    Science.gov (United States)

    Kennergren, C; Bucknall, C A; Butter, C; Charles, R; Fuhrer, J; Grosfeld, M; Tavernier, R; Morgado, T B; Mortensen, P; Paul, V; Richter, P; Schwartz, T; Wellens, F

    2007-08-01

    The aim of this study is to investigate the safety and effectiveness of Excimer laser-assisted lead extraction in Europe. The final European multi-centre study experience is presented. The Excimer is a cool cutting laser (50 degrees C) with a wavelength of 308 nm. The energy is emitted from the tip of a flexible sheath and is absorbed by proteins and lipids, 64% of the energy is absorbed at a tissue depth of 0.06 mm. The sheath is positioned over the lead, and the fibrosis surrounding the lead is vaporized while advancing the sheath without damaging other leads. From August 1996 to March 2001, 383 leads (170 atrial, 213 ventricular) in 292 patients (mean age 61.6 years, range 13-96) were extracted at 14 European centres. Mean implantation time was 74 months (3-358). Most frequent indications were pocket infection (26%), non-functional leads (21%), patient morbidity (21%), septicaemia or endocarditis (14%), erosion (5%), and lead interference (8%). Median extraction time was 15 min (1-300). Complete extraction was achieved in 90.9% of the leads and partial extraction in 3.4%. Extraction failed in 5.7% of the leads. Major complications = perforations caused 10/22 (3.4/5.7%) of the failures. Most partially extracted patients were considered clinically successful, as only minor lead parts without clinical significance were left. Femoral non-laser technique was used to remove 8/12 of the non-complication failures. The total complication rate, including five minor complications (1.7%), was 5.1%. No in-hospital mortality occurred. Pacing and implantable cardioverter-defibrillator leads can safely, effectively, and predictably be extracted. Open-heart extractions can be limited to special cases. The results indicate that the traditional policy of abandoning redundant leads, instead of removing them, may be obsolete in many patients.

  15. Readability assessment of online patient education materials provided by the European Association of Urology.

    Science.gov (United States)

    Betschart, Patrick; Zumstein, Valentin; Bentivoglio, Maico; Engeler, Daniel; Schmid, Hans-Peter; Abt, Dominik

    2017-12-01

    To assess the readability of the web-based patient education material provided by the European Association of Urology. English patient education materials (PEM) as available in May 2017 were obtained from the EAU website. Each topic was analyzed separately using six well-established readability assessment tools, including Flesch-Kincaid Grade Level (FKGL), SMOG Grade Level (SMOG), Coleman-Liau Index (CLI), Gunning Fog Index (GFI), Flesch Reading Ease Formula (FRE) and Fry Readability Graph (FRG). A total of 17 main topics were identified of which separate basic and in-depth information is provided for 14 topics. Calculation of grade levels (FKGL, SMOG, CLI, GFI) showed readability scores of 7th-13th grade for basic information, 8th-15th grade for in-depth information and 7th-15th grade for single PEM. Median FRE score was 54 points (range 45-65) for basic information and 56 points (41-64) for in-depth information. The FRG as a graphical assessment revealed only 13 valid results with an approximate 8th-17th grade level. The EAU provides carefully worked out PEM for 17 urological topics. Although improved readability compared to similar analyses was found, a simplification of certain chapters might be helpful to facilitate better patient understanding.

  16. Childhood obesity: knowledge, attitudes, and practices of European pediatric care providers.

    Science.gov (United States)

    Mazur, Artur; Matusik, Pawel; Revert, Krista; Nyankovskyy, Sergey; Socha, Piotr; Binkowska-Bury, Monika; Grzegorczyk, Joanna; Caroli, Margherita; Hassink, Sandra; Telega, Grzegorz; Malecka-Tendera, Ewa

    2013-07-01

    To determine and compare attitudes, skills, and practices in childhood obesity management in 4 European countries with different obesity prevalence, health care systems, and economic situations. A cross-sectional survey was distributed to primary health care providers from France, Italy, Poland, and Ukraine. The questionnaire was returned by 1119 participants with a response rate of 32.4%. The study revealed that most of the primary health care providers were convinced of their critical role in obesity management but did not feel sufficiently competent to perform effectively. The adherence to recommended practices such as routine weight and height measurements, BMI calculation, and plotting growth parameters on recommended growth charts was poor. Most primary health care providers recognized the need for continuing professional education in obesity management, stressing the importance of appropriate dietary counseling. The study underlines insufficient implementation of national guidelines for management of obesity regardless of the country and its health system. It also makes clear that the critical problem is not elaboration of guidelines but rather creating support systems for implementation of the medical standards among the primary care practitioners.

  17. Patient and provider experiences with active surveillance: A scoping review.

    Directory of Open Access Journals (Sweden)

    Claire Kim

    Full Text Available Active surveillance (AS represents a fundamental shift in managing select cancer patients that initiates treatment only upon disease progression to avoid overtreatment. Given uncertain outcomes, patient engagement could support decision-making about AS. Little is known about how to optimize patient engagement for AS decision-making. This scoping review aimed to characterize research on patient and provider communication about AS, and associated determinants and outcomes.MEDLINE, EMBASE, CINAHL, and The Cochrane Library were searched from 2006 to October 2016. English language studies that evaluated cancer patient or provider AS views, experiences or behavioural interventions were eligible. Screening and data extraction were done in duplicate. Summary statistics were used to describe study characteristics and findings.A total of 2,078 studies were identified, 1,587 were unique, and 1,243 were excluded based on titles/abstracts. Among 344 full-text articles, 73 studies were eligible: 2 ductal carcinoma in situ (DCIS, 4 chronic lymphocytic leukemia (CLL, 6 renal cell carcinoma (RCC and 61 prostate cancer. The most influential determinant of initiating AS was physician recommendation. Others included higher socioeconomic status, smaller tumor size, comorbid disease, older age, and preference to avoid adverse treatment effects. AS patients desired more information about AS and reassurance about future treatment options, involvement in decision-making and assessment of illness uncertainty and supportive care needs during follow-up. Only three studies of prostate cancer evaluated interventions to improve AS communication or experience.This study revealed a paucity of research on AS communication for DCIS, RCC and CLL, but generated insight on how to optimize AS discussions in the context of routine care or clinical trials from research on AS for prostate cancer. Further research is needed on AS for patients with DCIS, RCC and CLL, and to evaluate

  18. Experiences of Cultural Activities provided by the Employer in Finland

    Directory of Open Access Journals (Sweden)

    Katinka Tuisku

    2015-03-01

    Full Text Available The increasing mental demands of healthcare work call for developing complementary health promotion strategies. Cultural leisure activities have long been recognized as a source of wellbeing and coping for employees. Yet, little is known about implementation of employer-provided cultural activities—how they are encountered and experienced. In this study, a public sector hospital department offered monthly cultural events for personnel: Theater, concerts, musicals, dance-performances, museum visits and sight-seeing. A digital questionnaire was sent to hospital staff (N = 769 to ask about their participation in employer-provided cultural activities during the past 6 months. The motives and obstacles for participation, and the quality of experience of the cultural events, were explored quantitatively and qualitatively. The main motives for participation were related to well-being, content of cultural events and invitations from employer or colleagues. For some, the participation was hampered by work-shifts and missing information. The participants experienced recreation, relaxation and psychological detachment from strain, which is essential for recovery. Community participation was more common than individual participation. Shared cultural experiences among employees may increase the social capital at workplace, but equal access for all employees should be guaranteed.

  19. Experiences and challenges in developing European soil hydrological databases

    NARCIS (Netherlands)

    Lilly, A.; Nemes, A.; Wösten, J.H.M.; Hiederer, R.

    2014-01-01

    Development of the Hydraulic Properties of European Soils (HYPRES) database began in 1995 and was funded by the European Commission. The main aims of the project were to collate existing soil hydrological data held by Universities and Research Institutes into a single database and to use these data

  20. Student mobility and European identity: Erasmus study as a civic experience?

    Directory of Open Access Journals (Sweden)

    Kristine Mitchell

    2012-12-01

    Full Text Available From its inception, the Erasmus student exchange programme has been promoted by the European Commission as a “civic experience” that instils or enhances a European consciousness among participants. Recent scholarship on European identity has made similar claims about the civic significance of foreign study, yet the empirical basis for these claims remains a subject of debate. This article unpacks the logic of the civic view of Erasmus and submits the individual assumptions to empirical investigation. Based on a survey of more than 2000 respondents from 25 EU countries, this study has the advantage of being both larger and more multinational in composition than the major previous studies. The data largely support the logic of the civic view of Erasmus, demonstrating the intercultural nature of the sojourn abroad, providing compelling evidence that the Erasmus experience contributes to attitudinal changes about Europe among participants, and highlighting significant differences between the Erasmus students and those who do not study abroad when it comes to levels of support for the EU and extent of identifying as European.

  1. European practices of providing of efficiency of self-organizations institutions of population in the context of public services

    Directory of Open Access Journals (Sweden)

    T. V. Serohina

    2017-06-01

    Full Text Available The research revealed that European countries devote sufficient attention to ensuring the effectiveness of the institutions of self-organization in the context of their public services. The most common areas where they operate are a system of health, education and assistance during emergencies. The study showed that in the development of public services, there were significant transformations in terms of subject-provider. Historically it was confessional organizations working on a voluntary basis, and linked their activity with the realization of Christian mission. Subsequently, when there had been formation of a «welfare state», the state took over responsibility for the area of public services. In favor of institutions of self-organization has been a change in the system when it became clear that they are best in the provide public services, especially in the social sphere, because they are the demonstrating of social needs. The main mechanisms of cooperation between institutions of self-organization and the public sector are, first, subsidies for statutory activities of the organization. Another mechanism is delegating services or outsourcing and in this case contracts mostly are for one year with possibility of further extension. In addition there is auxiliary element of providing of effectiveness institutions of self-organization, it consists in deprivation of their donors from taxes. Although institutions of self-organization are financed mainly by public authorities, they remain independent, because they have opportunity of funding from other sources. German experience showed that the starting point in the system of public services is the understanding of the necessity of paying taxes as acknowledgment of the rights of all members of society. That is why every taxpayer expects to receive public services at the appropriate level. This unwritten rule contributes to a very high level of provision of public services through an adequate

  2. Minority healthcare providers experience challenges, trust, and interdependency in a multicultural team.

    Science.gov (United States)

    Egede-Nissen, Veslemøy; Sellevold, Gerd Sylvi; Jakobsen, Rita; Sørlie, Venke

    2018-01-01

    The nursing community in the Nordic countries has become multicultural because of migration from European, Asian and African countries. In Norway, minority health care providers are recruited in to nursing homes which have become multicultural workplaces. They overcome challenges such as language and strangeness but as a group they are vulnerable and exposed to many challenges. The aim is to explore minority healthcare providers, trained nurses and nurses' assistants, and their experiences of challenges when working in a multicultural team in a Norwegian context. The study has a qualitative design, using narrative interviews, and a phenomenological-hermeneutic analysis method to explore the experiences of challenges in dementia care. Ethical considerations: The study was approved by The Norwegian Regional Ethics Committee, and the Norwegian Social Science Data Services. Participation and research context: Five informants from different African, Asian and European countries participated in the study. The study was conducted in a Norwegian nursing home, in a dementia care unit. The results show that minority health care providers experience and find meaning in being a member of a team, they overcome challenges, characterized by the interdependency in the team, appreciating new cultural experiences and striving to belong. They must overcome challenges such as language problems and the feeling of strangeness. The findings are discussed considering Løgstrup's ethic of proximity, the ethical demand of trust, and interdependency. The ethical demand is an answer to a common, transparent, unspoken agreement to be met, seen, and understood. The study shows that cooperation in a multi-professional and multi-ethnic team is important, and secures the quality of care to persons with dementia. Further research is necessary to examine the relation between a multi-ethnic staff and the patients experiencing dementia. Further research is necessary to examine ethnicity, the relation

  3. EUROPEAN TERATOLOGY INFORMATION SERVICE: EXPERIENCE, PROBLEMS AND PERSPECTIVES

    Directory of Open Access Journals (Sweden)

    A.V. Ostrovskaya

    2007-01-01

    Full Text Available Congenital malformations are still the important medical and social issue. They take the second place among the reasons for the infant mortality and cause up to 18,3% of disablement cases among the children. Exogenous factors, effecting the growing fetus, are very essential along with the genetic matters among the reasons for the congenital malformations. The importance of information on the teratogenic potential of the medications is acknowledged by the doctors from various countries. The article outlines the information on entis activity — European network of teratology information services — a non profit organization, rendering consulting services to the pregnant women and medical staff, regarding the embryo and fetotoxic actions of the medications. The authors highlight the history of entis, its objectives, principles of operation and consulting algorithm and list the basic scientific publications by the entis members for the recent years. The article deals with the most obvious problems, which the organization members face, first of all — the quality of the information they receive. The authors also provide the substantiation for the necessity to develop such an information service in Russia and express hope for the successful development of the entis subsidiary they formed in Moscow.Key words: congenital malformations, medications, pregnancy, embryotoxicity.

  4. Practical decommissioning experience with nuclear installations in the European Community

    International Nuclear Information System (INIS)

    Skupinski, E.

    1992-01-01

    Initiated by the Commission of the European Communities (CEC), this seminar was jointly organized by the AEA, BNFL and the CEC at Windermere and the sites of Windscale/Sellafield, where the former Windscale advanced gas-cooled reactor and the Windscale piles are currently being dismantled. The meeting aimed at gathering a limited number of European experts for the presentation and discussion of operations, results and conclusions on techniques and procedures currently applied in the dismantling of large scale nuclear installations in the European Community

  5. Financial Management and Economic Growth: The European Countries Experience

    Directory of Open Access Journals (Sweden)

    Nuno Carlos LEITÃO

    2012-12-01

    Full Text Available The purpose of this research is to investigate the impact of financial development on economic growth applied to European Countries. The initial GDP per capita is negatively correlated with growth of real GDP per capita. Our study shows that there is convergence within European Countries for the period 1990-2009. This paper confirms relevant theoretical hypothesis as international trade and saving encourage the economic growth. The inflation has a negative impact on economic growth as previous studies.

  6. Criticality experiments to provide benchmark data on neutron flux traps

    International Nuclear Information System (INIS)

    Bierman, S.R.

    1988-06-01

    The experimental measurements covered by this report were designed to provide benchmark type data on water moderated LWR type fuel arrays containing neutron flux traps. The experiments were performed at the US Department of Energy Hanford Critical Mass Laboratory, operated by Pacific Northwest Laboratory. The experimental assemblies consisted of 2 /times/ 2 arrays of 4.31 wt % 235 U enriched UO 2 fuel rods, uniformly arranged in water on a 1.891 cm square center-to-center spacing. Neutron flux traps were created between the fuel units using metal plates containing varying amounts of boron. Measurements were made to determine the effect that boron loading and distance between the fuel and flux trap had on the amount of fuel required for criticality. Also, measurements were made, using the pulse neutron source technique, to determine the effect of boron loading on the effective neutron multiplications constant. On two assemblies, reaction rate measurements were made using solid state track recorders to determine absolute fission rates in 235 U and 238 U. 14 refs., 12 figs., 7 tabs

  7. Inclusive Planetary Science Outreach and Education: a Pioneering European Experience

    Science.gov (United States)

    Galvez, A.; Ballesteros, F.; García-Frank, A.; Gil, S.; Gil-Ortiz, A.; Gómez-Heras, M.; Martínez-Frías, J.; Parro, L. M.; Parro, V.; Pérez-Montero, E.; Raposo, V.; Vaquerizo, J. A.

    2017-09-01

    Abstract Universal access to space science and exploration for researchers, students and the public, regardless of physical abilities or condition, is the main objective of work by the Space Inclusive Network (SpaceIn). The purpose of SpaceIn is to conduct educational and communication activities on Space Science in an inclusive and accessible way, so that physical disability is not an impediment for participating. SpaceIn members aim to enlarge the network also by raising awareness among individuals such as undergraduate students, secondary school teachers, and members of the public with an interest and basic knowledge on science and astronomy. As part of a pilot experience, current activities are focused on education and outreach in the field of comparative Planetary Science and Astrobiology. Themes include the similarities and differences between terrestrial planets, the role of water and its interaction with minerals on their surfaces, the importance of internal thermal energy in shaping planets and moons and the implications for the appearance of life, as we know it, in our planet and, possibly, in other places in our Solar System and beyond. The topics also include how scientific research and space missions can shed light on these fundamental issues, such as how life appears on a planet, and thus, why planetary missions are important in our society, as a source of knowledge and inspiration. The tools that are used to communicate the concepts include talks with support of multimedia and multi-sensorial material (video, audio, tactile, taste, smell) and field trips to planetary analogue sites that are accessible to most members of the public, including people with some kind of disability. The field trips help illustrate scientific concepts in geology e.g. lava formations, folds, impact features, gullies, salt plains; biology, e.g. extremophiles, halophites; and exploration technology, e.g. navigation in an unknown environment, hazard and obstacle avoidance

  8. Supervision Experiences of Professional Counselors Providing Crisis Counseling

    Science.gov (United States)

    Dupre, Madeleine; Echterling, Lennis G.; Meixner, Cara; Anderson, Robin; Kielty, Michele

    2014-01-01

    In this phenomenological study, the authors explored supervision experiences of 13 licensed professional counselors in situations requiring crisis counseling. Five themes concerning crisis and supervision were identified from individual interviews. Findings support intensive, immediate crisis supervision and postlicensure clinical supervision.

  9. Solid domestic wastes as a renewable resource: European experience

    Science.gov (United States)

    Fridland, V. S.; Livshits, I. M.

    2011-01-01

    Ways in which different types of solid domestic wastes, such as wastepaper, crushed glass, plastics and worn-out tires, can be efficiently included into the production, raw-material, and energy balances of the national economy are shown taking Germany and other European countries an example. Methods for recycling these solid domestic wastes and application fields of the obtained products are discussed.

  10. GOVERNANCE OF SMART SPECIALISATION: EXPERIENCES OF FOUR EUROPEAN REGIONS

    Directory of Open Access Journals (Sweden)

    Raluca SĂFTESCU

    2016-12-01

    Full Text Available In the present article we compare four European regional development models in order to conclude on good practices on smart specialisation. The concept of smart specialisation (European Commission, 2008, Foray et al., 2009, S3 Platform, 2016 has been placed at the core of the European regional development strategies and it brought the focus on local endowments, international network orientation of the regions and their potential for excellence globally. That encouraged the regions’ governments to align their actions to the general consent and to adopt place-based policies which foster innovation. The analysis draws from four European regions, each with a different innovation performance, according to the Regional Innovation Scoreboard: South-East Ireland is an Innovation Follower, Castilla de la Mancha, Spain and Central Hungary, are moderate innovators, while Bucharest-Ilfov in Romania is a modest innovator. Their different level of development gives a broader perspective on the regional development policies and, therefore, it allows us to identify good practices of smart specialisation approach and their current position in the global value chain. The present article is not limited to the description of various models for smart specialisation governance, but it also proposes a series of recommendations to better capitalise regional strengths and to create regional governance environments that generates smarter public services supportive for entrepreneurship, wealth creation and growth.

  11. European University Students' Experiences and Attitudes toward Campus Alcohol Policy

    DEFF Research Database (Denmark)

    Van Hal, Guido; Tavolacci, Marie-Pierre; Stock, Christiane

    2018-01-01

    BACKGROUND: Many studies indicate that a substantial part of the student population drinks excessively, yet most European universities do not have an alcohol policy. In the absence of an alcohol guideline at universities and the easy access to alcohol sold at the student cafeteria, for instance, ...

  12. European birds and aposematic Heteroptera: review of comparative experiments

    NARCIS (Netherlands)

    Exnerová, A.; Svádová, K.; Fousová, P.; Fučiková, E.; Ježová, D.; Niederlová, A.; Kopečková, M.; Štys, P.

    2008-01-01

    The efficiency of defensive mechanisms in 11 European aposematic species of Heteroptera against various passerine predators was analysed. Bird species differed in their reactions to aposematic preys: small insectivorous birds generally avoided aposematic bugs, but granivorous birds as well as large

  13. "Small" languages in the European context: The Danish experience

    DEFF Research Database (Denmark)

    Lauridsen, Karen M.

    The paper briefly describes the training of translators and interpreters in Denmark, taking into consideration that fact that Danish is one of the less widely used and taught languages in the European Union and the implication this has for the training of professional translators/interpreters....

  14. Help-Seeking Experiences and Attitudes among African American, Asian American, and European American College Students

    Science.gov (United States)

    Masuda, Akihiko; Anderson, Page L.; Twohig, Michael P.; Feinstein, Amanda B.; Chou, Ying-Yi; Wendell, Johanna W.; Stormo, Analia R.

    2009-01-01

    The study examined African American, Asian American, and European American college students' previous direct and indirect experiences of seeking professional psychological services and related attitudes. Survey data were collected from 254 European American, 182 African American and 82 Asian American college students. Results revealed that fewer…

  15. Guidelines for Professional Training of Junior Medical Staff in the Context of European Experience

    Science.gov (United States)

    Sosnova, Myroslava

    2016-01-01

    The article deals with outlining guidelines for improving professional training of junior medical staff based on European experience. Consequently, guidelines and recommendations on enhancing the efficiency of medical education in general and junior medical specialists' professional training, in particular, published by European Union of Medical…

  16. The National System for quality control and the European experience

    International Nuclear Information System (INIS)

    Dimov, A.; Vassileva, J.; Ingilizova, K.; Slavchev, A. and others

    2003-01-01

    Objective: The aim of the work is to present the structure and functions of the National System for quality control (NSQC) in the medical irradiation, created to guarantee the safety and the safe use of the radiological equipment. Material and method: The approaches are studies in the development of the NSQC, applied in Bulgaria and some European Union members - such as Germany and Great Britain - and the specifics of the way in which the Directive for medical irradiation EURATOM 97/43 is implemented in national legislations. Results: The advantages and disadvantages of Bulgarian NSQC are analysed and some ideas for tis improvement are suggested. Conclusions: The developed draft NSQC for medical irradiation is in compliance with the requirement of the European Directive. The real advantages and disadvantages of the NSQC will show after its implementation in the practical radiation protection and control in the country

  17. Public financing systems for radiology: experience in 12 European countries

    International Nuclear Information System (INIS)

    Kesteloot, K.

    1999-01-01

    This paper illustrates the evolution in public health care financing systems in 12 European countries, in terms of the financing of radiology services. The financing systems for radiology used by public health care financing agencies are described in detail. The implications of these new financing conditions for health care delivery are briefly sketched. The paper concludes with some strategies to help radiologists cope with the tightening financing conditions for medical imaging. (orig.) (orig.)

  18. The impact of media coverage of referendums. Recent European experiences

    DEFF Research Database (Denmark)

    Svensson, Palle

    During the last decade a number of national referendums have taken place in Europe, mostly obligatory or government called referendums on European issues. Following these events a growing literature of research has dealt with this important aspect of democracy. In this paper the main results of t...... of this new literature are reviewed in order to identify the extent to which and under what circumstances the outcome of referendums can be influenced by the media and their coverage of referendums....

  19. European Experience and Ukrainian Realities in the Policy of Financial Support Entrepreneurial Sector

    Directory of Open Access Journals (Sweden)

    Olga Savchenko

    2017-10-01

    Full Text Available Aim/purpose - We want to provide recommendations to bridge the gap in access to financing of the entrepreneurial sector in Ukraine based on the analysis of European experience, EBF approaches, financial funds for SMEs and the current state of the credit market in Ukraine. Design/methodology/approach - We used the general scientific methods of knowledge, conceptual tenets of the theory of market economy, abstract logical analysis and synthesis, induction and deduction, historical (to determine the nature and causes of bank investment in SMEs, refine categories and terms; formalization, systems analysis (to determine factors of investment banking, institutional and legal environment; statistical, retrospective analysis. The results of surveys conducted by the EBF on the issues of support and development of SMEs are used, own research of 120 Ukrainian SMEs, which was conducted during the period from January to July 2016. The nature of the research questions was reinforced by the decision to survey only SMEs. Independent reporting (from entrepreneurs or CEOs was used to account for both business activity and the external sources of information. Findings - Policy initiatives should primarily be developed at the national level in the field of lending to SMEs based on the European experience and Ukrainian realities; it is necessary to develop an understanding of the need for access to certain types of information; SMEs are the main providers and the most valuable source of credit information. Research implications/limitations - When using the methods of calculation creditworthiness perhaps to take into account the methods for assessing the quality of management, the image of the enterprise, ISO certificates. Originality/value/contribution - Based on the cross-country comparison of the EU and Ukraine, highlight the necessity of focusing on some legal unification of SME lending procedures for the development of a culture of sustainable entrepreneurship

  20. European Community initiatives and experience in scientific and technical information

    Energy Technology Data Exchange (ETDEWEB)

    Steven, G [Commission of the European Communities, Luxembourg (Luxembourg)

    1990-05-01

    Scientific and technical information (STI) is an increasingly important resource for R and D and industrial development. The rapid development of the market for electronic information and the increasing potential offered through new information technologies require new approaches for the collection and dissemination of STI. Activities of the Commission of the European Communities (CEC) in this area are reviewed. More recent CEC initiatives in the areas of biotechnology information and factual materials data banks have proved the need for international collaboration and for the implementation of infrastructural measures as a basis for such collaboration. The implementation of the EC Demonstrator Programme on materials property data systems has evaluated the potential of eleven European materials data banks against the market requirements and has helped to launch wide international collaboration. The concluding European workshop on materials data systems has developed a set of recommendations for future initiatives. These are shortly reviewed together with initial findings of a study aimed at developing a business plan for the establishment of a biotechnology information infrastructure for the bio-industries and research base in Europe. (author). 3 refs.

  1. European Community initiatives and experience in scientific and technical information

    International Nuclear Information System (INIS)

    Steven, G.

    1990-05-01

    Scientific and technical information (STI) is an increasingly important resource for R and D and industrial development. The rapid development of the market for electronic information and the increasing potential offered through new information technologies require new approaches for the collection and dissemination of STI. Activities of the Commission of the European Communities (CEC) in this area are reviewed. More recent CEC initiatives in the areas of biotechnology information and factual materials data banks have proved the need for international collaboration and for the implementation of infrastructural measures as a basis for such collaboration. The implementation of the EC Demonstrator Programme on materials property data systems has evaluated the potential of eleven European materials data banks against the market requirements and has helped to launch wide international collaboration. The concluding European workshop on materials data systems has developed a set of recommendations for future initiatives. These are shortly reviewed together with initial findings of a study aimed at developing a business plan for the establishment of a biotechnology information infrastructure for the bio-industries and research base in Europe. (author). 3 refs

  2. Providing feedback on emotional experiences and decision making

    NARCIS (Netherlands)

    Machajdik, J.; Stöttinger, J.; Danelova, E.; Pongratz, M.; Kavicky, L.; Valenti, R.; Hanbury, A.

    2011-01-01

    We present a novel lifelog system concept created to provide a human user with feedback on their conscious and unconscious emotional reactions and encourage the process of self-reflection by looking into an affective mirror. The emotion of the user is deduced from biometric data and enhanced by

  3. Price war or instrumentalization of price uncertainty: which strategy for a dominant provider on the European gas market

    International Nuclear Information System (INIS)

    Boussena, Sadek; Locatelli, Catherine

    2016-03-01

    The objective of this article is to try to assess which strategy could be implemented by a European dominant provider (or a group of big providers) during the current phase of transition of the European gas market in order to keep (or increase) his market shares and maximise his revenues. The authors aim at exploring possibilities of strategic actions on the long term other than those of defence of volumes through a price war, or the possibility of a strategy similar to that of Saudi Arabia which instrumentalises uncertainty on future prices. This last type of strategy is defined for the case of natural gas. The authors show that it could be implemented on the EU gas market, provided some specific conditions. They show that Gazprom has not enough power to become a price maker, and explore which kind of strategy of uncertainty could be implemented by this actor

  4. Numerical Experiments Providing New Insights into Plasma Focus Fusion Devices

    Directory of Open Access Journals (Sweden)

    Sing Lee

    2010-04-01

    Full Text Available Recent extensive and systematic numerical experiments have uncovered new insights into plasma focus fusion devices including the following: (1 a plasma current limitation effect, as device static inductance is reduced towards very small values; (2 scaling laws of neutron yield and soft x-ray yield as functions of storage energies and currents; (3 a global scaling law for neutron yield as a function of storage energy combining experimental and numerical data showing that scaling deterioration has probably been interpreted as neutron ‘saturation’; and (4 a fundamental cause of neutron ‘saturation’. The ground-breaking insights thus gained may completely change the directions of plasma focus fusion research.

  5. Vaginal Construction and Treatment Providers' Experiences: A Qualitative Analysis.

    Science.gov (United States)

    Roen, Katrina; Creighton, Sarah M; Hegarty, Peter; Liao, Lih-Mei

    2018-06-01

    To investigate specialist clinicians' experiences of treating vaginal agenesis. Semi-structured interviews. Twelve hospitals in Britain and Sweden. Thirty-two health professionals connected to multidisciplinary teams (MDTs) including medical specialists and psychologists. Theoretical thematic analysis of recorded verbatim data. The gynecologist and psychologist interviewees share certain observations including the importance of psychological readiness for and appropriate timing of treatment. Three overlapping themes are identified in our theoretical analysis of the MDT clinicians' talk: (1) the stigma of vaginal agenesis and the pressure to be "normal" can lead patients to minimize the time, effort, physical discomfort, and emotional cost inherent in treatment. (2) Under pressure, treatment might be presented to patients with insufficient attention to the potential psychological effect of the language used. Furthermore, the opportunity to question what is "normal" in sex is generally not taken up. It can be challenging to help the women to transcend their medicalized experiences to come to experiencing their bodies as sexual and enjoyable. (3) The reality of treatment demands, which are not always adequately processed before treatment, can lead to discontinuation and even disengagement with services. The MDT clinicians in this study emphasized the importance of psychological input in vaginal construction. However, such input should proactively question social norms about how women's genitalia should appear and function. Furthermore, rather than steering patients (back) to treatment, the entire MDT could more explicitly question social norms and help the women to do the same. By shifting the definition of success from anatomy to personal agency, the clinical focus is transformed from treatment to women. Copyright © 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  6. European Nuclear Education Network ENEN, Ten years of experience

    International Nuclear Information System (INIS)

    Ambrosini, W.; Dies, J.; Dieguez, P.

    2014-01-01

    Conclusions: Networking between European Universities based on mutual recognition (ECTS Bologna system) enabled: • Development of new academic programmes at a Master level; • Mobility of students to hosting universities, members of ENEN; • Mobility of Professors to teach in other Universities, when needed; • Maintain the quality of the educational programmes; • Joint and successful organisation of activities in the fields of: Education, Training and Knowledge Management; • The establishment of bridges between the Universities and the end-users (industries, regulatory bodies, research centres, etc.)

  7. Public information and licensing procedures for nuclear installations. European experience

    International Nuclear Information System (INIS)

    Mayoux, J.C.; Chevillard, F.; Mutschler, U.; Stubbe, C.

    1981-10-01

    This paper reviews the licensing procedures for nuclear installations in various European countries and examines the form, content and methods selected for information and consultation of the public. The author stresses the importance of this stage in the procedure, both for the nuclear operator and the public authorities, given the population's concern about the environment. He concludes that, irrespective of its complexity, the nuclear field cannot remain the concern of a few initiates competent to take decisions and that, consequently, this implies creation of new information systems to meet the public's desire to participate more directly in the process. (NEA) [fr

  8. Opportunities for two-color experiments at the SASE3 undulator line of the European XFEL

    Energy Technology Data Exchange (ETDEWEB)

    Geloni, Gianluca; Mazza, Tommaso; Meyer, Michael; Serkez, Svitozar [European XFEL GmbH, Hamburg (Germany); Kocharyan, Vitali; Saldin, Evgeni [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2017-06-15

    X-ray Free Electron Lasers (XFELs) have been proven to generate short and powerful radiation pulses allowing for a wide class of novel experiments. If an XFEL facility supports the generation of two X-ray pulses with different wavelengths and controllable delay, the range of possible experiments is broadened even further to include X-ray-pump/X-ray-probe applications. In this work we discuss the possibility of applying a simple and cost-effective method for producing two-color pulses at the SASE3 soft X-ray beamline of the European XFEL. The technique is based on the installation of a magnetic chicane in the baseline undulator and can be accomplished in several steps. We discuss the scientific interest of this upgrade for the Small Quantum Systems (SQS) instrument, in connection with the high-repetition rate of the European XFEL, and we provide start-to-end simulations up to the radiation focus on the sample, proving the feasibility of our concept.

  9. Primary care providers' lived experiences of genetics in practice.

    Science.gov (United States)

    Harding, Brittany; Webber, Colleen; Ruhland, Lucia; Dalgarno, Nancy; Armour, Christine M; Birtwhistle, Richard; Brown, Glenn; Carroll, June C; Flavin, Michael; Phillips, Susan; MacKenzie, Jennifer J

    2018-04-26

    To effectively translate genetic advances into practice, engagement of primary care providers (PCPs) is essential. Using a qualitative, phenomenological methodology, we analyzed key informant interviews and focus groups designed to explore perspectives of urban and rural PCPs. PCPs endorsed a responsibility to integrate genetics into their practices and expected advances in genetic medicine to expand. However, PCPs reported limited knowledge and difficulties accessing resources, experts, and continuing education. Rural practitioners' additional concerns included cost, distance, and poor patient engagement. PCPs' perspectives are crucial to develop relevant educational and systems-based interventions to further expand genetic medicine in primary care.

  10. Setting-up a European Cross-Provider Data Collection on Open Online Courses

    NARCIS (Netherlands)

    Kalz, Marco; Kreijns, Karel; Walhout, Jaap; Castaño-Muñoz, Jonatan; Espasa, Anna; Tovar, Edmundo

    2015-01-01

    While MOOCS have emerged as a new form of open online education around the world, research is still lagging behind to come up with a sound theoretical basis that can cover the impact of socio- economic background variables, ICT competences, prior experiences and lifelong learning profile, variance

  11. European Experiments on 2-D Molten Core Concrete Interaction: Hecla and Vulcano

    International Nuclear Information System (INIS)

    Journeau, Ch.; Bonnet, J. M.; Boccaccio, E.; Piluso, P.; Monerris, J.; Breton, M.; Fritz, G.; Sevon, Tuomo; Pankakoski Pekka, H.; Holmstrom, St.; Virta, Jouko

    2010-01-01

    This paper presents results from two ongoing European experimental programs on molten core concrete interactions: HECLA at VTT and VULCANO at the Commissariat a l'Energie Atomique. In the HECLA experiments, metallic melt is poured into a cylindrical concrete crucible. The focus is on the initial, pouring phase of the interaction. Therefore, decay heat simulation is not required. The HECLA-2 experiment involved 50 kg of stainless steel at 1700 C and siliceous concrete. The final ablation depths were 25-30 mm in the basemat and similar to 15 mm in the side wall. The VULCANO VB experiments have been devoted to the study of the interaction of 28 to 45 kg of oxidic corium with silica-rich or limestone-rich concretes. These tests focus on long-term ablation and require the use of induction heating to simulate the decay heat fluxes. Anisotropic ablation between the horizontal and vertical direction has been observed with silica-rich concrete, confirming the CCI tests. A new series of experiments VULCANO VBS has been launched in which there are both oxide and metallic phases in the melt. In these tests, magnetic screening is used so that the induction power is provided almost only to the upper oxidic layer after stratification. (authors)

  12. Current european experiments on 2d molten core concrete interaction: HECLA and VULCANO

    International Nuclear Information System (INIS)

    Journeau, C.; Bonnet, J. M.; Boccaccio, E.; Piluso, P.; Sevon, T.; Pankakoski, P. H.; Holmstroem, S.; Virta, J.

    2008-01-01

    This paper presents results from two ongoing European experimental programs on molten core concrete interactions: HECLA at VTT and VULCANO at CEA. In the HECLA experiments, metallic melt is poured into a cylindrical concrete crucible. The focus is on the initial, pouring phase of the interaction. Therefore, decay heat simulation is not required. The HECLA-2 experiment involved 50 kg of stainless steel at 1700 deg. C and siliceous concrete. The final ablation depths were 25-30 mm in the basemat and about 15 mm in the sidewall. The VULCANO VB experiments have been devoted to the study of the interaction of 28 to 45 kg of oxidic corium with silica-rich or limestone-rich concretes. These tests are focusing on long-term ablation and require the use of induction heating to simulate the decay heat fluxes. Anisotropic ablation between the horizontal and vertical direction has been observed with silica-rich concrete, confirming the CCI tests. A new series of experiments VULCANO VBS has been launched in which there are both oxide and metallic phases in the melt. In these tests, magnetic screening is used so that the induction power is provided almost only to the upper oxidic layer after stratification. (authors)

  13. European Experiments on 2-D Molten Core Concrete Interaction: Hecla and Vulcano

    Energy Technology Data Exchange (ETDEWEB)

    Journeau, Ch.; Bonnet, J. M.; Boccaccio, E.; Piluso, P.; Monerris, J.; Breton, M.; Fritz, G. [CEA Cadarache, Dept Technol Nucl, Serv Technol Reacteurs Ind, Lab Essais Maitrise Accid Graves, F-13108 St Paul Les Durance (France); Sevon, Tuomo; Pankakoski Pekka, H.; Holmstrom, St.; Virta, Jouko [VTT Tech Res Ctr Finland, FI-02044 Espoo (Finland)

    2010-07-01

    This paper presents results from two ongoing European experimental programs on molten core concrete interactions: HECLA at VTT and VULCANO at the Commissariat a l'Energie Atomique. In the HECLA experiments, metallic melt is poured into a cylindrical concrete crucible. The focus is on the initial, pouring phase of the interaction. Therefore, decay heat simulation is not required. The HECLA-2 experiment involved 50 kg of stainless steel at 1700 C and siliceous concrete. The final ablation depths were 25-30 mm in the basemat and similar to 15 mm in the side wall. The VULCANO VB experiments have been devoted to the study of the interaction of 28 to 45 kg of oxidic corium with silica-rich or limestone-rich concretes. These tests focus on long-term ablation and require the use of induction heating to simulate the decay heat fluxes. Anisotropic ablation between the horizontal and vertical direction has been observed with silica-rich concrete, confirming the CCI tests. A new series of experiments VULCANO VBS has been launched in which there are both oxide and metallic phases in the melt. In these tests, magnetic screening is used so that the induction power is provided almost only to the upper oxidic layer after stratification. (authors)

  14. European Experience after The Gas Directive On The Business

    Energy Technology Data Exchange (ETDEWEB)

    Holm, Tore

    1999-07-01

    The Gas Directive came into effect in August 1998. Its main building block is Third Party Access (TPA) to gas transmission and distribution. The transposition into national law in the Member States is in progress as planned. A much higher percentage of the market will be open to competition than the minimum required in the Gas Directive. This presentation asserts that those who have attempted to predict the outcome, the process and the timing of the ongoing development are largely people or organizations with vested interests either way or people who have simply ''transposed'' the UK model into a Continental setting. But there are much more important issues for the European gas industry than the EU liberalization process per se. The presentation discusses what the people in Shell call the Low Oil Price World, then the ''Tokyo'' implementation and then gas fundamentals in Europe. Finally, an attempt is given to see how the political and commercial processes that are already under way may unfold in the future.

  15. Development and implementation of guidelines for quality assurance in breast cancer screening: The European experience.

    Directory of Open Access Journals (Sweden)

    Lawrence von Karsa

    2013-05-01

    Full Text Available In Europe, as in many other regions of the world, breast cancer is a major cause of suffering and death. Early detection of breast cancer by systematic mammography screening can find lesions for which treatment is more effective and generally more favourable for quality of life. Comprehensive quality assurance guidelines for breast cancer screening based on mammography have been developed in the Europe Against Cancer programme with the aim of maximising screening benefits while minimising adverse effects, such as unnecessary examination or treatment resulting from false-positive screening tests. The present report provides an overview of the European experience in developing and implementing quality assurance guidelines for breast cancer screening. It highlights implications relevant to those regions of the world in which the burden of breast cancer in the coming years will make population-based screening an option for cancer control.

  16. MANAGEMENT OF RENEWABLE ENERGY AND REGIONAL DEVELOPMENT: EUROPEAN EXPERIENCES AND STEPS FORWARD

    OpenAIRE

    Andreea Ileana Zamfir

    2011-01-01

    The issues of the renewable energy and regional development have become major priorities for public policymakers across the globe. Therefore, this study explores some European experiences and steps forward in the field of the management of renewable energy and regional development. Firstly, an overview of renewable energy issues in European regions is revealed, and secondly, some measures and actions for managing regional development of renewable energy in Romania taking into account the fina...

  17. Content of Orthopedic Patient Education Provided by Nurses in Seven European Countries.

    Science.gov (United States)

    Charalambous, Andreas; Papastavrou, E; Valkeapää, K; Zabalegui, A; Ingadóttir, B; Lemonidou, C; Fatkulina, N; Jouko, K; Leino-Kilpi, H

    2017-07-01

    Patients' and their significant others' education during the perioperative phase is an important and challenging aspect of care. This study explored the content of education provided by nurses to arthroplasty patients and their significant others. Data were collected with the Education of Patients-NURSE content (EPNURSE-Content), Received Knowledge of Hospital Patient (RKhp), and Received Knowledge of Significant Other (RKso) scales. The results showed that the content of education emphasized biophysiological and functional needs, differed between countries, and was related to how physically demanding nurses found their job to be and the amount of education provided. There is congruence between the received knowledge of patients and their significant others in relation to the content of education provided by nurses. The findings can support nurses in developing aid material for patients and significant others explaining the nature of education and advising them what to expect and how to optimize their participation in the process.

  18. Theorizing the European union as Union as an International Security Provider

    DEFF Research Database (Denmark)

    This final paper will summarise the theoretical strands of the discussion in the preceding papers and reflect on the suitability of the analytical framework in the introduction in light of the empirical analysis by other contributors to the special issue. It will sketch out the main tenets of a t...... of a theory of the EU as an international security provider and point to directions for further research in this area.......This final paper will summarise the theoretical strands of the discussion in the preceding papers and reflect on the suitability of the analytical framework in the introduction in light of the empirical analysis by other contributors to the special issue. It will sketch out the main tenets...

  19. European Experience of Low Crested Structures for Coastal Management

    DEFF Research Database (Denmark)

    Kramer, Morten

    2005-01-01

    and the results of the inventory are summarized with statistical comparison with LCS characteristics in the worldwide scenario (Japan and USA). In the second part a description of the sites and prototype observation of the impact of LCSs is given: a description of the site, environmental conditions and response...... to its construction based on existing literature and on activities performed during the project are summarized and the research results are reported. Where available observation on ecological impacts and socioeconomic effects are provided. The descriptions are introductory to other DELOS Special Issue...

  20. First insights from common GRS and IRSN evaluations of operational experiences for the European Clearinghouse

    International Nuclear Information System (INIS)

    Maqua, M.; Bertrand, R.

    2012-01-01

    The European Clearinghouse on Operating Experience Feedback (OEF) for NPPs was established in 2008 by several European Nuclear Safety Regulators. The technical work on common operational experience evaluation was launched at the Joint Research Center of the European Union. Main goals of the European Clearinghouse include promotion of collaboration on OEF, dissemination of the lessons learnt from NPP operational experience and promoting advanced event assessment approaches and methods. The extended knowledge of both IRSN and GRS in the evaluation of the national operating experiences in France and Germany, respectively, is used by the European Clearinghouse with the objective of receiving detailed insights on safety related topics. IRSN and GRS develop common reports on safety issues upon request of the Clearinghouse that involve a detailed review of their national event databases, and that are combined afterwards in a European Clearinghouse report including also the review carried out by the JRC on the basis of the Incident Report System (IRS) database and the US NRC Licensee Event Reports (LERs) database. The aim is to perform in-depth analyses (causes, root causes, contributing factors, actual and potential consequences, and lessons learnt) of specific OEF topics. 3 topics have been already analyzed: -) external events (Serious accidents caused by external hazards were not found in the German and French operating experience), -) ageing of components (it can be concluded that ageing management in French and German NPP is basically effective), and -) component supply (the main cause for events related to the supply of components was insufficiency during manufacturing or testing). This paper is followed by the slides of the presentation

  1. European experience of regulating distance selling of medicines for Ukraine.

    Science.gov (United States)

    Pashkov, Vitalii; Hrekov, Yevhen; Hrekova, Maryna

    Some countries have already tried and tested mechanisms of regulating distance sales as form of distribution of medicines that have been used more or less effectively for a fairly long time. Herewith, so far, the approach of the competent authorities of some countries including Ukraine can be called prevailing in quantitative terms under which the official prohibition on distance sales of medicines is set. The aim of this study is a detailed examination of the nature of the prohibition of the medicines distance selling in Ukraine, namely the an analysis of advantages and disadvantages of this form of distribution of medicines and identification of appropriate ways for gradual repeal of the prohibition in terms of regulatory reform in Ukraine in the sphere of circulation of medicines due to the process of adaptation of statutory regulation in this area to the EU legislation. This study is based on Ukrainian regulation acts, Council Directives 97/7/EC, 2000/31/EC, 2001/83/EC, scientific works and opinions of progressiveminded people in this sphere. Such methods as dialectical, comparative, analytic, synthetic and comprehensive have been used in the article. Reception of the described experience of regulation in EU will allow a further review of the principles of regulation in Ukraine in the sphere of medicines with a shift in the main emphasis in the direction of ensuring adequate consumer rights in this area and preventing the risks of patients' and public health.

  2. European experience in transport/storage cask for vitrified residues

    International Nuclear Information System (INIS)

    Otton, Camille; Sicard, Damien

    2007-01-01

    Available in abstract form only. Full text of publication follows: Because of the evolution of burnup of spent fuel to be reprocessed, the high activity vitrified residues would not be transported in the existing cask designs. Therefore, TN International has decided in the late nineties to develop a brand new design of casks with optimized capacity able to store and transport the most active and hottest canisters: the TN TM 81 casks currently in use in Switzerland and the TN TM 85 cask which shall permit in the near future in Germany the storage and the transport of the most active vitrified residues defining a thermal power of 56 kW (kilowatts). The challenges for the TN TM 81 and TN TM 85 cask designs were that the geometry entry data were very restrictive and were combined with a fairly wide range set by the AREVA NC Specification relative to vitrified residue canister. The TN TM 81 and the TN TM 85 casks have been designed to fully anticipate shipment constraints of the present vitrified residue production. It also used the feedback of current shipments and the operational constraints and experience of receiving and shipping facilities. The casks had to fit as much as possible in the existing procedures for the already existing flasks such as the TN TM 28 cask and TS 28 V cask, all along the logistics chain of loading, unloading, transport and maintenance. (authors)

  3. Reported barriers to evaluation in chronic care: experiences in six European countries.

    Science.gov (United States)

    Knai, Cécile; Nolte, Ellen; Brunn, Matthias; Elissen, Arianne; Conklin, Annalijn; Pedersen, Janice Pedersen; Brereton, Laura; Erler, Antje; Frølich, Anne; Flamm, Maria; Fullerton, Birgitte; Jacobsen, Ramune; Krohn, Robert; Saz-Parkinson, Zuleika; Vrijhoef, Bert; Chevreul, Karine; Durand-Zaleski, Isabelle; Farsi, Fadila; Sarría-Santamera, Antonio; Soennichsen, Andreas

    2013-05-01

    The growing movement of innovative approaches to chronic disease management in Europe has not been matched by a corresponding effort to evaluate them. This paper discusses challenges to evaluation of chronic disease management as reported by experts in six European countries. We conducted 42 semi-structured interviews with key informants from Austria, Denmark, France, Germany, The Netherlands and Spain involved in decision-making and implementation of chronic disease management approaches. Interviews were complemented by a survey on approaches to chronic disease management in each country. Finally two project teams (France and the Netherlands) conducted in-depth case studies on various aspects of chronic care evaluation. We identified three common challenges to evaluation of chronic disease management approaches: (1) a lack of evaluation culture and related shortage of capacity; (2) reluctance of payers or providers to engage in evaluation and (3) practical challenges around data and the heterogeity of IT infrastructure. The ability to evaluate chronic disease management interventions is influenced by contextual and cultural factors. This study contributes to our understanding of some of the most common underlying barriers to chronic care evaluation by highlighting the views and experiences of stakeholders and experts in six European countries. Overcoming the cultural, political and structural barriers to evaluation should be driven by payers and providers, for example by building in incentives such as feedback on performance, aligning financial incentives with programme objectives, collectively participating in designing an appropriate framework for evaluation, and making data use and accessibility consistent with data protection policies. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Opportunities Provided by the Design of a Website Focused on the Promotion of Collaborative Projects Within European IT Industry

    Directory of Open Access Journals (Sweden)

    Alexandru CAPATINA

    2011-11-01

    Full Text Available Our paper emphasizes the opportunities provided both for the academic research and business partnerships by the design of a website which promotes the collaborative projects within European IT industry. From the academic perspective, the companies registered in the website database will represent the sample for different researches focused on cross-cultural interactions, intellectual capital components and competitive intelligence strategies. From the business perspective, the registration of the companies will allow the access to the list with all the potential future partners’ in the field of software development. In the first part of the paper dedicated to literature review, we highlighted the main types of IT collaborative projects; then, we presented the tools provided by the website that was designed in view to increase the awareness of the European IT companies. In the last part of the paper, we tested by means of chi-square statistical method the correlation between R&D investments and average length of time for software design in the case of a sample of 58 IT companies included in the database. We also revealed our future research intentions related to the domain of IT partnerships patterns.

  5. Public or private water management: Experience from different European Countries

    Science.gov (United States)

    Wackerbauer, Johann

    2008-11-01

    Faced with liberalisation proposals and an increasing internationalisation of water resource management, the question arises as to how a change of the regulatory framework would affect the market structure and the supply conditions in this area. While the term "privatisation" relates to the ownership structure of the providers, the term "liberalisation" implies extensive free market ideas. Privatisation involves the outsourcing of public services from the public authorities to a privately organised organisation. Through this, however, nothing needs to change in terms of the market or the intensity of competition for the commodity in question. Within the framework of privatisation it can also occur that the public monopoly is only transferred to a private monopoly. The term "liberalisation" in addition refers to the basic regulatory constraints: liberalisation signifies the cessation of limitations to competition and supply monopolies, and open competition between several suppliers for the consumers. In the EU-15, the only country where the provision of operational services in the water supply has been totally passed to the private sector is the UK, but this is only true for UK and Wales. Another singular case is France, where there is a mix of mainly private operating companies and municipalities which have divided the regional supply areas among themselves. In six other EU-15 countries where some privatisation took place, either the municipalities or (majority) publicly owned companies are controlling water supply. In the remaining seven countries, the water supply is organised by municipality companies only. In an international comparison, there are three basic models for the regulation of natural monopolies in the public water supply: the Anglo-Saxon, the French and the German model. The delimitation between supervisory bodies and operations in the water supply is strongest in the first model and weakest in the last. This has led to three basic types of

  6. Public or private water management: Experience from different European Countries

    International Nuclear Information System (INIS)

    Wackerbauer, Johann

    2008-01-01

    Faced with liberalisation proposals and an increasing internationalisation of water resource management, the question arises as to how a change of the regulatory framework would affect the market structure and the supply conditions in this area. While the term 'privatisation' relates to the ownership structure of the providers, the term 'liberalisation' implies extensive free market ideas. Privatisation involves the outsourcing of public services from the public authorities to a privately organised organisation. Through this, however, nothing needs to change in terms of the market or the intensity of competition for the commodity in question. Within the framework of privatisation it can also occur that the public monopoly is only transferred to a private monopoly. The term 'liberalisation' in addition refers to the basic regulatory constraints: liberalisation signifies the cessation of limitations to competition and supply monopolies, and open competition between several suppliers for the consumers. In the EU-15, the only country where the provision of operational services in the water supply has been totally passed to the private sector is the UK, but this is only true for UK and Wales. Another singular case is France, where there is a mix of mainly private operating companies and municipalities which have divided the regional supply areas among themselves. In six other EU-15 countries where some privatisation took place, either the municipalities or (majority) publicly owned companies are controlling water supply. In the remaining seven countries, the water supply is organised by municipality companies only. In an international comparison, there are three basic models for the regulation of natural monopolies in the public water supply: the Anglo-Saxon, the French and the German model. The delimitation between supervisory bodies and operations in the water supply is strongest in the first model and weakest in the last. This has led to three basic types of

  7. Public or private water management: Experience from different European Countries

    Energy Technology Data Exchange (ETDEWEB)

    Wackerbauer, Johann [Ifo Institute for Economic Research, Poschingerstrasse 5, 81679 Munich (Germany)], E-mail: wackerbauer@ifo.de

    2008-11-01

    Faced with liberalisation proposals and an increasing internationalisation of water resource management, the question arises as to how a change of the regulatory framework would affect the market structure and the supply conditions in this area. While the term 'privatisation' relates to the ownership structure of the providers, the term 'liberalisation' implies extensive free market ideas. Privatisation involves the outsourcing of public services from the public authorities to a privately organised organisation. Through this, however, nothing needs to change in terms of the market or the intensity of competition for the commodity in question. Within the framework of privatisation it can also occur that the public monopoly is only transferred to a private monopoly. The term 'liberalisation' in addition refers to the basic regulatory constraints: liberalisation signifies the cessation of limitations to competition and supply monopolies, and open competition between several suppliers for the consumers. In the EU-15, the only country where the provision of operational services in the water supply has been totally passed to the private sector is the UK, but this is only true for UK and Wales. Another singular case is France, where there is a mix of mainly private operating companies and municipalities which have divided the regional supply areas among themselves. In six other EU-15 countries where some privatisation took place, either the municipalities or (majority) publicly owned companies are controlling water supply. In the remaining seven countries, the water supply is organised by municipality companies only. In an international comparison, there are three basic models for the regulation of natural monopolies in the public water supply: the Anglo-Saxon, the French and the German model. The delimitation between supervisory bodies and operations in the water supply is strongest in the first model and weakest in the last. This has led to

  8. Measures to overcome consequences of agricultural land fragmentation: European experience and Ukrainian realities

    Directory of Open Access Journals (Sweden)

    Andriy Popov

    2016-03-01

    Full Text Available One of the land reform implementation results in Ukraine is the distribution of the state-owned agricultural land to the rural population in the form of physical land parcels. As a consequence, however, the land was subdivided into many small units. This land fragmentation has led to fundamental changes in the formation of the new agricultural enterprises and brought some negative consequences in their functioning. The problem of the land fragmentation in Ukraine is quite new and uninvestigated. The aim of the article is to analyze the existing measures (instruments in European countries for reducing the effects of agricultural land fragmentation and to determine the possibility of «transplantability» of Western experience to Ukraine. The principal measures to decrease the agricultural land fragmentation in European countries are: voluntary parcel exchange, land banking and land consolidation. The article presents the characteristics and comparative analysis of these measures. One of the four types of land fragmentation is a main problem of Ukraine, namely the discrepancy between the landownership and the land use. The Western European countries have been used the three instruments for reducing only two types of land fragmentation: the land use fragmentation and the internal fragmentation. Consequently, the using of Western European measures to decrease agricultural land fragmentation is impossible without their adaptation to the Ukrainian realities. Therefore, the actual problem in Ukraine today is to find the own measures to overcome the problem of agricultural land fragmentation based on the Western European experience.

  9. Improved outcome of childhood acute myeloid leukemia in an Eastern European country: Lithuanian experience.

    Science.gov (United States)

    Kairiene, Igne; Pasauliene, Ramune; Lipunova, Nadezda; Vaitkeviciene, Goda; Rageliene, Lina; Rascon, Jelena

    2017-10-01

    The reported treatment outcomes of children treated for cancer in Eastern European countries are inferior to those in Northern/Western Europe. We hypothesized that recent survival rates could be comparable to the current standards and performed a population-based analysis of treatment outcome of childhood acute myeloid leukemia (AML) in Lithuania, a small Eastern European country. Children  80% in high-income countries. The difference in survival rates between Northern/Western and Eastern European countries as well as between high- and middle-/low-income countries is as much as 20%. Recently, the 5-year event-free survival rate of acute myeloid leukemia (AML) has reached > 60% in high-income countries. The survival rates for myeloproliferative diseases were the lowest in Eastern European countries. • The reported inferior survival rates were calculated based on outcome data of patients treated until 2007. The recent survival rates in Eastern European countries are unknown. What is New: • Being a small Eastern European country, Lithuania has experienced good economic growth during the last decade. We hypothesized that economic growth and gain of experience could result in better survival rates of children treated for cancer in our country in recent years. • A population-based analysis of treatment outcome of childhood AML treated in Lithuania in the recent years was performed for the first time. The survival rates of childhood AML in Lithuania are comparable to those of other high-income countries. Current survival rates of children treated for cancer in Eastern European countries could be comparable to the best current standards contributing to better European survival rates of childhood cancer in general.

  10. The EFQM excellence model: European and Dutch experiences with the EFQM approach in health care. European Foundation for Quality Management

    NARCIS (Netherlands)

    Nabitz, U.; Klazinga, N.; Walburg, J.

    2000-01-01

    One way to meet the challenges in creating a high performance organization in health care is the approach of the European Foundation for Quality Management (EFQM). The Foundation is in the tradition of the American Malcolm Baldrige Award and was initiated by the European Commission and 14 European

  11. Complementary and conventional providers in cancer care: experience of communication with patients and steps to improve communication with other providers.

    Science.gov (United States)

    Stub, Trine; Quandt, Sara A; Arcury, Thomas A; Sandberg, Joanne C; Kristoffersen, Agnete E

    2017-06-08

    Effective interdisciplinary communication is important to achieve better quality in health care. The aims of this study were to compare conventional and complementary providers' experience of communication about complementary therapies and conventional medicine with their cancer patients, and to investigate how they experience interdisciplinary communication and cooperation. This study analyzed data from a self-administrated questionnaire. A total of 606 different health care providers, from four counties in Norway, completed the questionnaire. The survey was developed to describe aspects of the communication pattern among oncology doctors, nurses, family physicians and complementary therapists (acupuncturists, massage therapists and reflexologists/zone-therapists). Between-group differences were analyzed using chi-square, ANOVA and Fisher's exact tests. Significance level was defined as p communication with their cancer patients regarding complementary therapies. While complementary therapists advised their patients to apply both complementary and conventional modalities, medical doctors were less supportive of their patients' use of complementary therapies. Of conventional providers, nurses expressed more positive attitudes toward complementary therapies. Opportunities to improve communication between conventional and complementary providers were most strongly supported by complementary providers and nurses; medical doctors were less supportive of such attempts. A number of doctors showed lack of respect for complementary therapists, but asked for more research, guidelines for complementary modalities and training in conventional medicine for complementary therapists. For better quality of care, greater communication about complementary therapy use is needed between cancer patients and their conventional and complementary providers. In addition, more communication between conventional and complementary providers is needed. Nurses may have a crucial role in

  12. Spatial Planning Experiences for Vulnerability Reduction in the Wildland-Urban Interface in Mediterranean European Countries

    Directory of Open Access Journals (Sweden)

    Galiana-Martín Luis

    2017-09-01

    Full Text Available Expansion of the wildland-urban interface in countries in the European Mediterranean basin is increasing vulnerability to forest fires. Despite more effective extinction systems, this is still a growing problem. This article defends the importance of spatial planning (land-use and urban planning and the need for systematic intervention to mitigate this wildfire risk. A critical review of the current situation, noting intervention focused on buildings and plots and insufficient action on intermediate spatial scales, is followed by the presentation of significant and relevant experiences in the European context.

  13. European Union. Court of Justice of the European Union: EU Law and Fundamental Rights Preclude Requested Filtering Injunction against Hosting Provider

    NARCIS (Netherlands)

    Breemen, K.

    2012-01-01

    On 16 February 2012, the Court of Justice of the European Union delivered its preliminary ruling in the case of SABAM v. Netlog NV. The judgment was issued on a request made by the Court of First Instance of Brussels.

  14. The relevance of US experience to the completion of the European internal energy market for natural gas

    Energy Technology Data Exchange (ETDEWEB)

    Wood-Collins, John [Little (Arthur D.), Inc., London (GB); Lee, William [Shearman and Sterling, Paris (FR)

    1990-01-01

    The European Commission's 1988 document on the completion of the internal energy market made a number of recommendations which, if adopted, would significantly affect the European natural gas industry. These were principally that: user's access to transmission systems should be facilitated, in order to permit them direct access to suppliers; greater price transparency should be encouraged, to remove competitive distortions; and fiscal harmonisation should be accelerated, in order to ''level the playing field'' between industrial users in different countries. Advocates of ''open access'' or ''common carriage'', i.e. of a system under which owners of gas pipeline and storage facilities would have a legal obligation to provide transportation and related services to third parties for a specific fee, have argued that adoption of a US-style regulatory system could improve the efficiency of European markets by removing anti-competitive practices. The purpose of this article is to review the arguments on both sides and, in particular, to consider whether US experience may be a relevant model for European authorities to adopt. (author).

  15. Receiving recommendations and providing feedback : the user-experience of a recommender system

    NARCIS (Netherlands)

    Knijnenburg, B.P.; Willemsen, M.C.; Hirtbach, S.; Buccafurri, F.; Semeraro, G.

    2010-01-01

    This paper systematically evaluates the user experience of a recommender system. Using both behavioral data and subjective measures of user experience, we demonstrate that choice satisfaction and system effectiveness increase when a system provides personalized recommendations (compared to the same

  16. International infectious diseases teaching to undergraduate medical students: A successful European collaborative experience.

    Science.gov (United States)

    Charlier, Caroline; Johannessen, Ingólfur; Mackintosh, Claire L; Wilks, David; Cauda, Roberto; Wolf, Federica I; Le Jeunne, Claire

    2017-09-01

    The emerging global-health paradigm requires medical teaching to be continuously redefined and updated; to this end, transnational approaches should be encouraged and medical training harmonized. Infectious diseases (ID) teaching in the current context of emerging infections, fast-increasing bacterial resistance and large-scale human migration, was chosen to develop a common international course. We report the successful implementation of a joint European undergraduate course aiming to (i) develop a common ID core curriculum among European medical schools; (ii) promote mobility among teachers and students (iii) promote international cooperation among European teachers. The course was built around teachers' mobility. It was delivered in English by a team of European medical educators from Paris Descartes University, Università Cattolica del Sacro Cuore in Rome and the University of Edinburgh to groups of 25-30 undergraduate medical students at each university. Partner Institutions officially recognized the course as substitutive of or additive to the regular curriculum. The course has been running for 3 years and received excellent satisfaction scores by students and staff as regards to scientific content, pedagogy and international exchanges. This cooperative approach demonstrates the feasibility of a harmonized European undergraduate medical education, having ID as a test experiment for future developments.

  17. Pre-purchase customer experience : multiple case study of leading service providers in Norway

    OpenAIRE

    Kujala, Lisanna Carolina; Citic, Marija

    2015-01-01

    The theory of experience economy presents customer experience as a form of new economic offering and stresses the importance of customer experience for companies that are trying to differentiate from the competitors. Many service providers are increasing their focus on customer experience by putting the customer in the center of their business. This study investigates how experience centricity and customer centricity can be enhanced at prepurchase level. Nowadays, customer a...

  18. [Policies encouraging price competition in the generic drug market: Lessons from the European experience].

    Science.gov (United States)

    Puig-Junoy, Jaume

    2010-01-01

    To describe alternative policies aimed at encouraging price competition in generic drug markets in countries with strict price regulation, and to present some case studies drawn from the European experience. Systematic literature review of articles and technical reports published after 1999. The shortcomings in consumer price competition observed in some European generic markets, including Spain, may be reduced through three types of public reimbursement or financing reforms: policies aimed at improving the design of current maximum reimbursement level policies; policies aimed at monitoring competitive prices in order to reimburse real acquisition cost to pharmacies; and, more radical and market-oriented policies such as competitive tendering of public drug purchases. The experience of recent reforms adopted in Germany, Belgium, Holland, Norway, and Sweden offers a useful guide for highly price-regulated European countries, such as Spain, currently characterized by limited consumer price competition and the high discounts offered to pharmacy purchases. Direct price regulation and/or the generic reference pricing systems used to reduce generic drug prices in many European countries can be successfully reformed by adopting measures more closely aimed at encouraging consumer price competition in generic drug markets. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

  19. The European experience in safeguarding nuclear fuel recycle processes and Pu stores

    International Nuclear Information System (INIS)

    Synetos, Sotiris

    2013-01-01

    Civil nuclear programs in the European Union member states have from their onset included fuel recycling as an option. The EURATOM Treaty gives to the European Commission the obligation to apply safeguards controls to all civil Nuclear Material in the European Union, and to facilitate the implementation of IAEA safeguards. The European Commission (EURATOM) has thus gained years of experience in safeguarding reprocessing plants, Pu storages, and MOX fuel fabrication plants and is currently participating in the development of approaches and measures for safeguarding long term repositories. The aim of this paper is to present the regulator's views and experience on safeguarding nuclear fuel recycle processes and Pu stores, which is based on the following principles: -) Early involvement of the control organizations in the design of the safeguards measures to be developed for a plant (currently referred to as Safeguards by Design); -) Early definition of a safeguards strategy including key measurement points; -) The design and development of plant specific Safeguards equipment, including an on site laboratory for sample analysis; -) The development by the operator of an appropriate Nuclear Material accountancy system to facilitate their declaration obligations; -) The introduction of an inspection regime allowing comprehensive controls under the restrictions imposed by financial and Human Resources limitations; -) Optimization of the inspection effort by using unattended measuring stations, containment and surveillance systems and secure remote transmission of data to the regulator's headquarters. The paper is followed by the slides of the presentation. (authors)

  20. Role of the European Food Safety Authority (EFSA in providing scientific advice on the welfare of food producing animals

    Directory of Open Access Journals (Sweden)

    Jordi Serratosa

    2010-01-01

    Full Text Available The survey describes the work of the Animal Health and Welfare (AHAW Panel of the European Food Safety Authority (EFSA in the provision of scientific advice on the welfare of food producing animals including animal health and food safety aspects, where relevant, and on the impact of these scientific assessments on the EU regulatory framework. EFSA was created in 2002 with the mission to provide advice and scientific and technical support for the Community legislation and policies in all fields which have a direct or indirect impact on food and feed safety, plant health, environment and animal health and animal welfare. When providing objective and independent science-based advice, the risk assessment approach should be followed, whenever possible. The AHAW Panel of EFSA provides specific advices on risk factors related to animal diseases and welfare, mainly of food producing animals, including fish. According to EFSA’s remit, ethical, socio-economic, cultural and religious aspects are outside the scope of the EFSA’s assessments. Since 2004, the Animal Health and Welfare Panel of EFSA adopted a total of 21 scientific opinions on animal welfare. Animal diseases and food safety aspects have also been taken into account, where relevant. Animal welfare aspects have been considered in some scientific opinions on animal diseases (e.g. AI, FMD. The AHAW Panel is currently working on five scientific opinions on the welfare of dairy cows and on the welfare aspects of the stunning and killing of farmed fish for eight fish species (salmon, trout, carp, eel, tuna, sea bass, sea bream and turbot. The possible interactions and implications for food safety and animal disease have been considered, when relevant, in most of the AW scientific opinions, involving other areas of expertise in EFSA, like Biohazards, Contaminants and Plant Health. The final aim of EFSA’s scientific assessments on animal welfare is to support animal welfare EU legislation on the

  1. Commitment of involved actors in the preparation of accidental and post-accident situations: European experiments

    International Nuclear Information System (INIS)

    Schneider, Th.

    2010-01-01

    The author briefly describes some approaches developed within the EURANOS European research programme between 2004 and 2009 which aims at promoting the building up of a European network (NERIS) for the management of nuclear accidental and post-accident situations. Notably, he comments the experiment which took place in the Montbeliard district where two types of radiological events have been modelled and simulated: an accident in the Fessenheim nuclear power plant with two scenarios of release, and a transportation accident with a release of radioactive caesium 137. He also evokes the Norwegian experience and some other actions in Finland, Great-Britain, Spain and Slovakia where reflections on the management of accidental and post-accident situations or crisis exercises have been organized

  2. Fabrication and vertical test experience of the European X-ray Free Electron Laser 3.9 GHz superconducting cavities

    Science.gov (United States)

    Pierini, P.; Bertucci, M.; Bosotti, A.; Chen, J. F.; Maiano, C. G.; Michelato, P.; Monaco, L.; Moretti, M.; Pagani, C.; Paparella, R.; Sertore, D.; Vogel, E.

    2017-04-01

    We report the experience of the production, processing and qualification testing of the superconducting radio frequency cavities at 3.9 GHz for the third harmonic system at the European XFEL (EXFEL) injector. The rf structure concept, originally developed for the FLASH FEL facility, was adapted to the new interfaces provided by the EXFEL design and the cavities were procured from a qualified vendor, delivered ready for the testing at the INFN infrastructure. A total of 23 cavities, three prototypes and two batches of 10, have been realized and tested up to specifications.

  3. Experience of European irradiated fuel transport - the first four hundred tonnes

    International Nuclear Information System (INIS)

    Curtis, H.W.

    1977-01-01

    The paper describes the successful integration of the experience of its three shareholders into an international company providing an irradiated fuel transport service throughout Europe. The experience of transporting more than 400 tonnes of irradiated uranium from fifteen power reactors is used to illustrate the flexibility which the transport organisation requires when the access and handling facilities are different at almost every reactor. Variations in fuel cross sections and lengths of fuel elements used in first generation reactors created the need for first generation flasks with sufficient variants to accommodate all reactor fuels but the trend now is towards standardisation of flasks to perhaps two basic types. Increases in fuel rating have raised the flask shielding and heat dissipation requirements and have influenced the design of later flasks. More stringent criticality acceptance criteria have tended to reduce the flask capacity below the maximum number of elements which could physically be contained. Reprocessing plant acceptance criteria initiated because of the presence of substantial quantities of loose crud released in the flask and the need to transport substantial numbers of failed elements have also reduced the flask capacity. Different modes of transport have been developed to cater for the various limitations on access to reactor sites arising from geographical and routing considerations. The safety record of irradiated fuel transport is examined with explanation of the means whereby this has been achieved. The problems of programming the movement of a pool of flasks for fifteen reactors in eight countries are discussed together with the steps taken to ensure that the service operates fairly to give priority to those reactors with the greatest problems. The transport of European irradiated fuel can be presented as an example of international collaboration which works

  4. EXPERIENCES AND TENDENCIES TO DECENTRALIZE THE CAPABILITIES OF THE ECONOMIC POLICY AT THE EUROPEAN UNION LEVEL

    Directory of Open Access Journals (Sweden)

    Dodescu Anca

    2011-07-01

    , coordinator: Professor Dr. Valeriu Ioan Franc. The question we intend to answer, in the present phase of our research, based on the comparative analysis of the decentralisation systems of several Member States of European Union, respectively on the analysis of the regional disparities existing at the European Union level and of the effects of the economic integration, is- to what extent the capabilities of the regional policy should rather be concentrated in the hands of regional authorities or of the European Union than to be left individually to the Member States which should conceive their own regional policy? What we intend in this paper, based on the analysis of some experiences to decentralize the capabilities of economic policy at the European Union level, is to identify the regional implications of the interconnection of decentralization, centralization, respectively supra-nationalization tendencies and, implicitly, the analysis of the way to reconfigure the role of state in economy at the regional level, in the context of integration in the European model. The examination of the way to reconfigure the role of state in economy at regional level requires the review of the allocative, distributive, and regulating roles of the state from a regional perspective, the analysis, on one side, of the decentralization of economic policy capabilities from the national level to the regional level (for example, national level: pure public goods supply, for instance, national defence and the centralization of fiscal policy capabilities in order to achieve macroeconomic stability and revenue redistribution; regional level: mixed public goods supply, for instance, waste collection and community policy, on the other hand, the centralization/decentralization of regional capabilities at the European Union level.

  5. Improvement of the Pension System in Uzbekistan: Through the Experience of the European Union Countries

    Directory of Open Access Journals (Sweden)

    Dilshodjon Alidjonovich Rakhmonov

    2016-01-01

    Full Text Available Government’s policy in financing social sphere is becoming more and more topical. In this regard, managing pension system effectively, conducting research basing on “income distribution through the time” principle in its financing is of particular significance. In this article the possibility of applying the experience of European Union countries in the level of coverage of population by the pension plan and its development in Uzbekistan.

  6. Target development and transmutation experiments in the frame of the EFTTRA European collaboration

    International Nuclear Information System (INIS)

    Prunier, C.; Salvatores, M.; Muehling, G.; Rome, M.

    1995-01-01

    The aim of the EFTTRA collaboration between CEA (France), ECN (The Netherlands), EDF (France), FZK (Germany), IAM and ITU (European Commission), is to organize joint experiments for the study of materials for transmutation in reactors. The work is focused on the transmutation of 99 Tc (metal), of 129 I (compound), and of Am (in an inert matrix). Irradiation experiments are taking place in parallel in the Phenix fast reactor in France, and in the high flux thermal reactor HFR in the Netherlands. Examination of iodine compounds and Tc samples, following irradiation in HFR, has started. (authors). 10 refs., 2 figs

  7. Westinghouse Electric Company experiences in chemistry on-line monitoring in Eastern European nuclear power plants

    International Nuclear Information System (INIS)

    Balavage, J.

    2001-01-01

    Westinghouse Electric Company has provided a number of Chemistry On-Line Monitoring (OLM) Systems to Nuclear Power Plants in Eastern Europe. Eleven systems were provided to the Temelin Nuclear Power Plant in the south of the Czech Republic. Four systems were provided to the Russian NPP at Novovoronezh. In addition, a system design was developed for primary side chemistry monitoring for units 5 and 6 of another eastern European VVER. The status of the Temelin OLM systems is discussed including updates to the Temelin designs, and the other Eastern European installations and designs are also described briefly. Some of the problems encountered and lessons learned from these projects are also discussed. (R.P.)

  8. Profile of currently employed European Food Scientists and Technologists: Education, experience and skills

    Directory of Open Access Journals (Sweden)

    Katherine Flynn

    2013-10-01

    Full Text Available The food & drink (F&D sector in Europe ranks low in innovation and the European F&D industry has been losing importance in the global market. The food professionals, i.e., food scientists and technologists (FSTs, may not be meeting the varied demands of the sector. Here, we identify education, experience and skills of current FSTs and compare  geographic regions and employment areas. Between 2009 and 2012, 287 questionnaires representing over 4000 FSTs were collected from employers in 16 countries. Analyses showed that more than 80% of FSTs have a university degree; but only in Industry in the Central European region are most degrees in food science/technology. More than half of FSTs, and almost 60% in the South, have less than 10 years’ experience. The most common FST job title is Quality Manager, but with several variations based on region and employment area. Among skills, the most common is Communicating; found in over 90% of FSTs in all regions and employment areas. Food Safety is the most common of the food sector-specific skills, present in more than 75% of FSTs, yet there are differences in food sector skills based on employment area. Overall, these data suggest similarities among currently employed food professionals throughout Europe; they are young and highly educated, but also differences, especially in their food sector-specific skills. An understanding of the current FST should contribute to the improvement of FST training and thus benefit the European food sector.

  9. Educational Research Capacity Building in the European Union: A Critique of the Lived Experiences of Emerging Researchers

    Science.gov (United States)

    Hallet, Fiona; Fidalgo, Patricia

    2014-01-01

    The purpose of this article is to explore the extent to which European Union (EU) policies impact upon the activities of associations such as the European Educational Research Association (EERA) and the experiences of emerging researchers aligned to such associations. In essence, the authors explore potential tensions between policy and the lived…

  10. Influence of Provider Communication on Women's Delivery Expectations and Birth Experience Appraisal: A Qualitative Study.

    Science.gov (United States)

    Ledford, Christy J W; Canzona, Mollie Rose; Womack, Jasmyne J; Hodge, Joshua A

    2016-07-01

    Although current research suggests that patient-provider prenatal communication and expectation-setting affects women's outcomes, more needs to be understood about the kinds of communication experiences that shape women's expectations, the nature of expectations that women hold, and how those expectations influence their appraisal of labor and delivery. The goal of this study is to draw connections between provider communication, birth experience expectations, and birth experience appraisals. Recently delivered mothers (n=36) were recruited at a mid-Atlantic community hospital. Using a grounded theory approach, interviews were systematically analyzed to uncover how participants perceived provider communication during their prenatal care, how participants described their expectations of the birth experience, and how expectations affected appraisals of the experience. Mothers recognize providers' use of patient-centered communication in messages of empowerment, emotional support, explanation, decision making, and elicitation. Findings posit that it is the inflexibility or flexibility of expectations that may determine mothers' appraisals of the birth experience. Mothers continue to rely on providers as partners in health care. Through patient-centered communication, providers can help mothers develop flexible expectations of the birth experience, which in turn can result in positive appraisals of delivery.

  11. Experience of European LWR irradiated fuel transport: the first five hundred tonnes

    International Nuclear Information System (INIS)

    Curtis, H.W.

    1978-01-01

    The paper describes the service provided by an international company specializing in the transport of LWR irradiated fuel throughout Europe. Methods of transport used to the reprocessing plants at La Hague and Windscale include road transport of 38 te flasks over the whole route; transport of flasks between 55 and 105 te by rail, with rail-head and the reprocessing plant, where required, performed by road using heavy trailers; roll-on, roll-off sea ferries; and charter ships. Different modes of transport have been developed to cater for the various limitations on access to reactor sites arising from geographical and routing considerations. The experience of transporting more than 500 tonnes of irradiated uranium from twenty-one power reactors is used to illustrate the flexibility which the transport organization requires when the access and handling facilities are different at almost every reactor. Variations in fuel cross sections and lengths of fuel elements used in first generation reactors created the need for first generation flasks with sufficient variants to accommodate all reactor fuels but the trend now is towards standardization of flasks to perhaps two basic types. The safety record of irradiated fuel transport is examined with explanation of the means whereby this has been achieved. The problems of programming the movement of a pool of eighteen flasks for twenty-one reactors in eight countries are discussed together with the steps taken to ensure that the service operates fairly to give priority to those reactors with the greatest problems. The transport of irradiated fuel across several national frontiers is an international task which requires an international company. The transport of European irradiated fuel can be presented as an example of international collaboration which works

  12. Integrated Personal Health and Care Services deployment: Experiences in eight European countries

    DEFF Research Database (Denmark)

    Villalba, Elena; Casas, Isabel; Abadie, Fabienne

    2013-01-01

    conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...... mechanisms, interoperable information systems, policy commitment, engaged professionals, national investments and funding programmes, and incentives and financing. Conclusion: In those cases which provided evidence of success beyond the pilot stage, we observed a promising trend: awareness and introduction...

  13. `Learning Experience' Provided by Science Teaching Practice in a Classroom and the Development of Students' Competences

    Science.gov (United States)

    Lopes, J. Bernardino; Branco, Julia; Jimenez-Aleixandre, Maria Pilar

    2011-11-01

    According to the literature, there is a very important corpus of knowledge that allows for the investigation of some dimensions of `learning experience' provided to students, in relation to epistemic, pedagogical and meta-cognitive practices. However, in the literature, there is little investigation into the invariance (or not) of the characteristics of students' learning experience while being taught a scientific subject by the same teacher. This paper suggests that the relationship between the learning experience provided and the competences developed is not properly highlighted. This paper analyses the learning experience provided to students in epistemic, pedagogical and meta-cognitive terms. The students were taught the proprieties and applications of light by one teacher, in three classes, over 7 weeks. We analysed the data in each referred learning experience, using a pre-defined category system. The students' competences were evaluated by a competence test. The epistemic demand of each item and the students' performances were also analysed. Our findings point to the non invariance of learning experiences provided to students and the influence of some dimensions of learning experiences provided in the development of certain competences. These findings and their implications are contextualized and discussed.

  14. Older hospitalized patients' experiences of dialogue with healthcare providers in hospitals

    DEFF Research Database (Denmark)

    Nielsen, Gitte; Larsen, Karen Lyng; Uhrenfeldt, Lisbeth

    2017-01-01

    REVIEW QUESTION/OBJECTIVE:: The objective is to identify and synthesize findings from qualitative studies of older (over 65 years) hospitalized patients' experiences of the barriers and facilitators to their dialogues with healthcare providers (HCPs) concerning their health and well-being.Specifi......REVIEW QUESTION/OBJECTIVE:: The objective is to identify and synthesize findings from qualitative studies of older (over 65 years) hospitalized patients' experiences of the barriers and facilitators to their dialogues with healthcare providers (HCPs) concerning their health and well...

  15. Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis: a discrete choice experiment among European rheumatologists

    NARCIS (Netherlands)

    Hifinger, M.; Hiligsmann, M.; Ramiro, S.; Watson, V.; Severens, J. L.; Fautrel, B.; Uhlig, T.; van Vollenhoven, R.; Jacques, P.; Detert, J.; Canas da Silva, J.; Scirè, C. A.; Berghea, F.; Carmona, L.; Péntek, M.; Keat, A.; Boonen, A.

    2017-01-01

    To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with

  16. ADVANCED VOCATIONAL TRAINING OF ENVIRONMENTAL PROFESSIONALS FOR PROVIDING SUSTAINABLE DEVELOPMENT OF RAILWAYS OF UKRAINE ON THE WAY TO EUROPEAN INTEGRATION

    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

  17. Gas Reactor International Cooperative Program. Interim report. Construction and operating experience of selected European Gas-Cooled Reactors

    International Nuclear Information System (INIS)

    1978-09-01

    The construction and operating experience of selected European Gas-Cooled Reactors is summarized along with technical descriptions of the plants. Included in the report are the AVR Experimental Pebble Bed Reactor, the Dragon Reactor, AGR Reactors, and the Thorium High Temperature Reactor (THTR). The study demonstrates that the European experience has been favorable and forms a good foundation for the development of Advanced High Temperature Reactors

  18. European University Students' Experiences and Attitudes toward Campus Alcohol Policy: A Qualitative Study.

    Science.gov (United States)

    Van Hal, Guido; Tavolacci, Marie-Pierre; Stock, Christiane; Vriesacker, Bart; Orosova, Olga; Kalina, Ondrej; Salonna, Ferdinand; Lukacs, Andrea; Ladekjaer Larsen, Eva; Ladner, Joël; Jacobs, Liezille

    2018-01-24

    Many studies indicate that a substantial part of the student population drinks excessively, yet most European universities do not have an alcohol policy. In the absence of an alcohol guideline at universities and the easy access to alcohol sold at the student cafeteria, for instance, this has the potential to place students at risk of overconsumption, which has adverse health consequences. Therefore, our study objectives were to explore and compare university students' experiences and attitudes toward alcohol policy on their campus using a qualitative approach. 29 focus group discussions (FGDs) were conducted among students from universities in five European countries: Belgium (4 FGDs), Denmark (6 FGDs), France (5 FGDs), Hungary (6 FGDs), and the Slovak Republic (8 FGDs), with a total number of 189 participants. Across the five European countries, students recognized that alcohol was a big problem on their campuses yet they knew very little, if any, about the rules concerning alcohol on their campus. Students will not support an on campus alcohol restriction and a policy should therefore focus on prevention initiatives.

  19. LAG, GAPS AND CONVERGENCES – FIVE CENTURIES OF EUROPEAN ECONOMIC EXPERIENCES

    Directory of Open Access Journals (Sweden)

    Dr. Bogdan MURGESCU

    2010-11-01

    Full Text Available This paper entails the experience of different European countries in what concerns economic gaps storage, “economic lag” and “catching-up the lag time”, confronting economic theories regarding economic growth determinants. Taking into consideration the cases of Denmark and Ireland, which have managed, in different historical periods, to surpass the peripheral condition and relative economic under- development, and to be part of the most developed and prosper group countries; the study evaluates the chances of other countries to realize similar progresses.

  20. Academic performance and students' teaching assessment in pilot experiments of European Higher Education

    OpenAIRE

    Molero López Barajas, David

    2007-01-01

    In this work we show a study based on an analysis of academic marks as well as on a teaching valuation of a students sample participating in a pilot experience for the European Credit System Implantation in the Music Teachers Instruction Course. We also detail the way of evaluating the students and the resources used to valuate the teaching. We analyse the differences between the student’s marks and their opinion about the teaching in two students groups, one of them using a traditional teach...

  1. DOCTORAL STUDIES IN THE HOMELAND HIGHER EDUCATION: EXPERIENCE AND PROSPECTS OF THE EUROPEAN DIMENSION

    Directory of Open Access Journals (Sweden)

    Svitlana Holovko

    2017-11-01

    Full Text Available Purpose: Ensuring compliance of doctoral training in Ukraine with the European standards is an objective condition for the complete integration of our state into the united educational and scientific environment. In order to ensure the effectiveness of this process, the necessity of research conducted on the European experience as well as the first achievements and difficulties in the national high school, the determining factors, in particular, the state and prospects of the legal area development for the implementation of the new model appears to be urgent. Methods: general and specific scientific (special methods were used to achieve the research target. Applying the methods of the first group made it possible to outline the tendencies of the doctoral training transformation in European countries and in Ukraine. By means of the comparative legal method, the peculiarities of the development of the normative-legal field of doctoral training in the national high school were analyzed, and the areas of its improvement were determined. Results: The features of development of doctoral training in the European educational space and the prospects of its introduction in the national higher education were considered. The formation of the legal area of doctoral training in Ukraine was argued, and the ways of its improvement were outlined. Exemplified on the National Aviation University, as one of the leading research institutions, the first experience of introducing a European model for training scientific staff is summarized. Discussion: In doctoral training, one of the leading trends is the issue of ensuring the quality of the implementation of curricula of the Doctor of Philosophy, enhancing the autonomy and responsibility of postgraduate students and academic leaders, improving the academic and geographical mobility of scholars, increasing funding for research and enhancing its innovation. In the projection of this issue on the national university

  2. How do General Practitioners experience providing care for their psychotic patients?

    NARCIS (Netherlands)

    Oud, Marian J. T.; Schuling, Jan; Slooff, Cees J.; Meyboom-de Jong, Betty

    2007-01-01

    Background: In primary care, GPs usually provide care for patients with chronic diseases according to professional guidelines. However, such guidelines are not available in the Netherlands for patients with recurring psychoses. It seems that the specific difficulties that GPs experience in providing

  3. Using Combined Marine Spatial Planning Tools and Observing System Experiments to define Gaps in the Emerging European Ocean Observing System.

    Science.gov (United States)

    Nolan, G.; Pinardi, N.; Vukicevic, T.; Le Traon, P. Y.; Fernandez, V.

    2016-02-01

    Ocean observations are critical to providing accurate ocean forecasts that support operational decision making in European open and coastal seas. Observations are available in many forms from Fixed platforms e.g. Moored Buoys and tide gauges, underway measurements from Ferrybox systems, High Frequency radars and more recently from underwater Gliders and profiling floats. Observing System Simulation Experiments have been conducted to examine the relative contribution of each type of platform to an improvement in our ability to accurately forecast the future state of the ocean with HF radar and Gliders showing particular promise in improving model skill. There is considerable demand for ecosystem products and services from today's ocean observing system and biogeochemical observations are still relatively sparse particularly in coastal and shelf seas. There is a need to widen the techniques used to assess the fitness for purpose and gaps in the ocean observing system. As well as Observing System Simulation Experiments that quantify the effect of observations on the overall model skill we present a gap analysis based on (1) Examining where high model skill is required based on a marine spatial planning analysis of European seas i.e where does activity take place that requires more accurate forecasts? and (2) assessing gaps based on the capacity of the observing system to answer key societal challenges e.g. site suitability for aquaculture and ocean energy, oil spill response and contextual oceanographic products for fisheries and ecosystems. The broad based analysis will inform the development of the proposed European Ocean Observing System as a contribution to the Global Ocean Observing System (GOOS).

  4. Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

    Science.gov (United States)

    Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

    2018-05-15

    MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

  5. Mental health service users' experiences of an education intervention based on a European Union project: A comparison between nine European countries.

    Science.gov (United States)

    Nieminen, Irja; Kaunonen, Marja

    2018-06-19

    Mental health service users (MHSUs) often face difficulties in achieving successful participation in education; however, the tools that could help them succeed are rarely investigated. This study aimed to illuminate the experiences of MHSUs in an education intervention based on a European Union (EU) project. Their experiences are compared across nine EU countries. The data were collected through individual interviews with MHSUs (n = 47) at day activity centres that provide mental health services. An inductive content analysis was used as the method of analysis. Three main categories, which include seven subcategories, are revealed by the analysis. The main categories are as follows: (i) the factors related to MHSUs' educational preparedness, (ii) the dimensions of the learning environment, and (iii) the effects of training intervention. The MHSUs' experiences with the education intervention were similar across all countries. The findings showed that this education intervention is a multidimensional process. It contains social, mental, and physical dimensions linked to a learner and learning environment. These dimensions influence the MHSUs' ability to participate in the education process. At its best, the education intervention supports the personal growth of MHSUs and prepares them for social integration. An education intervention can be a usable tool in the rehabilitation of MHSUs if the multidimensional nature of education is taken into consideration. Therefore, designing and executing education interventions requires the attendance of the MHSUs in cooperation with mental health and education professionals. Our findings suggest a tentative framework that can be used in designing and executing education for MHSUs. © 2018 Australian College of Mental Health Nurses Inc.

  6. European Society of Cardiology smartphone and tablet applications for patients with atrial fibrillation and their health care providers.

    Science.gov (United States)

    Kotecha, Dipak; Chua, Winnie W L; Fabritz, Larissa; Hendriks, Jeroen; Casadei, Barbara; Schotten, Ulrich; Vardas, Panos; Heidbuchel, Hein; Dean, Veronica; Kirchhof, Paulus

    2018-02-01

    We are in the midst of a digital revolution in health care, although the application of new and useful technology in routine clinical practice is variable. The Characterizing Atrial fibrillation by Translating its Causes into Health Modifiers in the Elderly (CATCH ME) Consortium, in collaboration with the European Society of Cardiology (ESC), has funded the creation of two applications (apps) in atrial fibrillation (AF) for use in smartphones and tablets. The patient app aims to enhance patient education, improve communication between patients and health care professionals, and encourage active patient involvement in the management of their condition. The health care professional app is designed as an interactive management tool incorporating the new ESC Practice Guidelines on AF and supported by the European Heart Rhythm Association (EHRA), with the aim of improving best practice approaches for the care of patients with AF. Both stand-alone apps are now freely available for Android and iOS devices though the Google Play, Amazon, and Apple stores. In this article, we outline the rationale for the design and implementation of these apps. Our objective is to demonstrate the value of integrating novel digital technology into clinical practice, with the potential for patient engagement, optimization of pharmacological and interventional therapy in AF, and ultimately to improve patient outcomes. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Cardiology.

  7. A qualitative exploration of psychosocial specialists' experiences of providing support in UK burn care services.

    Science.gov (United States)

    Guest, Ella; Griffiths, Catrin; Harcourt, Diana

    2018-01-01

    A burn can have a significant and long-lasting psychosocial impact on a patient and their family. The National Burn Care Standards (2013) recommend psychosocial support should be available in all UK burn services; however, little is known about how it is provided. The current study aimed to explore experiences of psychosocial specialists working in UK burn care, with a focus on the challenges they experience in their role. Semi-structured telephone interviews with eight psychosocial specialists (two psychotherapists and six clinical psychologists) who worked within UK burn care explored their experiences of providing support to patients and their families. Thematic analysis revealed two main themes: burn service-related experiences and challenges reflected health professionals having little time and resources to support all patients; reduced patient attendance due to them living large distances from service; psychosocial appointments being prioritised below wound-related treatments; and difficulties detecting patient needs with current outcome measures. Therapy-related experiences and challenges outlined the sociocultural and familial factors affecting engagement with support, difficulties treating patients with pre-existing mental health conditions within the burn service and individual differences in the stage at which patients are amenable to support. Findings provide an insight into the experiences of psychosocial specialists working in UK burn care and suggest a number of ways in which psychosocial provision in the NHS burn service could be developed.

  8. Nondestructive tests for railway monitoring. European Experience in COST Action TU1208

    Science.gov (United States)

    Fontul, Simona; Solla, Mercedes; Loizos, Andreas

    2016-04-01

    The railway monitoring is an important issue for a proper maintenance planning. With the increase in loads and travel speed, it is important to be able to diagnose the track defects and to plan the proper maintenance without interfering with the users. Traditionally, the maintenance actions are planned based on the geometric level parameters assessed without contact with the line, at traffic speed, by dedicated inspection vehicles. Nevertheless, the geometric condition of the line does not provide information on the defects causes. In order to complements the information on the causes, geophysics measurements can be performed in a nondestructive way. Among these later methods, Ground Penetrating Radar (GPR) is a quick and effective technique to evaluate infrastructure condition in a continuous manner, replacing or reducing the use of traditional drilling method. GPR application to railways infrastructures, during construction and monitoring phase, is relatively recent. It is based on the measuring of layers thicknesses and detection of structural changes. It also enables the assessment of materials properties that constitute the infrastructure and the evaluation of the different types of defects such as ballast pockets, fouled ballast, poor drainage, subgrade settlement and transitions problems. These deteriorations are generally the causes of vertical deviations in track geometry. Moreover, the development of new GPR systems with higher antenna frequencies, better data acquisition systems, more user friendly software and new algorithms for calculation of materials properties can lead to a regular use of GPR. A resume of the European experience in COST Action TU1208 of the application of GPR for railway monitoring and the measurement interpretation is presented in this paper. Also complementary nondestructive tests and other geophysical methods are referred, together with case studies of their application. The main troubleshooting and the needs for data analysis

  9. How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark.

    Science.gov (United States)

    Jensen, Natasja Koitzsch; Norredam, Marie; Priebe, Stefan; Krasnik, Allan

    2013-01-28

    Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients' refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management of refugees. The findings from this

  10. The EFQM excellence model: European and Dutch experiences with the EFQM approach in health care. European Foundation for Quality Management.

    Science.gov (United States)

    Nabitz, U; Klazinga, N; Walburg, J

    2000-06-01

    One way to meet the challenges in creating a high performance organization in health care is the approach of the European Foundation for Quality Management (EFQM). The Foundation is in the tradition of the American Malcolm Baldrige Award and was initiated by the European Commission and 14 European multi-national organizations in 1988. The essence of the approach is the EFQM Model, which can be used as a self-assessment instrument on all levels of a health care organization and as an auditing instrument for the Quality Award. In 1999 the EFQM Model was revised but its principles remained the same. In The Netherlands many health care organizations apply the EFQM Model. In addition to improvement projects, peer review of professional practices, accreditation and certification, the EFQM Approach is used mainly as a framework for quality management and as a conceptualization for organizational excellence. The Dutch National Institute for Quality, the Instituut Nederlandse Kwaliteit, delivers training and supports self-assessment and runs the Dutch quality award programme. Two specific guidelines for health care organizations, 'Positioning and Improving' and 'Self-Assessment', have been developed and are used frequently. To illustrate the EFQM approach in The Netherlands, the improvement project of the Jellinek Centre is described. The Jellinek Centre conducted internal and external assessments and received in 1996, as the first health care organization, the Dutch Quality Prize.

  11. A Global Remote Laboratory Experimentation Network and the Experiment Service Provider Business Model and Plans

    Directory of Open Access Journals (Sweden)

    Tor Ivar Eikaas

    2003-07-01

    Full Text Available This paper presents results from the IST KAII Trial project ReLAX - Remote LAboratory eXperimentation trial (IST 1999-20827, and contributes with a framework for a global remote laboratory experimentation network supported by a new business model. The paper presents this new Experiment Service Provider business model that aims at bringing physical experimentation back into the learning arena, where remotely operable laboratory experiments used in advanced education and training schemes are made available to a global education and training market in industry and academia. The business model is based on an approach where individual experiment owners offer remote access to their high-quality laboratory facilities to users around the world. The usage can be for research, education, on-the-job training etc. The access to these facilities is offered via an independent operating company - the Experiment Service Provider. The Experiment Service Provider offers eCommerce services like booking, access control, invoicing, dispute resolution, quality control, customer evaluation services and a unified Lab Portal.

  12. Experiences With Insurance Plans and Providers Among Persons With Mental Illness.

    Science.gov (United States)

    Rowan, Kathleen; Shippee, Nathan D

    2016-03-01

    This study used nationally representative household survey data to examine the association between mental illness and experiences with usual care providers and health plans among persons with public or private insurance (N=25,176). Data were from the 2004-2012 Medical Expenditure Panel Surveys. Mental illness was assessed with symptom scales of serious psychological distress and depression at two time points, and persons were categorized by whether mental illness was episodic or persistent over time. Questions about experiences with providers (four questions) and plans (five questions) were based on the Consumer Assessment of Healthcare Providers and Systems survey. Rates of problems with plans and providers were reported for each category of mental illness, and multivariate regression was used to examine the association of problems with mental illness. Rates of problems with health plans were high, specifically for treatment approvals, finding information, and customer service, and were higher among persons with mental illness. Rates of problems with providers were lower than problems with plans, but persons with mental illness were more likely to report problems, specifically that doctors do not explain treatment options, respect treatment choices, or seek participation in decisions. Persons with mental illness reported experiencing more clinical and administrative problems at their usual source of care, although the reasons were not clear. Efforts by plans to improve health care before and after the clinical encounter and by providers to design treatments in line with patient preferences may improve experiences for all patients and particularly for those with mental illness.

  13. Professional carers' experiences of providing a pediatric palliative care service in Ireland.

    Science.gov (United States)

    Clarke, Jean; Quin, Suzanne

    2007-11-01

    In this article the authors present findings on professional carers' experience of providing pediatric palliative care to children with life-limiting conditions. For this qualitative study, part of a national pediatric palliative care needs analysis, the authors engaged in 15 focus group interviews and drew on the responses of open-ended questions to give voice to the experiences of professional carers and to situate the humanity of their caring reality. This humanity is articulated through three themes: clarity of definition and complexity of engagement, seeking to deliver a palliative care service, and the emotional cost of providing palliative care. Further analysis of these themes points to a work-life experience of skilled and emotional engagement with children, and their parents, in complex processes of caregiving and decision making. Pediatric palliative care occurs in an environment where parents shoulder a large burden of the care and professionals find themselves working in underresourced services.

  14. Program Experiences of Adults with Autism, Their Families, and Providers: Findings from a Focus Group Study

    Science.gov (United States)

    Koffer Miller, Kaitlin H.; Mathew, Mary; Nonnemacher, Stacy L.; Shea, Lindsay L.

    2018-01-01

    A growing number of individuals with autism spectrum disorder are aging into adulthood. In the United States, Medicaid is the primary payer for services for adults with autism spectrum disorder, yet there are few funded programs that provide dedicated supports to this population. This study examined the experiences of adults with autism spectrum…

  15. Entering the Fray: The Role of Outdoor Education in Providing Nature-Based Experiences that Matter

    Science.gov (United States)

    Nicol, Robbie

    2014-01-01

    This article draws on different bodies of knowledge in order to review the potential role of outdoor education in providing nature-based experiences that might contribute to sustainable living. A pragmatic perspective is adopted to critique what outdoor education is, and then what it might be. Phenomenology is used to challenge the belief that…

  16. Teachers' Experiences Providing One-on-One Instruction to Struggling Readers

    Science.gov (United States)

    Liebfreund, Meghan D.; Amendum, Steven J.

    2017-01-01

    This study examined the experiences of 12 kindergarten, first-, and second-grade classroom teachers who provided one-on-one intervention instruction for struggling readers within the general classroom context. Teachers were interviewed at the end of the project. Interview statements clustered into four themes: Managing One-on-One Intervention,…

  17. The Baltic Sea Experiment (BALTEX): A European contribution to the investigation of the energy and water cycle over a large drainage basin

    DEFF Research Database (Denmark)

    Raschke, E.; Meywerk, J.; Warrach, K.

    2001-01-01

    The Baltic Sea Experiment (BALTEX) is one of the five continental-scale experiments of the Global Energy and Water Cycle Experiment (GEWEX). More than 50 research groups from 14 European countries are participating in this project to measure and model the energy and water cycle over the large...... drainage basin of the Baltic Sea in northern Europe. BALTEX aims to provide a better understanding of the processes of the climate system and to improve and to validate the water cycle in regional numerical models for weather forecasting and climate studies. A major effort is undertaken to couple...

  18. Experience of the pilot implementation of the european information sharing and alerting system in the field of information security

    Directory of Open Access Journals (Sweden)

    Anatoly A. Malyuk

    2018-03-01

    Full Text Available The formation of a global information society poses a particular challenge to the development of an information security culture. In the Doctrine of Information Security of the Russian Federation, adopted in December 2016, one of the main threats is the low awareness of citizens in matters of ensuring personal information security. One of the most important mechanisms for increasing competence and forming an in-formation security culture, in addition to mass training of people, are methods of propaganda and creation of "hot lines". They allow the general public to take the initiative in monitoring and reporting computer incidents. The development of such approaches should be carried out taking into account the international experience accumulated today. To this end, the article examines the European experience of creating a system of information and advisory assistance in the field of preventing threats to the security of public and corporate information systems, primarily information and telecommunications networks, as well as eliminating the consequences of threats in the information sphere. The analysis of the experience of implementing the pilot project of the European Information Sharing and Alert System has revealed the advisability of designing such systems on the basis of a management model with four players that unites network operators, information producers (who are IT product suppliers or IT security specialists; local information intermediaries and consumers of information. As a model of the information flow, a node can be selected that runs a local web portal that provides information to end users, generates new information, adapts information to the constraints of various distribution channels, and to the characteristics of end-user target groups. The methodology of the pilot project can be used in the design and deployment of a notification and information exchange system aimed at end-users of several regions or countries

  19. Provider Experiences with Chronic Care Management (CCM) Services and Fees: A Qualitative Research Study.

    Science.gov (United States)

    O'Malley, Ann S; Sarwar, Rumin; Keith, Rosalind; Balke, Patrick; Ma, Sai; McCall, Nancy

    2017-12-01

    Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward. Semi-structured telephone interviews from January to April 2016 with 71 respondents. Sixty billing and non-billing providers and practice staff knowledgeable about their practices' CCM services, and 11 professional society representatives. Practice respondents noted that most patients expressed positive views of CCM services. Practice respondents also perceived several patient benefits, including improved adherence to treatment, access to care team members, satisfaction, care continuity, and care coordination. Facilitators of CCM provision included having an in-practice care manager, patient-centered medical home recognition, experience developing care plans, patient trust in their provider, and supplemental insurance to cover CCM copayments. Most billing practices reported few problems obtaining patients' consent for CCM, though providers felt that CMS could better facilitate consent by marketing CCM's goals to beneficiaries. Barriers reported by professional society representatives and by billing and non-billing providers included inadequacy of CCM payments to cover upfront investments for staffing, workflow modification, and time needed to manage complex patients. Other barriers included inadequate infrastructure for health information exchange with other providers and limited electronic health record capabilities for documenting and updating care plans. Practices owned by hospital systems and large medical groups faced greater bureaucracy in implementing CCM than did smaller, independent practices

  20. European Society of Cardiology smartphone and tablet applications for patients with atrial fibrillation and their health care providers

    Science.gov (United States)

    Kotecha, Dipak; Chua, Winnie W L; Fabritz, Larissa; Hendriks, Jeroen; Casadei, Barbara; Schotten, Ulrich; Vardas, Panos; Heidbuchel, Hein; Dean, Veronica; Kirchhof, Paulus

    2018-01-01

    Abstract We are in the midst of a digital revolution in health care, although the application of new and useful technology in routine clinical practice is variable. The Characterizing Atrial fibrillation by Translating its Causes into Health Modifiers in the Elderly (CATCH ME) Consortium, in collaboration with the European Society of Cardiology (ESC), has funded the creation of two applications (apps) in atrial fibrillation (AF) for use in smartphones and tablets. The patient app aims to enhance patient education, improve communication between patients and health care professionals, and encourage active patient involvement in the management of their condition. The health care professional app is designed as an interactive management tool incorporating the new ESC Practice Guidelines on AF and supported by the European Heart Rhythm Association (EHRA), with the aim of improving best practice approaches for the care of patients with AF. Both stand-alone apps are now freely available for Android and iOS devices though the Google Play, Amazon, and Apple stores. In this article, we outline the rationale for the design and implementation of these apps. Our objective is to demonstrate the value of integrating novel digital technology into clinical practice, with the potential for patient engagement, optimization of pharmacological and interventional therapy in AF, and ultimately to improve patient outcomes. PMID:29040548

  1. Parents' Experiences and Perceptions when Classifying their Children with Cerebral Palsy: Recommendations for Service Providers.

    Science.gov (United States)

    Scime, Natalie V; Bartlett, Doreen J; Brunton, Laura K; Palisano, Robert J

    2017-08-01

    This study investigated the experiences and perceptions of parents of children with cerebral palsy (CP) when classifying their children using the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS). The second aim was to collate parents' recommendations for service providers on how to interact and communicate with families. A purposive sample of seven parents participating in the On Track study was recruited. Semi-structured interviews were conducted orally and were audiotaped, transcribed, and coded openly. A descriptive interpretive approach within a pragmatic perspective was used during analysis. Seven themes encompassing parents' experiences and perspectives reflect a process of increased understanding when classifying their children, with perceptions of utility evident throughout this process. Six recommendations for service providers emerged, including making the child a priority and being a dependable resource. Knowledge of parents' experiences when using the GMFCS, MACS, and CFCS can provide useful insight for service providers collaborating with parents to classify function in children with CP. Using the recommendations from these parents can facilitate family-provider collaboration for goal setting and intervention planning.

  2. Return-to-work intervention during cancer treatment - The providers' experiences

    DEFF Research Database (Denmark)

    Petersen, K S; Momsen, A H; Stapelfeldt, C M

    2018-01-01

    To explore in-depth understanding of providers' experiences when involved in a return-to-work (RTW) intervention offered during cancer treatment. Semi-structured individual interviews and participant observations at a hospital department and two municipal job centers were carried out, including ten...... providers (physicians, nurses and social workers). A phenomenological-hermeneutic approach was applied, involving coding, identification of themes and interpretation of findings. Three major themes were identified: Treatment first, Work as an integrated component in cancer rehabilitation, and Challenges...... in bringing up work issues. Differences in providers' experiences of the RTW intervention offered to cancer patients were found: in the hospital setting RTW was a second priority, whereas in the municipality job centers it was an integrated component. Further studies are needed to investigate how and when...

  3. Patient Experience Of Provider Refusal Of Medicaid Coverage And Its Implications.

    Science.gov (United States)

    Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

    2016-01-01

    Previous studies show that many physicians do not accept new patients with Medicaid coverage, but no study has examined Medicaid enrollees' actual experience of provider refusal of their coverage and its implications. Using the 2012 National Health Interview Survey, we estimate provider refusal of health insurance coverage reported by 23,992 adults with continuous coverage for the past 12 months. We find that among Medicaid enrollees, 6.73% reported their coverage being refused by a provider in 2012, a rate higher than that in Medicare and private insurance by 4.07 (p<.01) and 3.68 (p<.001) percentage points, respectively. Refusal of Medicaid coverage is associated with delaying needed care, using emergency room (ER) as a usual source of care, and perceiving current coverage as worse than last year. In view of the Affordable Care Act's (ACA) Medicaid expansion, future studies should continue monitoring enrollees' experience of coverage refusal.

  4. Containment integrity and leak testing. Procedures applied and experiences gained in European countries

    International Nuclear Information System (INIS)

    1987-01-01

    Containment systems are the ultimate safety barrier for preventing the escape of gaseous, liquid and solid radioactive materials produced in normal operation, not retained in process systems, and for keeping back radioactive materials released by system malfunction or equipment failure. A primary element of the containment shell is therefore its leak-tight design. The report describes the present containment concepts mostly used in European countries. The leak-testing procedures applied and the experiences gained in their application are also discussed. The report refers more particularly to pre-operational testing, periodic testing and extrapolation methods of leak rates measured at test conditions to expected leak rates at calculated accident conditions. The actual problems in periodic containment leak rate testing are critically reviewed. In the appendix to the report a summary is given of the regulations and specifications applied in different member countries

  5. Reaching an entrepreneurial management system of amoebas. A qualitative insight into the European experiences

    Directory of Open Access Journals (Sweden)

    Urban Wiesław

    2016-03-01

    Full Text Available The aim of the study is an assessment of the Amoeba Management System (AMS introduction advancements in some European companies. The study takes the practically focused research approach. The approaches, achievements and phases whilst introducing the AMS principles by companies are observed and critically assessed. First insight into the challenges of AMS introduction is taken basing on critical study of the literature output. The scientific studies and managerial publications are taken into consideration. The empirical part of the study is based on the qualitative approach. A multiple case study methodology is employed. The research objects are three companies, one of them operates in Sweden, the next two in Poland. Each of them have different experiences in AMS implementation, they also manifest different management styles and habits. The study demonstrates that AMS is a very prospective management methodology which can support companies in employees commitment during their journey towards operational excellence. The analysis results show different motivations for AMS introduction as well as different development paths, these are harmonized with different management styles in companies and culture occurring in countries. The study is particularly valuable because this is one of the first empirical investigations of AMS implementation in European companies. In the field of theory the study proposes the four level scale for amoebas system maturity. This scale allows to classify companies following AMS principles and, at the same time, this scale is also the kind of path of AMS implementation. The study points out basic tools for companies which support AMS implementation. These tools are already known in management literature, but experience of investigated companies shows that they are fundamental for successful AMS implementation.

  6. Drivers of decomposition in forest soils: Insights from a trans-European experiment.

    Science.gov (United States)

    Hood-Nowotny, Rebecca

    2017-04-01

    Meta-data analyses and the model based hypotheses state that global soil C storage is controlled by microbial scale processes of fungal competition for available nitrogen (N). The details of these microbe-dependent feedback mechanisms on N and C dynamics in European soils are largely unknown and contentious. Global trends of increasing atmospheric N deposition and the continuing use of inorganic N fertilizer in both agriculture and forestry mean that the soils vital function as a carbon sink is potentially under threat. We set out to experimentally investigate these hypotheses across a Trans-European gradient of forest soils and provide reliable information on soil microbial responses to nitrogen inputs for predictive climate change models. Changes in nutrient status could result in a chain reaction of interacting microbial mechanisms which in turn could lead to the shifts in underlying ecosystem biogeochemical process rates. Recent meta-analysis has shown that plant fungal symbiont community structure, exerts a greater fundamental control over soil C storage than temperature, precipitation or net primary production. Based on the hypothesis that plant associated fungi effectively scavenge all available organic and inorganic N leaving little N for the growth of the free-living decomposer microbial community and preventing further breakdown of SOM. To investigate these possible effects we have sampled forest soils across a trans European gradient (ALTER-net-MSII network) which have received additional inputs of inorganic nitrogen fertilizer or carbon in the form of sugar, over a three year period. We have studied both nitrogen and carbon dynamics in these systems using a tool box of stable isotopes, high through-put sequencing for microbial community analysis and be-spoke litter bags to tease out the dominant drivers of decomposition. The results and conclusions from these analyses will be presented.

  7. Young People's Preferences for Family Planning Service Providers in Rural Malawi: A Discrete Choice Experiment.

    Directory of Open Access Journals (Sweden)

    Christine Michaels-Igbokwe

    Full Text Available To quantify the impact of service provider characteristics on young people's choice of family planning (FP service provider in rural Malawi in order to identify strategies for increasing access and uptake of FP among youth.A discrete choice experiment was developed to assess the relative impact of service characteristics on preferences for FP service providers among young people (aged 15-24. Four alternative providers were included (government facility, private facility, outreach and community based distribution of FP and described by six attributes (the distance between participants' home and the service delivery point, frequency of service delivery, waiting time at the facility, service providers' attitude, availability of FP commodities and price. A random parameters logit model was used to estimate preferences for service providers and the likely uptake of services following the expansion of outreach and community based distribution (CBDA services. In the choice experiment young people were twice as likely to choose a friendly provider (government service odds ratio [OR] = 2.45, p<0.01; private service OR = 1.99, p<0.01; CBDA OR = 1.88, p<0.01 and more than two to three times more likely to choose a provider with an adequate supply of FP commodities (government service OR = 2.48, p<0.01; private service OR = 2.33, p<0.01; CBDA = 3.85, p<0.01. Uptake of community based services was greater than facility based services across a variety of simulated service scenarios indicating that such services may be an effective means of expanding access for youth in rural areas and an important tool for increasing service uptake among youth.Ensuring that services are acceptable to young people may require additional training for service providers in order to ensure that all providers are friendly and non-judgemental when dealing with younger clients and to ensure that supplies are consistently available.

  8. Healthcare Providers' Formative Experiences with Race and Black Male Patients in Urban Hospital Environments.

    Science.gov (United States)

    Plaisime, Marie V; Malebranche, David J; Davis, Andrea L; Taylor, Jennifer A

    2017-12-01

    We explored health providers' formative personal and professional experiences with race and Black men as a way to assess their potential influence on interactions with Black male patients. Utilizing convenience sampling with snowballing techniques, we identified healthcare providers in two urban university hospitals. We compared Black and White providers' experiences based on race and level of training. We used the Gardener's Tale to conceptualize how racism may lead to racial health disparities. A semi-structured interview guide was used to conduct in-person interviews (n = 16). Using the grounded theory approach, we conducted three types of coding to examine data patterns. We found two themes reflective of personally mediated racism: (1) perception of Black males accompanied by two subthemes (a) biased care and (b) fear and discomfort and (2) cognitive dissonance. While this latter theme is more reflective of Jones's internalized racism level, we present its results because its novelty is compelling. Perception of Black males and cognitive dissonance appear to influence providers' approaches with Black male patients. This study suggests the need to develop initiatives and curricula in health professional schools that address provider racial bias. Understanding the dynamics operating in the patient-provider encounter enhances the ability to address and reduce health disparities.

  9. Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse.

    Science.gov (United States)

    Eriksson, Irene; Lindblad, Monica; Möller, Ulrika; Gillsjö, Catharina

    2018-02-01

    Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system. To describe patients' experiences of health care provided by an APN in primary health care. An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze. The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care. The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context. © 2017 The Authors. International Journal of Nursing Practice Published by John Wiley & Sons Australia, Ltd.

  10. U.S. Taxation of Business: Relevance of the European Experience. German Studies Notes.

    Science.gov (United States)

    McLure, Charles E., Jr.

    American and European business taxation policies are compared in this booklet. Topics discussed in the paper include effects of the corporation income tax, integration of income taxation, and the value added tax. Two major differences between the American and European systems are noted. First, European countries derive substantial portions of…

  11. ICT Tools of Professional Teacher Activity: A Comparative Analysis of Russian and European Experience

    Directory of Open Access Journals (Sweden)

    Tatiana N.

    2018-03-01

    Full Text Available Introduction: electronic, distance and blended educational technologies are actively used in modern teaching and learning process. The relevance of the study is predetermined by the necessity to consolidate teachers’ competencies in the field of ICT tools. The purpose of the article is to study and compare the competences of Russian and European teachers in using pedagogical ICT tools. Materials and Methods: comparison and analysis of domestic and foreign pedagogical practices are used. Data was obtained with the help of elaborated questionnaires for teachers with sufficient experience in the use of ICT. Results: the results of a comparative analysis of data characterising the experience of pedagogical ICT tools application by teachers of Russian and foreign universities are presented. Similar trends and problem areas were identified. They relate both to the use of information technology and electronic educational resources and to the variability of the educational opportunities. The obtained results show that the educational request of students in the electronic environment is not always sufficiently recognised and taken into account by teachers. The revealed general directions of research in the area of ICT tools application in teaching activity indicate the tendencies of the integration of the Russian and European experience into the global information and educational space. Discussion and Conclusions: in summary, Russian and foreign teachers have similar competencies in the use of educational ICT tools. They apply the tools to the learning process with varying intensity depending on the experience of distance educational services implementation, the policy of an educational institution, and the awareness of the blended learning specifics. The practical significance of the results it the following: firstly, the directions that need to be strengthened in vocational training programs for future and practicing teachers are identified; secondly

  12. The AlpArray Seismic Network: A Large-Scale European Experiment to Image the Alpine Orogen

    Science.gov (United States)

    Hetényi, György; Molinari, Irene; Clinton, John; Bokelmann, Götz; Bondár, István; Crawford, Wayne C.; Dessa, Jean-Xavier; Doubre, Cécile; Friederich, Wolfgang; Fuchs, Florian; Giardini, Domenico; Gráczer, Zoltán; Handy, Mark R.; Herak, Marijan; Jia, Yan; Kissling, Edi; Kopp, Heidrun; Korn, Michael; Margheriti, Lucia; Meier, Thomas; Mucciarelli, Marco; Paul, Anne; Pesaresi, Damiano; Piromallo, Claudia; Plenefisch, Thomas; Plomerová, Jaroslava; Ritter, Joachim; Rümpker, Georg; Šipka, Vesna; Spallarossa, Daniele; Thomas, Christine; Tilmann, Frederik; Wassermann, Joachim; Weber, Michael; Wéber, Zoltán; Wesztergom, Viktor; Živčić, Mladen

    2018-04-01

    The AlpArray programme is a multinational, European consortium to advance our understanding of orogenesis and its relationship to mantle dynamics, plate reorganizations, surface processes and seismic hazard in the Alps-Apennines-Carpathians-Dinarides orogenic system. The AlpArray Seismic Network has been deployed with contributions from 36 institutions from 11 countries to map physical properties of the lithosphere and asthenosphere in 3D and thus to obtain new, high-resolution geophysical images of structures from the surface down to the base of the mantle transition zone. With over 600 broadband stations operated for 2 years, this seismic experiment is one of the largest simultaneously operated seismological networks in the academic domain, employing hexagonal coverage with station spacing at less than 52 km. This dense and regularly spaced experiment is made possible by the coordinated coeval deployment of temporary stations from numerous national pools, including ocean-bottom seismometers, which were funded by different national agencies. They combine with permanent networks, which also required the cooperation of many different operators. Together these stations ultimately fill coverage gaps. Following a short overview of previous large-scale seismological experiments in the Alpine region, we here present the goals, construction, deployment, characteristics and data management of the AlpArray Seismic Network, which will provide data that is expected to be unprecedented in quality to image the complex Alpine mountains at depth.

  13. The effect of providing free autopoweroff plugs to households on electricity consumption - a field experiment

    DEFF Research Database (Denmark)

    Jensen, Carsten Lynge; Hansen, Lars Gårn; Fjordbak, Troels

    on metered electricity consumption for different types of households. We find effects for single men and couples without children, while we find no effect for single women and households with children. We suggest that this could be because of differences in saving potential (e.g. some households do not have......Experimental evidence of the effect of providing cheap energy saving technology to households is sparse. We present results from a field experiment in which autopoweroff plugs are provided free of charge to randomly selected households. We use propensity score matching to find treatment effects...... increase efficiency of programmes....

  14. Experiences and perspectives of African American, Latina/o, Asian American, and European American psychology graduate students: A national study.

    Science.gov (United States)

    Maton, Kenneth I; Wimms, Harriette E; Grant, Sheila K; Wittig, Michele A; Rogers, Margaret R; Vasquez, Melba J T

    2011-01-01

    A national, Web-based survey of 1,219 African American, Latina/o, Asian American, and European American psychology graduate students revealed both similarities and differences in experiences and perspectives. Mentoring was found to be the strongest predictor of satisfaction across groups. Academic supports and barriers, along with perceptions of diversity within the academic environment, were also important predictors of satisfaction. Students of color perceived less fairness of representation of their ethnic group within psychology than European American students, and a greater linkage between aspects of the graduate school experience and their ethnicity. Limitations of the study and implications for future research and action are discussed.

  15. Population Trends of Central European Montane Birds Provide Evidence for Adverse Impacts of Climate Change on High-Altitude Species.

    Directory of Open Access Journals (Sweden)

    Jiří Flousek

    Full Text Available Climate change is among the most important global threats to biodiversity and mountain areas are supposed to be under especially high pressure. Although recent modelling studies suggest considerable future range contractions of montane species accompanied with increased extinction risk, data allowing to test actual population consequences of the observed climate changes and identifying traits associated to their adverse impacts are very scarce. To fill this knowledge gap, we estimated long-term population trends of montane birds from 1984 to 2011 in a central European mountain range, the Giant Mountains (Krkonoše, where significant warming occurred over this period. We then related the population trends to several species' traits related to the climate change effects. We found that the species breeding in various habitats at higher altitudes had more negative trends than species breeding at lower altitudes. We also found that the species moved upwards as a response to warming climate, and these altitudinal range shifts were associated with more positive population trends at lower altitudes than at higher altitudes. Moreover, long-distance migrants declined more than residents or species migrating for shorter distances. Taken together, these results indicate that the climate change, besides other possible environmental changes, already influences populations of montane birds with particularly adverse impacts on high-altitude species such as water pipit (Anthus spinoletta. It is evident that the alpine species, predicted to undergo serious climatically induced range contractions due to warming climate in the future, already started moving along this trajectory.

  16. Risk perception, experience, and objective risk: a cross-national study with European emergency survivors.

    Science.gov (United States)

    Knuth, Daniela; Kehl, Doris; Hulse, Lynn; Schmidt, Silke

    2014-07-01

    Understanding public risk perceptions and their underlying processes is important in order to learn more about the way people interpret and respond to hazardous emergency events. Direct experience with an involuntary hazard has been found to heighten the perceived risk of experiencing the same hazard and its consequences in the future, but it remains unclear if cross-over effects are possible (i.e., experience with one hazard influencing perceived risk for other hazards also). Furthermore, the impact of objective risk and country of residence on perceived risk is not well understood. As part of the BeSeCu (Behavior, Security, and Culture) Project, a sample of 1,045 survivors of emergencies from seven European countries (i.e., Germany, the Czech Republic, Poland, Sweden, Spain, Turkey, and Italy) was drawn. Results revealed heightened perceived risk for emergency events (i.e., domestic and public fires, earthquakes, floods, and terrorist attacks) when the event had been experienced previously plus some evidence of cross-over effects, although these effects were not so strong. The largest country differences in perceived risk were observed for earthquakes, but this effect was significantly reduced by taking into account the objective earthquake risk. For fires, floods, terrorist attacks, and traffic accidents, only small country differences in perceived risk were found. Further studies including a larger number of countries are welcomed. © 2013 Society for Risk Analysis.

  17. [European Marketing Authorisation: a long process. Experiences of small biotech companies with the ATMP regulation].

    Science.gov (United States)

    Buljovčić, Z

    2011-07-01

    On 30 December 2008, the Regulation (EC) 1394/2007 on advanced therapy medicinal products (ATMPs) entered into force. Herewith the first EU-wide regulatory framework for ATMPs was established. It requires a central marketing authorisation application to the EMA (European Medicinal Agency). This new framework especially changes the code of regulatory practice for tissue engineered products (TEPs), as no registration procedure had been previously required for autologous TEPs. This also meant that no clinical proof of efficacy achieved by a pivotal clinical trial was necessary. Difficulties and their background as well as the vast requirements for product development that have to be addressed by small companies within a very short time frame are presented. Hereby, it is obvious that regulatory experience which is required to identify and implement the resulting implications was not in place yet and still had to be established. The lack of regulatory experience also resulted in difficulties with scientific advice preparation, expectations toward regulatory agencies, consultants, and transformation of regulatory requirements. Addressing the regulatory requirements within the transition period is even more difficult for entrepreneurs with products which are assigned for indications resulting in complex challenges to the trial design. Due to the enormous time pressure to generate data and due to the implied financial pressure, different adaptation strategies are evolving. In Germany the "hospital exemption" according to §4b AMG (German Medicinal Products Law) is of major importance. A reorientation toward acellular products and a slow down in development of new ATMP products is expected.

  18. Experience with the european quality assurance guidelines for digital mammography systems in a national screening programme

    International Nuclear Information System (INIS)

    McCullagh, J.; Keavey, E.; Egan, G.; Phelan, N.

    2013-01-01

    The transition to a fully digital breast screening programme, utilising three different full-field digital mammography (FFDM) systems has presented many challenges to the implementation of the European guidelines for physico-technical quality assurance (QA) testing. An analysis of the QA results collected from the FFDM systems in the screening programme over a 2-y period indicates that the three different systems have similar QA performances. Generally, the same tests were failed by all systems and failure rates were low. The findings provide some assurance that the QA guidelines are being correctly implemented. They also suggest that there is more scope for the development of the relevance of the guidelines with respect to modern FFDM systems. This study has also shown that a summary review of the QA data can be achieved by simple organisation of the QA data storage and by automation of data query and retrieval using commonly available software. (authors)

  19. Impact of the European Working Time Directive (EWTD) on the operative experience of surgery residents.

    Science.gov (United States)

    Hopmans, Cornelis J; den Hoed, Pieter T; van der Laan, Lijckle; van der Harst, Erwin; van der Elst, Maarten; Mannaerts, Guido H H; Dawson, Imro; Timman, Reinier; Wijnhoven, Bas P L; IJzermans, Jan N M

    2015-04-01

    In Europe and the United States, work hour restrictions are considered to be particularly burdensome for residents in surgery specialties. The aim of this study was to examine whether reduction of the work week to 48 hours resulting from the implementation of the European Working Time Directive has affected the operative experience of surgery residents. This study was conducted in a general surgery training region in the Netherlands, consisting of 1 university hospital and 6 district training hospitals. Operating records summarizing the surgical procedures performed as "primary surgeon" in the operating theater for different grades of surgeons were retrospectively analyzed for the period 2005-2012 by the use of linear regression models. Operative procedures performed by residents were considered the main outcome measure. In total, 235,357 operative procedures were performed, including 47,458 (20.2%) in the university hospital and 187,899 (79.8%) in the district training hospitals (n = 5). For residents in the university hospital, the mean number of operative procedures performed per 1.0 full-time equivalent increased from 128 operations in 2005 to 204 operations in 2012 (P = .001), whereas for residents in district training hospitals, no substantial differences were found over time. The mean (±SD) operative caseload of 64 residents who completed the 6-year training program between 2005 and 2012 was 1,391 ± 226 (range, 768-1856). A comparison of the operative caseload according to year of board-certification showed no difference. Implementation of the European Working Time Directive has not affected adversely the number of surgical procedures performed by residents within a general surgical training region in the Netherlands. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Malaysian government dentists' experience, willingness and barriers in providing domiciliary care for elderly people.

    Science.gov (United States)

    Othman, Akmal Aida; Yusof, Zamros; Saub, Roslan

    2014-06-01

    To assess Malaysian government dentists' experience, willingness and barriers in providing domiciliary care for elderly people. A descriptive cross-sectional study was conducted using a self-administered postal questionnaire targeting government dentists working in the Ministry of Health in Peninsular Malaysia. Seven hundred and eleven out of 962 dentists responded with a response rate of 74.0%. Only 36.1% of the dentists had experience in providing domiciliary care for elderly people in the past 2 years with mean number of visit per year of 1. Younger dentists below the age of 30 and those with confidence in providing the service were the most willing to undertake domiciliary care for elderly patients (OR=13.5, pworking condition (64.4%). The majority of Malaysian government dentists had not been involved in providing domiciliary care for elderly patients. Apart from overcoming the barriers, other recommendations include improving undergraduate dental education, education for elderly people and carers, improving dentist's working condition, and introducing domiciliary financial incentive for dentist. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

  1. Rapid prototyping, astronaut training, and experiment control and supervision: distributed virtual worlds for COLUMBUS, the European Space Laboratory module

    Science.gov (United States)

    Freund, Eckhard; Rossmann, Juergen

    2002-02-01

    In 2004, the European COLUMBUS Module is to be attached to the International Space Station. On the way to the successful planning, deployment and operation of the module, computer generated and animated models are being used to optimize performance. Under contract of the German Space Agency DLR, it has become IRF's task to provide a Projective Virtual Reality System to provide a virtual world built after the planned layout of the COLUMBUS module let astronauts and experimentators practice operational procedures and the handling of experiments. The key features of the system currently being realized comprise the possibility for distributed multi-user access to the virtual lab and the visualization of real-world experiment data. Through the capabilities to share the virtual world, cooperative operations can be practiced easily, but also trainers and trainees can work together more effectively sharing the virtual environment. The capability to visualize real-world data will be used to introduce measured data of experiments into the virtual world online in order to realistically interact with the science-reference model hardware: The user's actions in the virtual world are translated into corresponding changes of the inputs of the science reference model hardware; the measured data is than in turn fed back into the virtual world. During the operation of COLUMBUS, the capabilities for distributed access and the capabilities to visualize measured data through the use of metaphors and augmentations of the virtual world may be used to provide virtual access to the COLUMBUS module, e.g. via Internet. Currently, finishing touches are being put to the system. In November 2001 the virtual world shall be operational, so that besides the design and the key ideas, first experimental results can be presented.

  2. The experiences of midwives and nurses collaborating to provide birthing care: a systematic review.

    Science.gov (United States)

    Macdonald, Danielle; Snelgrove-Clarke, Erna; Campbell-Yeo, Marsha; Aston, Megan; Helwig, Melissa; Baker, Kathy A

    2015-11-01

    Collaboration has been associated with improved health outcomes in maternity care. Collaborative relationships between midwives and physicians have been a focus of literature regarding collaboration in maternity care. However despite the front line role of nurses in the provision of maternity care, there has not yet been a systematic review conducted about the experiences of midwives and nurses collaborating to provide birthing care. The objective of this review was to identify, appraise and synthesize qualitative evidence on the experiences of midwives and nurses collaborating to provide birthing care.Specifically, the review question was: what are the experiences of midwives and nurses collaborating to provide birthing care? This review considered studies that included educated and licensed midwives and nurses with any length of practice. Nurses who work in labor and delivery, postpartum care, prenatal care, public health and community health were included in this systematic review.This review considered studies that investigated the experiences of midwives and nurses collaborating during the provision of birthing care. Experiences, of any duration, included any interactions between midwives and nurses working in collaboration to provide birthing care.Birthing care referred to: (a) supportive care throughout the pregnancy, labor, delivery and postpartum, (b) administrative tasks throughout the pregnancy, labor, delivery and postpartum, and (c) clinical skills throughout the pregnancy, labor, delivery and postpartum. The postpartum period included the six weeks after delivery.The review considered English language studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research.This review considered qualitative studies that explored the experiences of collaboration in areas where midwives and nurses work together. Examples of these areas included: hospitals

  3. Provider training and experience for people living with HIV/AIDS.

    Science.gov (United States)

    Rackal, Julia M; Tynan, Anne-Marie; Handford, Curtis D; Rzeznikiewiz, Damian; Agha, Ayda; Glazier, Richard

    2011-06-15

    The complexity of HIV/AIDS raises challenges for the effective delivery of care. It is important to ensure that the expertise and experience of care providers is of high quality. Training and experience of HIV/AIDS providers may impact not only individual patient outcomes but increasingly on health care costs as well. The objective of this review is to assess the effects of provider training and experience on people living with HIV/AIDS on the following outcomes: immunological (ie. viral load, CD4 count), medical (ie. mortality, proportion on antiretrovirals), psychosocial (ie. quality of life measures) and economic outcomes (ie health care costs). We searched MEDLINE, EMBASE, Dissertation Abstracts International (DAI), CINAHL, HealthStar, PsycInfo, PsycLit, Social Sciences Abstracts, and Sociological Abstracts from January 1, 1980 through May 29, 2009.  Electronic searches were performed for abstracts from major international AIDS conferences. Reference lists from pertinent articles, books and review articles were retrieved and reviewed. Randomized controlled trials (RCTs), controlled clinical trials, cohort, case control, cross-sectional studies and controlled before and after designs that examined the qualifications/training and patient volume of HIV/AIDS care of providers caring for persons known to be infected with HIV/AIDS were included. At least two authors independently assessed trial quality and extracted data. Study authors were contacted for further information as required. Assessment of confounding factors was undertaken independently by two reviewers. A total of four studies (one randomized controlled trial, three non- randomized studies) involving 8488 people living with HIV/AIDS were included. The main findings of this review demonstrated a trend to improved outcomes when treated by a provider with more training/expertise in HIV/AIDS care in the outpatient (clinic) setting. Due to the heterogeneity of the included studies, we could not perform a

  4. The Lived Experience of Providing Care and Support Services for Holocaust Survivors in Australia.

    Science.gov (United States)

    Teshuva, Karen; Borowski, Allan; Wells, Yvonne

    2017-06-01

    Lack of awareness among paid carers of the possible late-life consequences of early-life periods of extreme and prolonged traumatization may have negative impacts on the experiences of trauma survivors in receiving care. An interpretive phenomenological approach was used to investigate the lived experience of paid carers in providing care for Jewish Holocaust survivors. In total, 70 carers participated in 10 focus group discussions. Credibility of the findings was ensured by methodological triangulation and peer debriefing. Three major themes emerged: (a) knowing about survivors' past helps me make sense of who they are, (b) the trauma adds an extra dimension to caregiving, and (c) caring for survivors has an emotional impact. Specific knowledge, attitudes, and skills for building positive care relationships with Holocaust survivors were identified. The findings offer a starting point for advancing knowledge about the care of older survivors from other refugee backgrounds.

  5. Experience of plastic surgery registrars in a European Working Time Directive compliant rota.

    Science.gov (United States)

    de Blacam, Catherine; Tierney, Sean; Shelley, Odhran

    2017-08-01

    Surgical training requires exposure to clinical decision-making and operative experience in a supervised environment. It is recognised that learning ability is compromised when fatigued. The European Working Time Directive requires a decrease in working hours, but compliance reduces trainees' clinical exposure, which has profound implications for plastic surgery training. The aim of this study was to evaluate plastic surgery registrars' experience of an EWTD-compliant rota, and to examine its impact on patient care, education, and logbook activity. An electronic survey was distributed to plastic surgery registrars in a university teaching hospital. Registrars were asked to rate 31 items on a five-point Likert scale, including statements on patient care, clinical and operative duties, training, and quality-of-life. Interquartile deviations explored consensus among responses. Operative caseload was objectively evaluated using eLogbook data to compare activity at equal time points before and after implementation of the EWTD rota. Highest levels of consensus among respondents were found in positive statements addressing alertness and preparation for theatre, as well as time to read and study for exams. Registrars agreed that EWTD compliance improved their quality-of-life. However, it was felt that continuity of patient care was compromised by work hours restriction. Registrars were concerned about their operative experience. eLogbook data confirmed a fall-off in mean caseload of 31.8% compared to activity prior to EWTD rota implementation. While EWTD compliant rotas promote trainee quality-of-life and satisfaction with training, attention needs to be paid to optimising operative opportunities.

  6. Competence in providing mental health care: a grounded theory analysis of nurses' experiences.

    Science.gov (United States)

    Sharrock, Julie; Happell, Brenda

    In view of the evidence that general nurses have difficulty in caring for patients experiencing mental health problems, the aim of this study was to explore and describe the subjective experience of nurses in providing care for this client group. A grounded theory approach was used. The data were collected via semi-structured individual interviews and analysed using the constant comparative method. The study was conducted with nurses from general health care settings that provide medical and surgical care and treatment. Four nurses who were completing their second year post graduation participated in the study. The experiences of providing care for people experiencing a mental illness as described by participants. The findings indicated the nurses were striving for competence in the provision of mental health care. They acknowledged the mental health needs of patients and their right to quality care. This study supports the notion that general nurses lack confidence when caring for patients with mental health problems in medical and surgical settings. It also highlights a discrepancy between the holistic framework encouraged at undergraduate level and what is experienced in practice.

  7. Life Experience of Parents with Amblyopic Children in Contact with Health Care Providers

    Directory of Open Access Journals (Sweden)

    Mohammad Kamali

    2009-10-01

    Full Text Available Objectives: Amblyopia is most common binocular vision anomalies. To comprise is decrease of visual acuity witch doesn't remove by optical correction. Nowadays because of the psychosocial problem with amblyopia, is a functional disability. Awareness of parents of children with amblyopic life experience, when facing with curing system can provide effective for promotion of self-assessment, treatment and rehabilitation. Methods: To explore parent's experience in relation with health care provider utilize a qualitative study with phenomenological method. This study involving semi-structured on-depth interviews with 9 parents of child with amblyopia. Interviews were tape recorded. Data analysis was based on Van manen method. Results: Parents of children describe five subjects in relation with health care providers include: on time and correct diagnosis, consultation, therapist's behavior, change the therapist and visual screening. Discussion: This study indicates that on time diagnosis and intervention, therapists appropriate behavior, consultation and prescribe an appropriate treatment can effect on parental and child acceptance and successful treatment.

  8. Experience of family members providing care for HIV-exposed children: beginning of the trajectory

    Directory of Open Access Journals (Sweden)

    Willyane de Andrade Alvarenga

    Full Text Available During and after pregnancy, mothers with HIV can undergo treatment that is capable of preventing vertical transmission (VT to their babies. The purpose of this study was to analyze the experience of family members that provide care for children whose mothers have HIV, to reduce the risk of VT, with emphasis on the beginning of this trajectory. This study was based on the qualitative approach and Symbolic Interactionism was adopted as a theoretical framework. A total of 36 family members participated in the study, all of whom were carers of children aged up to 18 months and waiting for confirmation of the HIV diagnosis. Data were collected in a hospital in north-eastern Brazil, between December 2012 and February 2013, and examined by means of content analysis. Child care began during pregnancy, when the possibility of the child having HIV was expected. Some had previous experience in providing care for exposed children. Understanding the early trajectory of care will help find ways to provide better support for carers during the trajectory of diagnosis confirmation.

  9. How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

    Science.gov (United States)

    2013-01-01

    Background Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. Methods The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. Results One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. Conclusion General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management

  10. How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

    Directory of Open Access Journals (Sweden)

    Jensen Natasja Koitzsch

    2013-01-01

    Full Text Available Abstract Background Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. Methods The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE. Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. Results One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. Conclusion General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy

  11. Towards a higher energy efficiency and lower carbon society the European approach and experience

    International Nuclear Information System (INIS)

    Hein, Klaus R.G.

    2010-01-01

    strategic considerations and the political intentions of the European Union an overview of the present situation with regard to fuel conversion and environmental protection technologies including the greenhouse issue will be provided. Special attention will be given to recent advances in fuel conversion processes on industrial scale using solid fuels, biomass, biogenic wastes and natural gas in direct combustion and in integrated combined cycles followed by highlights of corresponding ongoing research and development activities. The presentation will finish with an outlook to the future energy scene in Europe and a comparison with other regions of the world. (author)

  12. Primary care providers' experiences caring for complex patients in primary care: a qualitative study.

    Science.gov (United States)

    Loeb, Danielle F; Bayliss, Elizabeth A; Candrian, Carey; deGruy, Frank V; Binswanger, Ingrid A

    2016-03-22

    Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care. Using a general inductive approach, our qualitative research study was guided by an interpretive epistemology, or way of knowing. Our method for understanding included semi-structured in-depth interviews with internal medicine PCPs from two university-based and three community health clinics. We developed an interview guide, which included questions on PCPs' experiences, perceived system barriers and facilitators, and strategies to improve their ability to effectively treat complex patients. To focus interviews on real cases, providers were asked to bring de-identified clinical notes from patients they considered complex to the interview. Interview transcripts were coded and analyzed to develop categories from the raw data, which were then conceptualized into broad themes after team-based discussion. PCPs (N = 15) described complex patients with multidimensional needs, such as socio-economic, medical, and mental health. A vision of optimal care emerged from the data, which included coordinating care, preventing hospitalizations, and developing patient trust. PCPs relied on professional values and individual care strategies to overcome local and system barriers. Team based approaches were endorsed to improve the management of complex patients. Given the barriers to effective care described by PCPs, individual PCP efforts alone are unlikely to meet the needs of complex patients. To fulfill PCP's expressed concepts of

  13. Loads Providing Ancillary Services: Review of InternationalExperience-- Technical Appendix: Market Descriptions

    Energy Technology Data Exchange (ETDEWEB)

    Grayson Heffner, Charles Goldman, Kintner-Meyer, M; Kirby, Brendan

    2007-05-01

    In this study, we examine the arrangements for andexperiences of end-use loads providing ancillary services (AS) in fiveelectricity markets: Australia, the United Kingdom (UK), the Nordicmarket, and the ERCOT and PJM markets in the United States. Our objectivein undertaking this review of international experience was to identifyspecific approaches or market designs that have enabled customer loads toeffectively deliver various ancillary services (AS) products. We hopethat this report will contribute to the ongoing discussion in the U.S.and elsewhere regarding what institutional and technical developments areneeded to ensure that customer loads can meaningfully participate in allwholesale electricity markets.

  14. The experiences of pediatric social workers providing end-of-life care.

    Science.gov (United States)

    Muskat, Barbara; Brownstone, David; Greenblatt, Andrea

    2017-07-01

    Pediatric social workers working in acute care hospital settings may care for children and their families in end-of-life circumstances. This qualitative study is part of a larger study focusing on the experiences of health care providers working with dying children. This study consisted of 9 semi-structured interviews of acute care pediatric social workers who work with dying children and their families. Themes included the role of social work with dying children, the impact of their work and coping strategies. Authors suggest a hospital-worker partnership in supporting staff and promotion of supportive resources.

  15. The price of policy risk — Empirical insights from choice experiments with European photovoltaic project developers

    International Nuclear Information System (INIS)

    Lüthi, Sonja; Wüstenhagen, Rolf

    2012-01-01

    Managing the transition to a renewable energy future is an important policy priority in many countries. Solar photovoltaic (PV) technology is expected to make an essential contribution, but due to relatively high cost, its growth to date has been largely driven by public policy, notably feed-in tariffs. Feed-in tariffs have been implemented in various countries, but with widely differing outcomes in terms of installed PV capacity. Previous research indicates that the level of policy risk may be an important driver for differences in renewable energy policy effectiveness. This paper suggests that project developers who make a decision between PV investment opportunities in different countries carefully weigh feed-in tariff-induced returns against a set of policy risks, and choose the country with the most favorable risk-return profile. This model is empirically tested by a stated preference survey among European PV project developers, consisting of 1575 choice decisions by 63 investors. The findings demonstrate that risk matters in PV policy design, and that a “price tag” can be attached to specific policy risks, such as the duration of administrative processes or uncertainty induced by an approaching capacity cap. Governments can build on these empirical results to design policies that will be effective in attracting private PV investment, while at the same time maintaining efficiency by providing an adequate compensation for policy risk. - Highlights: ► This study is based on 1575 choice and rating decisions made by 63 European PV project developers. ► This study confirms importance of “non-economic” barriers to deployment of renewable energy. ► This study measures “price of policy risk”, i.e. investors' willingness-to-accept certain policy risks.

  16. EUROPEAN EXPERIENCE OF SOCIAL PARTNERSHIP IN THE LABOUR FIELD: PERSPECTIVES FOR THE REPUBLIC OF MOLDOVA

    Directory of Open Access Journals (Sweden)

    Irina Nicolaescu

    2012-06-01

    Full Text Available European integration is not a slogan, a political discourse or a foundation for the political platform of political parties. European integration includes concrete directives of action to be taken into account by all states. One of the most important of them might be considered the social partnership in the labour field. Under current circumstances, the need to study relations established within social partnership, factors contributing to social dialogue development and fulfillment of social partnership potential within existing political and socio-economic reforms increased. Analysis of European dimension of Moldovan social partnership evolution is essential for further democratization of labour field and European perspectives of the country.

  17. Introduction to the special issue on experiences with the impact and prevention of subsoil compaction in the European Union

    NARCIS (Netherlands)

    Akker, van den J.J.H.; Arvidsson, J.; Horn, R.

    2003-01-01

    The papers in this special issue present results of the European Union (EU) concerted action ¿Experiences with the impact of subsoil compaction on soil crop growth and environment and ways to prevent subsoil compaction¿. The results and conclusions of earlier research on subsoil compaction are

  18. Use of Simulation in Nursing Education: Initial Experiences on a European Union Lifelong Learning Programme--Leonardo Da Vinci Project

    Science.gov (United States)

    Terzioglu, Fusun; Tuna, Zahide; Duygulu, Sergul; Boztepe, Handan; Kapucu, Sevgisun; Ozdemir, Leyla; Akdemir, Nuran; Kocoglu, Deniz; Alinier, Guillaume; Festini, Filippo

    2013-01-01

    Aim: The aim of this paper is to share the initial experiences on a European Union (EU) Lifelong Learning Programme Leonardo Da Vinci Transfer of Innovation Project related to the use of simulation-based learning with nursing students from Turkey. The project started at the end of the 2010 involving 7 partners from 3 different countries including…

  19. Value and Benefits of European Student Mobility for Romanian Students: Experiences and Perspectives of Participants in the ERASMUS Programme

    Science.gov (United States)

    Salajan, Florin D.; Chiper, Sorina

    2012-01-01

    This article reports on the experiences and perspectives of Romanian students participating in the ERASMUS Programme, regarding the benefits and value of academic mobility. It situates their accounts in the framework of internationalization and Europeanization processes occurring in Romanian higher education. The study draws on primary data…

  20. Experience of Forming Professional and Communicative Competency of Future Social Workers in Education Systems of Western European Countries

    Science.gov (United States)

    Baranyuk, Vita

    2015-01-01

    The article analyzes the experience of forming professional and communicative competency of future social workers in the education systems of Western European countries, in particular, France, Germany and Switzerland. On the basis of generalization of the studied data it has been found out that each country has its own techniques of forming…

  1. Healthcare providers' experiences of working with alcohol addiction treatment in Thailand.

    Science.gov (United States)

    Hanpatchaiyakul, Kulnaree; Eriksson, Henrik; Kijsomporn, Jureerat; Östlund, Gunnel

    2016-02-01

    The high prevalence of alcohol consumption, together with its associated health risk factors, has long-term negative impacts on both society and the economy in Thailand. The aim of this study was to explore the experiences of healthcare providers working with people experiencing alcohol addiction and the treatment programs in a Thai hospital. Qualitative study was applied in this study by conducting focus group interviews with 32 interdisciplinary healthcare providers, most of which were nurses. Content analysis was applied to analyze the verbatim-transcribed data. Two main topics emerged: (1) the collaborative practices related to alcohol treatment, and (2) the fit of the program, including how the treatment program functions. Obstacles were identified and formulated from several sub-categories. The findings included obstacles linked to the imported (Western) program and the patriarchal structure in Thai culture, which seem to intersect and reinforce each other.

  2. Pregnancy planning and risk behaviours - a survey of women's experiences in selected European countries.

    Science.gov (United States)

    Lesińska-Sawicka, Małgorzata; Nagórska, Małgorzata

    2018-03-14

    Pregnancy, a special period in a woman's life, should be preceded by proper preparation: a positive attitude to procreation, selection of optimum time for becoming pregnant, starting prevention of neural tube defects, restriction of the use of drugs, smoking, etc. The aim of this study was to determine the effect of pregnancy planning and antenatal classes on the use of stimulants during pregnancy. The study group included 877 women living in 7 European countries, and their experiences of planning pregnancy and substance abuse during pregnancy were investigated. In about a half (50.3%) of respondents the pregnancy was planned. The highest percentage of mothers who planned pregnancy was recorded in Poland and Bulgaria (about 76%). By contrast, in Germany the proportion of mothers who planned pregnancy was the lowest (46.2%). Surprisingly, they became pregnant despite very frequent use of birth control (96.7%). On average, 17.3% of respondents disclosed that they drank alcohol or coffee, smoked cigarettes or used psychoactive drugs during pregnancy. Among women who did not plan to be pregnant, the use of stimulants was recorded more often. However, pregnancy planning only slightly inclined women to stop the consumption of stimulants. Attendance at antenatal classes did not have any significant effect on the use of stimulants.

  3. [Recent developments on the European ban on animal experiments for cosmetics].

    Science.gov (United States)

    Ruhdel, I W

    2001-01-01

    For the second time the European Commission has postponed the sales ban on cosmetics products that have been developed and tested in animal experiments now until 2002. In the meantime the Commission wants to adopt the Seventh Amendment of the EU Cosmetics Directive. In its draft the Commission proposes to scrap the sales ban and replace it with an animal testing ban. This change would avoid possible conflicts with the WTO, however, from the animal welfare point of view would result in animal testing moving into third countries instead of avoiding them. This is because cosmetics products tested on animals outside the EU could be sold in the EU without any restrictions. As a consequence this measure would take the pressure from authorities and industry to further develop and adopt alternative methods. Other proposed measures are not acceptable from the animal welfare point of view, e.g. because they contradict Directive 86/609 and would result in a delay of the application of validated alternative methods. The Deutscher Tierschutzbund therefore still demands an immediate and complete sales ban in connection with an animal testing ban within the EU.

  4. Shielding benchmark experiments and sensitivity studies in progress at some European laboratories

    International Nuclear Information System (INIS)

    Hehn, G.; Mattes, M.; Matthes, W.; Nicks, R.; Rief, H.

    1975-01-01

    A 100 group standard library based on ENDF/B3 has been prepared by IKE and JRC. This library is used for the analysis of the current European and Japanese iron benchmark experiments. Further measurements are planned for checking the data sets for graphite, sodium and water. In a cooperation between the IKE and JRC groups coupled neutron-photon cross section sets will be produced. Point data are processed at IKE by the modular program system RSYST (CDC 6600) for elaborating the ENDFB data, whereas the JRC group, apart from using standard codes such as SUPERTOG 3, GAMLEG etc., has developed a series of auxiliary programs (IBM 360) for handling the DLC 2D and POPOP libraries and for producing the combined neutron-plus gamma library EL4 (119 groups). Sensitivity studies (in progress at IKE) make possible improvements in methods and optimization of calculation efforts for establishing group data. A tentative sensitivity study for a 3 dimensional MC approach is in progress at Ispra. As for nuclear data evaluation, the JRC group is calculating barium cross sections and their associated gamma spectra. 6 figures

  5. Providing pervasive Learning eXperiences by Combining Internet of Things and e-Learning standards

    Directory of Open Access Journals (Sweden)

    Aroua TAAMALLAH

    2015-12-01

    Full Text Available Nowadays, learning is more and more taking place anywhere and anytime. This implies that e-learning environments are expanded from only virtual learning environments to both virtual and physical ones. Thanks to the evolution of Internet, ICT (Information and Communication Technology and Internet of Things, new learning scenarios could be experienced by learners either individually or collaboratively. These learning scenarios are Pervasive in such a way that they allow to mix virtual and physical learning environments as well. They are therefore characterized by possible interactions of the learner with the physical environment, the Learner's contextual data detection as well as the adaptation of pedagogical strategies and services according to this context. This paper aims to take advantage of this trend and keep up also with existing e-Learning standards such as IMS LD and LOM. The solution proposed is therefore to extend these standards models with that of Internet of Things and to provide an adaptation approach of learning activities based on learner's context and her/his track using the eXperience API. In this context and in order to allow both reasoning capabilities and interoperability between the proposed models Ontological representations and implementation are therefore proposed. Moreover a technical architecture highlighting the required software components and their interactions is provided. And finally, a relevant pervasive learning scenario is implemented and experimented.

  6. Fast and high-energy neutron detection with nuclear track detectors: Results of the European joint experiments 1992/93

    Energy Technology Data Exchange (ETDEWEB)

    Schraube, H. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany); Alberts, W.G. [Physikalisch-Technische Bundesanstalt, Braunschweig (Germany); Weeks, A.R. [comps.] [Nuclear Electric plc, Berkeley (United Kingdom). Berkeley Technology Centre

    1997-12-31

    Under the auspices of EURADOS, the European radiation dosimetry group, seventeen recognised laboratories engaged in the field of individual neutron dosimetry with passive track detectors participated in an international comparative experiment. A number of twenty-seven detector systems, predominantly etched track detectors with the material PADC (poly allyl diglycol carbonate), were employed by the participating laboratories. Quasi-monoenergetic neutrons were provided for irradiations free-in-air and on front of a PMMA phantom by the GSF (Forschungszentrum fuer Umwelt und Gesundheit, Neuherberg, Germany) and by the PTB (Physikalisch-Technische Bundesanstalt, Braunschweig, Germany). High energy irradiations were conducted by the PSI (Paul-Scherrer Institut, Villigen, Switzerland). The results of the on-phantom irradiations were used to derive energy and angular responses of the track detectors, those of the free-in-air irradiations to obtain data for the linearity characteristics of the response with dose. The report contains a short description and the original data of the participating laboratories, displays the irradiation and reference conditions, and provides an over-all evaluation. Emphasis is placed on the quantitative evaluation of the background characteristics and of the non-linearity observed with most of the systems employed which limits their useful dose-range of application. (orig.)

  7. Envri Cluster - a Community-Driven Platform of European Environmental Researcher Infrastructures for Providing Common E-Solutions for Earth Science

    Science.gov (United States)

    Asmi, A.; Sorvari, S.; Kutsch, W. L.; Laj, P.

    2017-12-01

    European long-term environmental research infrastructures (often referred as ESFRI RIs) are the core facilities for providing services for scientists in their quest for understanding and predicting the complex Earth system and its functioning that requires long-term efforts to identify environmental changes (trends, thresholds and resilience, interactions and feedbacks). Many of the research infrastructures originally have been developed to respond to the needs of their specific research communities, however, it is clear that strong collaboration among research infrastructures is needed to serve the trans-boundary research requires exploring scientific questions at the intersection of different scientific fields, conducting joint research projects and developing concepts, devices, and methods that can be used to integrate knowledge. European Environmental research infrastructures have already been successfully worked together for many years and have established a cluster - ENVRI cluster - for their collaborative work. ENVRI cluster act as a collaborative platform where the RIs can jointly agree on the common solutions for their operations, draft strategies and policies and share best practices and knowledge. Supporting project for the ENVRI cluster, ENVRIplus project, brings together 21 European research infrastructures and infrastructure networks to work on joint technical solutions, data interoperability, access management, training, strategies and dissemination efforts. ENVRI cluster act as one stop shop for multidisciplinary RI users, other collaborative initiatives, projects and programmes and coordinates and implement jointly agreed RI strategies.

  8. From Action to Insight: A Professional Learning Community’s Experiences with the European Language Portfolio

    Directory of Open Access Journals (Sweden)

    Paula Lee Kristmanson

    2011-12-01

    Full Text Available Abstract This paper focuses on an action research project set in the context of one professional learning community‟s (PLC‟s exploration of the Common European Framework of Reference (CEFR and the European Language Portfolio (ELP. Teachers of second and foreign languages in a large urban high school examined the potential of principles and tools related to the CEFR and ELP and shared their experiences during PLC meetings. This study examines data collected as part of the PLC discussions and deliberations and presents two particular pedagogical results emerging from this work: the development of a philosophical stance and an action plan. The paper concludes with a discussion of the process in which teachers engaged as they co-constructed understanding and explored pedagogical implications of their professional dialogue. Résumé Cet article traite d'un projet de recherche action mené dans le contexte d'une communauté d'apprentissage professionnelle (CAP qui a exploré le Cadre européen commun de référence (CECR et le Portfolio européen des langues (PEL et comment la CAP les a mis en oeuvre dans des classes de langue. Les enseignants des langues secondes et étrangères situés à une école secondaire urbaine ont partagé leurs expériences lors des réunions de CAP. Cette étude analyse les données recueillies lors des discussions et des délibérations de la CAP et elle présente deux résultats pédagogiques particuliers émergeant de ce travail— le développement d‟une approche philosophique et un plan d‟action. L'article se termine sur une discussion des processus vécus par les enseignants en co-construisant leurs connaissances pédagogiques par l‟entremise du dialogue professionnel.

  9. European integration and the supervision of local and regional authorities
    Experiences in the Netherlands with requirements of European Community law

    Directory of Open Access Journals (Sweden)

    Bart Hessel

    2006-06-01

    Full Text Available As a result of increasing European integration, local and regional authorities are having to deal with European law more and more intensively. As Member States (read: central government are responsible vis-à-vis the Community for the errors of local and regional authorities, the question arises within Member States whether the central government possesses sufficient supervisory instruments for complying with their obligations under Community law: they must ensure that the errors of local and regional authorities are rectified in time, and national law must provide for sufficient possibilities to do so. Although Community law is neutral towards the internal relations between the various tiers of government within the Member States, this responsibility of the central government may, as a result of European integration, lead to a need for more powerful supervisory instruments in relation to local and regional authorities. In the past five years there has been some debate on this subject within the Netherlands and after a long delay the Dutch cabinet in 2004 decided that the existing supervisory instruments in the decentralized unitary state of the Netherlands should be expanded. The legislation intended to realize this expansion is being prepared. This discussion and its results would seem of interest to other Member States of the Community facing similar problems.

  10. Improved Emergency Preparedness For Management Of The Food chain Via Stakeholder Involvement: Belgian and European Experience

    Energy Technology Data Exchange (ETDEWEB)

    Hardeman, Frank; Carle, Benny [SCK.CEN, the Belgian Nuclear Research Centre, Boeretang 200, 2400 Mol (Belgium); Turcanu, Catrinel [Universite Libre de Bruxelles, Av. F. Roosevelt 50, 1050 Brussels (Belgium); Vandecasteele, Christian [FANC, Federal Agency for Nuclear Control, Ravensteinstraat 36, 1000 Brussels (Belgium)

    2006-07-01

    Initiatives involving stakeholder engagement have gained increasing importance in sustainable decision making for many risk-related issues. This paper describes a Belgian experience within a European context related to food management options in the event of a radioactive contamination of the food chain. Under the auspices of the European Commission's 5. Framework Programme, the F.A.R.M.I.N.G. (F.A.R.M.I.N.G. 2000) project (co-ordinated by H.P.A.) a stakeholder network was established in a number of European countries, following a successful approach originally adopted in the UK. In a comparable approach, national working groups were thus established in Belgium, Finland, France and Greece in order to organise stakeholder panels and to discuss the outcomes of scientific and technical research related to management options for the food chain. The results of these panels were exchanged between participating Member States and on a wider international basis at the W.I.S.D.O.M.2. workshop in 2003. The F.A.R.M.I.N.G. project had many achievements and there were also several important lessons learned for Belgium (Vandecasteele et al., 2005): Firstly, many stakeholders showed a real interest in tackling problems relating to food chain contamination; Secondly, the Belgian agricultural system is very intensive and technically and economically optimised, making many of the options envisaged difficult to implement; thirdly, the applicability of management options is also limited by political and legal issues (e.g. competencies, environmental legislation), operational constraints (e.g. waste treatment, supplies of materials), societal and ethical aspects (e.g. milk disposal to sea, animal welfare), and economics (e.g. who pays the intervention cost?); fourthly, there is a now a greater awareness of these problems in both the food production sector and among the experts involved in emergency management; Fifthly, increased attention is now given in Belgium to the medium and

  11. Improved Emergency Preparedness For Management Of The Food chain Via Stakeholder Involvement: Belgian and European Experience

    International Nuclear Information System (INIS)

    Hardeman, Frank; Carle, Benny; Turcanu, Catrinel; Vandecasteele, Christian

    2006-01-01

    Initiatives involving stakeholder engagement have gained increasing importance in sustainable decision making for many risk-related issues. This paper describes a Belgian experience within a European context related to food management options in the event of a radioactive contamination of the food chain. Under the auspices of the European Commission's 5. Framework Programme, the F.A.R.M.I.N.G. (F.A.R.M.I.N.G. 2000) project (co-ordinated by H.P.A.) a stakeholder network was established in a number of European countries, following a successful approach originally adopted in the UK. In a comparable approach, national working groups were thus established in Belgium, Finland, France and Greece in order to organise stakeholder panels and to discuss the outcomes of scientific and technical research related to management options for the food chain. The results of these panels were exchanged between participating Member States and on a wider international basis at the W.I.S.D.O.M.2. workshop in 2003. The F.A.R.M.I.N.G. project had many achievements and there were also several important lessons learned for Belgium (Vandecasteele et al., 2005): Firstly, many stakeholders showed a real interest in tackling problems relating to food chain contamination; Secondly, the Belgian agricultural system is very intensive and technically and economically optimised, making many of the options envisaged difficult to implement; thirdly, the applicability of management options is also limited by political and legal issues (e.g. competencies, environmental legislation), operational constraints (e.g. waste treatment, supplies of materials), societal and ethical aspects (e.g. milk disposal to sea, animal welfare), and economics (e.g. who pays the intervention cost?); fourthly, there is a now a greater awareness of these problems in both the food production sector and among the experts involved in emergency management; Fifthly, increased attention is now given in Belgium to the medium and long

  12. Primary Care Providers' experiences with Pharmaceutical Care-based Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Heather L. Maracle

    2012-01-01

    Full Text Available This study explored primary care providers' (PCPs experiences with the practice of pharmaceutical care-based medication therapy management (MTM. Qualitative, semi-structured interviews were conducted with six PCPs who have experiences working with MTM pharmacists for at least three years. The first author conducted the interviews that were audio-taped, transcribed, and coded independently. The codes were then harmonized via discussion and consensus with the other authors. Data were analyzed for themes using the hermeneutic-phenomenological method as proposed by Max van Manen. Three men and three women were interviewed. On average, the interviewees have worked with MTM pharmacists for seven years. The six (6 themes uncovered from the interviews included: (1 "MTM is just part of our team approach to the practice of medicine": MTM as an integral part of PCPs' practices; (2 "Frankly it's education for the patient but it's also education for me": MTM services as a source of education; (3 "It's not exactly just the pharmacist that passes out the medicines at the pharmacy": The MTM practitioner is different from the dispensing pharmacist; (4 "So, less reactive, cleaning up the mess, and more proactive and catching things before they become so involved": MTM services as preventative health care efforts; (5"I think that time is the big thing": MTM pharmacists spend more time with patients; (6 "There's an access piece, there's an availability piece, there's a finance piece": MTM services are underutilized at the clinics. In conclusion, PCPs value having MTM pharmacists as part of their team in ambulatory clinics. MTM pharmacists are considered an important source of education to patients as well as to providers as they are seen as having a unique body of knowledge äóñmedication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients' medications, and their capability to

  13. How do General Practitioners experience providing care for their psychotic patients?

    Directory of Open Access Journals (Sweden)

    Slooff Cees J

    2007-06-01

    Full Text Available Abstract Background In primary care, GPs usually provide care for patients with chronic diseases according to professional guidelines. However, such guidelines are not available in the Netherlands for patients with recurring psychoses. It seems that the specific difficulties that GPs experience in providing care for these patients hinder the development and implementation of such guidelines. This study aims to explore the chances and problems GPs meet when providing care for patients susceptible for recurring psychoses, including schizophrenia and related disorders, bipolar disorder, and psychotic depression. Methods A qualitative study of focus group discussions with practising GPs in both town and rural areas. Transcripts from three focus groups with 19 GPs were analysed with the computer program 'Kwalitan'. Theoretical saturation was achieved after these three groups. Results Analysis showed that eight categories of factors influenced the GPs' care for psychotic patients: patient presentation (acute vs. chronic phase, emotional impact, expertise, professional attitude, patient related factors, patient's family, practice organization, and collaboration with psychiatric specialists. Conclusion Current primary care for psychotic patients depends very much on personal characteristics of the GP and the quality of local collaboration with the Mental Health Service. A quantitative study among GPs using a questionnaire based on the eight categories mentioned above would determine the extent of the problems and limitations experienced with this type of care. From the results of this quantitative study, new realistic guidelines could be developed to improve the quality of care for psychotic patients.

  14. Corporate realignments in the natural gas industry: does the North American experience foretell the future for the European Union?

    Energy Technology Data Exchange (ETDEWEB)

    Rutledge, I.; Wright, Ph. [Sheffield Univ., Energy Studies Programme (United Kingdom); Wright, Ph. [Montpellier-1 Univ., CREDEN-LASER, 34 (France)

    2000-09-01

    This paper seeks to explore the extent to which the corporate realignments which have occurred in the North American Natural Gas Industry during a now relatively lengthy experience with liberalization involving a large number of players, will be imitated in the future by European Union countries other than the UK (which is of course already long-embarked along the path of Anglo-Saxon liberalization). The paper first of all catalogues the North American experience, drawing on company performance data assembled by the authors over the last decade (Rutledge and Wright, 1993, 1995, 1997, 1999, 2000). Secondly, this empirical exploration gives way to theoretical speculation: are there elements of the North American experience for which explanatory generalizations are possible? Thirdly, these empirical and theoretical insights are employed to identify and explore actual and potential differences in the corporate evolution of the European Union natural gas industry. (authors)

  15. Clinical providers' experiences with returning results from genomic sequencing: an interview study.

    Science.gov (United States)

    Wynn, Julia; Lewis, Katie; Amendola, Laura M; Bernhardt, Barbara A; Biswas, Sawona; Joshi, Manasi; McMullen, Carmit; Scollon, Sarah

    2018-05-08

    Current medical practice includes the application of genomic sequencing (GS) in clinical and research settings. Despite expanded use of this technology, the process of disclosure of genomic results to patients and research participants has not been thoroughly examined and there are no established best practices. We conducted semi-structured interviews with 21 genetic and non-genetic clinicians returning results of GS as part of the NIH funded Clinical Sequencing Exploratory Research (CSER) Consortium projects. Interviews focused on the logistics of sessions, participant/patient reactions and factors influencing them, how the sessions changed with experience, and resources and training recommended to return genomic results. The length of preparation and disclosure sessions varied depending on the type and number of results and their implications. Internal and external databases, online resources and result review meetings were used to prepare. Respondents reported that participants' reactions were variable and ranged from enthusiasm and relief to confusion and disappointment. Factors influencing reactions were types of results, expectations and health status. A recurrent challenge was managing inflated expectations about GS. Other challenges included returning multiple, unanticipated and/or uncertain results and navigating a rare diagnosis. Methods to address these challenges included traditional genetic counseling techniques and modifying practice over time in order to provide anticipatory guidance and modulate expectations. Respondents made recommendations to improve access to genomic resources and genetic referrals to prepare future providers as the uptake of GS increases in both genetic and non-genetic settings. These findings indicate that returning genomic results is similar to return of results in traditional genetic testing but is magnified by the additional complexity and potential uncertainty of the results. Managing patient expectations, initially

  16. Energy supplier obligations and white certificate schemes: Comparative analysis of experiences in the European Union

    International Nuclear Information System (INIS)

    Bertoldi, Paolo; Rezessy, Silvia; Lees, Eoin; Baudry, Paul; Jeandel, Alexandre; Labanca, Nicola

    2010-01-01

    A number of Member States of the European Union (EU) have introduced market-based policy portfolios based on quantified energy savings obligations on energy distributors or suppliers, possibly coupled with certification of project-based energy savings (via white certificates), and the option to trade the certificates or obligations. The paper provides an up-to-date review and analysis of results to date of white certificate schemes in the EU. In the EU supplier obligations and white certificate schemes have delivered larger savings than originally expected with obliged companies exceeding targets and, in some cases, at cost below what policy makers have anticipated. Supplier obligations foster the uptake of standardised energy efficiency actions often targeting smaller energy users (residential sector), lowering the transaction costs and contributing to market transformation. The role of certificate trading is more ambiguous. Trading can bring benefits where the target is set sufficiently high with respect to the energy-saving potential in the sectors covered. Theoretically trading may be better suited for broader systems with comprehensive coverage, but even in smaller schemes trading may reduce the transaction costs of compliance for obliged actors without sufficient expertise on end-use energy efficiency. Yet, trading increases the administrative cost ratio of energy-saving obligations.

  17. Energy supplier obligations and white certificate schemes: Comparative analysis of experiences in the European Union

    Energy Technology Data Exchange (ETDEWEB)

    Bertoldi, Paolo, E-mail: paolo.bertoldi@ec.europa.e [European Commission, Joint Research Centre, Institute for Energy, Via E. Fermi 1, TP 450, 21027 Ispra (Vatican City State, Holy See) (Italy); Rezessy, Silvia, E-mail: silvia.rezessy@ec.europa.e [European Commission, Joint Research Centre, Institute for Energy, Via E. Fermi 1, TP 450, 21027 Ispra (Vatican City State, Holy See) (Italy); Lees, Eoin, E-mail: eoin@eoinleesenergy.co [Eoin Lees Energy, 4 Silver Lane, West Challow, Wantage, Oxon OX12 9TX (United Kingdom); Baudry, Paul, E-mail: paul.baudry@edf.f [EDF R and D, Centre des Renardieres, 77818 Moret sur Loing (France); Jeandel, Alexandre, E-mail: alexandre.jeandel@gdfsuez.co [GDF SUEZ, 16, rue Ville L' Eveque, 75008 Paris (France); Labanca, Nicola, E-mail: nicola.labanca@polimi.i [eERG, Politecnico di Milano, Via Lambruschini n. 4, 20156 Milano (Italy)

    2010-03-15

    A number of Member States of the European Union (EU) have introduced market-based policy portfolios based on quantified energy savings obligations on energy distributors or suppliers, possibly coupled with certification of project-based energy savings (via white certificates), and the option to trade the certificates or obligations. The paper provides an up-to-date review and analysis of results to date of white certificate schemes in the EU. In the EU supplier obligations and white certificate schemes have delivered larger savings than originally expected with obliged companies exceeding targets and, in some cases, at cost below what policy makers have anticipated. Supplier obligations foster the uptake of standardised energy efficiency actions often targeting smaller energy users (residential sector), lowering the transaction costs and contributing to market transformation. The role of certificate trading is more ambiguous. Trading can bring benefits where the target is set sufficiently high with respect to the energy-saving potential in the sectors covered. Theoretically trading may be better suited for broader systems with comprehensive coverage, but even in smaller schemes trading may reduce the transaction costs of compliance for obliged actors without sufficient expertise on end-use energy efficiency. Yet, trading increases the administrative cost ratio of energy-saving obligations.

  18. Parents’ lived experience of providing kangaroo care to their preterm infants

    Directory of Open Access Journals (Sweden)

    Angela Leonard

    2008-12-01

    Full Text Available Premature and low birthweight infants pose particular challenges to health services in South Africa. While there is good evidence to demonstrate the benefits of kangaroo care in low birthweight infants, limited research has been conducted locally on the experiences of parents who provide kangaroo care to their preterm infants. This phenomenological study explores the lived experience of parents who provided their preterm infants with kangaroo care at a tertiary-level maternity centre in the Western Cape. In-depth interviews were conducted with six parents: four mothers and two fathers. Data was analysed using an adaptation of the approaches described by Colaizzi (1978:48-71 and Hycner (1985:280-294. To ensure trustworthiness, the trustworthiness criteria described by Guba and Lincoln (1989:242-243 were applied. Kangaroo care is a phased process, each phase bringing a unique set of experiences. The eight themes that emerged are described: unforeseen, unprepared and uncertain - the experience of birth; anxiety and barriers; an intimate connection; adjustments, roles and responsibilities; measuring success; a network of encouragement and support; living-in challenges; and living with the infant outside of hospital. Challenges facing health care providers are described and recommendations for information about kangaroo care and support for parents are made. Opsomming Vroeggebore babas en babas met ’n lae geboortegewig stel besondere uitdagings vir Suid-Afrikaanse gesondhiedsdienste. Daar bestaan goeie bewyse dat die kangaroesorgmetode voordelig is vir babas met ’n laegeboortegewig, dog is minimale plaaslike navorsing gedoen oor die ondervindinge van ouers wat hierdie metode gebruik om vir hul vroeggebore babas te sorg. Hierdie fenomenologiese studie verken die geleefde ervaringe van ouers wat vir hulle vroeggebore babas deur middel van die kangaroesorgmetode in ’n tersiêre kraamsentrum in die Weskaap gesorg het. Data is ingesamel deur in

  19. Implementation of utilities operation and maintenance experience into the European pressurized water reactor design

    International Nuclear Information System (INIS)

    Zaiss, W.; Lallier, M.

    1999-01-01

    Since 1992 Electricite de France EDF and German Utilities GU work together with Nuclear Power International NPI, a subsidiary of Framatome and Siemens, in the development of the future European Pressurized Water Reactor EPR. The EPR is an evolutionary concept, based on the French N4 plants and the German KONVOI plants. From the beginning, experienced operation and maintenance people from the precursor plants participate at the design process. Their experience will lead to a plant, which is not only characterised by low investment costs, but also by good operability, high availability and low operation and maintenance costs. No expensive back-fittings should be necessary after commissioning, to reach these availability and maintenance targets. The utility specialists give design requirements for outage performance, system design, and layout. These design requirements are really determining the system performances, and not what was design basis before. It does not necessarily lead to system increases. Mainly it is a shifting of the emphasis to other items. There are even cases, where the system performances can be reduced. Mostly very small modifications, which are nearly cost neutral when implemented early in the design, have big impact on the further operation. If there are big cost influences, a sound balance between investment and gained availability is made together with the designers. There is very fruitful discussion between designers and operators, which is highly estimated by both sides. In this frame also new, revolutionary ideas are coming up, which are going mostly in the direction of investment cost reduction, without loosing operation freedom. It is the first time in Europe, that designers and operators are working so close together. It is also the first time, that the management and the decision making is dominated by the utilities. (author)

  20. European experience of HIV prevention policy among men who have sex with men

    Directory of Open Access Journals (Sweden)

    Klymenko, Nadiia

    2012-07-01

    Full Text Available BACKGROUND: Men who have sex with men (MSM are a high-risk group for HIV. Implementation of effective preventive activities is an important way to combat HIV among MSM. However, in Ukraine there is no real HIV prevention policy among MSM and the need for its formulation is still open. MATERIAL AND METHODS: Analysis of legal acts, national reports and other official documents related to HIV prevention among MSM was carried out for Romania, Slovenia, the Netherlands, and Sweden.RESULTS: European countries use various approaches to HIV prevention among MSM: institutional, structural, and media approach.Countries under consideration have fully specified the minimum standard package for HIV prevention among MSM, who are defined as the highest priority group. Distinct strategies for MSM and ways to achieve them are outlined within the national plans and strategies for combating HIV/AIDS (Slovenia, Romania, the Netherlands. The National plan for HIV prevention among MSM will come into action in 2012 in Sweden. Countries, chosen for this study, use the principle of social contract by which the government provides subsidies and grants to nongovernmental organizations (NGOs working with MSM through its specialized health care units (Slovenia, Sweden, and sometimes only for one national NGO (the Netherlands. Outreach is the most common model of NGO’s activities.. In Sweden, MSM can get counseling and HIV testing in specialized HIV clinic for MSM. HIV prevention among MSM is run by representatives of NGOs through dating sites (Slovenia, Romania, through educating MSM and further promotion of healthy lifestyles among their friends. Along with the behavior modification activities, anti-discrimination strategies are used (Sweden, the Netherlands, Slovenia.CONCLUSIONS: Review of the regulatory frameworks, empowerment of NGOs, implementation of the social contract mechanisms, using interactive tools and providing education for MSM can be key points of HIV

  1. European experience on air and water pollution control: monitoring network and warning station

    Energy Technology Data Exchange (ETDEWEB)

    Aflalo, Sergio S. [Groupe Environnement S.A., Poissy (France)

    1993-12-31

    After a review of the energy consumption and pollutants emitted in the European Community, especially those concerning the `green house effect`, the author proceeded a summary of the actual legislation and Europeans directives, and also, the Best Available Technology for reducing air pollution is discussed. Original Air Quality monitoring networks performed by Environnement SA are described including measurements obtained around Paris and other areas of France. 7 refs., 11 figs.

  2. Trans-European transport networks influence on the regional development and urban systems: Serbian experience

    OpenAIRE

    Maksin-Mićić Marija

    2004-01-01

    The trans-European transport network has different effects at macro-regional, mezzo-regional and micro-regional level, and on urban systems development, and its effectiveness rises at the lower regional levels. Possible approaches to the trans-European transport network impact and effect survey and policy options have been pointed out. The importance of increased accessibility and mobility for regional expansion and for more balanced and polycentric system of city networks has been underlined...

  3. European experience on air and water pollution control: monitoring network and warning station

    Energy Technology Data Exchange (ETDEWEB)

    Aflalo, Sergio S [Groupe Environnement S.A., Poissy (France)

    1994-12-31

    After a review of the energy consumption and pollutants emitted in the European Community, especially those concerning the `green house effect`, the author proceeded a summary of the actual legislation and Europeans directives, and also, the Best Available Technology for reducing air pollution is discussed. Original Air Quality monitoring networks performed by Environnement SA are described including measurements obtained around Paris and other areas of France. 7 refs., 11 figs.

  4. Providers' Experiences with Vaginal Dilator Training for Patients with Vaginal Agenesis.

    Science.gov (United States)

    Patel, Vrunda; Hakim, Julie; Gomez-Lobo, Veronica; Amies Oelschlager, Anne-Marie

    2018-02-01

    To examine providers' experiences with vaginal dilator training for patients with vaginal agenesis. Anonymous electronic survey. Members of the North American Society for Pediatric and Adolescent Gynecology. How providers learn about vaginal dilator training, common techniques, and methods used for patient training, assessment of patient readiness, common patient complaints, issues leading to early discontinuation. There were a total of 55 completed survey responses of which 31 respondents (56%) had been in practice for more than 10 years. Forty-nine were gynecologists (89%), 20 had completed a fellowship in pediatric and adolescent gynecology (36%), and 6 were reproductive endocrinologists (11%). Thirty-one respondents had first learned about vaginal dilator training through lectures (56%) whereas only 9 through mentorship and fellowship (16%). According to respondents, the most common issue leading to early discontinuation was lack of patient motivation and readiness (n = 42; 76%). The most common complication was pain or discomfort (n = 45; 82%). More than half of respondents determined dilator therapy was successful when patients reported comfortable sexual intercourse (n = 30; 55%) and 65% (n = 35) did not delineate any restrictions to initiation of sexual intercourse. Most respondents (87%) requested further vaginal dilator training at either a clinical meeting (n = 26; 47%) or with a training video (n = 22; 40%). Our study in an experienced cohort of pediatric gynecology providers highlights the need for further research and training on vaginal dilation education. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  5. Provider Preferences and Experiences With a Countywide Centralized Collaborative Reminder/Recall for Childhood Immunizations.

    Science.gov (United States)

    Saville, Alison W; Gurfinkel, Dennis; Sevick, Carter; Beaty, Brenda; Dickinson, L Miriam; Kempe, Allison

    2016-01-01

    To assess among providers in 7 Colorado counties where a collaborative centralized reminder/recall (CC-R/R) using the Colorado Immunization Information System (CIIS) was performed: 1) preferences about CC-R/R conducted by the public health department (PHD); 2) preferences for future CC-R/R for different vaccines with and without practice names; and 3) experiences with including their name on CC-R/R notices. A mailed survey was sent to all primary care sites where CC-R/R had been previously conducted. Respondents self-identified as the "the person in charge of immunization policy within the practice." Overall response rate was 69.9% (160 of 229). Twenty-one were removed because they did not provide immunizations to children. Among respondents, 65.0% were from family medicine and 26.3% from pediatric practices; 32.1% physicians or midlevel providers; 34.3% nurses or medical assistants; and 33.6% office managers. Taking into account all issues, 57.6% were "okay" with either the PHD or their practice conducting recall; 27.3% preferred the PHD; and 14.4% preferred their practice conduct R/R. Fifty-six percent of active CIIS practices (n = 95) included their practice's name on CC-R/R notices. Interest in future CC-R/R for different ages and vaccines was strongly related to whether reminders included the practice name: 77.8% for routine immunizations in 4- to 6-year-olds; 74.8% for immunizations for 0- to 3-year-olds; 73.3% for vaccines administered to adolescents; and 59.7% for influenza (P < .001). Most practices are accepting of the PHD centrally conducting R/R, but most prefer collaboration that includes their name. Given the success and support of this method, it should be more widely adopted. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  6. The top five research priorities in physician-provided pre-hospital critical care: a consensus report from a European research collaboration

    Directory of Open Access Journals (Sweden)

    Lockey David

    2011-10-01

    Full Text Available Abstract Background Physician-manned emergency medical teams supplement other emergency medical services in some countries. These teams are often selectively deployed to patients who are considered likely to require critical care treatment in the pre-hospital phase. The evidence base for guidelines for pre-hospital triage and immediate medical care is often poor. We used a recognised consensus methodology to define key priority areas for research within the subfield of physician-provided pre-hospital critical care. Methods A European expert panel participated in a consensus process based upon a four-stage modified nominal group technique that included a consensus meeting. Results The expert panel concluded that the five most important areas for further research in the field of physician-based pre-hospital critical care were the following: Appropriate staffing and training in pre-hospital critical care and the effect on outcomes, advanced airway management in pre-hospital care, definition of time windows for key critical interventions which are indicated in the pre-hospital phase of care, the role of pre-hospital ultrasound and dispatch criteria for pre-hospital critical care services. Conclusion A modified nominal group technique was successfully used by a European expert group to reach consensus on the most important research priorities in physician-provided pre-hospital critical care.

  7. Experiences of primary care professionals providing healthcare to recently arrived migrants: a qualitative study.

    Science.gov (United States)

    Lindenmeyer, Antje; Redwood, Sabi; Griffith, Laura; Teladia, Zaheera; Phillimore, Jenny

    2016-09-22

    The main objectives of the study were to explore the experiences of primary care professionals providing care to recent migrants in a superdiverse city and to elicit barriers and facilitators to meeting migrants' care needs. This paper focuses on a strong emergent theme: participants' descriptions and understandings of creating a fit between patients and practices. An exploratory, qualitative study based on the thematic analysis of semistructured interviews. A purposive sample of 10 practices. We interviewed 6 general practitioners, 5 nurses and 6 administrative staff; those based at the same practice opted to be interviewed together. 10 interviewees were from an ethnic minority background; some discussed their own experiences of migration. Creating a fit between patients and practice was complex and could be problematic. Some participants defined this in a positive way (reaching out, creating rapport) while others also focused on ways in which patients did not fit in, for example, different expectations or lack of medical records. A small but vocal minority put the responsibility to fit in on to migrant patients. Some participants believed that practice staff and patients sharing a language could contribute to achieving a fit but others outlined the disadvantages of over-reliance on language concordance. A clearly articulated, team-based strategy to create bridges between practice and patients was often seen as preferable. Although participants agreed that a fit between patients and practice was desirable, some aimed to adapt to the needs of recently arrived migrants, while others thought that it was the responsibility of migrants to adapt to practice needs; a few viewed migrant patients as a burden to the system. Practices wishing to improve fit might consider developing strategies such as introducing link workers and other 'bridging' people; however, they could also aim to foster a general stance of openness to diversity. Published by the BMJ Publishing Group

  8. Irish midwives' experiences of providing maternity care to non-Irish women seeking asylum

    Directory of Open Access Journals (Sweden)

    Tobin CL

    2014-01-01

    Full Text Available Carolyn L Tobin,1 Jo Murphy-Lawless2 1Department of Nursing, College of Health and Human Services, University of New Hampshire, Durham, NH, USA; 2School of Nursing and Midwifery, Trinity College, Dublin, Ireland Background: Immigration and asylum seeking has been an important social and political phenomenon in Ireland since the mid 1990s. Inward migration to Ireland was seen in unprecedented numbers from 1995 onward, peaking in 2002 with 11,634 applications for refugee status. Asylum and immigration is an issue of national and international relevance as the numbers of displaced people worldwide continues to grow, reaching the highest level in 20 years at 45.2 million in 2012. Midwives provide the majority of care to childbearing women around the world, whether working as autonomous practitioners or under the direction of an obstetrician. Limited data currently exist on the perspectives of midwives who provide care to childbearing women while they are in the process of seeking asylum. Such data are important to midwifery leaders, educators, and policy-makers. The aims of this study were to explore midwives' perceptions and experiences of providing care to women in the asylum process and to gain insight into how midwives can be equipped and supported to provide more effective care to this group in the future.Methods: Data were collected via indepth unstructured interviews with a purposive sample of ten midwives from two sites, one a large urban inner city hospital, and the second, a smaller more rural maternity hospital. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using content analysis. Results: Five themes emerged from the data, barriers to communication, understanding cultural difference, challenges of caring for women who were unbooked, the emotional cost of caring, and structural barriers to effective care. Conclusion: Findings highlight a need to focus on support and education for midwives, improved

  9. Latina and European American Girls’ Experiences with Academic Sexism and their Self-Concepts in Mathematics and Science During Adolescence

    Science.gov (United States)

    Leaper, Campbell

    2010-01-01

    The study investigated Latina and European American adolescent girls’ (N = 345, M = 15.2 years, range = 13 to 18) experiences with academic sexism in mathematics and science (M/S) and their M/S perceived competence and M/S value (liking and importance). M/S academic sexism was based on girls’ reported experiences hearing sexist comments about girls’ abilities in math and science. Older European American adolescents, and both younger and older Latina adolescents, who experienced several instances of academic sexism felt less competent in M/S than girls who experienced less sexism (controlling for M/S grades). In addition, among older girls (regardless of ethnicity), those who experienced several instances of academic sexism valued M/S less than girls who experienced less sexism. PMID:21212810

  10. Latina and European American Girls' Experiences with Academic Sexism and their Self-Concepts in Mathematics and Science During Adolescence.

    Science.gov (United States)

    Brown, Christia Spears; Leaper, Campbell

    2010-12-01

    The study investigated Latina and European American adolescent girls' (N = 345, M = 15.2 years, range = 13 to 18) experiences with academic sexism in mathematics and science (M/S) and their M/S perceived competence and M/S value (liking and importance). M/S academic sexism was based on girls' reported experiences hearing sexist comments about girls' abilities in math and science. Older European American adolescents, and both younger and older Latina adolescents, who experienced several instances of academic sexism felt less competent in M/S than girls who experienced less sexism (controlling for M/S grades). In addition, among older girls (regardless of ethnicity), those who experienced several instances of academic sexism valued M/S less than girls who experienced less sexism.

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

    Directory of Open Access Journals (Sweden)

    Matthew J Gibson

    2016-07-01

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

  12. An experience of field work learning for healthcare providers: new perspectives between disadvantages and critical issues.

    Science.gov (United States)

    Pennini, A; Cittadini, N; Basilici Zannetti, E; Cervoni, C; Vellone, E; D'Agostino, F; Alvaro, R

    2016-01-01

    The learning models used in traditional education are not very effective for the continuing education of healthcare providers. Fieldwork learning is an active learning method that is feasible in the workplace and is also suitable for professionals who possess a style of experiential learning. Guardian Angel 2.0® is a fieldwork learning project designed to promote educational skills in nurses to improve the self-care and quality of life in women affected by osteoporosis. The purpose of this article is to present the Guardian Angel 2.0® project and its results. The Guardian Angel 2.0® effort lasted nine months and involved 212 nurses in the north, centre and south of Italy. A socio-demographic questionnaire, an evaluation scale of the learning process and a participants' satisfaction questionnaire were used to evaluate and monitor the fieldwork learning project. Out of the 212 nurses who participated in the project, 119 (70%) completed it. The mean age of these participants was 48 years (± 7.98), and 83.5% were female. About half of the participants (52.0%, 55.4% and 45.0%, respectively) were good (a) at respecting deadlines, (b) at using the methodological instruments and (c) the information tools properly. Almost all nurses considered the project to be very relevant (96.4%). In regards to the project's quality, the nurses perceived it as excellent (51.0%) and very good (48.5%). Finally, the project was considered very useful or useful by 100% of nurses. The general satisfaction of nurses was high. The fieldwork learning was relevant and useful for developing educational skills in nurses. It would therefore be appropriate to use fieldwork learning in clinical settings to improve the existing experience of healthcare providers and thereby reduce the difficulties of transforming the knowledge from a theoretical to a practical level and to promote the development of new behaviours when the existing ones become obsolete or inefficient.

  13. Pregnancy planning and risk behaviours – a survey of women’s experiences in selected European countries

    OpenAIRE

    Małgorzata Lesińska-Sawicka; Małgorzata Nagórska

    2018-01-01

    Pregnancy, a special period in a woman’s life, should be preceded by proper preparation: a positive attitude to procreation, selection of optimum time for becoming pregnant, starting prevention of neural tube defects, restriction of the use of drugs, smoking, etc. The aim of this study was to determine the effect of pregnancy planning and antenatal classes on the use of stimulants during pregnancy. The study group included 877 women living in 7 European countries, and their experiences of pla...

  14. Experiences of providing prosthetic and orthotic services in Sierra Leone--the local staff's perspective.

    Science.gov (United States)

    Magnusson, Lina; Ahlström, Gerd

    2012-01-01

    In Sierra Leone, West Africa, there are many people with disabilities in need of rehabilitation services after a long civil war. The aim of this qualitative study was to explore the experiences of prosthetic and orthotic service delivery in Sierra Leone from the local staff's perspective. Fifteen prosthetic and orthotic technicians working at all the rehabilitation centres providing prosthetic and orthotic services in Sierra Leone were interviewed. The interviews were transcribed and subjected to latent content analysis. One main theme emerged: sense of inability to deliver high-quality prosthetic and orthotic services. This main theme was generated from eight sub-themes: Desire for professional development; appraisals of work satisfaction and norms; patients neglected by family; limited access to the prosthetic and orthotic services available; problems with materials and machines; low public awareness concerning disabilities; marginalisation in society and low priority on the part of government. The findings illustrated traditional beliefs about the causes of disability and that the public's attitude needs to change to include and value people with disabilities. Support from international organisations was considered necessary as well as educating more prosthetic and orthotic staff to a higher level.

  15. Trans-European transport networks influence on the regional development and urban systems: Serbian experience

    Directory of Open Access Journals (Sweden)

    Maksin-Mićić Marija

    2004-01-01

    Full Text Available The trans-European transport network has different effects at macro-regional, mezzo-regional and micro-regional level, and on urban systems development, and its effectiveness rises at the lower regional levels. Possible approaches to the trans-European transport network impact and effect survey and policy options have been pointed out. The importance of increased accessibility and mobility for regional expansion and for more balanced and polycentric system of city networks has been underlined. The question is how the new major transport infrastructure affects the development of functional complementarity between cities and regions. Changes of the spatial organization, utilization and structure of cities, as well as of social benefits and losses subsequent to impacts of trans-European transport corridor "X" on urban system Ćuprija-Jagodina-Paraćin at section Belgrade-Nis have been analysed. The new trans-European or major transport infrastructure does not per se create regional and urban system network development, although it can affect the conditions for the processes that create growth and development. The effects can be increased by co-ordination of measures of regional and urban policy, land use, transport and other policies. The guidances and options of urban systems and urban centres development policies in trans-European transport corridor, as well as possibilities to improve our planning system have been given. The necessary measure is the introduction of spatial impact assessment as sectorial policy instrument for the large transport infrastructure projects.

  16. Mobile Extracorporeal Membrane Oxygenation Teams: The North American Versus the European Experience.

    Science.gov (United States)

    Nwozuzu, Adambeke; Fontes, Manuel L; Schonberger, Robert B

    2016-12-01

    To evaluate differences in the inclusion of anesthesiologists in mobile extracorporeal membrane oxygenation (ECMO) teams between North American and European centers. A retrospective review of North American versus European mobile ECMO teams. The search terms used to identify relevant articles were the following: "extracorporeal membrane transport," "mobile ECMO," and "interhospital transport." MEDLINE review of articles. None. None. Between 1986 and 2015, 25 articles were published that reported the personnel makeup of mobile ECMO teams in North America and Europe: 6 from North American centers and 19 from European centers. The included articles reported a total of 1,329 cases: 389 (29%) adult-only cohorts and 940 (71%) mixed-age cohorts. Among North American studies, 0 of 6 (0%) reported the presence of an anesthesiologist on the mobile ECMO team in contrast to European studies, in which 10 of 19 (53%) reported the inclusion of an anesthesiologist (Fisher exact p for difference = 0.05). In terms of number of cases, this discrepancy translated to 543 total cases in North America (all without an anesthesiologist) and 499 cases in Europe (37%) including an anesthesiologist on the team (Fisher exact p for difference<0.001). This study demonstrated significant geographic discrepancies in the inclusion of anesthesiologists on mobile ECMO teams, with European centers more likely to incorporate an anesthesiologist into the mobile ECMO process compared with North American centers. Copyright © 2016. Published by Elsevier Inc.

  17. Diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds.

    Science.gov (United States)

    Carolan, Mary

    2014-05-01

    To explore diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds and to gather information which would assist with the development of an educational programme that would support both women and diabetes educators. Rates of gestational diabetes mellitus have increased dramatically in recent years. This is concerning as gestational diabetes mellitus is linked to poorer pregnancy outcomes including hypertension, stillbirth, and nursery admission. Poorest outcomes occur among disadvantaged women. gestational diabetes mellitus is also associated with maternal type 2 diabetes and with child obesity and type 2 diabetes among offspring. Effective self-management of gestational diabetes mellitus reduces these risks. Diabetes nurse educators provide most education and support for gestational diabetes mellitus self-management. An interpretative phenomenological analysis approach, as espoused by Smith and Osborn (Qualitative Psychology: A Practical Guide to Research Methods, 2008, Sage, London, 51), provided the framework for this study. The views of six diabetes educators were explored through in-depth interviewing. Interviews were transcribed verbatim and analysed according to steps outlined by Smith and Osborn (Qualitative Psychology: A Practical Guide to Research Methods, 2008, Sage, London, 51). Three themes emerged from the data: (1) working in a suboptimal environment, (2) working to address the difficulties and (3) looking to the future. Throughout, the diabetes nurse educators sought opportunities to connect with women in their care and to make the educational content understandable and meaningful. Low literacy among disadvantaged women has a significant impact on their understanding of gestational diabetes mellitus information. In turn, catering for women with low literacy contributes to increased workloads for diabetes nurse educators, making them vulnerable to burnout. There is a need

  18. New technological developments provide deep-sea sediment density flow insights: the Monterey Coordinated Canyon Experiment

    Science.gov (United States)

    O'Reilly, T. C.; Kieft, B.; Chaffey, M. R.; Wolfson-Schwehr, M.; Herlien, R.; Bird, L.; Klimov, D.; Paull, C. K.; Gwiazda, R.; Lundsten, E. M.; Anderson, K.; Caress, D. W.; Sumner, E. J.; Simmons, S.; Parsons, D. R.; Talling, P.; Rosenberger, K. J.; Xu, J.; Maier, K. L.; Gales, J. A.

    2017-12-01

    The Monterey Coordinated Canyon Experiment (CCE) deployed an array of instruments along the Monterey Canyon floor to characterize the structure, velocity and frequency of sediment flows. CCE utilized novel technologies developed at MBARI to capture sediment flow data in unprecedented detail. 1. The Seafloor Instrument Node (SIN) at 1850 meters depth housed 3 ADCPs at 3 different frequencies, CTD, current meter, oxygen optode, fluorometer/backscatter sensor, and logged data at 10 second intervals or faster. The SIN included an acoustic modem for communication with shore through a Wave Glider relay, and provided high-resolution measurements of three flow events during three successive deployments over 1.5 years. 2. Beachball-sized Benthic Event Detectors (BEDs) were deployed on or under the seafloor to measure the characteristics of sediment density flows. Each BED recorded data from a pressure sensor and a 3-axis accelerometer and gyro to characterize motions during transport events (e.g. tumble vs rotation). An acoustic modem capable of operating through more than a meter of sediment enabled communications with a ship or autonomous surface vehicle. Multiple BEDs were deployed at various depths in the canyon during CCE, detecting and measuring many transport events; one BED moved 9 km down canyon in 50 minutes during one event. 3. Wave Glider Hot Spot (HS), equipped with acoustic and RF modems, acted as data relay between SIN, BEDs and shore, and acoustically located BEDs after sediment density flows.. In some cases HS relayed BED motion data to shore within a few hours of the event. HS provided an acoustic console to the SIN, allowing shore-based users to check SIN health and status, perform maintenance, etc. 4. Mapping operations were conducted 4 times at the SIN site to quantify depositional and erosional patterns, utilizing a prototype ultra-high-resolution mapping system on the ROV Doc Ricketts. The system consists of a 400-kHz Reson 7125 multibeam sonar, a 3

  19. Miscanthus: A Review of European Experience with a Novel Energy Crop

    Energy Technology Data Exchange (ETDEWEB)

    Scurlock, J.M.O.

    1999-02-01

    Miscanthus is a tall perennial grass which has been evaluated in Europe over the past 5-10 years as a new bioenergy crop. The sustained European interest in miscanthus suggests that this novel energy crop deserves serious investigation as a possible candidate biofuel crop for the US alongside switchgrass. To date, no agronomic trials or trial results for miscanthus are known from the conterminous US, so its performance under US conditions is virtually unknown. Speculating from European data, under typical agricultural practices over large areas, an average of about 8t/ha (3t/acre dry weight) may be expected at harvest time. As with most of the new bioenergy crops, there seems to be a steep ''learning curve.'' Establishment costs appear to be fairly high at present (a wide range is reported from different European countries), although these may be expected to fall as improved management techniques are developed.

  20. EUROPEAN NEIGHBOUHOOD POLICY: THE EXPERIENCE OF IMPLEMENTATION IN RESPECT OF MOLDOVA AND GEORGIA

    Directory of Open Access Journals (Sweden)

    Elena Sergeevna Poskrebysheva

    2014-10-01

    Full Text Available This article presents the analysis of the main conceptual principles and dynamics of the European Neighbourhood Policy (ENP, aimed at minimizing conflict potential in countries outside the European Union. On the basis of empirical data concerning the ENP approach to some of the post-Soviet states, the authors come to the conclusion that the policy of the EU, first of all , is far from effective implementation of a real political process, and, secondly, is part of the traditional paradigm of the West self - imposition, veiled bright slogans and declarations. 

  1. European experiences as guidelines for public, private and civil sector role redefinition in spatial policy formulation process in Serbia

    Directory of Open Access Journals (Sweden)

    Maksić Milica

    2012-01-01

    Full Text Available The period of post-socialist transition in Serbia brings more complex actors environment compared to socialistic period, while institutional arrangements are not enough developed to actively involve different groups of actors in spatial policy formulation process. In order to gather certain knowledge as guidelines for redefining institutional practices in Serbia, institutional framework of Serbia was compared in this paper with institutional framework of three developed European countries, especially in relation to the roles of public, private and civil sector in spatial policy formulation process. The European countries selected for the analysis are United Kingdom, Netherlands and Germany because of diverse national administrative traditions, so different institutional arrangements could be researched. By comparing institutional framework in Serbia with the ones in developed European countries following questions are researched: which actors are missing in Serbia, what are the ways institutional arrangements for different groups inclusion into spatial policy formulation process are formed, what are the differences between the roles of certain groups of actors in decision-making process. Current roles of actors in spatial policy formulation process in Serbia are reviewed and possible directions for public, private and civil sector role redefinition in Serbia are discussed in accordance with experiences of developed European countries.

  2. Health-care providers' experiences with opt-out HIV testing: a systematic review.

    Science.gov (United States)

    Leidel, Stacy; Wilson, Sally; McConigley, Ruth; Boldy, Duncan; Girdler, Sonya

    2015-01-01

    HIV is now a manageable chronic disease with a good prognosis, but early detection and referral for treatment are vital. In opt-out HIV testing, patients are informed that they will be tested unless they decline. This qualitative systematic review explored the experiences, attitudes, barriers, and facilitators of opt-out HIV testing from a health-care provider (HCP) perspective. Four articles were included in the synthesis and reported on findings from approximately 70 participants, representing diverse geographical regions and a range of human development status and HIV prevalence. Two synthesized findings emerged: HCP attitudes and systems. The first synthesized finding encompassed HCP decision-making attitudes about who and when to test for HIV. It also included the assumptions the HCPs made about patient consequences. The second synthesized finding related to systems. System-related barriers to opt-out HIV testing included lack of time, resources, and adequate training. System-related facilitators included integration into standard practice, support of the medical setting, and electronic reminders. A common attitude among HCPs was the outdated notion that HIV is a terrible disease that equates to certain death. Some HCPs stated that offering the HIV test implied that the patient had engaged in immoral behaviour, which could lead to stigma or disengagement with health services. This paternalism diminished patient autonomy, because patients who were excluded from opt-out HIV testing could have benefited from it. One study highlighted the positive aspects of opt-out HIV testing, in which participants underscored the professional satisfaction that arose from making an HIV diagnosis, particularly when marginalized patients could be connected to treatment and social services. Recommendations for opt-out HIV testing should be disseminated to HCPs in a broad range of settings. Implementation of system-related factors such as electronic reminders and care coordination

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

    Science.gov (United States)

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

    2009-07-01

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

  4. Nursing students’ perception of clinical learning experiences as provided by the nursing staff in the wards

    Directory of Open Access Journals (Sweden)

    N. R. C. TIakula

    1993-03-01

    Full Text Available A descriptive survey was carried out, using convenience and systematic sampling in order to better understand the manner in which student nurses perceive their clinical experience in the hospital. Data were collected from 80 subjects in 4 nursing colleges using a critical incident technique. Positive and negative experiences are described,

  5. Trans-European transport networks influence on the regional development and urban systems: Serbian experience

    Directory of Open Access Journals (Sweden)

    Maksin-Mićić Marija

    2004-01-01

    Full Text Available The trans-European transport network has different effects at macro regional mezzo-regional and micro-regional level, and its effectiveness rises with the lower regional levels. Possible approaches to the trans-European transport network impact and effect survey and policy options have been pointed out. The importance of increased accessibility and mobility for regional expansion and for a more balanced and polycentric system of city networks has been underlined. Changes in the spatial organization utilization and structure of cities, as well as in social benefits and losses subsequent to impacts of trans-European transport corridor "X" section Belgrade-Niš have been analyzed. The new trans-European or major transport infrastructure does not per se create regional and urban system network development, although it can affect the conditions for the processes that create growth and development. The effects can be increased by co-ordination of measures of regional, spatial and urban policy, land use transport, environmental and other policies. The necessary measure is the introduction of spatial impact assessment as sartorial policy instrument for the large transport infrastructure plans and projects.

  6. How Does Transport Policy Cope with Climate Challenges? Experiences from the UK and Other European Countries

    DEFF Research Database (Denmark)

    Gudmundsson, Henrik; Lawler, Mary; Meza, Maria Josefina Figueroa

    2011-01-01

    Transport is one of the fastest growing sources of emissions of greenhouse gases. Some European countries have adopted comprehensive “sustainable transport” policies, in which climate change is addressed. This paper looks into how sustainable transport policy frameworks deal with climate change c...

  7. Using the Financial Instruments for Electric Energy Industry Modernization: the Experience of European Countries

    Directory of Open Access Journals (Sweden)

    Hnedina Kateryna V.

    2018-03-01

    Full Text Available A review of the financial instruments used in the European countries to modernize the electric energy industry has been undertaken. A review of the European practices indicates that financial support for the electric energy industry modernization projects is financed by such instruments, mechanisms and incentives as «green» tariff, «green» certificates and «quota obligations», «green» bonds, auctions, concessional lending, grants, investment subsidies. Venture capital investment is a common form of financing for electric energy industry modernization in the European countries. It has been determined that «green» bonds are an effective instrument that allows to accumulate significant amounts of funds and direct them to the renewable energy industry. Nowadays a significant number of renewable energy industry projects in the EU countries have already been implemented at the expense of the funds obtained from the «green» bonds issue. «Green» bonds are a pivotal promising financial instrument for the modernization of electric energy industry in the European countries. Formation of the mechanism for their issue in Ukraine, taking account of the foreign practice of creating a market of «green bonds», will allow to accumulate the financial resources that are necessary for development of the renewable energy industry.

  8. Lowering Blood Alcohol Content Levels to Save Lives: The European Experience

    Science.gov (United States)

    Albalate, Daniel

    2008-01-01

    Road safety is of increasing concern in developed countries because of the significant number of deaths and large economic losses. One tool commonly used by governments to deal with road accidents is the enactment of stricter policies and regulations. Drunk driving is one of the leading concerns in this field and several European countries have…

  9. European communion

    DEFF Research Database (Denmark)

    Manners, Ian James

    2013-01-01

    Political theory of European union, through an engagement between political concepts and theoretical understandings, provides a means of identifying the EU as a political object. It is argued that understanding the projects, processes and products of European union, based on ‘sharing’ or ‘communion......’, provides a better means of perceiving the EU as a political object rather than terms such as ‘integration’ or ‘co-operation’. The concept of ‘European communion’ is defined as the ‘subjective sharing of relationships’, understood as the extent to which individuals or groups believe themselves to be sharing...... relations (or not), and the consequences of these beliefs for European political projects, processes and products. By exploring European communion through an engagement with contemporary political theory, using very brief illustrations from the Treaty of Lisbon, the article also suggests that European...

  10. Experience and activities in the field of plutonium recycling in civilian nuclear power plants in the European Union

    International Nuclear Information System (INIS)

    Decressin, A.; Gambier, D.J.; Lehmann, J.-P.; Nietzold, D.E.

    1996-01-01

    The European Union industry has established a world-wide leadership position in manufacturing and exploiting plutonium bearing fuel (MOX). About 15 to 20 tons of plutonium have been manufactured in the MOX fuel fabrication plants of E.U. companies. The current capacity of about 60 tons of MOX fuel per year is being upgraded to reach 400 tons/year by the year 2000. As a result, the excess amounts of separated plutonium, presently stored in the European Union, should no longer raise but should steadily decrease to converge to zero. Studies by the European Commission have indicated that the best use at present of weapons-grade and reactor-grade plutonium is to burn it in operating and future planned nuclear reactors. Disposing of plutonium by blending it with fission products or immobilising it into synthetic matrices appears to be far from being an industrially viable option. Following this path would mean to continue storing the excess plutonium of both military and civilian origin for an unknown, but very long period of time. For these and other reasons, the European Commission is striving to foster international cooperation between the European Union companies, having a long industrial experience accumulated in the field of recycling plutonium, and, so far, the Russian Federation and the Newly Independent States. This cooperation is aiming at supporting projects that could be mutually beneficial to all parties involved. To meet this objective, several programmes have been established either bilaterally or multilaterally, in particular within the framework of the International Science and Technology Centre (I.S.T.C.) in Moscow. Some examples of such collaborations will be described. (author)

  11. Risk based inspection experience from the European chemical- and petrochemical industries

    International Nuclear Information System (INIS)

    Kristensen, Hans; Jeppesen, Leif; Larsen, Bjarne; Kim, Na Yon

    2001-01-01

    As an inspection vendor with 60 years of experience and with more than 25 years of experience as manufacturer of the Automated Ultrasonic NDT systems, the P-scan systems, FORCE Institute is continuously analysing the market for NDT. This is done to assure that both the equipment product line and the service mix provided by FORCE Institute are meeting the requirements from the industry today and in the future. The concept of Risk Based Inspection Programmes were adopted early by the offshore industry and has in the recent years been adopted by many other industries as a reliable and cost efficient way of maintaining a production facility. A Risk/Reliability Based Inspection Programme is a 'living organism' that constantly needs information if it shall be of any value and NDT information is only one type of information that is required. The NDT information required is normally related to corrosion/base material information and weld integrity information. NDT as an integrated part of a plants maintenance system is, in Europe, currently influenced by the following tendencies which all are related to 'Risk Based Inspection': · Increased use of Base-Line Inspections · Reduction in the use of repeated inspections(qualitative- instead of quantitative Inspections). · Inspection results are fed directly into the plant maintenance system. · Fitness-for-Purpose acceptance criteria instead of conventional acceptance criteria. As repeatability and accuracy is a key issue for the data, automated ultrasonic inspection is increasingly used as an alternative to manual ultrasonic inspection, but due to the physical size of most automated ultrasonic inspection systems the gain in productivity has not been as significant as the gain in repeatability and accuracy. In this paper some of FORCE Institute's practical experiences with examinations carried out in connection with Risk Based Inspection is used to illustrate the above described tendencies. Not only examples using automated

  12. CEM: Increasing productivity through the management and monitoring of experiences provided to customers

    Directory of Open Access Journals (Sweden)

    Adriana Arineli

    2015-12-01

    Full Text Available Dealing with intangible and so subtle experience is unusual and a huge challenge for management that is not used to measure what has no numbers, but maybe they need to see beyond the obvious and accessible statistics. Recently, several studies point to the importance of customer experience management (CEM. However, if the CEM is a strategy to focus on operations and processes of a business around the customers’ experiences with the company, it is essential to seek grants to structure it and find out its effectiveness. This study examines the issues involved in offering superior customer experiences on fashion retail stores in Brazil, identifying the relation between productivity and CEM. Through a research with managers of three important Brazilian clothing retail chains, it was possible to analyze the aspects that impact on the customer experience and their relevance. A questionnaire was applied to evaluate 23 variables that make up the experience of the customer and their impact on increasing productivity. Some statistical techniques were used for data processing and it was possible to realize that only 4 of the 23 items were not relevant for customer experience. It can be concluded that CEM is effective in increasing productivity and can be used as a guideline matrix management in decision-making to promote superior customer experiences. Specific characteristics of each segment suggest different impacts in every aspect. Therefore, it is crucial that each segment review its own variables that will structure the CEM. Even assuming that it is defiant see beyond the obvious, maybe this is the necessary opportunity to create real competitive advantage and longevity for companies that want to stand out and be successful over time.

  13. Local investment in renewable energies - European experiences; Investissement local dans les energies renouvelables - recueil d'experiences europeennes

    Energy Technology Data Exchange (ETDEWEB)

    Quantin, J; Grepmeier, K; Larsen, J; Manolakaki, E; Smith, M

    2004-01-01

    This booklet is realized within the framework of the european commission called PREDAC. This document have been conceived by a working group specialized on the local investment into renewable energies thematic. The objectives of this project are: to promote citizen participation in the financing of renewable energies projects in Europe; to make organizations, investor clubs and local government to be aware of this way of implication into renewable energies development; to examine more especially three renewable energy sources: biomass, photovoltaic and wind in Denmark, France, Germany, Greece and United Kingdom. (author)

  14. Local investment in renewable energies - European experiences; Investissement local dans les energies renouvelables - recueil d'experiences europeennes

    Energy Technology Data Exchange (ETDEWEB)

    Quantin, J.; Grepmeier, K.; Larsen, J.; Manolakaki, E.; Smith, M

    2004-01-01

    This booklet is realized within the framework of the european commission called PREDAC. This document have been conceived by a working group specialized on the local investment into renewable energies thematic. The objectives of this project are: to promote citizen participation in the financing of renewable energies projects in Europe; to make organizations, investor clubs and local government to be aware of this way of implication into renewable energies development; to examine more especially three renewable energy sources: biomass, photovoltaic and wind in Denmark, France, Germany, Greece and United Kingdom. (author)

  15. The IceCube MasterClass: providing high school students an authentic research experience

    Science.gov (United States)

    Bravo Gallart, Silvia; Bechtol, Ellen; Schultz, David; Madsen, Megan; Demerit, Jean; IceCube Collaboration

    2017-01-01

    In May 2014, the first one-day long IceCube Masterclass for high school students was offered. The program was inspired by the masterclasses started in 2005 by the International Particle Physics Outreach Group and supported in the U.S. by QuarkNet. Participation in the IceCube masterclasses has grown each year, with a total of over 500 students in three U.S states and three European countries after three editions. In a masterclass, students join an IceCube research team to learn about astrophysics and replicate the results of a published paper, such as the discovery of astrophysical neutrinos or a measurement of the cosmic ray flux. We will discuss both the scientific and educational goals of the program as well as the organizational challenges. Data from the program evaluation will be used to support the need of educational activities based on actual research as a powerful approach for motivating more students to pursue STEM college programs, making science and scientists more approachable to teenagers, and helping students envision a career in science.

  16. PIRAMID 1: a prime European CEC experiment in BR2 at Mol, Belgium

    International Nuclear Information System (INIS)

    Joly, C.; Simoni, O.

    1987-01-01

    In the event of a core disruptive accident in a Liquid Metal Fast Breeder Reactor (LMFBR), molten core materials interacting with liquid sodium may form debris beds to settle on the retention structures or on the reactor vessel. The decay heat of retained fission products can induce high temperatures or high thermal loads on the retention structures or the reactor vessel with consequent fission product release. To assess the long-term coolability of core debris beds the Commission of the European Communities (CEC) decided to coordinate and fund the European PAHR (Post-Accident Heat Removal) program. The first work carried out for the program resulted in PIRAMID 1 (Pahr IRradiation According to a Mol Integrated Device), a unique irradiation device, designed, constructed and tested at Mol

  17. Designing a Financial Stability Architecture for a Regionally Integrated Financial Space: The European Experience.

    OpenAIRE

    Heinrich, Gregor

    2015-01-01

    Any discussion on improving the existing arrangements for assessing and managing financial risks and in particular supervising the relevant institutions will also need to address the question on which institution should be responsible for which task and for which sector of the financial system, how these institutions should be organized and, if there are several, how they should interact with each other. Based on the example of the European Union, this paper shows the gradual change from ...

  18. The Eastern European experience on occupational skin diseases. Make underreporting an issue?

    Science.gov (United States)

    Moldovan, H R; Voidazan, S T; John, S M; Weinert, P; Moldovan, G; Vlasiu, M A; Szasz, Z A; Tiplica, G S; Szasz, S; Marin, A C; Salavastru, C M

    2017-06-01

    While legislation in most of the Eastern European countries is nowadays widely harmonized with the legal safety and health provisions of Western countries, there is still a sustained resistance to the notification of occupational skin diseases (OSD). The aim of the study was to identify the main barriers in notification and recognition of OSD in 22 Eastern European countries. An online survey was administered to key persons in the field of occupational safety and health in 22 Eastern European countries. Multiple variables of the notification system were studied, including clinical, organizational and educational issues. The main causes of underreporting OSD are ineffective enforcement of occupational safety and health legislation, contractual relationship employer-employee, long duration of the notifying process, restrictions of the notification systems in terms of who is entitled to notify an OSD, ineffective regulations in regards to the pre-employment and periodical medical examination, ineffective compensation schemes, restraints and hesitations, mainly from the doctors, inappropriate mentalities - fear of losing the jobs, fining of the employers by the authorities, stigmatization of the workers with OSD, additional costs for employers, stakeholders' lack of interest in notifying, lack of guidelines and protocols and lack of preventive programmes. The most valuable method for a proper recognition of OSD is to increase the awareness of physicians involved in the management of OSD (occupational physicians, GPs, dermatologists), as well as employers and workers. There is an urgent need to improve national legislation, to develop and promote adequate preventive programmes, emphasizing ethical, legal, economical and psychological aspects in order to achieve an increased recognition and a real reporting of OSD, and to enforce an international action plan for Eastern Europe in order to improve the notification of OSD. © 2017 European Academy of Dermatology and

  19. The European Nuclear Society Young Generation Network: Five years of networking experience

    International Nuclear Information System (INIS)

    Meskens, Gaston

    2000-01-01

    In 1995, Mr Jan Runermark (Sweden), aware of a need for an exchange of knowledge from the older to the younger generation, came up with the idea of starting a European Nuclear Society Young Generation Network. A first network was formed with Sweden, the Netherlands, Spain, Finland, Germany and Belgium. The ENSYGN is now affiliated to the European Nuclear Society and brings together young students and professionals from 21 member countries Belgium, Bulgaria, Croatia, Czech Republic, Denmark Finland, France, Germany, Hungary, Italy, Netherlands, Poland, Romania, Russia, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, Ukraine, and United Kingdom, The ENSYGN Core group meets (at least) twice a year and elects its own chair and co chair for a term of two years. The ENSYGN chair has a seat in the ENS Steering Committee and in the ENS Board. The ENSYGN works closely together with other young generation networks from the US, Australia, Japan and South America. ENSYGN organises workshops and courses on European level, takes part in international meetings (fl. UNFCCC, OECD) and stimulates networking on national level

  20. INDEBTEDNESS AS DISCRIMINATORY ELEMENT FOR PERFORMING NOTARIAL SERVICES:CROATIAN SOLUTION AND EUROPEAN EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Dejan Bodul

    2014-01-01

    Full Text Available Analysis of the historical development of institute of notaries and comparative analysis of legal systems show that the institute of notaries is regulated differently, but what is common to all systems and refers to the legal nature of this institute is the fact that the notaries are persons worthy of public trust. This statement is the backbone of all the considerations relating to the institution of the notaries and theirs activities in the field of European legislation. The aim of this paper is to analyze the anachronism of indebtedness criteria as one of the positive legal obstacles in performing notarial services adequately. The complexity of the research topic and tasks of this paper have determined the choice of methods that are used here. During the research it was used methodological approach that includes the study of domestic and foreign literature, the study of relevant legislation, as well as an analysis of domestic and international jurisprudence. In this paper, authors shall analyze the case law of the European Court of Human Rights according to Article 14 of the European Convention for the Protection of Human Rights and Fundamental Freedoms (Prohibition of discrimination. ** This work has been supported by the Croatian science foundation under the project number 6558 "Business and Personal Insolvency - the Ways to Overcome Excessive Indebtedness"

  1. Doctoral e-Theses; experiences in harvesting on a national and European level

    CERN Multimedia

    CERN. Geneva

    2007-01-01

    In many countries in Europe doctoral e-theses are an integrated part of institutional repositories, which have been set up in recent years. In some countries they have been harvested on a national level, like in the Netherlands with the ‘Promise of Science’ portal (http://www.darenet.nl/promiseofscience) . In October 2006 SURFfoundation (The Netherlands), JISC (UK) and DIVA (funded through BIBSAM in Sweden) started a common project to harvest repositories with e-theses on an international scale and to set up a freely accessible European portal and test in practice the interoperability. The project, which aims at creating a value added service for doctoral e-Theses, will finish in June 2007. In the presentation we will show some lessons learned and the first results of the Demonstrator, an interoperable portal of European doctoral e-theses in five countries: Denmark, Germany, the Netherlands, Sweden and the UK. Furthermore, we will present the developments regarding the European coordination of doctoral...

  2. Providing Montessori: Identity and Dilemmas in a Montessori Teacher's Lived Experience

    Science.gov (United States)

    Christensen, Olivia

    2016-01-01

    This phenomenological case study was conducted to better understand the experience of a Montessori teacher in a leadership role. A veteran Montessori teacher, newly hired by an established Montessori preschool, was interviewed over the course of her first year in the position. A critical discourse analysis revealed multiple social identities that…

  3. Student-Run Communications Agencies: Providing Students with Real-World Experiences That Impact Their Careers

    Science.gov (United States)

    Bush, Lee; Haygood, Daniel; Vincent, Harold

    2017-01-01

    While several studies have examined the learning outcomes of student-run communications agencies, these studies have mostly been from the perspective of faculty advisors. Through in-depth interviews with student agency graduates, this study examined how current industry professionals perceive the benefits of their student agency experiences and…

  4. Providing guidance in virtual lab experimentation : the case of an experiment design tool

    NARCIS (Netherlands)

    Efstathiou, Charalampos; Hovardas, Tasos; Xenofontos, Nikoletta A.; Zacharia, Zacharias C.; de Jong, Ton A.J.M.; Anjewierden, Anjo; van Riesen, Siswa A.N.

    2018-01-01

    The present study employed a quasi-experimental design to assess a computer-based tool, which was intended to scaffold the task of designing experiments when using a virtual lab for the process of experimentation. In particular, we assessed the impact of this tool on primary school students’

  5. The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC): experiences from a successful ERS Clinical Research Collaboration.

    Science.gov (United States)

    Chalmers, James D; Crichton, Megan; Goeminne, Pieter C; Loebinger, Michael R; Haworth, Charles; Almagro, Marta; Vendrell, Montse; De Soyza, Anthony; Dhar, Raja; Morgan, Lucy; Blasi, Francesco; Aliberti, Stefano; Boyd, Jeanette; Polverino, Eva

    2017-09-01

    In contrast to airway diseases like chronic obstructive pulmonary disease or asthma, and rare diseases such as cystic fibrosis, there has been little research and few clinical trials in bronchiectasis. Guidelines are primarily based on expert opinion and treatment is challenging because of the heterogeneous nature of the disease. In an effort to address decades of underinvestment in bronchiectasis research, education and clinical care, the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) was established in 2012 as a collaborative pan-European network to bring together bronchiectasis researchers. The European Respiratory Society officially funded EMBARC in 2013 as a Clinical Research Collaboration, providing support and infrastructure to allow the project to grow. EMBARC has now established an international bronchiectasis registry that is active in more than 30 countries both within and outside Europe. Beyond the registry, the network participates in designing and facilitating clinical trials, has set international research priorities, promotes education and has participated in producing the first international bronchiectasis guidelines. This manuscript article the development, structure and achievements of EMBARC from 2012 to 2017. To understand the role of Clinical Research Collaborations as the major way in which the European Respiratory Society can stimulate clinical research in different disease areasTo understand some of the key features of successful disease registriesTo review key epidemiological, clinical and translational studies of bronchiectasis contributed by the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) project in the past 5 yearsTo understand the key research priorities identified by EMBARC for the next 5 years.

  6. A qualitative description of service providers' experiences of ethical issues in HIV care.

    Science.gov (United States)

    Sabone, Motshedisi B; Mogobe, Keitshokile Dintle; Matshediso, Ellah; Shaibu, Sheila; Ntsayagae, Esther I; Corless, Inge B; Cuca, Yvette P; Holzemer, William L; Dawson-Rose, Carol; Baez, Solymar S Soliz; Rivero-Mendz, Marta; Webel, Allison R; Eller, Lucille Sanzero; Reid, Paula; Johnson, Mallory O; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Wantland, Dean; Nicholas, Patrice K; Lingren, Teri; Portillo, Carmen J; Sefcik, Elizabeth; Long-Middleton, Ellen

    2018-01-01

    Managing HIV treatment is a complex multi-dimensional task because of a combination of factors such as stigma and discrimination of some populations who frequently get infected with HIV. In addition, patient-provider encounters have become increasingly multicultural, making effective communication and provision of ethically sound care a challenge. This article explores ethical issues that health service providers in the United States and Botswana encountered in their interaction with patients in HIV care. A descriptive qualitative design was used to collect data from health service providers and patients using focused group discussions. This article is based on responses from health service providers only. Participants and context: This article is based on 11 focused group discussions with a total sample of 71 service providers in seven US sites and one Botswana site. Ethical considerations: Ethical review boards at all the study sites reviewed the study protocol and approved it. Ethical review boards of the study's coordinating centers, Rutgers University and the University of California at San Francisco, also approved it. The study participants provided a written informed consent to participate. HIV service providers encountered ethical challenges in all the four Beauchamp and Childress' biomedical ethics of respect for patients' autonomy, beneficence, justice, and nonmaleficence. The finding that HIV service providers encounter ethical challenges in their interaction with patients is supported by prior studies. The ethical challenges are particularly prominent in multicultural care and resource-constrained care environments. Provision of HIV care is fraught with ethical challenges that tend to pose different issues depending on a given care environment. It is important that strong partnerships are developed among key stakeholders in HIV care. In addition, health service providers need to be provided with resources so they can provide quality and ethically sound

  7. Examining Clinicians' Experiences Providing Sexual Health Services for LGBTQ Youth: Considering Social and Structural Determinants of Health in Clinical Practice

    Science.gov (United States)

    Knight, R. E.; Shoveller, J. A.; Carson, A. M.; Contreras-Whitney, J. G.

    2014-01-01

    Although barriers related to lesbian, gay, bisexual, transgender and queer (LGBTQ) youth's experiences accessing sexual health services have been examined in detail, research into the experiences and perceptions of clinicians providing these services has been conspicuously absent. The aim of this article is to explore the perceptions and…

  8. Key aspects of state-society relations the in the sphere of volunteering: european and ukrainian experiences

    Directory of Open Access Journals (Sweden)

    V. L. Golub

    2016-03-01

    Full Text Available The article examines the experience of state-society relations in the sphere of volunteering in Ukraine and in the UK, Germany, Poland, and France. The author has determined key aspects of the analysis of European and Ukrainian experiences of state-society relations the in the sphere of volunteering. These are the level of development of national legislation on volunteering; organization of the system of executive bodies at the national level, which deal with volunteering issues; functioning of volunteering public advisory formations at authorities, their legal status, compositions and content of activity; the actual existence and the sense of the government volunteering. On this base, the author has carried out a comparative analysis of the conditions of the state-society relations in the field of volunteering in Europe and Ukraine at the current stage through the prism of their key aspects. The paper focuses on the certain benefits of European experience of state-society relations in the sphere of volunteering as possible goals of domestic development.

  9. Physical Science Informatics: Providing Open Science Access to Microheater Array Boiling Experiment Data

    Science.gov (United States)

    McQuillen, John; Green, Robert D.; Henrie, Ben; Miller, Teresa; Chiaramonte, Fran

    2014-01-01

    The Physical Science Informatics (PSI) system is the next step in this an effort to make NASA sponsored flight data available to the scientific and engineering community, along with the general public. The experimental data, from six overall disciplines, Combustion Science, Fluid Physics, Complex Fluids, Fundamental Physics, and Materials Science, will present some unique challenges. Besides data in textual or numerical format, large portions of both the raw and analyzed data for many of these experiments are digital images and video, requiring large data storage requirements. In addition, the accessible data will include experiment design and engineering data (including applicable drawings), any analytical or numerical models, publications, reports, and patents, and any commercial products developed as a result of the research. This objective of paper includes the following: Present the preliminary layout (Figure 2) of MABE data within the PSI database. Obtain feedback on the layout. Present the procedure to obtain access to this database.

  10. Radiation physics of high power spallation targets. State of the art simulation methods and experiments, the 'European Spallation Source' (ESS)

    International Nuclear Information System (INIS)

    Filges, D.; Cloth, P.; Neef, R.D.; Schaal, H.

    1998-01-01

    Particle transport and nuclear interactions of planned high power spallation targets with GeV proton beams can be simulated using widely developed Monte Carlo transport methods. This includes available high energy radiation transport codes and systems for low energy, earlier developed for reactor physics and fusion technology. Monte Carlo simulation codes and applied methods are discussed. The capabilities of the world-wide existing state-of-the-art computer code systems are demonstrated. Results of computational studies for the 'European Spallation Source' (ESS) mercury high power target station are given. The needs for spallation related data and planned experiments are shown. (author)

  11. User experiences with clinical social franchising: qualitative insights from providers and clients in Ghana and Kenya.

    Science.gov (United States)

    Sieverding, Maia; Briegleb, Christina; Montagu, Dominic

    2015-02-01

    Clinical social franchising is a rapidly growing delivery model in private healthcare markets in low- and middle-income countries. Despite this growth, little is known about providers' perceptions of the benefits and challenges of social franchising or clients' reasons for choosing franchised facilities over other healthcare options. We examine these questions in the context of three social franchise networks in Ghana and Kenya. We conducted in-depth interviews with a purposive sample of providers from the BlueStar Ghana, and Amua and Tunza networks in Kenya. We also conducted qualitative exit interviews with female clients who were leaving franchised facilities after a visit for a reproductive or child health reason. The total sample consists of 47 providers and 47 clients across the three networks. Providers perceived the main benefits of participation in a social franchise network to be training opportunities and access to a consistent supply of low-cost family planning commodities; few providers mentioned branding as a benefit of participation. Although most providers said that client flows for franchised services increased after joining the network, they did not associate this with improved finances for their facility. Clients overwhelmingly cited the quality of the client-provider relationship as their main motivation for attending the franchise facility. Recognition of the franchise brand was low among clients who were exiting a franchised facility. The most important benefit of social franchise programs to both providers and their clients may have more to do with training on business practices, patient counseling and customer service, than with subsidies, technical input, branding or clinical support. This finding may lead to a reconsideration of how franchise programs interact with both their member clinics and the larger health-seeking communities they serve.

  12. European and Italian experience of Smart Cities: A model for the smart planning of city built

    Directory of Open Access Journals (Sweden)

    Starlight Vattano

    2013-05-01

    Full Text Available The construction of the city through smart measures is now a frontier reached from many cities in the world. The built environment requires smart planning able to relate urban realities that are relegated to a marginal change. But how does the smart cities can create a relationship between sustainable cities of the future and their heritage? The article highlights the way of smart urban transformation of reality European and Italian proposing critical comparisons from which to infer smart parameters most used and easy to apply for the sustainable construction of these smart cities focusing on the urban sources of intelligent retrieval for quality their historical and cultural heritage.

  13. Practical experience in post-mortem tissue donation in consideration of the European tissue law.

    Science.gov (United States)

    Karbe, Thomas; Braun, Christian; Wulff, Birgit; Schröder, Ann Sophie; Püschel, Klaus; Bratzke, Hansjürgen; Parzeller, Markus

    2010-03-01

    In consequence of the European guidelines of safety and quality standards for the donation, retrieval, storing and distribution of human tissues and cells the purpose of tissue transplantation was implemented into German legislation in May 2007. The law came into effect on August 1st 2007 considering of the European rules. The Institutes for Legal Medicine of the University of Frankfurt/Main and the University Medical Center Hamburg-Eppendorf developed a model for tissue retrieval. The Institute of Legal Medicine (I.f.R.) at the University Medical Center Hamburg cooperates with the German Institute of Cell and Tissue Replacement (Deutsches Institut für Zell--und Gewebeersatz DIZG). Potential post-mortem tissue donors (PMTD) among the deceased are selected by standardized sets of defined criteria. The procedure is guided by the intended exclusion criteria of the tissue regulation draft (German Transplant Law TPG GewV) in accordance with the European Guideline (2006/17/EC). Following the identification of the donor and subsequent removal of tissue, the retrieved samples were sent to the DIZG, a non-profit tissue bank according to the tissue regulation. Here the final processing into transplantable tissue grafts takes place, which then results in the allocation of tissue to hospitals in Germany and other European countries. The Center of Legal Medicine at the Johann Wolfgang Goethe-University Medical Center Frankfurt/Main cooperates since 2000 with Tutogen, a pharmaceutical company. Harvesting of musculoskeletal tissues follows corresponding regulations. To verify the outcome of PMTD at the I.f.R. Hamburg, two-statistic analysis over 12 and 4 months have been implemented. Our results have shown an increasing number of potential appropriate PMTD within the second inquiry interval but a relatively small and unvaryingly rate of successful post-mortem tissue retrievals similar to the first examination period. Thus, the aim of the model developed by the I.f.R. is to

  14. EuroEco (European Health Economic Trial on Home Monitoring in ICD Patients): a provider perspective in five European countries on costs and net financial impact of follow-up with or without remote monitoring.

    Science.gov (United States)

    Heidbuchel, Hein; Hindricks, Gerd; Broadhurst, Paul; Van Erven, Lieselot; Fernandez-Lozano, Ignacio; Rivero-Ayerza, Maximo; Malinowski, Klaus; Marek, Andrea; Romero Garrido, Rafael F; Löscher, Steffen; Beeton, Ian; Garcia, Enrique; Cross, Stephen; Vijgen, Johan; Koivisto, Ulla-Maija; Peinado, Rafael; Smala, Antje; Annemans, Lieven

    2015-01-14

    different for remote FU vs. purely in-office FU, despite reorganized care. However, disparity in the impact on provider budget among different countries illustrates the need for proper reimbursement to ensure effective remote FU implementation. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Cardiology.

  15. Healthcare providers' experiences screening for intimate partner violence among migrant and seasonal farmworking women: A phenomenological study.

    Science.gov (United States)

    Wilson, Jonathan B; Rappleyea, Damon L; Hodgson, Jennifer L; Brimhall, Andrew S; Hall, Tana L; Thompson, Alyssa P

    2016-12-01

    Migrant and seasonal farmworking (MSFW) women patients experience substantially more intimate partner violence (IPV) than the general population, but few health-care providers screen patients for IPV. While researchers have examined screening practices in health-care settings, none have exclusively focused on MSFW women. The aim of this phenomenological study was to explore the experiences of health-care providers who have screened for and/or addressed IPV with MSFW women patients. Researchers utilized descriptive phenomenology to capture the lived experiences of these health-care providers. Data were analysed using Colaizzi's seven-stage framework. Interviews were conducted with nine female participants - all of whom: (i) were clinically active health-care providers within the MSFW community, (ii) were bilingual in English and Spanish or had access to a translator, (iii) had treated MSFW patients who had experienced IPV and (iv) were at least 18 years of age. Participants' experiences were reflected in four emergent themes: (i) provider-centered factors, (ii) patient-centered factors, (iii) clinic-centered factors and (iv) community-centered factors. Participants described barriers to establish routine IPV assessment, decrease patient ambivalence and increase on-site support and community resources. This study aimed to generate a greater understanding of the experiences of health-care providers with screening for and addressing IPV with MSFW patients. Implications and recommendations for research, clinical practice and policy are provided. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  16. Health system factors influencing management of multidrug-resistant tuberculosis in four European Union countries - learning from country experiences

    Directory of Open Access Journals (Sweden)

    Gerard de Vries

    2017-04-01

    Full Text Available Abstract Background In the European Union and European Economic Area only 38% of multidrug-resistant tuberculosis patients notified in 2011 completed treatment successfully at 24 months’ evaluation. Socio-economic factors and patient factors such as demographic characteristics, behaviour and attitudes are associated with treatment outcomes. Characteristics of healthcare systems also affect health outcomes. This study was conducted to identify and better understand the contribution of health system components to successful treatment of multidrug-resistant tuberculosis. Methods We selected four European Union countries to provide for a broad range of geographical locations and levels of treatment success rates of the multidrug-resistant tuberculosis cohort in 2009. We conducted semi-structured interviews following a conceptual framework with representatives from policy and planning authorities, healthcare providers and civil society organisations. Responses were organised according to the six building blocks of the World Health Organization health systems framework. Results In the four included countries, Austria, Bulgaria, Spain, and the United Kingdom, the following healthcare system factors were perceived as key to achieving good treatment results for patients with multidrug-resistant tuberculosis: timely diagnosis of drug-resistant tuberculosis; financial systems that ensure access to a full course of treatment and support for multidrug-resistant tuberculosis patients; patient-centred approaches with strong intersectoral collaboration that address patients’ emotional and social needs; motivated and dedicated healthcare workers with sufficient mandate and means to support patients; and cross-border management of multidrug-resistant tuberculosis to secure continuum of care between countries. Conclusion We suggest that the following actions may improve the success of treatment for multidrug-resistant tuberculosis patients: deployment of

  17. Initial experience with the providence nighttime bracing in adolescent idiopathic scoliosis

    DEFF Research Database (Denmark)

    Quisth, Lena; Beuschau, Inge; Simony, A.

    2015-01-01

    Background: Since 2008 the primary non-surgical treatment of adolescent idiopathic scoliosis (AIS) in the southern part of Denmark, went from full-time bracing with Boston brace, to Providence nighttime bracing. Aim: To evaluate the effectiveness of nighttime bracing, with the Providence brace...... with the Providence nighttime brace and an acceptable 18 % failure rate. The nighttime brace is an excellent alternative to standard conservative treatment, and reduces the need for physiotherapy after brace termination. The patients tolerate the nighttime brace treatment well, and compliance within the cohort......, in AIS. Method: Patients diagnosed with AIS. With an apex from TH7 and below and with a cobb angel between 20-45 degrees. The patients were evaluated every 6 months with standing x-rays and the brace treatment was continued until two years post menarche. Cobb angle of the major curve pretreatment, in...

  18. Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study.

    Directory of Open Access Journals (Sweden)

    Maryse C Cnossen

    Full Text Available The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI is low. Comparative effectiveness research (CER has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI study.We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions.All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%, designated as a level I trauma center (n = 48, 68% and situated in an urban location (n = 70, 99%. The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57% had a dedicated neuro-intensive care unit (ICU, 36 (51% had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45 of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers.Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches.

  19. TERRITORIAL DISPARITIES REGARDING THE DISTRIBUTION OF HEALTH SERVICE PROVIDERS IN ROMANIA AFTER JOINING THE EUROPEAN UNION STUDY CASE: MEDICAL STAFF WITH TERTIARY LEVEL OF EDUCATION

    Directory of Open Access Journals (Sweden)

    Babucea Ana-Gabriela

    2017-02-01

    Full Text Available In Romania 90ˈs, there was a relatively low level of regional disparities compared with western economies in all fields, but inequalities have emerged and widened rapidly because only certain areas, especially urban areas have benefited from inflows of capital and specialized human resources. Currently, Romania has a low level of development between EU countries, five of the eight NUTS 2 regions being the most underdeveloped in Europe. The aim of this research is a comparative analysis of developments and trends manifested in the public health system in terms of distribution of health services providers at the regional level in Romania. For the analysis of regional disparities, the research seeks to highlight a comprehensive image of the level and dynamics of the Romania territorial inequalities regarding the personnel with tertiary education, which includes physicians, dentists, and pharmaceutical chemists, as professional providers of the health services. Were took into account statistical indicators that describe the distribution of such as healthcare providers, at level of the eight Romanian NUTS2 regions, highlighting inequalities in access to health services for the population. We used available data, accessed from National Institute of Statistics of Romania, regarding Romania, and itˊs eight regions. We appeal also to statistical publications at the national and European level, other data analysis, and experts' opinions expressed in recent articles in the field. In order to identify the factors that can reduce the disparities, and ensure the equity for disadvantaged population, in terms of ensuring the health system of medical services in parallel with a homogeneous distribution of resources and services in this area, we apply specific statistics for territorial analysis and comparisons.

  20. Analysis of the BFS-62 critical experiment. A report produced for BNFL (Joint European contribution)

    International Nuclear Information System (INIS)

    Newton, T.D.; Hosking, J.G.; Smith, P.J.

    2004-01-01

    A benchmark analysis for a hybrid UOX/MOX fuelled core of the BN-600 reactor was proposed during the first Research Co-ordination Meeting of the IAEA Co-ordinated Research Project 'Updated Codes and Methods to Reduce Calculational Uncertainties of LMFR Reactivity Effects'. Phase 5 of the benchmark focuses on validation of calculated sodium void coefficient distributions and integral reactivity coefficients by comparison with experimental measurements made in the critical facility BFS-62. The European. participation in Phase 5 of the benchmark analyses consists of a joint contribution from France (CEA Cadarache) and the UK (Serco Assurance Winfrith - sponsored by BNFL). Calculations have been performed using the ERANOS code and data system, which has been developed in the framework of the European collaboration on fast reactors. Results are presented in this paper for the sodium void reactivity effect based on calculated values of the absolute core reactivity. The spatial distribution of the void effect, determined using first order perturbation theory with the diffusion theory approximation, is also presented

  1. A qualitative study of English community pharmacists' experiences of providing lifestyle advice to patients with cardiovascular disease

    OpenAIRE

    Morton, Kirsty; Pattison, Helen; Langley, Chris; Powell, Rachael

    2015-01-01

    Background - Cardiovascular disease (CVD) progression is modifiable through lifestyle behaviors. Community pharmacists are ideally placed to facilitate self-management of cardiovascular health however research shows varied pharmacist engagement in providing lifestyle advice. Objective - This study explored community pharmacists' experiences and perceptions of providing lifestyle advice to patients with CVD. Methods - Semi-structured interviews were conducted with fifteen pharmacists (1 superm...

  2. Comparing medical and dental providers of oral health services on early dental caries experience.

    Science.gov (United States)

    Kranz, Ashley M; Rozier, R Gary; Preisser, John S; Stearns, Sally C; Weinberger, Morris; Lee, Jessica Y

    2014-07-01

    Most state Medicaid programs reimburse nondental primary care providers (PCPs) for providing preventive oral health services to young children. We examined the association between who (PCP, dentist, or both) provides these services to Medicaid enrollees before age 3 years and oral health at age 5 years. We linked North Carolina Medicaid claims (1999-2006) to oral health surveillance data (2005-2006). Regression models estimated oral health status (number of decayed, missing, and filled primary teeth) and untreated disease (proportion of untreated decayed teeth), with adjustment for relevant characteristics and by using inverse-probability-of-treatment weights to address confounding. We analyzed data for 5235 children with 2 or more oral health visits from a PCP, dentist, or both. Children with multiple PCP or dentist visits had a similar number of overall mean decayed, missing, and filled primary teeth in kindergarten, whereas children with only PCP visits had a higher proportion of untreated decayed teeth. The setting and provider type did not influence the effectiveness of preventive oral health services on children's overall oral health. However, children having only PCP visits may encounter barriers to obtaining dental treatment.

  3. Student-selected components in surgery: providing practical experience and increasing student confidence.

    LENUS (Irish Health Repository)

    Falk, G A

    2009-09-01

    Reviews of the medical school curriculum in the UK and Ireland have recommended the introduction of student-selected components (SSCs). The Department of Surgery in The Royal College of Surgeons in Ireland (RCSI) has introduced a 6-week surgical SSC, which aims to develop practical clinical skills, provide mentorship and prepare students for internship.

  4. Witnesses to Transformation: Family Member Experiences Providing Individualized Music to Their Relatives with Dementia

    Science.gov (United States)

    Johnston, Elizabeth; Rasmusson, Xeno; Foyil, Barbara; Shopland, Patricia

    2017-01-01

    Content analysis of 35 family members stories found that sharing individualized music enhanced memory, mood and provided interactive opportunities, where family members connected and communicated with relatives who had dementia. Technology supports a positive new role for family members, who often use MP3 players (e.g. iPods), headphones,…

  5. Middle-class household food providers' views and experiences of food marketing in Vietnam.

    Science.gov (United States)

    Pham, Quynh Th; Worsley, Anthony

    2016-12-01

    Food marketing has been identified as a target for intervention in the prevention of childhood overweight and obesity within countries and globally, and promotion of healthy diets has been classified as a key strategy to reduce the burden of non-communicable diseases and health inequalities. The present study aims to investigate how Vietnamese middle-class household food providers are impacted by food advertising communications, their views of food marketing and the ways they think the government can control food marketing to assist people to consume healthier diets. 810 household food providers participated in the online survey. Frequency counts were calculated using IBM SPSS version 21. Many respondents had been exposed to food marketing; 82.8% had seen food advertising in magazines at least once a month, 65.1% had received free food samples in public places, 68.0% had received food advertising information via email. Many household food providers appeared to support food marketing; 73.3% approved of nutrition education in schools or on television being provided by soft drink or fast food companies, 63.7% supported the marketing of infant formula milk. There were mixed views about what actions the government could implement to control food marketing; 88.2% supported clearer food content on food labels, 84.1% believed that children should learn how to purchase and cook foods at school. A substantial majority of Vietnamese middle-class household food providers appeared unaware of the adverse effects of food marketing. Education and policy leadership in food and nutrition are urgently required.

  6. A virtual outpatient department provides a satisfactory patient experience following endoscopy.

    Science.gov (United States)

    Ryan, Elizabeth M; Rogers, Ailín C; Hanly, Ann M; McCawley, Niamh; Deasy, Joseph; McNamara, Deborah A

    2014-03-01

    The purpose of this study was to investigate telephone follow-up of post-endoscopy patients as an alternative to attendance at the outpatient department. Access to outpatient appointments is often a target for improvement in healthcare systems. Increased outpatient clinic capacity is not feasible without investment and extra manpower in an already constrained service. Outpatient attendance was audited at a busy colorectal surgical service. A subset of patients appropriate for follow-up in a "virtual outpatient department" (VOPD) were identified. A pilot study was designed and involved telephone follow-up of low-risk endoscopic procedures. Patient satisfaction was assessed using the Medical Interview Satisfaction Scale (MISS), which is a standardised survey of patient satisfaction with healthcare experiences. This was conducted via anonymous questionnaire at the end of the study. Of a total of 166 patients undergoing endoscopy in the time period, 79 were prospectively recruited to VOPD follow-up based on eligibility criteria. Overall, 67 (84.8 %) were successfully followed up by telephone consultation; nine patients (11.4 %) were contacted by mail. The remaining three patients (3.8 %) were brought back to the OPD. Patients recruited were more likely to be younger (55.82 ± 14.96 versus 60.78 ± 13.97 years, P = 0.029) and to have had normal examinations (49.4 versus 31.0 %, χ (2) = 5.070, P = 0.025). Nearly three quarters of patients responded to the questionnaire. The mean scores for all four aspects of the MISS were satisfactory, and overall patients were satisfied with the VOPD experience. VOPD is a target for improved healthcare provision, with improved efficiency and a high patient satisfaction rate.

  7. Technology and distribution of pellets. Experience about the European network on wood pellets

    International Nuclear Information System (INIS)

    Rapp, S.W.

    1999-01-01

    Wood pellets might become the most important alternative to fossil fuels in the near future. As a bio-fuel it has the following characteristics: heat value, min 4.7 kWh/kg; ash fraction less than 1.0 vol. %; humidity less than 10 vol. %; diameter (rod shaped) min 6 mm and volumetric weight about 650 kg/m 3 . About 2.1 t pellets substitute 1000 l fuel oil. Sweden and Austria have more than 15 year experience in using wood pellets, followed by Germany. They are an environmentally friendly alternative for private houses, for district heating plants and especially suitable for densely built-up and inhabited areas. Having high energy density they can be transported to the areas with high energy requirements. Among their advantages are: low humidity, easy transport and storage, can be produced by renewable raw materials and provide new local jobs, fit for renewable energy systems with closed cycle. Disadvantages include: relatively more expensive for private houses compared to oil and gas and necessity of two times larger storage space than oil. Wood pellets are produced by all kind of paper waste and wood wastes from industry. They are especially suitable for small boiler plants and the oil burner can be replaced by a pellet burner in the same boiler. The leading producer of wood pellets is Sweden, of pellet stoves - USA. Pellet stoves, pellet burners and pellet boilers both for private houses and for heating plants are manufactured also in Sweden, Denmark,Finland, Germany, Austria and Ireland

  8. User experiences with clinical social franchising: qualitative insights from providers and clients in Ghana and Kenya

    OpenAIRE

    Sieverding, Maia; Briegleb, Christina; Montagu, Dominic

    2015-01-01

    Background Clinical social franchising is a rapidly growing delivery model in private healthcare markets in low- and middle-income countries. Despite this growth, little is known about providers? perceptions of the benefits and challenges of social franchising or clients? reasons for choosing franchised facilities over other healthcare options. We examine these questions in the context of three social franchise networks in Ghana and Kenya. Methods We conducted in-depth interviews with a purpo...

  9. A Qualitative Study of Patient and Provider Experiences during Preoperative Care Transitions

    Science.gov (United States)

    MALLEY, ANN; YOUNG, GARY J.

    2017-01-01

    Aims To explore the issues and challenges of care transitions in the preoperative environment. Background Ineffective transitions play a role in a majority of serious medical errors. There is a paucity of research related to the preoperative arena and the multiple inherent transitions in care that occur there. Design Qualitative descriptive design was used. Methods Semi-structured interviews were conducted in a 975 bed academic medical center. Results 30 providers and 10 preoperative patients participated. Themes that arose were: (1) Need for clarity of purpose of preoperative care (2) Care coordination (3) Inter-professional boundaries of care (4) Inadequate time and resources. Conclusion Effective transitions in the preoperative environment require that providers bridge scope of practice barriers to promote good teamwork. Preoperative care that is a product of well-informed providers and patients can improve the entire perioperative care process and potentially influence post-operative patient outcomes. Relevance to Clinical Practice Nurses are well positioned to bridge the gaps within transitions of care and accordingly affect health outcomes. PMID:27706872

  10. Parental experiences of providing skin-to-skin care to their newborn infant—Part 1: A qualitative systematic review

    Directory of Open Access Journals (Sweden)

    Agneta Anderzén-Carlsson

    2014-10-01

    Full Text Available Aim: To describe parental experiences of providing skin-to-skin care (SSC to their newborn infants. Background: SSC care for newborn infants has been reported to have positive physiological and psychological benefits to the infants and their parents. No systematic review regarding parental experiences has been identified. Design: In this first part of a meta-study, the findings of a systematic literature review on parental experience of SSC care are presented. Data sources: Four databases were searched, without year or language limitations, up until December 2013. Manual searches were performed in reference lists and in a bibliography of the topic. Review methods: After a quality-appraisal process, data from the original articles were extracted and analysed using qualitative content analysis. Results: The systematic and manual searches led to the inclusion of 29 original qualitative papers from nine countries, reporting experiences from 401 mothers and 94 fathers. Two themes that characterized the provision of SSC emerged: a restoring experience and an energy-draining experience. Conclusion: This review has added scientific and systematic knowledge about parental experiences of providing SSC. Further research about fathers’ experiences is recommended.

  11. The Experiences of Sexual Harassment in Sport and Education among European Female Sports Science Students

    Science.gov (United States)

    Fasting, Kari; Chroni, Stiliani; Knorre, Nada

    2014-01-01

    The study investigates whether sport is an especially risky environment for sexual harassment to occur. It explores female students' experiences of sexual harassment in organized sport and compares them with their experiences in formal education, by addressing the following research questions: (1) Are there any differences in female sport…

  12. Towards a stakeholders' consensus on patient payment policy: the views of health-care consumers, providers, insurers and policy makers in six Central and Eastern European countries.

    Science.gov (United States)

    Tambor, Marzena; Pavlova, Milena; Golinowska, Stanisława; Sowada, Christoph; Groot, Wim

    2015-08-01

    Although patient charges for health-care services may contribute to a more sustainable health-care financing, they often raise public opposition, which impedes their introduction. Thus, a consensus among the main stakeholders on the presence and role of patient charges should be worked out to assure their successful implementation. To analyse the acceptability of formal patient charges for health-care services in a basic package among different health-care system stakeholders in six Central and Eastern European countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine). Qualitative data were collected in 2009 via focus group discussions and in-depth interviews with health-care consumers, providers, policy makers and insurers. The same participants were asked to fill in a self-administrative questionnaire. Qualitative and quantitative data are analysed separately to outline similarities and differences in the opinions between the stakeholder groups and across countries. There is a rather weak consensus on patient charges in the countries. Health policy makers and insurers strongly advocate patient charges. Health-care providers overall support charges but their financial profits from the system strongly affects their approval. Consumers are against paying for services, mostly due to poor quality and access to health-care services and inability to pay. To build consensus on patient charges, the payment policy should be responsive to consumers' needs with regard to quality and equity. Transparency and accountability in the health-care system should be improved to enhance public trust and acceptance of patient payments. © 2012 John Wiley & Sons Ltd.

  13. European souding-rocket, balloon and related research, with emphasis on experiments at high latitudes. Proceedings

    International Nuclear Information System (INIS)

    Halvorsen, T.; Battrick, B.; Rowley, C.

    1978-06-01

    The document contains 75 papers presented at the fourth symposium held within the framework of the ESA programme advisory committee on the special project concerning the launching of sounding rockets (PAC), which took place at Ajaccio, Corsica, from 24-29 April 1978. The symposium, organised jointly by the PAC and the Centre national d'etudes spaciales (CNES), was divided into 8 sessions embracing, respectively, a review of the national programmes, magnetospheric physics, launch range presentations, middle-atmosphere physics, astrophysic, material sciences, subsatellites and technology, as relevant to souding-rocket and balloon research. Working groups formed during the symposium formulated proposals to the PAC for new or intensified studies based on coordination of other experiments with EISCAT, optical experiments in connection with range and other experiment, middle-atmosphere programme experiments, and subsatellite experiments

  14. The Association of European Airlines (AEA) Perspective: The Operator Experience and Views

    International Nuclear Information System (INIS)

    Oksanen, P.J.

    1999-01-01

    The EU Council has adopted a Directive laying down the basic safety standards for the protection of aircrew exposed to cosmic radiation. As a result, carriers must determine which operations are likely to result in exposures exceeding 1 mSv, how to estimate the effective doses for individual crew members, inform the flight crews of possible health risks involved and ensure that the dose received by the foetus will not exceed 1 mSv following declaration of pregnancy. Members of the Association of European Airlines (AEA) welcome this initiative but emphasise the need for an harmonised approach. Over the years many AEA carriers have been involved in work on cosmic radiation in cooperation with the scientific community. They have measured and estimated doses on their network, made educational materials available to crew members, participated in epidemiological studies and collaborated with other interested parties. At present, AEA carriers are in the process of harmonising the advice given to all crew members together with the additional more specific information necessary for women. Many airlines are also participating in a major European epidemiological study. Finally, AEA airlines continue to be extensively involved in the measurement and estimation of cosmic radiation levels. The AEA airlines believe the EURATOM Directive may best be implemented by route dose estimation using a common mathematical model. This would have the advantage that modelling is accepted worldwide as a credible and practical method of dose estimates and overcomes the logistic problems, the likelihood of equipment failure and error inherent in direct measurement. In addition, it allows for consistency of route dose estimates among various airlines and finally offers the opportunity for independent scrutiny and audit as required. (author)

  15. Student pharmacists provide tobacco use prevention education to elementary school children: A pilot experience.

    Science.gov (United States)

    Ostroff, Jared L; Wolff, Marissa L; Andros, Christina; Nemec, Eric C

    2017-09-01

    The purpose of this article is to describe a service learning experience involving tobacco prevention education and to measure the education's effect on the learners' knowledge of tobacco products. Student pharmacists planned and presented a 40-min tobacco prevention education program using the Tar Wars curriculum to fourth and fifth grade students at three suburban elementary schools in Western Massachusetts. Mean scores on a five-question assessment given to school age children before and after the presentation were compared. A total of 206 elementary school students in ten classrooms participated. The average survey score increased from 1.87 on the pre-survey to 3.72 out of a maximum of five on the post-survey (Peducation to three suburban elementary schools. The children demonstrated an increase in short-term knowledge regarding tobacco use. Tobacco prevention is a unique co-curricular opportunity for student pharmacists to get involved in their community. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Experiences Providing Medical Assistance during the Sewol Ferry Disaster Using Traditional Korean Medicine.

    Science.gov (United States)

    Kim, Kyeong Han; Jang, Soobin; Lee, Ju Ah; Jang, Bo-Hyoung; Go, Ho-Yeon; Park, Sunju; Jo, Hee-Guen; Lee, Myeong Soo; Ko, Seong-Gyu

    2017-01-01

    This study aimed to investigate medical records using traditional Korean medicine (TKM) in Sewol Ferry disaster in 2014 and further explore the possible role of traditional medicine in disaster situation. After Sewol Ferry accident, 3 on-site tents for TKM assistance by the Association of Korean Medicine (AKOM) in Jindo area were installed. The AKOM mobilized volunteer TKM doctors and assistants and dispatched each on-site tent in three shifts within 24 hours. Anyone could use on-site tent without restriction and TKM treatments including herb medicine were administered individually. The total of 1,860 patients were treated during the periods except for medical assistance on the barge. Most patients were diagnosed in musculoskeletal diseases (66.4%) and respiratory diseases (7.4%) and circulatory diseases (8.4%) followed. The most frequently used herbal medicines were Shuanghe decoction (80 days), Su He Xiang Wan (288 pills), and Wuji powder (73 days). TKM in medical assistance can be helpful to rescue worker or group life people in open shelter when national disasters occur. Therefore, it is important to construct a rapid respond system using TKM resources based on experience.

  17. Field experiment provides ground truth for surface nuclear magnetic resonance measurement

    Science.gov (United States)

    Knight, R.; Grunewald, E.; Irons, T.; Dlubac, K.; Song, Y.; Bachman, H.N.; Grau, B.; Walsh, D.; Abraham, J.D.; Cannia, J.

    2012-01-01

    The need for sustainable management of fresh water resources is one of the great challenges of the 21st century. Since most of the planet's liquid fresh water exists as groundwater, it is essential to develop non-invasive geophysical techniques to characterize groundwater aquifers. A field experiment was conducted in the High Plains Aquifer, central United States, to explore the mechanisms governing the non-invasive Surface NMR (SNMR) technology. We acquired both SNMR data and logging NMR data at a field site, along with lithology information from drill cuttings. This allowed us to directly compare the NMR relaxation parameter measured during logging,T2, to the relaxation parameter T2* measured using the SNMR method. The latter can be affected by inhomogeneity in the magnetic field, thus obscuring the link between the NMR relaxation parameter and the hydraulic conductivity of the geologic material. When the logging T2data were transformed to pseudo-T2* data, by accounting for inhomogeneity in the magnetic field and instrument dead time, we found good agreement with T2* obtained from the SNMR measurement. These results, combined with the additional information about lithology at the site, allowed us to delineate the physical mechanisms governing the SNMR measurement. Such understanding is a critical step in developing SNMR as a reliable geophysical method for the assessment of groundwater resources.

  18. Experiences Providing Medical Assistance during the Sewol Ferry Disaster Using Traditional Korean Medicine

    Directory of Open Access Journals (Sweden)

    Kyeong Han Kim

    2017-01-01

    Full Text Available Background. This study aimed to investigate medical records using traditional Korean medicine (TKM in Sewol Ferry disaster in 2014 and further explore the possible role of traditional medicine in disaster situation. Methods. After Sewol Ferry accident, 3 on-site tents for TKM assistance by the Association of Korean Medicine (AKOM in Jindo area were installed. The AKOM mobilized volunteer TKM doctors and assistants and dispatched each on-site tent in three shifts within 24 hours. Anyone could use on-site tent without restriction and TKM treatments including herb medicine were administered individually. Results. The total of 1,860 patients were treated during the periods except for medical assistance on the barge. Most patients were diagnosed in musculoskeletal diseases (66.4% and respiratory diseases (7.4% and circulatory diseases (8.4% followed. The most frequently used herbal medicines were Shuanghe decoction (80 days, Su He Xiang Wan (288 pills, and Wuji powder (73 days. Conclusions. TKM in medical assistance can be helpful to rescue worker or group life people in open shelter when national disasters occur. Therefore, it is important to construct a rapid respond system using TKM resources based on experience.

  19. Multiple genetic interaction experiments provide complementary information useful for gene function prediction.

    Directory of Open Access Journals (Sweden)

    Magali Michaut

    Full Text Available Genetic interactions help map biological processes and their functional relationships. A genetic interaction is defined as a deviation from the expected phenotype when combining multiple genetic mutations. In Saccharomyces cerevisiae, most genetic interactions are measured under a single phenotype - growth rate in standard laboratory conditions. Recently genetic interactions have been collected under different phenotypic readouts and experimental conditions. How different are these networks and what can we learn from their differences? We conducted a systematic analysis of quantitative genetic interaction networks in yeast performed under different experimental conditions. We find that networks obtained using different phenotypic readouts, in different conditions and from different laboratories overlap less than expected and provide significant unique information. To exploit this information, we develop a novel method to combine individual genetic interaction data sets and show that the resulting network improves gene function prediction performance, demonstrating that individual networks provide complementary information. Our results support the notion that using diverse phenotypic readouts and experimental conditions will substantially increase the amount of gene function information produced by genetic interaction screens.

  20. NRC test results and operations experience provide insights for a new gate valve stem force correlation

    International Nuclear Information System (INIS)

    Watkins, John C.; Steele, Robert Jr.; DeWall, Kevin G.; Weidenhamer, G.H.; Rothberg, O.O.

    1994-01-01

    This paper presents the results of testing sponsored by the NRC to assess valve and motor operator performance under varying pressure and fluid conditions. This effort included an examination of the methods used by the industry to predict the required stem force of a valve, and research to provide guidelines for the extrapolation of in situ test results to design basis conditions.Years ago, when most of these valves were originally installed, the industry used a set of equations to determine analytically that the valves' motor-operators were large enough and the control switches were set high enough to close the valves at their design basis conditions. Our research has identified several inconsistencies with the industry's existing gate valve stem force equation and has challenged the overly simplistic assumptions inherent in its use. This paper discusses the development of the INEL correlation, which serves as the basis for a method to bound the stem force necessary to close flexwedge gate valves whose operational characteristics have been shown to be predictable. As utilities undertake to provide assurance of their valves' operability, this ability to predict analytically the required stem force is especially important for valves that cannot be tested at design basis conditions. For such valves, the results of tests conducted at less severe conditions can be used with the INEL correlation to make the necessary prediction. ((orig.))

  1. PReSaFe: A model of barriers and facilitators to patients providing feedback on experiences of safety.

    Science.gov (United States)

    De Brún, Aoife; Heavey, Emily; Waring, Justin; Dawson, Pamela; Scott, Jason

    2017-08-01

    The importance of involving patients in reporting on safety is increasingly recognized. Whilst studies have identified barriers to clinician incident reporting, few have explored barriers and facilitators to patient reporting of safety experiences. This paper explores patient perspectives on providing feedback on safety experiences. Patients (n=28) were invited to take part in semi-structured interviews when given a survey about their experiences of safety following hospital discharge. Transcripts were thematically analysed using NVivo10. Patients were recruited from four hospitals in the UK. Three themes were identified as barriers and facilitators to patient involvement in providing feedback on their safety experiences. The first, cognitive-cultural, found that whilst safety was a priority for most, some felt the term was not relevant to them because safety was the "default" position, and/or because safety could not be disentangled from the overall experience of care. The structural-procedural theme indicated that reporting was facilitated when patients saw the process as straightforward, but that disinclination or perceived inability to provide feedback was a barrier. Finally, learning and change illustrated that perception of the impact of feedback could facilitate or inhibit reporting. When collecting patient feedback on experiences of safety, it is important to consider what may help or hinder this process, beyond the process alone. We present a staged model of prerequisite barriers and facilitators and hypothesize that each stage needs to be achieved for patients to provide feedback on safety experiences. Implications for collecting meaningful data on patients' safety experiences are considered. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  2. Examining clinicians’ experiences providing sexual health services for LGBTQ youth: considering social and structural determinants of health in clinical practice

    Science.gov (United States)

    Knight, R. E.; Shoveller, J. A.; Carson, A. M.; Contreras-Whitney, J. G.

    2014-01-01

    Although barriers related to lesbian, gay, bisexual, transgender and queer (LGBTQ) youth’s experiences accessing sexual health services have been examined in detail, research into the experiences and perceptions of clinicians providing these services has been conspicuously absent. The aim of this article is to explore the perceptions and experiences of clinicians providing sexual health services for LGBTQ youth. Drawing on in-depth, semi-structured interviews, this study examines 24 clinicians’ experiences providing sexual health services to LGBTQ youth in five communities in British Columbia, Canada. Our findings reveal how many clinicians provide services to LGBTQ youth with a lack of cultural competency—either implicitly (e.g. by describing heteronormative practices) or explicitly (e.g. by expressing frustration that they had not been sufficiently provided with appropriate training related to LGBTQ youth sexual health). Institutional norms and values were identified as the dominant barriers in the effective provision of LGBTQ-tailored services. Many clinicians find themselves unprepared to provide culturally competent sexual health services that have both the capacity to address individual-level issues (e.g. promoting condom use) while considering (and adapting services to) the broader socio-cultural and structural conditions that can render LGBTQ youth socially vulnerable. PMID:24412811

  3. Experiments on the evaluation of protection provided by full-face masks as worn

    International Nuclear Information System (INIS)

    Kinouchi, Nobuyuki; Ikezawa, Yoshio; Izumi, Yukio.

    1991-01-01

    The performance of a dust respirator is affected mostly by the leakage through the interstice between mask and face. Mask man-test using NaCl aerosols has been developed to evaluate protection provided by worn masks. However, there were some problems in application of man-test to field test. The sampling method of the NaCl aerosols inside the mask was discussed. The tool for sampling operated easily was selected, and the best sampling position at the mask was decided. The correction of the measured values was also discussed. Because of NaCl aerosols deposition in the respiratory tract and sampling lines, the leakage might be underestimated. The correction coefficient was experimentally measured and discussed. (author)

  4. Twenty years of providing information on nuclear power. The experience of EDF

    International Nuclear Information System (INIS)

    Durr, M.; Ansel, P.; Chaussade, J.P.; Haller, P.; Hezard, L.; Hue, L.

    1995-01-01

    In France, the anti-nuclear protest movement became a real problem after 1968, as new sites were sought. Initially, information on nuclear power involved communication by the entities responsible for building the plants. Once Government officials and politicians overcame their initial hesitation, their support, which underscores the continuity of France's energy policy, came to play a major role in the public acceptance of nuclear power. Electricite de France (EDF) then had to master the art of informing and communicating with the public. The change in the parliamentary majority in 1981 did not call into question the nuclear programme, and new plants were commissioned with relative ease. The situation changed dramatically with the Chernobyl disaster. It therefore became vital to establish an efficient structure for crisis communications, and transparency became crucial. The focus shifted from launching new plants to operating existing facilities and restoring public confidence. While not neglecting the general public, the emphasis was on certain strategic segments of the population, notably teachers and health care professionals. Advertising campaigns are today aimed at certain segments of the public, whose opinion could well shift in favour of nuclear power. Lastly, EDF, as power plant operator, has to realize the importance of providing information on nuclear waste. Starting from a strategic policy of informing politicians and senior decision makers, in 1974 EDF began to focus on providing information that would 'educate' the public. This information was issued via technicians who had no specific training in communications techniques. In addition to the need to explain and justify its projects, EDF had to adopt a policy of transparency, and to dispense with the esoteric language of specialists and their preference for secrecy. After Chernobyl, EDF's managers made communications with the 'outside world' an integral part of their jobs. Nuclear information became a

  5. Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya.

    Science.gov (United States)

    Sieverding, Maia; Onyango, Cynthia; Suchman, Lauren

    2018-01-01

    Incorporating private healthcare providers into social health insurance schemes is an important means towards achieving universal health coverage in low and middle income countries. However, little research has been conducted about why private providers choose to participate in social health insurance systems in such contexts, or their experiences with these systems. We explored private providers' perceptions of and experiences with participation in two different social health insurance schemes in Sub-Saharan Africa-the National Health Insurance Scheme (NHIS) in Ghana and the National Hospital Insurance Fund (NHIF) in Kenya. In-depth interviews were held with providers working at 79 facilities of varying sizes in three regions of Kenya (N = 52) and three regions of Ghana (N = 27). Most providers were members of a social franchise network. Interviews covered providers' reasons for (non) enrollment in the health insurance system, their experiences with the accreditation process, and benefits and challenges with the system. Interviews were coded in Atlas.ti using an open coding approach and analyzed thematically. Most providers in Ghana were NHIS-accredited and perceived accreditation to be essential to their businesses, despite challenges they encountered due to long delays in claims reimbursement. In Kenya, fewer than half of providers were NHIF-accredited and several said that their clientele were not NHIF enrolled. Understanding of how the NHIF functioned was generally low. The lengthy and cumbersome accreditation process also emerged as a major barrier to providers' participation in the NHIF in Kenya, but the NHIS accreditation process was not a major concern for providers in Ghana. In expanding social health insurance, coordinated efforts are needed to increase coverage rates among underserved populations while also accrediting the private providers who serve those populations. Market pressure was a key force driving providers to gain and maintain accreditation

  6. Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya.

    Directory of Open Access Journals (Sweden)

    Maia Sieverding

    Full Text Available Incorporating private healthcare providers into social health insurance schemes is an important means towards achieving universal health coverage in low and middle income countries. However, little research has been conducted about why private providers choose to participate in social health insurance systems in such contexts, or their experiences with these systems. We explored private providers' perceptions of and experiences with participation in two different social health insurance schemes in Sub-Saharan Africa-the National Health Insurance Scheme (NHIS in Ghana and the National Hospital Insurance Fund (NHIF in Kenya.In-depth interviews were held with providers working at 79 facilities of varying sizes in three regions of Kenya (N = 52 and three regions of Ghana (N = 27. Most providers were members of a social franchise network. Interviews covered providers' reasons for (non enrollment in the health insurance system, their experiences with the accreditation process, and benefits and challenges with the system. Interviews were coded in Atlas.ti using an open coding approach and analyzed thematically.Most providers in Ghana were NHIS-accredited and perceived accreditation to be essential to their businesses, despite challenges they encountered due to long delays in claims reimbursement. In Kenya, fewer than half of providers were NHIF-accredited and several said that their clientele were not NHIF enrolled. Understanding of how the NHIF functioned was generally low. The lengthy and cumbersome accreditation process also emerged as a major barrier to providers' participation in the NHIF in Kenya, but the NHIS accreditation process was not a major concern for providers in Ghana.In expanding social health insurance, coordinated efforts are needed to increase coverage rates among underserved populations while also accrediting the private providers who serve those populations. Market pressure was a key force driving providers to gain and maintain

  7. How to reconcile wood production and biodiversity conservation? The Pan-European boreal forest history gradient as an "experiment".

    Science.gov (United States)

    Naumov, Vladimir; Manton, Michael; Elbakidze, Marine; Rendenieks, Zigmars; Priednieks, Janis; Uhlianets, Siarhei; Yamelynets, Taras; Zhivotov, Anton; Angelstam, Per

    2018-07-15

    , different regional forest histories provide different challenges in terms of satisfying both wood production and biodiversity conservation objectives in a forest management unit. These regional differences in northern Europe create opportunities for exchanging experiences among different regional contexts about how to achieve both objectives. We discuss this in the context of land-sharing versus land-sparing. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. Integrating Project Management, Product Design with Industry Sponsored Projects provides Stimulating Senior Capstone Experiences

    Directory of Open Access Journals (Sweden)

    Phillip A. Sanger

    2011-07-01

    authentic life experience and introducing them to the real world of engineering.

  9. Australian experience of providing for fish passage at small instream structures

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, B. [Forest Hill, Victoria (Australia)

    2006-07-01

    Various instream structures have been constructed in Australia as a result of increasing agricultural activities. However, even small structures such as culverts and stream gauging stations can restrict essential fish movements and result in the extinction of local fish species. This paper discussed methods of modifying and designing new structures to ensure adequate fish passage. It was suggested that instream structures can provide for fish passage through the provision of bridges, or through the use of low profile structures for small weirs. Recommendations for site-specific instream structures included an assessment of fish species, topography, flow characteristics and cost effectiveness. Solutions for reducing the impact of small instream barriers to fish movement were also discussed. Provision for fish passage is an important consideration for planners and designers of dams. Legislation is now in place to ensure a planning and approval process prior to the commencement of construction and operation. It was concluded that significant works are now being undertaken to restore fish migration pathways caused by barriers that restrict fish movement. However, monitoring is needed to ensure that designs operate effectively. 17 refs., 3 figs.

  10. Australian experience of providing for fish passage at small instream structures

    International Nuclear Information System (INIS)

    Lewis, B.

    2006-01-01

    Various instream structures have been constructed in Australia as a result of increasing agricultural activities. However, even small structures such as culverts and stream gauging stations can restrict essential fish movements and result in the extinction of local fish species. This paper discussed methods of modifying and designing new structures to ensure adequate fish passage. It was suggested that instream structures can provide for fish passage through the provision of bridges, or through the use of low profile structures for small weirs. Recommendations for site-specific instream structures included an assessment of fish species, topography, flow characteristics and cost effectiveness. Solutions for reducing the impact of small instream barriers to fish movement were also discussed. Provision for fish passage is an important consideration for planners and designers of dams. Legislation is now in place to ensure a planning and approval process prior to the commencement of construction and operation. It was concluded that significant works are now being undertaken to restore fish migration pathways caused by barriers that restrict fish movement. However, monitoring is needed to ensure that designs operate effectively. 17 refs., 3 figs

  11. Providing Middle School Students With Science Research Experiences Through Community Partnerships

    Science.gov (United States)

    Rodriguez, D.

    2007-12-01

    Science research courses have been around for years at the university and high school level. As inquiry based learning has become more and more a part of the science teacher's vocabulary, many of these courses have adopted an inquiry model for studying science. Learners of all ages benefit from learning through the natural process of inquiry. I participated in the CIRES Earthworks program for science teachers (Colorado University) in the summer of 2007 and experienced, first hand, the value of inquiry learning. With the support and vision of my school administration, and with the support and commitment of community partners, I have developed a Middle School Science Research Program that is transforming how science is taught to students in my community. Swift Creek Middle School is located in Tallahassee, Florida. There are approximately 1000 students in this suburban public school. Students at Swift Creek are required to take one science class each year through 8th grade. As more emphasis is placed on learning a large number of scientific facts and information, in order to prepare students for yearly, standardized tests, there is a concern that less emphasis may be placed on the process and nature of science. The program I developed draws from the inquiry model followed at the CIRES Earthworks program, utilizes valuable community partnerships, and plays an important role in meeting that need. There are three major components to this Middle School Research Program, and the Center for Integrated Research and Learning (CIRL) at the National High Magnetic Field Lab (NHMFL) at Florida State University is playing an important role in all three. First, each student will develop their own research question and design experiments to answer the question. Scientists from the NHMFL are serving as mentors, or "buddy scientists," to my students as they work through the process of inquiry. Scientists from the CIRES - Earthworks program, Florida State University, and other

  12. In situ gamma spectrometry aspects of an European intercomparison of national networks used to provide early warning of a nuclear accident

    International Nuclear Information System (INIS)

    Gurriaran, R.; Lemercier, M.; Bouisset, P.; Cagnat, X.; Saez-Vergara, J. C.; Tyler, A. N.

    2006-01-01

    In 2002, the EURADOS Working Group on Environmental Monitoring organised the second European intercomparison exercise of national network systems used to provide early warning in case of a nuclear accident. The aim of the exercise is to ensure consistent and comparable results reported by different countries during a nuclear accident, hence avoiding that the dose rate measurements reported present steps at national borders due to different calibrations or different measurement quantities being used. The exercise studied the response of the detectors to different situations: Free field site, a flat area covered with grass. The detectors where in presence of environmental radiation and point sources. Radioactive plume simulator. An incident was simulated by gradually increasing the ambient dose rate by values up to 50% of the normal value. Cosmic radiation site. A platform installed in the middle of a lake permitted to study the response of detectors to cosmic rays in the absence of other components. Ultra low background laboratory (UDO). Situated at 925 m in a salt mine this unique facility has a very low ambient dose (<1 nSv/h) and permitted the study of the response of detectors to collimated beams, in the absence of other components. The exercise was focused on the systems that continuously monitor the ambient dose rate but a novelty in the 2002 intercomparison was the participation of in situ gamma spectrometry teams. This presentation will focus on the in situ gamma spectrometry aspects: The interest of having the energy spectra information in order to discriminate the different contributors to the ambient dose, and the work that has been done in order to ensure an agreement between the dosimetry aspects and the spectrometry results

  13. Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis: a discrete choice experiment among European rheumatologists.

    Science.gov (United States)

    Hifinger, M; Hiligsmann, M; Ramiro, S; Watson, V; Severens, J L; Fautrel, B; Uhlig, T; van Vollenhoven, R; Jacques, P; Detert, J; Canas da Silva, J; Scirè, C A; Berghea, F; Carmona, L; Péntek, M; Keat, A; Boonen, A

    2017-01-01

    To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with moderate disease activity. Treatments differed in five attributes: efficacy (improvement and achieved state on disease activity), safety (probability of serious adverse events), patient's preference (level of agreement), medication costs and cost-effectiveness (incremental cost-effectiveness ratio (ICER)). A Bayesian efficient design defined 14 choice sets, and a random parameter logit model was used to estimate relative preferences for rheumatologists across countries. Cluster analyses and latent class models were applied to understand preference patterns across countries and among individual rheumatologists. Responses of 559 rheumatologists from 12 European countries were included in the analysis (49% females, mean age 48 years). In all countries, efficacy dominated treatment decisions followed by economic considerations and patients' preferences. Across countries, rheumatologists avoided selecting a treatment that patients disliked. Latent class models revealed four respondent profiles: one traded off all attributes except safety, and the remaining three classes disregarded ICER. Among individual rheumatologists, 57% disregarded ICER and these were more likely from Italy, Romania, Portugal or France, whereas 43% disregarded uncommon/rare side effects and were more likely from Belgium, Germany, Hungary, the Netherlands, Norway, Spain, Sweden or UK. Overall, European rheumatologists are willing to trade between treatment efficacy, patients' treatment preferences and economic considerations. However, the degree of trade-off differs between countries and among individuals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

  14. Environmental Tax Reforms and Mitigation for Energy-intensive Industries: Some Lessons from European Experience

    DEFF Research Database (Denmark)

    Andersen, Mikael Skou

    2009-01-01

    The purpose of this paper is to analyse in more detail the international experiences in applying carbon-energy taxation in two important energy-intensive sectors; iron and steel, as well as non-metallic mineral products (where cement is the most significant subsector).......The purpose of this paper is to analyse in more detail the international experiences in applying carbon-energy taxation in two important energy-intensive sectors; iron and steel, as well as non-metallic mineral products (where cement is the most significant subsector)....

  15. The experience of some European Countries in the implementation of preventive measures against the phenomenon of violence and aggression at football stadiums

    Directory of Open Access Journals (Sweden)

    Samuel Uhrin

    2013-12-01

    Full Text Available The article sets forward the experience of the Slovak Republic in the field of prevention of violence and aggression in football stadiums. The text discusses initiatives aiming at dimnishing this alarming and increasing in size phenomenon. The experiences stemming from preventive measures which have been taken in this regard in other European countries, have also been brought closer in the text.

  16. Exploring the Cervical Cancer Screening Experiences of Black Lesbian, Bisexual, and Queer Women: The Role of Patient-Provider Communication.

    Science.gov (United States)

    Agénor, Madina; Bailey, Zinzi; Krieger, Nancy; Austin, S Bryn; Gottlieb, Barbara R

    2015-01-01

    Few studies have focused on the health and health care of U.S. black lesbian, bisexual, and queer (LBQ) women. To understand the facilitators of and barriers to cervical cancer screening in this population, focus group discussions were conducted in Boston and Cambridge, Massachusetts between November and December 2012. Using purposive sampling methods, the authors enrolled 18 black LBQ women who participated in one of four focus groups. Using thematic analysis, patient-provider communication was identified, which consisted of four sub-themes--health care provider communication style and demeanor; heteronormative provider assumptions; heterosexism, racism, and classism; and provider professional and sociodemographic background--as the most salient theme. Participants reported fears and experiences of multiple forms of discrimination and preferred receiving care from providers who were knowledgeable about same-sex sexual health and shared their life experiences at the intersection of gender, race/ethnicity, and sexual orientation. The cervical cancer screening experiences of black LBQ women would be improved by training all health care providers in same-sex sexual health, offering opportunities for clinicians to learn about the effects of various forms of discrimination on women's health care, and increasing the presence of LBQ women of color in health care settings.

  17. Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya

    Science.gov (United States)

    Sieverding, Maia; Onyango, Cynthia

    2018-01-01

    Background Incorporating private healthcare providers into social health insurance schemes is an important means towards achieving universal health coverage in low and middle income countries. However, little research has been conducted about why private providers choose to participate in social health insurance systems in such contexts, or their experiences with these systems. We explored private providers’ perceptions of and experiences with participation in two different social health insurance schemes in Sub-Saharan Africa—the National Health Insurance Scheme (NHIS) in Ghana and the National Hospital Insurance Fund (NHIF) in Kenya. Methods In-depth interviews were held with providers working at 79 facilities of varying sizes in three regions of Kenya (N = 52) and three regions of Ghana (N = 27). Most providers were members of a social franchise network. Interviews covered providers’ reasons for (non) enrollment in the health insurance system, their experiences with the accreditation process, and benefits and challenges with the system. Interviews were coded in Atlas.ti using an open coding approach and analyzed thematically. Results Most providers in Ghana were NHIS-accredited and perceived accreditation to be essential to their businesses, despite challenges they encountered due to long delays in claims reimbursement. In Kenya, fewer than half of providers were NHIF-accredited and several said that their clientele were not NHIF enrolled. Understanding of how the NHIF functioned was generally low. The lengthy and cumbersome accreditation process also emerged as a major barrier to providers’ participation in the NHIF in Kenya, but the NHIS accreditation process was not a major concern for providers in Ghana. Conclusions In expanding social health insurance, coordinated efforts are needed to increase coverage rates among underserved populations while also accrediting the private providers who serve those populations. Market pressure was a key force

  18. On the Geography of Accountability: Comparative Analysis of Teachers' Experiences across Seven European Countries

    Science.gov (United States)

    Muller, Jorg; Hernandez, Fernando

    2010-01-01

    Different forms of accountability are part of educational restructuring across Europe. This article will focus on the different national configurations of accountability from teachers' point of view. A comparative perspective will enlarge on commonalities and differences between teachers' experiences in Spain, Portugal, Ireland, England, Sweden,…

  19. 'I was utterly mesmerised' : Audience experiences of different theatre types and genres in four European cities

    NARCIS (Netherlands)

    Wilders, Marline; Toome, Hedi-Liis; Sorli, Maja; Szábo, Attila; Zijlstra, Anna

    2015-01-01

    This article investigates the similarities and differences on how spectators experience theatre performances grouped along large, transnationally present types as Spoken Theatre, Dance Theatre, Musical Theatre and Kleinkunst. Our findings are based on the analysis of the extensive data collected by

  20. 'I was utterly mesmerised': Audience experiences of different theatre types and genres in four European cities

    NARCIS (Netherlands)

    Wilders, M.L.; Toome, H.-L.; Šorli, M.; Szabó, A.; Zijlstra, A.

    2015-01-01

    This article investigates the similarities and differences on how spectators experience theatre performances grouped along large, transnationally present types as Spoken Theatre, Dance Theatre, Musical Theatre and Kleinkunst. Our findings are based on the analysis of the extensive data collected by

  1. Outcomes of robot-assisted simple enucleation of renal masses: A single European center experience.

    Science.gov (United States)

    Matei, Deliu Victor; Vartolomei, Mihai Dorin; Musi, Gennaro; Renne, Giuseppe; Tringali, Valeria Maria Lucia; Mistretta, Francesco Alessandro; Delor, Maurizio; Russo, Andrea; Cioffi, Antonio; Bianchi, Roberto; Cozzi, Gabriele; Di Trapani, Ettore; Bottero, Danilo; Cordima, Giovanni; Lucarelli, Giuseppe; Ferro, Matteo; de Cobelli, Ottavio

    2017-05-01

    The aim of this study was to assess the ability of pre-and intraoperative parameters, to predict the risk of perioperative complications after robot-assisted laparoscopic simple enucleation (RASE) of renal masses, and to evaluate the rate of trifecta achievement of this approach stratifying the cohort according to the use of ischemia during the enucleation.From April 2009 to June 2016, 129 patients underwent RASE at our Institution. We stratified the procedures in 2 groups: clamping and clamp-less RASE. After RASE, all specimens were retrospectively reviewed to assess the surface-intermediate-base (SIB) scoring system. Patients were followed-up according to the European Association of Urology guidelines recommendations. All pre-, intra-, and postoperative outcomes were prospectively collected in a customized database and retrospectively analyzed.A total of 112 (86.8%) patients underwent a pure RASE and 17 (13.2%) had a hybrid according to SIB classification system. The mean age was 61.17 years. In 21 patients (16.3%), complications occurred, 13 (61.9%) were Clavien 1 and 2, while 8 were Clavien 3a and b complications. Statistical significant association with complications was found in patients with American Society of Anestesiology (ASA) score 3 (44.5%, P = .04), longer mean operative time (OT) 195 versus 161.36 minutes (P =.03), mean postoperative hemoglobin (Hb) 10.1 versus 11.8 (P 3, longer OT, and ΔHb. RASE is suitable for the clamp-less approach, which allows to perform easier the pure enucleation (SIB 0) and to obtain higher rates of trifecta outcomes.

  2. Semiperipheries in the World-System: Reflecting Eastern European and Latin American Experiences

    Directory of Open Access Journals (Sweden)

    Manuela Boatca

    2015-08-01

    Full Text Available This paper claims that, since many of the concepts relevant to our analysis of systemic change were coined in and about the core, the potential with which solutions to world-systemic crisis are credited in the long run should be assessed differently depending on the structural location of their origin. In the periphery, such concepts as conservatism, socialism and even liberalism took forms that often retained nothing of the original model but the name, such that strategies of applying them to (semiperipheral situations ranged from “stretching the ideology” to “discarding the (liberal myth” altogether. In a first step, “the hypothesis of semiperipheral development” (Chase-Dunn and Hall, according to which the semiperiphery represents the most likely locus of political, economical, and institutional change, is amended to say that, at least for the late modern world-system, the strength of the semiperiphery resides primarily in the cultural and epistemic sphere. In a second step, this contention is illustrated with the help of major challenges that the Eastern European and Latin American (semiperipheries have posed to the world-system’s political fields and institutional settings both in the past and to date—with different degrees of success corresponding to their respective structural position. In light of these examples, it is argued that a comparative analysis of continuities among political epistemologies developed in the semiperiphery can help us understand the ways in which similar attempts can become antisystemic today.

  3. When parents won't vaccinate their children: a qualitative investigation of australian primary care providers' experiences.

    Science.gov (United States)

    Berry, Nina J; Henry, Alexandra; Danchin, Margie; Trevena, Lyndal J; Willaby, Harold W; Leask, Julie

    2017-01-17

    Increasingly, the experiences and perceptions of parents who decline vaccination are the subject of investigation. However, the experiences of clinicians who encounter these parents in the course of their work has received little academic attention to date. This study aimed to understand the challenges faced and strategies used when general practitioners and immunising nurses encounter parents who choose not to vaccinate their children. Primary care providers were recruited from regions identified through the Australian Childhood Immunisation Register (ACIR) as having higher than national average rates of registered objection to childhood vaccination. Interviews began with an exploration of provider experiences with parents who accept, are hesitant towards, and who decline vaccination. Participants were asked specifically about how they addressed any difficulties they encountered in their interactions. Thematic analysis focused on encounters with parents - challenges and strategies. Twenty-six general practitioners (GPs), community and practice nurses (PNs) were interviewed across two regions in NSW, Australia. Providers' sense of professional identity as health advocates and experts became conflicted in their encounters with vaccine objecting parents. Providers were dissatisfied when such consultations resulted in a 'therapeutic roadblock' whereby provider-parent communication came to a standstill. There were mixed views about being asked to sign forms exempting parents from vaccinating their children. These ranged from a belief that completing the forms rewarded parents for non-conformity to seeing it as a positive opportunity for engagement. Three common strategies were employed by providers to navigate through these challenges; 1) to explore and inform, 2) to mobilise clinical rapport and 3) to adopt a general principle to first do no harm to the therapeutic relationship. Many healthcare providers find consultations with vaccine objecting parents challenging

  4. Euratom experience in safeguarding reprocessing and thermal reactor mixed oxide fuel fabrication facilities within the European Community

    International Nuclear Information System (INIS)

    1978-11-01

    The legal basis and instruments for the application of safeguards in the European Community are described. Euratom safeguards apply throughout the fuel cycle starting at the ore stage. Euratom has had experience in the application of safeguards to small and medium size reprocessing and MOX fabrication plants. In reprocessing plants accountancy, containment and surveillance methods are applied and the plant is divided into three material balance areas. Similar procedures are applied at fabrication plants. Euratom inspectors apply their main verification activities at strategic points but have the right of access at any time to all places which contain nuclear material. Under the Euratom-IAEA Agreements 'Joint Teams' of Euratom and IAEA inspectors will operate together to minimise the burden on operators and to avoid duplication of effort while enabling both organisations to achieve their safeguards objectives

  5. Effects of forest cover changes in European Russia on regional weather conditions: results of numerical experiments with the COSMO-CLM model

    Science.gov (United States)

    Olchev, Alexander; Kuzmina, Ekaterina; Rozinkina, Inna; Nikitin, Mikhail; Rivin, Gdaly S.

    2017-04-01

    The forests have a significant effect on the climatic system. They capture CO2 from the atmosphere, regulate the surface evaporation and runoff, and influence the radiation and thermal conditions of the land surface. It is obvious, that their influence depends on many different factors including regional climate conditions, land use and vegetation structure, surface topography, etc. The main goal of the study is to assess the possible influence of forest cover changes (under deforestation and/or afforestation) on regional weather conditions in the central part of European Russia using the results of modeling experiments provided by the meso-scale COSMO-CLM model. The need of the study lies in a lack of the experimental and modeling data characterizing the influence of the forest and land-use changes on regional weather conditions in European part of Russia. The forest ecosystems in the study region play a very important biosphere role that is significantly increased in the last decades due to considerable strengthening of anthropogenic activity in the area of European Russia. The area selected for the study is located in the central part of European Russia between 55 and 59N and 28 and 37E. It comprises several geographical zones including dark-coniferous forests of the South-European taiga in the north, the mixed forests in the central part and the broad-leaved forests in the south. The forests within the study area are very heterogeneous. The total area covered by forests according to recent remote sensing data is about 50%. The numerical experiments were provided using the COSMO-CLM model with the spatial resolution 13.2 km. As initial and boundary conditions for the numerical experiments the global reanalysis ERA Interim (with the 6-hour resolution in time and 0.75° × 0.75° in space) were used. The weather conditions were simulated in a continuous cycle for several months for the entire area of European Russia using the results of global reanalysis on

  6. Health care provider experience with canagliflozin in real-world clinical practice: favorability, treatment patterns, and patient outcomes

    Directory of Open Access Journals (Sweden)

    Bolge SC

    2017-06-01

    Full Text Available Susan C Bolge,1 Natalia M Flores,2 Shu Huang,3 Jennifer Cai1 1Janssen Scientific Affairs, LLC, Titusville, NJ, 2Kantar Health, Foster City, CA, 3Kantar Health, New York, NY, USA Purpose: This study describes how health care providers approach canagliflozin for the treatment of patients with type 2 diabetes mellitus (T2DM in the real world.Patients and methods: An Internet-based questionnaire was completed by 101 endocrinologists, 101 primary care physicians, and 100 nurse practitioners/physician assistants (NP/PAs. Health care providers were required to have experience prescribing or managing patients using canagliflozin to be included in the study. Health care providers compared canagliflozin with other T2DM medication classes on clinical characteristics, costs, and patient satisfaction. Confidence in canagliflozin was also measured. Health care providers reported their canagliflozin prescribing experience and good candidate characteristics for treatment. Finally, providers reported on patient outcomes among those receiving canagliflozin. All variables were compared across provider type.Results: Health care providers reported higher favorability for canagliflozin for blood pressure and body weight compared with dipeptidyl peptidase-4 (DPP-4 inhibitors and higher favorability for effect on blood pressure, body weight, treatment satisfaction, and glycosylated hemoglobin (HbA1c compared with sulfonylureas (SUs, with differences observed for effect on blood pressure. Health care providers reported being very/extremely confident (55%–74% with canagliflozin as a second- to fourth-line treatment. The top 3 characteristics reported by the providers, in terms of describing a good candidate for canagliflozin, include those concerned about their weight, insurance coverage/affordability, and avoiding injectable treatments. Finally, providers reported often/always observing patients’ lowering or controlling HbA1c (82%–88% and improvement in overall

  7. EVALUATION OF THE HTA CORE MODEL FOR NATIONAL HEALTH TECHNOLOGY ASSESSMENT REPORTS: COMPARATIVE STUDY AND EXPERIENCES FROM EUROPEAN COUNTRIES.

    Science.gov (United States)

    Kõrge, Kristina; Berndt, Nadine; Hohmann, Juergen; Romano, Florence; Hiligsmann, Mickael

    2017-01-01

    The health technology assessment (HTA) Core Model® is a tool for defining and standardizing the elements of HTA analyses within several domains for producing structured reports. This study explored the parallels between the Core Model and a national HTA report. Experiences from various European HTA agencies were also investigated to determine the Core Model's adaptability to national reports. A comparison between a national report on Genetic Counseling, produced by the Cellule d'expertise médicale Luxembourg, and the Core Model was performed to identify parallels in terms of relevant and comparable assessment elements (AEs). Semi-structured interviews with five representatives from European HTA agencies were performed to assess their user experiences with the Core Model. The comparative study revealed that 50 percent of the total number (n = 144) of AEs in the Core Model were relevant for the national report. Of these 144 AEs from the Core Model, 34 (24 percent) were covered in the national report. Some AEs were covered only partly. The interviewees emphasized flexibility in using the Core Model and stated that the most important aspects to be evaluated include characteristics of the disease and technology, clinical effectiveness, economic aspects, and safety. In the present study, the national report covered an acceptable number of AEs of the Core Model. These results need to be interpreted with caution because only one comparison was performed. The Core Model can be used in a flexible manner, applying only those elements that are relevant from the perspective of the technology assessment and specific country context.

  8. Recently created man-made habitats in Doñana provide alternative wintering space for the threatened continental European black-tailed godwit population

    NARCIS (Netherlands)

    Márquez-Ferrando, Rocío; Figuerola, Jordi; Hooijmeijer, Jos; Piersma, Theunis

    Over the last decades the Continental European population of black-tailed godwits, Limosa limosa limosa, has shown steep declines as a consequence of agricultural intensification on the breeding grounds. Although numbers have also declined in their traditional wintering areas in West-Africa, in the

  9. Recently created man-made habitats in Doñana provide alternative wintering space for the threatened Continental European black-tailed godwit population

    NARCIS (Netherlands)

    Márquez-Ferrando, R.; Figuerola, J.; Hooijmeijer, J.C.E.W.; Piersma, T.

    2014-01-01

    Over the last decades the Continental European population of black-tailed godwits, Limosa limosa limosa, has shown steep declines as a consequence of agricultural intensification on the breeding grounds. Although numbers have also declined in their traditional wintering areas in West-Africa, in the

  10. The experience of providing end-of-life care to a relative with advanced dementia: an integrative literature review.

    Science.gov (United States)

    Peacock, Shelley C

    2013-04-01

    The number of people with dementia is growing at an alarming rate. An abundance of research over the past two decades has examined the complex aspects of caring for a relative with dementia. However, far less research has been conducted specific to the experiences of family caregivers providing end-of-life care, which is perplexing, as dementia is a terminal illness. This article presents what is known and highlights the gaps in the literature relevant to the experiences of family caregivers of persons with dementia at the end of life. A thorough search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed databases from 1960 to 2011 was conducted. Ten studies were identified that specifically addressed the experience of family caregivers providing end-of-life care to a relative with advanced dementia. Common themes of these studies included: 1) the experience of grief, 2) guilt and burden with decision making, 3) how symptoms of depression may or may not be resolved with death of the care receiver, 4) how caregivers respond to the end-stage of dementia, and 5) expressed needs of family caregivers. It is evident from this literature review that much remains to be done to conceptualize the experience of end-of-life caregiving in dementia.

  11. At the European Hybrid Spectrometer (EHS) for the experiment NA27

    CERN Multimedia

    1983-01-01

    The experiment NA27 was intended to measure accurately the lifetime of Charm particles and to study their hadronic production and decay particles. The vertex detector was the hydrogen bubble chamber LEBC. The aim was to collect several hundreths of fully reconstructed D0 and D+-, and several tens of F+- and Lambda_c decays as produced by 360 GeV/c negative pions and 400 GeV/c protons. The photo gives a side view of a section of the spectrometer, with a 12 m long gas Cerenkov counter at the centre. The spectrometer axis enters the photo at bottom, left corner. See photo 8311661, 8311662X, 8311660X.

  12. Work experience, job-fulfillment and burnout among VMMC providers in Kenya, South Africa, Tanzania and Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Linnea Perry

    Full Text Available BACKGROUND: Human resource capacity is vital to the scale-up of voluntary medical male circumcision (VMMC services. VMMC providers are at risk of "burnout" from performing a single task repeatedly in a high volume work environment that produces long work hours and intense work effort. METHODS AND FINDINGS: The Systematic Monitoring of the Voluntary Medical Male Circumcision Scale-up (SYMMACS surveyed VMMC providers in Kenya, South Africa, Tanzania, and Zimbabwe in 2011 (n = 357 and 2012 (n = 591. Providers self-reported on their training, work experience, levels of job-fulfillment and work fatigue/burnout. Data analysis included a descriptive analysis of VMMC provider characteristics, and both bivariate and multivariate analyses of factors associated with provider work fatigue/burnout. In 2012, Kenyan providers had worked in VMMC for a median of 31 months compared to South Africa (10 months, Tanzania (15 months, and Zimbabwe (11 months. More than three-quarters (78 - 99% of providers in all countries in 2012 reported that VMMC is a personally fulfilling job. However, 67% of Kenyan providers reported starting to experience work fatigue/burnout compared to South Africa (33%, Zimbabwe (17%, and Tanzania (15%. Despite the high level of work fatigue/burnout in Kenya, none of the measured factors (i.e., gender, age, full-time versus part-time status, length of service, number of operations performed, or cadre were significantly associated with work fatigue/burnout in 2011. In 2012, logistic regression found increases in age (p<.05 and number of months working in VMMC (p<.01 were associated with an increased likelihood of experiencing work fatigue/burnout, while higher career total VMMCs decreased the likelihood of experiencing burnout. CONCLUSION: Given cross-country differences, further elucidation of cultural and other contextual factors that may influence provider burnout is required. Continuing to emphasize the contribution that providers make in

  13. The experiences of survivors and trauma counselling service providers in northern Uganda: Implications for mental health policy and legislation.

    Science.gov (United States)

    Liebling, H; Davidson, L; Akello, G F; Ochola, G

    Previous research in northern Uganda found high levels of trauma-related difficulties amongst the conflict-affected population. There is international evidence that psychological therapy can reduce depression, as one of the psychological effects of trauma, but very limited literature regarding the experiences of trauma counselling in Sub-Saharan Africa. The current British Academy and Leverhulme-funded research investigated the experiences of service users and providers of trauma services in Kitgum and Gulu, northern Uganda. It also examined their implications for mental health policy and legislation. A decision was made to utilise qualitative methodology to highlight the in-depth experiences of participants. The researcher's carried out interviews with 10 women and 10 men survivors attending trauma services in Kitgum and Gulu. The researchers also interviewed 15 key informants in Kitgum, Gulu and Kampala including trauma counselling service providers, ministers, cultural leaders and mental health professionals. The authors report the findings of the research based on thematic analysis of the interviews. Themes included the experiences of survivors, bearing witness and instilling hope, constraints to service provision, stigma and abuse, holistic approach, service providers doing their best, specialist populations, limited understanding, training and skills development, gaps in service provision and mental health policy and legislation. The interviews resulted in a clear indication that counselling and medication was valued by service users, and that service providers felt the treatments that were provided improved depression, and increased empowerment and engagement in social activities. However, the authors argue that there was a limit to the benefits that could be achieved without using the holistic approach that the survivors requested. Thus, in cases of trauma arising from conflict, there is a clear need for the state to ensure reparation and/or justice for the

  14. A systematic review of HIV partner counseling and referral services: client and provider attitudes, preferences, practices, and experiences.

    Science.gov (United States)

    Passin, Warren F; Kim, Angela S; Hutchinson, Angela B; Crepaz, Nicole; Herbst, Jeffrey H; Lyles, Cynthia M

    2006-05-01

    The objectives of this study were to understand client and provider attitudes, experiences, and practices regarding HIV partner notification in the United States and to help identify future research and program needs. The goals of this study were to synthesize the literature reporting client and provider attitudes, experiences, and practices and to identify potential negative effects of HIV partner notification. This study consisted of a systematic qualitative review. Clients were willing to self-notify partners and participate in provider notification, and few reported negative effects. The majority of health care providers were in favor of HIV partner notification; however, they did not consistently refer index clients to HIV partner notification programs. Considering that clients have positive attitudes toward self- and provider referral, local HIV prevention programs need to ensure that all HIV-positive clients are offered partner notification services. Additional research is needed to assess the potential risks of notifying partners and to identify effective techniques to improve client and provider participation.

  15. Integrating family planning into HIV care in western Kenya: HIV care providers' perspectives and experiences one year following integration.

    Science.gov (United States)

    Newmann, Sara J; Zakaras, Jennifer M; Tao, Amy R; Onono, Maricianah; Bukusi, Elizabeth A; Cohen, Craig R; Steinfeld, Rachel; Grossman, Daniel

    2016-01-01

    With high rates of unintended pregnancy in sub-Saharan Africa, integration of family planning (FP) into HIV care is being explored as a strategy to reduce unmet need for contraception. Perspectives and experiences of healthcare providers are critical in order to create sustainable models of integrated care. This qualitative study offers insight into how HIV care providers view and experience the benefits and challenges of providing integrated FP/HIV services in Nyanza Province, Kenya. Sixteen individual interviews were conducted among healthcare workers at six public sector HIV care facilities one year after the implementation of integrated FP and HIV services. Data were transcribed and analyzed qualitatively using grounded theory methods and Atlas.ti. Providers reported a number of benefits of integrated services that they believed increased the uptake and continuation of contraceptive methods. They felt that integrated services enabled them to reach a larger number of female and male patients and in a more efficient way for patients compared to non-integrated services. Availability of FP services in the same place as HIV care also eliminated the need for most referrals, which many providers saw as a barrier for patients seeking FP. Providers reported many challenges to providing integrated services, including the lack of space, time, and sufficient staff, inadequate training, and commodity shortages. Despite these challenges, the vast majority of providers was supportive of FP/HIV integration and found integrated services to be beneficial to HIV-infected patients. Providers' concerns relating to staffing, infrastructure, and training need to be addressed in order to create sustainable, cost-effective FP/HIV integrated service models.

  16. Access pricing on gas networks and capacity release markets: Lessons from North American and European experiences

    International Nuclear Information System (INIS)

    David, L.; Percebois, J.

    2004-01-01

    An evaluation of different access fee systems in North America and Europe in relation to normative prices is discussed. Among available alternatives the entry-exit pricing system as it is currently applied in the United Kingdom, the Netherlands, Italy and France, was judged to be the best solution to increased competition. Canadian and American experiences highlight the influence of the market power of shippers with regard to the efficacy of capping the market. Whether or not to cap the price on a capacity release market is a choice between the protection of shippers against market abuses and the promotion of secondary market liquidity, a choice that is linked to the level of congestion of a pipeline system. If there is much congestion, a price cap may be necessary; if there is little congestion, the need for market value given by an uncapped price may be more important than the market power of shippers. 15 refs., 2 tabs

  17. Experiences and Perspectives of African-American, Latina/o, Asian-American and European-American Psychology Graduate Students: A National Study

    Science.gov (United States)

    Maton, Kenneth I.; Wimms, Harriette E.; Grant, Sheila K.; Wittig, Michele A.; Rogers, Margaret R.; Vasquez, Melba J. T.

    2013-01-01

    A national, web-based survey of 1,222 African-American, Latina/o, Asian-American and European-American psychology graduate students revealed both similarities and differences in experiences and perspectives. Mentoring was found to be the strongest predictor of satisfaction across groups. Academic supports and barriers, along with perceptions of diversity were also important predictors of satisfaction. Students of color differed from European-American students in perceptions of fairness of representation of their ethnic group within psychology, and in aspects of the graduate school experience perceived as linked to ethnicity. Limitations of the study and implications for future research and action are discussed. PMID:21341899

  18. Patients' experiences and satisfaction about care provided by male nurses in medical surgical units in Islamabad, Pakistan: A pilot study.

    Science.gov (United States)

    Younas, Ahtisham; Sundus, Amara

    2018-01-01

    Nursing is predominantly a female profession and caring has been considered an attribute of female nurses, which could imply a noncaring image of male nurses. To determine patients' experiences and satisfaction from care provided by male nurses in a private hospital in Islamabad, Pakistan. This cross-sectional study included a purposive sample of 50 patients admitted to medical surgical units for at least 2 days and who had at least three professional interactions with a male nurse. The Newcastle Satisfaction with Nursing Scale was used for data collection. Descriptive statistics were used for data analysis. The total score for experience and satisfaction was 81 and 51, respectively. A statistically significant difference existed between experience and satisfaction scores of male and female participants, indicating that males were more pleased and satisfied with their experience of receiving care from male nurses compared to the female participants. The male nurses were concerned for their patients, they were knowledgeable about the patients' condition and care, and provided them with clear explanations of the medical and nursing procedures. However, they seem to lack interpersonal relationship with patients and did not take initiative in understanding their patients. © 2017 Wiley Periodicals, Inc.

  19. Sexual and reproductive health services for young people in Kenya and Zambia : Providers attitudes and young peoples needs and experiences

    OpenAIRE

    Warenius, Linnéa

    2008-01-01

    Background: Unintended pregnancy, abortion and STI, including HIV are common sexual and reproductive health problems among young people in Kenya and Zambia. Yet, the reproductive health services are underutilised. Nurses and midwives are key providers in the promotion young people s sexual and reproductive health in Kenya and Zambia. Aim: The overall aim was to describe and explore young people s sexual and reproductive health needs and experiences and to describe health ...

  20. A Qualitative Study of Multidisciplinary Providers' Experiences With the Transfer Process for Injured Children and Ideas for Improvement.

    Science.gov (United States)

    Gawel, Marcie; Emerson, Beth; Giuliano, John S; Rosenberg, Alana; Minges, Karl E; Feder, Shelli; Violano, Pina; Morrell, Patricia; Petersen, Judy; Christison-Lagay, Emily; Auerbach, Marc

    2018-02-01

    Most injured children initially present to a community hospital, and many will require transfer to a regional pediatric trauma center. The purpose of this study was 1) to explore multidisciplinary providers' experiences with the process of transferring injured children and 2) to describe proposed ideas for process improvement. This qualitative study involved 26 semistructured interviews. Subjects were recruited from 6 community hospital emergency departments and the trauma and transport teams of a level I pediatric trauma center in New Haven, Conn. Participants (n = 34) included interprofessional providers from sending facilities, transport teams, and receiving facilities. Using the constant comparative method, a multidisciplinary team coded transcripts and collectively refined codes to generate recurrent themes across interviews until theoretical saturation was achieved. Participants reported that the transfer process for injured children is complex, stressful, and necessitates collaboration. The transfer process was perceived to involve numerous interrelated components, including professions, disciplines, and institutions. The 5 themes identified as areas to improve this transfer process included 1) Creation of a unified standard operating procedure that crosses institutions/teams, 2) Enhancing 'shared sense making' of all providers, 3) Improving provider confidence, expertise, and skills in caring for pediatric trauma transfer cases, 4) Addressing organization and environmental factors that may impede/delay transfer, and 5) Fostering institutional and personal relationships. Efforts to improve the transfer process for injured children should be guided by the experiences of and input from multidisciplinary frontline emergency providers.

  1. Timeslice experiments for understanding regional climate projections: applications to the tropical hydrological cycle and European winter circulation

    Science.gov (United States)

    Chadwick, Robin; Douville, Hervé; Skinner, Christopher B.

    2017-11-01

    A set of atmosphere-only timeslice experiments are described, designed to examine the processes that cause regional climate change and inter-model uncertainty in coupled climate model responses to CO_2 forcing. The timeslice experiments are able to reproduce the pattern of regional climate change in the coupled models, and are applied here to two cases where inter-model uncertainty in future projections is large: the tropical hydrological cycle, and European winter circulation. In tropical forest regions, the plant physiological effect is the largest cause of hydrological cycle change in the two models that represent this process. This suggests that the CMIP5 ensemble mean may be underestimating the magnitude of water cycle change in these regions, due to the inclusion of models without the plant effect. SST pattern change is the dominant cause of precipitation and circulation change over the tropical oceans, and also appears to contribute to inter-model uncertainty in precipitation change over tropical land regions. Over Europe and the North Atlantic, uniform SST increases drive a poleward shift of the storm-track. However this does not consistently translate into an overall polewards storm-track shift, due to large circulation responses to SST pattern change, which varies across the models. Coupled model SST biases influence regional rainfall projections in regions such as the Maritime Continent, and so projections in these regions should be treated with caution.

  2. The trajectory of experience of critical care nurses in providing end-of-life care: A qualitative descriptive study.

    Science.gov (United States)

    Ong, Keh Kiong; Ting, Kit Cheng; Chow, Yeow Leng

    2018-01-01

    To understand the perceptions of critical care nurses towards providing end-of-life care. There has been an increasing interest in end-of-life care in the critical care setting. In Singapore, approximately half of deaths in the hospital occur during critical care. While nurses are well positioned to provide end-of-life care to patients and their family members, they faced barriers to providing end-of-life care. Also, providing end-of-life care has profound positive and negative psychological effects on nurses, with the latter being more prominent. Qualitative descriptive design. Data collection was performed in a medical intensive care unit of a public tertiary hospital in Singapore. Ten registered nurses were purposively sampled and interviewed individually using a semi-structured interview guide. A codebook was developed to guide coding, and data were thematically analysed. Rigour was maintained. Nurses went through a trajectory of experience. They experienced the culture of care and developed dissatisfaction with it. The tension shaped their perception and meaning of life and death, and they developed mechanisms to reach resolution. This study provides insight on nurses' perception as a trajectory of experience and raised several implications on clinical practice, policy and research. There is a need to alleviate the tension nurses face and to facilitate coming to terms with the tension by improving the culture of care and supporting nurses. Nurses could be involved more in decision-making and empowered to start end-of-life care conversations within the team and with family members. Communication with family members and between nurses and doctors could be improved. Support for nurses providing end-of-life care could be enhanced through promoting social networks, education and bereavement support. Further research is needed to explore ways to support and empower nurses to provide end-of-life care in critical care. © 2017 John Wiley & Sons Ltd.

  3. A Qualitative Study Examining Young Adults' Experiences of Disclosure and Nondisclosure of LGBTQ Identity to Health Care Providers.

    Science.gov (United States)

    Rossman, Kinton; Salamanca, Paul; Macapagal, Kathryn

    2017-01-01

    Shifting cultural attitudes and legislation have increased focus on the health care needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients. However, patient nondisclosure of LGBTQ identity creates a barrier to accessing care. This qualitative study examined a diverse sample of LGBTQ young adults and their experiences of disclosure and nondisclosure to medical providers. Participants (n = 206, age range 18-27) completed questionnaires assessing health care access and use as part of a larger study. Participants' responses to open-ended items asking about experiences of LGBTQ identity disclosure to medical providers and reasons for nondisclosure were analyzed thematically. Results revealed intra- and interpersonal factors related to patient disclosure and nondisclosure of LGBTQ identity. Reasons for participant nondisclosure included providers not asking about identity, internalized stigma, and belief that health and LGBTQ identity are not related. When participants did disclose, they experienced reactions ranging from discrimination and disbelief to affirmation and respect. Findings confirm and extend previous research on young adults' identity disclosure and provide avenues for health professionals' continuing education when working with LGBTQ patients.

  4. Biomass exploitation for revitalizing rural areas: experiences and lessons drawn from three South European countries

    Energy Technology Data Exchange (ETDEWEB)

    Santana, J.C.; Herrero, J. [Wood and Forest Service Center of Castilla y Leon (CESEFOR) Pol. Ind. Las Casas, Soria (Spain); Crema, L.; Bozzoli, A. [Fondazione Bruno Kessler (FKB), Trento (Italy); Karampinis, E.; Grammelis, P.; Margaritis, N. [Centre for Research and Technology Hellas/Inst. for Solid Fuels Technology and Applications (CERTH/ISFTA), Athens (Greece)

    2012-11-01

    Castilla y Leon (Spain), Trento (Italy) and Western Macedonia (Greece) are regions with a very high potential for forest and agricultural biomass production, but their biomass supply chains are not firmly established yet. In Castilla y Leon, a municipality from a forest area takes advantage of its large autochthonous stock of wood to arrange a complete chain of business, beginning with wood cutting and extraction, processing of raw biomass in local logistic centers to produce quality and traceable wood chips and pellets, distribution of the solid biofuels to consumers in a determined area and own use to generate energy and heat. In Trento, we analyse the exploitation of locally certified wood and residues pellets for public micro-cogeneration in a town, reaching a virtual closed cycle of use and recycling of resources. In a municipality from Western Macedonia, biomass residues from animal waste are being used to produce biogas to generate electric power to be sold and heat to dry wood biomass in a local pellet factory, revitalizing a land very conditioned by mining industry. These strategies maximize the number of jobs created and make optimum use of the local resources, providing them with high added value.

  5. European experiences of the proposed ASTM test method for crack arrest toughness of ferritic materials

    International Nuclear Information System (INIS)

    Jutla, T.; Lidbury, D.P.G.; Ziebs, J.; Zimmermann, C.

    1986-01-01

    The proposed ASTM test method for measuring the crack arrest toughness of ferritic materials using wedge-loaded, side-grooved, compact specimens was applied to three steels: A514 bridge steel, A588 bridge steel, and A533B pressure vessel steel. Five sets of results from different laboratories are discussed here. Notches were prepared by spark erosion, although root radii varied from ∝0.1-1.5 mm. Although fast fractures were successfully initiated, arrest did not occur in a significant number of cases. The results showed no obvious dependence of crack arrest toughness, K a , (determined by a static analysis) on crack initiation toughness, K 0 . It was found that K a decreases markedly with increasing crack jump distance. A limited amount of further work on smaller specimens of the A533B steel showed that lower K a values tended to be recorded. It is concluded that a number of points relating to the proposed test method and notch preparation are worthy of further consideration. It is pointed out that the proposed validity criteria may screen out lower bound data. Nevertheless, for present practical purposes, K a values may be regarded as useful in providing an estimate of arrest toughness - although not necessarily a conservative estimate. (orig./HP)

  6. The anti-human trafficking collaboration model and serving victims: Providers' perspectives on the impact and experience.

    Science.gov (United States)

    Kim, Hea-Won; Park, Taekyung; Quiring, Stephanie; Barrett, Diana

    2018-01-01

    A coalition model is often used to serve victims of human trafficking but little is known about whether the model is adequately meeting the needs of the victims. The purpose of this study was to examine anti-human trafficking collaboration model in terms of its impact and the collaborative experience, including challenges and lessons learned from the service providers' perspective. Mixed methods study was conducted to evaluate the impact of a citywide anti-trafficking coalition model from the providers' perspectives. Web-based survey was administered with service providers (n = 32) and focus groups were conducted with Core Group members (n = 10). Providers reported the coalition model has made important impacts in the community by increasing coordination among the key agencies, law enforcement, and service providers and improving quality of service provision. Providers identified the improved and expanded partnerships among coalition members as the key contributing factor to the success of the coalition model. Several key strategies were suggested to improve the coalition model: improved referral tracking, key partner and protocol development, and information sharing.

  7. Biosimilar versus patented erythropoietins: learning from 5 years of European and Japanese experience.

    Science.gov (United States)

    Bocquet, François; Paubel, Pascal; Fusier, Isabelle; Cordonnier, Anne-Laure; Sinègre, Martine; Le Pen, Claude

    2015-02-01

    Patent expiries on leading biologics are creating new momentum in the market for biosimilars (copies of off-patent biologics), paving the way for their development. However, little is known about the factors influencing the competition between biosimilars and their reference products (REF). The aim of this study was to analyse key global erythropoietin (EPO) markets and factors affecting biosimilar EPO (BIOSIM-EPO) uptakes, and to identify countries where BIOSIM-EPOs have gained significant market shares. Inclusion criteria for countries in the study were a biosimilar regulatory framework similar to the EU framework, and biological market value higher than US$2.5 billion. Factors evaluated included EPO market size, EPO retail/hospital distribution mix, national incentives to use biosimilars and BIOSIM-EPO/REF price differences. IMS Health provided EPO consumption in volumes, values, and EPO ex-manufacturer prices from 2007 to 2012. Japan: large-sized market, mixed retail/hospital distribution, no incentives, low BIOSIM-EPO uptake (6.8 % in 2012). France: large-sized market, dominant retail distribution, no incentives, low BIOSIM-EPO uptake (5.8 %). Spain and Italy: medium-sized market, dominant hospital distribution, no incentives, moderate BIOSIM-EPO uptakes (11.5 and 8.6 %). Germany: small-sized market, dominant retail distribution, presence of incentives, high BIOSIM-EPO uptake (30.4 %). UK: small-sized market, mixed retail/hospital distribution, no incentives, low BIOSIM-EPO uptake (2.0 %). BIOSIM-EPO/REF price differences play no role at a global level (-10.8 % in Germany and -26.9 % in Japan). EPO markets have proven to be highly country-specific. EPO market sizes, EPO retail/hospital distribution mixes and BIOSIM-EPO/REF price differences may not be determining factors of BIOSIM-EPO uptakes. Prescription and substitution incentives to use BIOSIM-EPO appear to be determining factors in Germany. The heterogeneity of national EPO markets makes it

  8. Use of building typologies for energy performance assessment of national building stocks. Existent experiences in European Countries and common approach. First TABULA synthesis report

    Energy Technology Data Exchange (ETDEWEB)

    Loga, Tobias; Diefenbach, Nikolaus (eds.)

    2010-06-15

    The present study examines the experiences with building typologies in the European countries. The objective is to learn how to structure the variety of energy-related features of existing build-ings. As a result of the enquiry it can be stated that there are a lot of different activities which are based on typological criteria. Some of them are concentrating on providing information material and conducting energy advice. On the other hand, building types are used for a better understand-ing of the energy performance of building portfolios on different levels: from the strategic planning of housing companies up to the evaluation of national policies and measures in the building sector. On the basis of these experiences a common approach for building typologies has been devel-oped. The core elements of this harmonised approach are a classification systematic, a structure for building and supply system data and a coherent energy balance method. Furthermore a uni-form classification of statistical data enables a concerted approach for designing national building stock models. Finally, a concise itinerary is described which allows experts to develop step by step a national or regional building typology which are compatible with the common TABULA approach. (orig.)

  9. The lived experience of family caregivers who provided end-of-life care to persons with advanced dementia.

    Science.gov (United States)

    Peacock, Shelley; Duggleby, Wendy; Koop, Priscilla

    2014-04-01

    Dementia is a terminal illness, and family caregivers play a vital role in providing end-of-life care to their relative. The present study begins to address the paucity of research regarding end-of-life caregiving experience with dementia. This study utilized Munhall's methodology for interpretive phenomenology. Seven women and four men were interviewed two to three times within a year of their relative's death; interviews were transcribed verbatim and hermeneutically analyzed. Findings reveal two essential aspects of end-of-life dementia caregiving: being-with and being-there. Further findings are organized according to the existential life worlds. Examination of the life worlds demonstrates that 1) spatiality provided a sense or lack of feeling welcome to provide end-of-life care; 2) temporality was an eternity or time melting away quickly, or the right or wrong time to die; 3) corporeality revealed feelings of exhaustion; and 4) relationality was felt as a closeness to others or in tension-filled relationships. An understanding from bereaved caregivers' perspectives will help healthcare practitioners better support and empathize with family caregivers. Further research is warranted that focuses on other places of death and differences in experience based on gender or relationship to the care receiver.

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

    Science.gov (United States)

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

    2014-01-01

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

  11. A qualitative study of English community pharmacists' experiences of providing lifestyle advice to patients with cardiovascular disease.

    Science.gov (United States)

    Morton, Kirsty; Pattison, Helen; Langley, Chris; Powell, Rachael

    2015-01-01

    Cardiovascular disease (CVD) progression is modifiable through lifestyle behaviors. Community pharmacists are ideally placed to facilitate self-management of cardiovascular health however research shows varied pharmacist engagement in providing lifestyle advice. This study explored community pharmacists' experiences and perceptions of providing lifestyle advice to patients with CVD. Semi-structured interviews were conducted with fifteen pharmacists (1 supermarket; 7 multiple; 7 independent) recruited through multiple methods from community pharmacies across the Midlands, England. A thematic analysis was conducted using a Framework approach. Pharmacists categorized patients according to their perceptions of the patients' ability to benefit from advice. Many barriers to providing lifestyle advice were identified. Confidence to provide lifestyle advice varied, with pharmacists most comfortable providing lifestyle advice in conjunction with conversations about medicines. Some pharmacists felt lifestyle advice was an integral part of their role whilst others questioned whether pharmacists should give lifestyle advice at all, particularly when receiving no remuneration for doing so. Pharmacists viewed providing lifestyle advice as important but identified many barriers to doing so. Lifestyle advice provision was influenced by pharmacists' perceptions of patients. Professional identity and associated role conflict appeared to underpin many of the barriers to pharmacists providing lifestyle advice. Pharmacists may benefit from enhanced training to: increase their confidence to provide lifestyle advice; integrate lifestyle advice with regular pharmaceutical practice and challenge their perceptions of some patients' receptiveness to lifestyle advice and behavior change. Changes to the way UK pharmacists are remunerated may increase the provision of lifestyle advice. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Patient-Provider Communication: Experiences of Low-Wage-Earning Breast Cancer Survivors in Managing Cancer and Work.

    Science.gov (United States)

    Nichols, Helen M; Swanberg, Jennifer E; Vanderpool, Robin C

    2018-02-26

    In 2017, there will be more than 250,000 new diagnoses of invasive breast cancer; most cases will occur in working-age women. The goal of this qualitative study was to explore low-wage-earning breast cancer survivors' experiences communicating with their oncology team about cancer and employment issues. Twenty-four low-wage-earning breast cancer survivors in the USA were interviewed in 2012 using a structured interview protocol. Sociodemographic data, cancer history, and patient-provider communication experiences regarding the management of cancer and work were collected. Interviews were analyzed using grounded theory strategy of constant comparative analysis. Low-wage-earning breast cancer survivors' experiences communicating with their oncology team about employment and cancer focused on three dimensions of patient-provider communication: extent, quality, and content. Over 70% of respondents reported no communication or only routine communication with their providers regarding work; three quarters of women reported poor or standard communication quality, and content of work-related communication covered scheduling issues, work absences, continuing to work during treatment, and financial concerns. Communication between oncology care teams and low-wage-earning cancer patients is critical to the successful management of treatment and work responsibilities given the vulnerable employment situation of these women. There is a need for education of oncology team members about how cancer and its treatment can impact employment for all workers, but especially for low-wage workers, thereby allowing the care team to address these issues proactively and help patients successfully manage both cancer treatment and work responsibilities.

  13. Pandemic risk prevention in European countries: role of the ECDC in preparing for pandemics. Development and experience with a national self-assessment procedure, 2005-2008.

    Science.gov (United States)

    Nicoll, A

    2010-12-01

    To be effective risk prevention work takes place well before pandemics through the three Ps: Planning, Preparedness and Practise. Between 2005 and 2008 the European Centre for Disease Prevention and Control (ECDC) worked with the European Commission (EC) and the WHO Regional Office for Europe (WHO-Euro) to assist European countries in preparing themselves for a future influenza pandemic. All eligible countries in the European Union and European Economic Area participated with energy and commitment. Indicators of preparedness were developed based on WHO planning guidance and these were set within a simple assessment which included a formal country visit. The procedure evolved considerably with field experience. As the complexity of pandemic preparedness was appreciated it changed from being a classical short external assessment to longer national self-assessments with demonstrable impact, especially when self-assessments were published. There were essential supporting activities undertaken including a series of pan-European pandemic preparedness workshops organised by EC, WHO-Euro, ECDC and countries holding the European Union Presidency. The self-assessments highlighted additional work and documentation that was needed by national authorities from the ECDC. This work was undertaken and the document produced. The benefits of the self-assessments were seen in the 2009 pandemic in that EU/EEA countries performed better than some others. A number of the guidance documents were updated to fit the specific features of the pandemic. However the pandemic revealed many weaknesses and brought new challenges for European countries, notably over communication and vaccines, the need to prepare for a variety of scenarios and to factor severity estimates into preparedness, to improve surveillance for severe disease and to deliver seroepidemiology. Any revised self-assessment procedure will need to respond to these challenges.

  14. [Experience of Handicap International in providing humanitarian relief in region near Aceh, Indonesia from March 1 to 27, 2005].

    Science.gov (United States)

    Gillet, Y

    2005-01-01

    This report describes the experience of the author in March 2005 during the relief efforts deployed in the region near Aceh, Indonesia (North Sumatra) by Handicap International, one of the 400 NGO that provided humanitarian aid following the tsunami disaster that struck Southeast Asia on December 26, 2004. Working in Banda Aceh and Meulaboh, the author was confronted with the extent of the devastation both in terms of property damage and human suffering. Clinical cases were often severe and rarely encountered in industrialized countries. The tsunami worsened the already poor sanitary conditions: rundown care facilities, poorly trained health care personnel, tropical disease, poor hygiene, and AVP.

  15. Development of a modelling framework in response to new European energy-efficiency regulatory obligations: The Irish experience

    International Nuclear Information System (INIS)

    Hull, David; O Gallachoir, Brian P.; Walker, Neil

    2009-01-01

    Momentum has been building for an EU-wide approach to energy policy in which energy end-use efficiency is regarded as one of the main planks. Member States are already obliged to plan for the achievement of energy savings targets in respect of the period 2008-2016 and they now face additional economy-wide targets for 2020. Efficiency investments are widely regarded as capable of improving industrial competitiveness, security of energy supply and the abatement of greenhouse gas emissions. Nevertheless, the design of policy packages may involve trade-offs between these objectives. The challenge for energy modellers is to quantify future energy savings associated with combinations of efficiency measures. This paper draws on the international experience in energy modelling and tracks recent progress that has been made towards a harmonised European framework for verification of savings. It points to the significant development work that remains to be done, particularly to enable an increased reliance on bottom-up evaluation methods. One significant gap in our knowledge relates to the required adjustment of technical savings due to behavioural factors such as rebound effects. The paper uses one country (Ireland) as a case study to demonstrate how a framework is being developed to respond to these new requirements.

  16. Pregnancy planning and risk behaviours – a survey of women’s experiences in selected European countries

    Directory of Open Access Journals (Sweden)

    Małgorzata Lesińska-Sawicka

    2018-03-01

    Full Text Available Pregnancy, a special period in a woman’s life, should be preceded by proper preparation: a positive attitude to procreation, selection of optimum time for becoming pregnant, starting prevention of neural tube defects, restriction of the use of drugs, smoking, etc. The aim of this study was to determine the effect of pregnancy planning and antenatal classes on the use of stimulants during pregnancy. The study group included 877 women living in 7 European countries, and their experiences of planning pregnancy and substance abuse during pregnancy were investigated. In about a half (50.3% of respondents the pregnancy was planned. The highest percentage of mothers who planned pregnancy was recorded in Poland and Bulgaria (about 76%. By contrast, in Germany the proportion of mothers who planned pregnancy was the lowest (46.2%. Surprisingly, they became pregnant despite very frequent use of birth control (96.7%. On average, 17.3% of respondents disclosed that they drank alcohol or coffee, smoked cigarettes or used psychoactive drugs during pregnancy. Among women who did not plan to be pregnant, the use of stimulants was recorded more often. However, pregnancy planning only slightly inclined women to stop the consumption of stimulants. Attendance at antenatal classes did not have any significant effect on the use of stimulants.

  17. Surveillance of Food- and Smear-Transmitted Pathogens in European Soldiers with Diarrhea on Deployment in the Tropics: Experience from the European Union Training Mission (EUTM Mali

    Directory of Open Access Journals (Sweden)

    Hagen Frickmann

    2015-01-01

    Full Text Available Introduction. Since 2013, European soldiers have been deployed on the European Union Training Mission (EUTM in Mali. From the beginning, diarrhea has been among the most “urgent” concerns. Diarrhea surveillance based on deployable real-time PCR equipment was conducted between December 2013 and August 2014. Material and Methods. In total, 53 stool samples were obtained from 51 soldiers with acute diarrhea. Multiplex PCR panels comprised enteroinvasive bacteria, diarrhea-associated Escherichia coli (EPEC, ETEC, EAEC, and EIEC, enteropathogenic viruses, and protozoa. Noroviruses were characterized by sequencing. Cultural screening for Enterobacteriaceae with extended-spectrum beta-lactamases (ESBL with subsequent repetitive sequence-based PCR (rep-PCR typing was performed. Clinical information was assessed. Results. Positive PCR results for diarrhea-associated pathogens were detected in 43/53 samples, comprising EPEC (n=21, ETEC (n=19, EAEC (n=15, Norovirus (n=10, Shigella spp./EIEC (n=6, Cryptosporidium parvum (n=3, Giardia duodenalis (n=2, Salmonella spp. (n=1, Astrovirus (n=1, Rotavirus (n=1, and Sapovirus (n=1. ESBL-positive Enterobacteriaceae were grown from 13 out of 48 samples. Simultaneous infections with several enteropathogenic agents were observed in 23 instances. Symptoms were mild to moderate. There were hints of autochthonous transmission. Conclusions. Multiplex real-time PCR proved to be suitable for diarrhea surveillance on deployment. Etiological attribution is challenging in cases of detection of multiple pathogens.

  18. Peculiarities of Calculating the Cost of Public Goods (from the Necessary to the Desired: Domestic Realities and European Experience

    Directory of Open Access Journals (Sweden)

    Aleksieieva N. I.

    2015-11-01

    Full Text Available Social needs and instruments for their satisfaction — public goods — have been studied. Attention is drawn to the fact that social needs are composed of individual and collective needs of economic entities. They are interrelated and complementary. An important difference between individual and collective needs is in their personification (individualization and divisibility. Proper consideration has been paid to concepts related to the needs of society — the public interest (as a form of social needs, public goods (all the goods, services that can satisfy social needs. For studying social needs and benefits in this work there was taken one of the most popular of their classification, which lies in their division into primary and secondary ones. Emphasis is placed on importance of its use in determining the priority of financing public goods. The focus is on the approach to calculating the cost of public goods. It is regarded as one of the stages in satisfying social needs (along with planning and analysis of the degree for their satisfaction. An approach to determining the structure of financing the total volume of public goods, calculating minimum admissible and desired volume of financing has been presented. The current interest in the European experience prompted the authors to analyze the cost and structure of financing public goods in France, the available statistical base allowing it to be implemented. The determined dependence between the indicators enabled conducting calculations of the desired volumes of financing the public needs per person according to three scenarios: optimistic, satisfactory and critical relevant to phases of the economic cycle. This simulation is aimed at being used in management decisionmaking, development of social and economic policy, etc. There have been noted serious shortcomings related to the lack of quality and reliable statistical information on Ukraine, which hamper the calculation and consideration

  19. Summary of Adsorption/Desorption Experiments for the European Database on Indoor Air Pollution Sources in Buildings

    DEFF Research Database (Denmark)

    Kjær, Ulla Dorte; Tirkkonen, T.

    1996-01-01

    Experimental data for adsorption/desorption in building materials. Contribution to the European Database on Indoor Air Pollution Sources in buildings.......Experimental data for adsorption/desorption in building materials. Contribution to the European Database on Indoor Air Pollution Sources in buildings....

  20. A large replication study and meta-analysis in European samples provides further support for association of AHI1 markers with schizophrenia

    DEFF Research Database (Denmark)

    Ingason, Andrés; Giegling, Ina; Cichon, Sven

    2010-01-01

    The Abelson helper integration site 1 (AHI1) gene locus on chromosome 6q23 is among a group of candidate loci for schizophrenia susceptibility that were initially identified by linkage followed by linkage disequilibrium mapping, and subsequent replication of the association in an independent sample....... Here, we present results of a replication study of AHI1 locus markers, previously implicated in schizophrenia, in a large European sample (in total 3907 affected and 7429 controls). Furthermore, we perform a meta-analysis of the implicated markers in 4496 affected and 18,920 controls. Both...... as the neighbouring phosphodiesterase 7B (PDE7B)-may be considered candidates for involvement in the genetic aetiology of schizophrenia....

  1. The Food and Drug Administration reports provided more data but were more difficult to use than the European Medicines Agency reports

    DEFF Research Database (Denmark)

    Schroll, Jeppe Bennekou; Abdel-Sattar, Maher; Bero, Lisa

    2015-01-01

    OBJECTIVES: To compare the accessibility, comprehensiveness, and usefulness of data available from the European Medicines Agency (EMA) and the Food and Drug Administration (FDA) drug reports. STUDY DESIGN AND SETTING: This is a cross-sectional study. All new molecular drugs approved between January...... 1, 2011 and December 31, 2012 from the FDA and EMA Web sites were eligible. RESULTS: We included 27 drug reports. Most were searchable, but the FDA table of contents did not match the file's page numbers. Several FDA documents must be searched compared with a single EMA document, but the FDA reports...... contain more summary data on harms. Detailed information about harms was reported for 93% of the FDA reports (25 of 27 reports) and 26% of the EMA reports (7 of 27 reports). The reports contained information about trial methodology but did not include trial registry IDs or investigator names. All reports...

  2. Family caregiver's experiences of providing care to patients with End-Stage Renal Disease in South-West Nigeria.

    Science.gov (United States)

    Oyegbile, Yemisi Okikiade; Brysiewicz, Petra

    2017-09-01

    To describe the experiences of family caregivers providing care for patients living with End-Stage Renal Disease in Nigeria BACKGROUND: Family caregiving is where an unpaid volunteer, usually a close family member, attends to the needs of a loved one with a chronic, disabling illness within the home. Much research has been conducted in the area of family caregiving in high-income countries. However, the same cannot be said for many of the low-resource, multicultural African countries. Qualitative descriptive study. This qualitative descriptive study used manifest content analysis to analyse data from semi-structured, individual interviews, with 15 purposively selected family caregivers. Two tertiary institutions providing renal care in South-Western Nigeria: the research setting for this study. Five categories were identified, and these included disconnectedness with self and others, never-ending burden, 'a fool being tossed around', obligation to care and promoting a closer relationship. Experiences associated with the caregiving of patients diagnosed with End-Stage Renal Disease evoked a number of emotions from the family caregivers, and the study revealed that caregiving imposed some burdens that are specific to low-resource countries on participants. Nurses need to engage family caregivers on disease-specific teachings that might promote understanding of the disease process and role expectation. Family caregivers may benefit from social support services. © 2016 John Wiley & Sons Ltd.

  3. Legal Aspects of the Implementation of European Union’s Common Commercial Policy: Lithuanian Experience and Practice

    Directory of Open Access Journals (Sweden)

    Valantiejus Gediminas

    2016-12-01

    Full Text Available The Common Commercial Policy is the essential basis of the European Union (hereinafter - the EU, which, in particular, is a free trade area between the 28 Member States with a common external customs tariff and a common foreign trade policy as well as common trade rules with the third countries. Implementation of this policy is characterized by the fact that it is based on an exclusive competence of the EU, which after the Treaty of Lisbon (2009 became even more apparent. Therefore the countries of the EU should follow the same legal principles and rules in the regulation of their foreign trade, that is to apply the uniform EU rules on the calculation of customs duties and determination of the customs origin of goods, customs valuation and tariff classification of goods (Common Customs Tariff. However, implementation of these provisions is always experiencing stress due to the different interests of the EU Member States and the different national practices, especially when the administration of customs duties is actually implemented only at the level of individual EU Member States. Therefore the aim of the article is to assess the implementation of the EU’s CCP from the perspective of the EU Member State (Lithuania and to describe existing discrepancies which may serve as an obstacle for the development of common regulatory regime for import customs duties in the EU or hinder its main economic goals in international trade. Analysis of relevant scientific problems is mainly based on the comparative method (comparison of the practice of the national courts in the Republic of Lithuania and the Court of Justice of the European Union in disputes related to the functioning of the EU's customs union and generalization of professional experience (national and EU judicial practice. The research leads to the conclusion that a uniform implementation of Common Commercial Policy and the Common Customs Tariff, as its main element, is not fully ensured on

  4. The national health insurance scheme: perceptions and experiences of health care providers and clients in two districts of Ghana.

    Science.gov (United States)

    Dalinjong, Philip Ayizem; Laar, Alexander Suuk

    2012-07-23

    Prepayments and risk pooling through social health insurance has been advocated by international development organizations. Social health insurance is seen as a mechanism that helps mobilize resources for health, pool risk, and provide more access to health care services for the poor. Hence Ghana implemented the National Health Insurance Scheme (NHIS) to help promote access to health care services for Ghanaians. The study examined the influence of the NHIS on the behavior of health care providers in their treatment of insured and uninsured clients. The study took place in Bolgatanga (urban) and Builsa (rural) districts in Ghana. Data was collected through exit survey with 200 insured and uninsured clients, 15 in-depth interviews with health care providers and health insurance managers, and 8 focus group discussions with insured and uninsured community members. The NHIS promoted access for insured and mobilized revenue for health care providers. Both insured and uninsured were satisfied with care (survey finding). However, increased utilization of health care services by the insured leading to increased workloads for providers influenced their behavior towards the insured. Most of the insured perceived and experienced long waiting times, verbal abuse, not being physically examined and discrimination in favor of the affluent and uninsured. The insured attributed their experience to the fact that they were not making immediate payments for services. A core challenge of the NHIS was a delay in reimbursement which affected the operations of health facilities and hence influenced providers' behavior as well. Providers preferred clients who would make instant payments for health care services. Few of the uninsured were utilizing health facilities and visit only in critical conditions. This is due to the increased cost of health care services under the NHIS. The perceived opportunistic behavior of the insured by providers was responsible for the difference in the behavior

  5. Communication and cultural issues in providing reproductive health care to immigrant women: health care providers' experiences in meeting the needs of [corrected] Somali women living in Finland.

    Science.gov (United States)

    Degni, Filio; Suominen, Sakari; Essén, Birgitta; El Ansari, Walid; Vehviläinen-Julkunen, Katri

    2012-04-01

    Communication problems due to language and cultural differences between health care professionals and patients are widely recognized. Finns are described as more silent whereas one concurrent large immigrant group, the Somalis, are described as more open in their communication. The aim of the study was to explore physicians-nurses/midwives' communication when providing reproductive and maternity health care to Somali women in Finland. Four individual and three focus group interviews were carried out with 10 gynecologists/obstetricians and 15 nurses/midwives from five selected clinics. The health care providers considered communication (including linguistic difficulties), cultural traditions, and religious beliefs to be problems when working with Somali women. Male and female physicians were generally more similar in communication style, interpersonal contacts, and cultural awareness than the nurses/midwives who were engaged in more partnership-building with the Somali women in the clinics. Despite the communication and cultural problems, there was a tentative mutual understanding between the Finnish reproductive health care professionals and the Somali women in the clinics.

  6. Service providers' experiences of using a telehealth network 12 months after digitisation of a large Australian rural mental health service.

    Science.gov (United States)

    Newman, Lareen; Bidargaddi, Niranjan; Schrader, Geoffrey

    2016-10-01

    Despite evidence of benefits of telehealth networks in increasing access to, or providing, previously unavailable mental health services, care providers still prefer traditional approaches. For psychiatric assessment, digital technology can offer improvements over analog systems for the technical and, subsequently, the social quality of provider-client interaction. This is in turn expected to support greater provider uptake and enhanced patient benefits. Within the framework of Innovation Diffusion Theory, to study service providers' experiences of an existing regional telehealth network for mental health care practice twelve months after digitisation in order to identify the benefits of digital telehealth over an analog system for mental health care purposes in rural Australia. Qualitative interviews and focus groups were conducted with over 40 service providers from June to September 2013 in South Australia, ranging from the metropolitan central operations to health providers located up to 600km away in rural and remote areas of the same state. Participants included rural mental health teams, directors of nursing at rural hospitals, metropolitan-based psychiatrists and registrars, the metropolitan-based mental health team dedicated to rural provider support, rural GPs, administrative staff, and the executive group of the state rural health department. Fieldwork was conducted 12 months after the analog system was digitised. The interview and focus group data were analysed using thematic analysis, focusing on three key areas of innovation diffusion theory: relative advantage, technical complexity and technical compatibility. Five themes with 11 sub-themes were identified: (1) "Existing Uses", with three sub-themes: current mental health use, use by GPs, and use for staff support; (2) "Relative Advantage", with four sub-themes: improved technical quality, improved clinical practice, time and cost benefits for providers, and improved patient care; (3) "Technical

  7. European hadrons

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    The European Hadron Facility (EHF) is a project for particle and nuclear physics in the 1990s which would consist of a fast cycling high intensity proton synchrotron of about 30 GeV primary energy and providing a varied spectrum of intense high quality secondary beams (polarized protons, pions, muons, kaons, antiprotons, neutrinos). The physics case of this project has been studied over the last two years by a European group of particle and nuclear physicists (EHF Study Group), whilst the conceptual design for the accelerator complex was worked out (and is still being worked on) by an international group of machine experts (EHF Design Study Group). Both aspects have been discussed in recent years in a series of working parties, topical seminars, and workshops held in Freiburg, Trieste, Heidelberg, Karlsruhe, Les Rasses and Villigen. This long series of meetings culminated in the International Conference on a European Hadron Facility held in Mainz from 10-14 March

  8. The International Heat Pipe Experiment. [international cooperation zero g experiment

    Science.gov (United States)

    Mcintosh, R.; Ollendorf, S.; Harwell, W.

    1976-01-01

    The aims of the experiment are outlined. Flight experiments included in this program were provided by NASA, Goddard Space Flight Center, ESA (European Space Agency), the German Ministry of Technology, Hughes Aircraft Company and NASA, Ames Research Center.

  9. The Experience and Impact of Contraceptive Stockouts Among Women, Providers and Policymakers in Two Districts of Uganda.

    Science.gov (United States)

    Grindlay, Kate; Turyakira, Eleanor; Kyamwanga, Imelda T; Nickerson, Adrianne; Blanchard, Kelly

    2016-09-01

    Little is known about the impact of contraceptive stockouts on women and health care providers, or how policymakers perceive and handle such stockouts. In May-July 2015, a qualitative study on experiences of contraceptive stockouts was conducted in two districts of Uganda. It comprised three data collection components: eight focus groups with 50 women, 24 individual in-depth interviews with family planning service providers and facility managers, and 11 in-depth interviews with district-level policymakers and decision makers. Data analysis followed the content analysis approach. Contraceptive stockouts were common, particularly for long-term methods and oral contraceptives. For women, the consequences included stress, increased costs, domestic conflict, and unwanted or unplanned pregnancies. Providers reported emotional distress, blame from clients, deterioration of skills and lower demand for their services as a result of stockouts; they also felt unable to address stockouts under current supply systems. Despite the widespread prevalence and adverse impact of stockouts, policymakers reported being unaware of the scope of the problem. The findings suggest there is a critical need to raise awareness of the issue, reduce stockouts and mitigate their negative consequences. Efforts to eliminate stockouts should include addressing supply chain issues. Raising community awareness and engaging with men on family planning may be ways to deal with the consequences of stockouts.

  10. Composition, labelling, and safety of food supplements based on bee products in the legislative framework of the European Union - Croatian experiences.

    Science.gov (United States)

    Vujić, Mario; Pollak, Lea

    2015-12-01

    The European Union market is overflown by food supplements and an increasing number of consumers prefer those where bee products play an important part in their composition. This paper deals with complex European Union legislation concerning food supplements based on bee products, placing a special emphasis on their composition, labelling, and safety. Correct labelling of food supplements also represents a great challenge since, in spite of legal regulations in force, there are still open issues regarding the statements on the amount of propolis, which is not clearly defined by the legal framework. One of the key issues are the labels containing health claims from the EU positive list approved by the European Food Safety Authority. Emphasis will also be placed on informing consumers about food, as statements which imply the healing properties of food supplements and their capacity to cure diseases are forbidden. One of the key elements of product safety is HACCP based on the EU Regulations EC 178/02 and 852/2004. Health safety analyses of food supplements with bee products used as raw materials, which are standardised by legal regulations will also be discussed. In the future, attention should also be paid to establishing the European Union "nutrivigilance" system. Croatian experiences in addressing challenges faced by producers, supervisory entities, and regulatory and inspection bodies may serve as an example to countries aspiring to become part of the large European family.

  11. The Internet as a source of health information: experiences of cancer survivors and caregivers with healthcare providers.

    Science.gov (United States)

    Dolce, Maria C

    2011-05-01

    To describe the experiences of cancer survivors and caregivers with healthcare providers in the context of the Internet as a source of health information. Qualitative description. Online cancer communities hosted by the Association of Cancer Online Resources. Purposive sample of 488 cancer survivors, with varying cancer types and survivorship stages, and caregivers. Secondary data analysis using Krippendorff's thematic clustering technique of qualitative content analysis. Survivorship, healthcare relationships, and the Internet. Disenchantment with healthcare relationships was associated with failed expectations related to evidence-based practice, clinical expertise, informational support, and therapeutic interpersonal communication. Survivors and caregivers exercised power in healthcare relationships through collaboration, direct confrontation, becoming expert, and endorsement to influence and control care decisions. Disenchantment propelled cancer survivors and caregivers to search the Internet for health information and resources. Conversely, Internet information-seeking precipitated the experience of disenchantment. Through online health information and resources, concealed failures in healthcare relationships were revealed and cancer survivors and caregivers were empowered to influence and control care decisions. The findings highlight failures in cancer survivorship care and underscore the importance of novel interdisciplinary programs and models of care that support evidence-informed decision making, self-management, and improved quality of life. Healthcare professionals need to receive education on survivors' use of the Internet as a source of health information and its impact on healthcare relationships. Future research should include studies examining the relationship between disenchantment and survivorship outcomes.

  12. The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC: experiences from a successful ERS Clinical Research Collaboration

    Directory of Open Access Journals (Sweden)

    James D. Chalmers

    2017-09-01

    To understand the role of Clinical Research Collaborations as the major way in which the European Respiratory Society can stimulate clinical research in different disease areas To understand some of the key features of successful disease registries To review key epidemiological, clinical and translational studies of bronchiectasis contributed by the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC project in the past 5 years To understand the key research priorities identified by EMBARC for the next 5 years

  13. The european ALARA network

    International Nuclear Information System (INIS)

    Croueail, P.; Lefaure, C.; Croft, J.

    2000-01-01

    Throughout the 1980s and early 1990s the European Commission sponsored projects on the understanding and practical implementation of the ALARA principle. These projects helped ensure that ALARA was integrated into many organisations radiation protection programmes, particularly in the nuclear industry. However there was still much to be done in the non-nuclear sector, as well as for the management of internal exposure. Therefore, the European Commission decided to set up, as of the first January 1996, a European ALARA Network (EAN) whose main goals are to: Further promote ALARA within non nuclear industry, research and the nuclear cycle; Provide a means for feedback experience and the exchange and dissemination of good radiological protection practices in these areas; Initiate proposals for research projects and workshops on topics dealing with optimisation of radiological protection for all types of occupational exposure. The Network has a Steering Committee of experts from 11 countries, with CEPN being the co-ordinator. Twice yearly, the EAN products for the international community a European ALARA Newsletter that reaches several thousand individuals or institutions, mainly in Europe. Each year since 1997, the EAN has organised an ALARA workshop attended by 60 to 80 experts from about ten countries. The first three Workshops were devoted to: ALARA and Decommissioning (1997, Saclay, France), Good Radiation Practices in Industry and Research (1998, Chilton, United Kingdam), and ALARA and Internal Exposure (1999, Munich, Germany). Each of these Workshops gave rise to sets of recommendations to the European Commission which included proposals for further research, modification of regulations, and actions to support feedback experience within the member states. (author)

  14. Forming and sustaining partnerships to provide integrated services for young people: an overview based on the headspace Geelong experience.

    Science.gov (United States)

    Callaly, Tom; von Treuer, Kathryn; van Hamond, Toni; Windle, Kelly

    2011-02-01

    To discuss critical considerations in the formation and maintenance of agency partnerships designed to provide integrated care for young people. Two years after its establishment, an evaluation of the headspace Barwon collaboration and a review of the health-care and management literature on agency collaboration were conducted. The principal findings together with the authors' experience working at establishing and maintaining the partnership are used to discuss critical issues in forming and maintaining inter-agency partnerships. Structural and process considerations are necessary but not sufficient for the successful formation and maintenance of inter-agency partnerships and integrated care provision. Specifically, organizational culture change and staff engagement is a significant challenge and planning for this is essential and often neglected. Although agreeing on common goals and objectives is an essential first step in forming partnerships designed to provide integrated care, goodwill is not enough, and the literature consistently shows that most collaborations fail to meet their objectives. Principles and lessons of organizational behaviour and management practices in the business sector can contribute a great deal to partnership planning. © 2011 Blackwell Publishing Asia Pty Ltd.

  15. Providing Telehealth Services to a Public Primary Care Network: The Experience of RedeNUTES in Pernambuco, Brazil.

    Science.gov (United States)

    Diniz, Paula Rejane Beserra; Ribeiro Sales, Fernando José; de Araújo Novaes, Magdala

    2016-08-01

    Information technologies have been applied in primary care domains to improve the delivery of health services. This article reports the telehealth network experience in Pernambuco, Brazil. Five different data sets were used, one by each service and the structural aspects of the network, collected from 2008 until August 2015. The data include solicited themes for educational activities, users' evaluation of services, numbers of sites, municipalities participating, participants in tele-education activities, teleconsultations, telediagnosis, and remote screenings. The analysis was done in absolute and percentage values using Microsoft Excel (version 2007). The indicators show high utilization of tele-education resources, followed by the teleconsultation service. The synchronous modality was the most used and the general clinical question was the most frequent type of question. Nurses are the professional category that most used the teleconsultation services (36%). Telediagnosis of electrocardiography has growth utilization, overcoming teleconsulting more recently. The satisfaction rate was 89%, and 68.5% of professionals changed their planning to patients' referrals to specialists. Telehealth has been considered effective since it avoids inappropriate referrals of the patient and provides continuous actualization to health professionals. Our results provide evidence of the feasibility and importance of using telehealth as a tool to ensure the universality, equality, and completeness in the health system.

  16. The lived experience of rescuing people who have driven into floodwater: Understanding challenges and identifying areas for providing support.

    Science.gov (United States)

    Keech, Jacob J; Smith, Stephanie R; Peden, Amy E; Hagger, Martin S; Hamilton, Kyra

    2018-06-11

    Drowning is a major public health issue, with risk increasing during times of flood. Driving though floodwater is a major risk factor for flood-related drowning and injury, and despite widespread public health campaigns, many people continue to undertake this risky behaviour and require rescue. We aimed to identify key challenges faced by emergency services personnel when rescuing those who have driven into floodwater, and to identify strategies for supporting rescuers in this important role. Australian flood rescue operators (N=8) who had previously rescued a driver who had driven through floodwater, participated in semi-structured interviews. Data were analysed using thematic analysis. Four challenges emerged from their experiences: Involvement of untrained personnel, varying information provided by emergency telephone operators, behaviour of drivers complicating the rescue, people sightseeing floods or flood rescues, or ignoring closed roads providing sources of distraction and frustration. We propose five strategies for translating these results into practice, including: training and protocol development for (1) emergency personnel and (2) telephone operators, (3) training for rescuers regarding non-compliant rescuees, (4) educating the public, and (5) increasing compliance with closed roads. Current findings provide valuable insights into how rescuers can be supported in performing their roles, and implementation of these strategies has the potential to reduce fatalities occurring due to driving through floodwater. SO WHAT?: The strategies presented have the potential to reduce the frequency and improve the outcomes of floodwater rescues, aiding in the prevention of injury and death. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. European Ethnopharmaceuticals for Self-Medication in Japan: Review Experience of Vitis vinifera L., Folium Extract and Vitex agnus-castus L., Fructus Extract as OTC Drugs.

    Science.gov (United States)

    Hoshino, Tatsuro; Muto, Nanami; Tsukada, Shinsuke; Nakamura, Takatoshi; Maegawa, Hikoichiro

    2018-01-06

    Since the publication of "Application Guideline for Western Traditional Herbal Medicines as OTC Drugs" in 2007, only two European ethnopharmaceuticals, Vitis vinifera L., folium extract (Antistax) and Vitex agnus-castus L., fructus extract (Prefemin), have been approved as OTC drugs in Japan. In this review, we describe the current regulation of Western ethnopharmaceuticals in Japan, summarize our regulatory experiences and discuss the scientific and regulatory issues involved.

  18. European Ethnopharmaceuticals for Self-Medication in Japan: Review Experience of Vitis vinifera L., Folium Extract and Vitex agnus-castus L., Fructus Extract as OTC Drugs

    Directory of Open Access Journals (Sweden)

    Tatsuro Hoshino

    2018-01-01

    Full Text Available Since the publication of “Application Guideline for Western Traditional Herbal Medicines as OTC Drugs” in 2007, only two European ethnopharmaceuticals, Vitis vinifera L., folium extract (Antistax and Vitex agnus-castus L., fructus extract (Prefemin, have been approved as OTC drugs in Japan. In this review, we describe the current regulation of Western ethnopharmaceuticals in Japan, summarize our regulatory experiences and discuss the scientific and regulatory issues involved.

  19. Providing surgery in a war-torn context: the Médecins Sans Frontières experience in Syria.

    Science.gov (United States)

    Trelles, Miguel; Dominguez, Lynette; Tayler-Smith, Katie; Kisswani, Katrin; Zerboni, Alberto; Vandenborre, Thierry; Dallatomasina, Silvia; Rahmoun, Alaa; Ferir, Marie-Christine

    2015-01-01

    Since 2011, civil war has crippled Syria leaving much of the population without access to healthcare. Various field hospitals have been clandestinely set up to provide basic healthcare but few have been able to provide quality surgical care. In 2012, Medecins Sans Frontieres (MSF) began providing surgical care in the Jabal al-Akrad region of north-western Syria. Based on the MSF experience, we describe, for the period 5th September 2012 to 1st January 2014: a) the volume and profile of surgical cases, b) the volume and type of anaesthetic and surgical procedures performed, and c) the intraoperative mortality rate. A descriptive study using routinely collected MSF programme data. Quality surgical care was assured through strict adherence to the following minimum standards: adequate infrastructure, adequate water and sanitation provisions, availability of all essential disposables, drugs and equipment, strict adherence to hygiene requirements and universal precautions, mandatory use of sterile equipment for surgical and anaesthesia procedures, capability for blood transfusion and adequate human resources. During the study period, MSF operated on 578 new patients, of whom 57 % were male and median age was 25 years (Interquartile range: 21-32 years). Violent trauma was the most common surgical indication (n-254, 44 %), followed by obstetric emergencies (n-191, 33 %) and accidental trauma (n-59, 10 %). In total, 712 anaesthetic procedures were performed. General anaesthesia without intubation was the most common type of anaesthesia (47 % of all anaesthetics) followed by spinal anaesthesia (25 %). A total of 831 surgical procedures were performed, just over half being minor/wound care procedures and nearly one fifth, caesarean sections. There were four intra-operative deaths, giving an intra-operative mortality rate of 0.7 %. Surgical needs in a conflict-afflicted setting like Syria are high and include both combat and non-combat indications, particularly

  20. Essential UX metrics to be considered when designing m-health applications in order to provide positive user experiences

    CSIR Research Space (South Africa)

    Ouma, S

    2010-07-01

    Full Text Available into positive user experiences. More complications arise in that there is no agreed standard of measuring the user experience of a particular product. In this working paper, the authors propose core user experience metrics that are essential and should...

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

    Science.gov (United States)

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

    2018-03-01

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

  2. HIV serostatus disclosure: Experiences and perceptions of people living with HIV/AIDS and their service providers in Gujarat, India

    Directory of Open Access Journals (Sweden)

    Sangita V Patel

    2012-01-01

    Full Text Available Background: Human immunodeficiency virus (HIV disclosure offers important benefits to people living with HIV/AIDS. However, fear of discrimination, blame, and disruption of family relationships can make disclosure a difficult decision. Barriers to HIV disclosure are influenced by the particular culture within which the individuals live. Although many studies have assessed such barriers in the U.S., very few studies have explored the factors that facilitate or prevent HIV disclosure in India. Understanding these factors is critical to the refinement, development, and implementation of a counseling intervention to facilitate disclosure. Materials and Methods: To explore these factors, we conducted 30 in-depth interviews in the local language with HIV- positive individuals from the Integrated Counselling and Testing Centre in Gujarat, India, assessing the experiences, perceived barriers, and facilitators to disclosure. To triangulate the findings, we conducted two focus group discussions with HIV medical and non-medical service providers, respectively. Results: Perceived HIV-associated stigma, fear of discrimination, and fear of family breakdown acted as barriers to HIV disclosure. Most people living with HIV/AIDS came to know of their HIV status due to poor physical health, spousal HIV-positive status, or a positive HIV test during pregnancy. Some wives only learned of their husbands′ HIV positive status after their husbands died. The focus group participants confirmed similar findings. Disclosure had serious implications for individuals living with HIV, such as divorce, maltreatment, ostracism, and decisions regarding child bearing. Interpretation and Conclusion: The identified barriers and facilitators in the present study can be used to augment training of HIV service providers working in voluntary counseling and testing centers in India.

  3. Tradeoff between User Quality-Of-Experience and Service Provider Profit in 5G Cloud Radio Access Network

    Directory of Open Access Journals (Sweden)

    Mahbuba Afrin

    2017-11-01

    Full Text Available In recent years, the Cloud Radio Access Network (CRAN has become a promising solution for increasing network capacity in terms of high data rates and low latencies for fifth-generation (5G cellular networks. In CRAN, the traditional base stations (BSs are decoupled into remote radio heads (RRHs and base band units (BBUs that are respectively responsible for radio and baseband functionalities. The RRHs are geographically proximated whereas the the BBUs are pooled in a centralized cloud named BBU pool. This virtualized architecture facilitates the system to offer high computation and communication loads from the impetuous rise of mobile devices and applications. Heterogeneous service requests from the devices to different RRHs are now sent to the BBUs to process centrally. Meeting the baseband processing of heterogeneous requests while keeping their Quality-of-Service (QoS requirements with the limited computational resources as well as enhancing service provider profit is a challenging multi-constraint problem. In this work, a multi-objective non-linear programming solution to the Quality-of-Experience (QoE and Profit-aware Resource Allocation problem is developed which makes a trade-off in between the two. Two computationally viable scheduling algorithms, named First Fit Satisfaction and First Fit Profit algorithms, are developed to focus on maximization of user QoE and profit, respectively, while keeping the minimum requirement level for the other one. The simulation environment is built on a relevant simulation toolkit. The experimental results demonstrate that the proposed system outperforms state-of-the-art works well across the requests QoS, average waiting time, user QoE, and service provider profit.

  4. A European Research Area

    International Nuclear Information System (INIS)

    Caro, R.

    2001-01-01

    This article is a summary of the presentation of the European Commissioner, Philippe Busquen, to the European Parliament (beginning of year 2000) with the proposal and method for a revival of the Research and Development in this wider sense in the European Union. The starting point of his thesis is that Europe performs less, and more disorderly, activities in this field that her main competitors. USA and Japan. His basic proposal is a larger coordination among the european research projects, with a previous phase of informatics intoxicator among the european research centres and the cross-linked participation, real of virtual in the experiments and projects. (Author)

  5. Experiences of lay counsellors who provide VCT for PMTCT of HIV and AIDS in the Capricorn district, Limpopo Province

    Directory of Open Access Journals (Sweden)

    R.N. Malema

    2009-09-01

    Full Text Available Human Immune Deficiency Virus (HIV and Acquired Immune-Deficiency Syndrome (AIDS still carry a stigma in the community. Many people do not know their status and they are still reluctant to be tested including pregnant women despite the fact that Voluntary Counselling and Testing (VCT is offered for free in South Africa. In South Africa VCT for HIV and AIDS is offered by lay counsellors in public hospitals and clinics. The study conducted by Mate, Bennet, Mphatswe, Barker and Rollins (2009:5483 outlined that in South Africa the prevention of mother-to-child transmission (PMTCT of HIV guidelines have raised hope that the national goal of reducing perinatal HIV transmission rates to less than 5% can be attained. A qualitative, exploratory, descriptive and contextual study was conducted in 15 public clinics of the Polokwane Municipality in the Capricorn District, Limpopo Province. The purpose of the study was to determine the experiences of the lay counsellors who provide VCT for the PMTCT of HIV and AIDS in the Capricorn District, Limpopo Province. Data were collected through one-to-one interviews using a semi-structured guide (De Vos et al, 2006:296. The findings of the study reflected the following: the content of training and counselling skills received by lay counsellors were satisfactory, there was lack of counsellor support and in-service education. A program for in-service education and support for all lay counsellors who have had VCT training should be conceptualised and implemented.

  6. Experiences of lay counsellors who provide VCT for PMTCT of HIV and AIDS in the Capricorn district, Limpopo Province

    Directory of Open Access Journals (Sweden)

    R. N. Malema

    2010-06-01

    Full Text Available Human Immune Deficiency Virus (HIV and Acquired Immune-Deficiency Syndrome (AIDS still carry a stigma in the community. Many people do not know their status and they are still reluctant to be tested including pregnant women despite the fact that Voluntary Counselling and Testing (VCT is offered for free in South Africa. In South Africa VCT for HIV and AIDS is offered by lay counsellors in public hospitals and clinics. The study conducted by Mate, Bennet, Mphatswe, Barker and Rollins (2009:5483 outlined that in South Africa the prevention of mother-to-child transmission (PMTCT of HIV guidelines have raised hope that the national goal of reducing perinatal HIV transmission rates to less than 5% can be attained. A qualitative, exploratory, descriptive and contextual study was conducted in 15 public clinics of the Polokwane Municipality in the Capricorn District, Limpopo Province. The purpose of the study was to determine the experiences of the lay counsellors who provide VCT for the PMTCT of HIV and AIDS in the Capricorn District, Limpopo Province. Data were collected through one-to-one interviews using a semi-structured guide (De Vos et al, 2006:296. The findings of the study reflected the following: the content of training and counselling skills received by lay counsellors were satisfactory, there was lack of counsellor support and in-service education. A program for in-service education and support for all lay counsellors who have had VCT training should be conceptualised and implemented.

  7. Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation.

    Science.gov (United States)

    Fang, Michele; Linson, Eric; Suneja, Manish; Kuperman, Ethan F

    2017-02-22

    Excellence in Graduate Medical Education requires the right clinical environment with an appropriate workload where residents have enough patients to gain proficiency in medicine with optimal time for reflection. The Accreditation Council for Graduate Medical Education (ACGME) has focused more on work hours rather than workload; however, high resident workload has been associated with lower resident participation in education and fatigue-related errors. Recognizing the potential risks associated with high resident workload and being mindful of the costs of reducing resident workload, we sought to reduce residents' workload by adding an advanced practice provider (APP) to the surgical comanagement service (SCM) and study its effect on resident satisfaction and perceived educational value of the rotation. In Fiscal Year (FY) 2014 and 2015, an additional faculty member was added to the SCM rotation. In FY 2014, the faculty member was a staff physician, and in FY 2015, the faculty member was an APP.. Resident workload was assessed using billing data. We measured residents' perceptions of the rotation using an anonymous electronic survey tool. We compared FY2014-2015 data to the baseline FY2013. The number of patients seen per resident per day decreased from 8.0(SD 3.3) in FY2013 to 5.0(SD 1.9) in FY2014 (p value of the rotation (40.0%, 72.2%, 72.6% in FY2013, 2014, 2015 respectively, p perceived educational value and clinical experience of a medical consultation rotation.

  8. Non-Model-Based Control of a Wheeled Vehicle Pulling Two Trailers to Provide Early Powered Mobility and Driving Experiences.

    Science.gov (United States)

    Sanders Td Vr, David A

    2018-01-01

    Non-model-based control of a wheeled vehicle pulling two trailers is proposed. It is a fun train for disabled children consisting of a locomotive and two carriages. The fun train has afforded opportunities for both disabled and able bodied young people to share an activity and has provided early driving experiences for disabled children; it has introduced them to assistive and powered mobility. The train is a nonlinear system and subject to nonholonomic kinematic constraints, so that position and state depend on the path taken to get there. The train is described, and then, a robust control algorithm using proportional-derivative filtered errors is proposed to control the locomotive. The controller was not dependent on an accurate model of the train, because the mass of the vehicle and two carriages changed depending on the number, size, and shape of children and wheelchair seats on the train. The controller was robust and stable in uncertainty. Results are presented to show the effectiveness of the approach, and the suggested control algorithm is shown to be acceptable without knowing the exact plant dynamics.

  9. Analysis of the experience of providing radiation protection of population and environment within the international collaboration network

    International Nuclear Information System (INIS)

    Sergei Aleksanin; Eugene Zheleznyakov; Regina Fedortseva

    2007-01-01

    Complete text of publication follows. The All-Russian Center of Emergency and Radiation Medicine (ARCERM) in St. Petersburg is a specialized radiation health institution and World Health Organization (WHO) collaborating center within the Radiation Emergency Medical Preparedness and Assistance Network (REMPAN), which primary objectives are: - To promote medical preparedness for radiation accidents and radio-nuclear threats among WHO Member States; - To provide medical and public health advice, assistance and coordination of medical management at international and regional levels in the case of a nuclear accident or radiological emergency; - To assist in follow-up studies and rehabilitation. ARCERM serves as a national focal point for advice and possible medical care in cases of radiation injuries in humans as well as assists WHO to prepare relevant documents and guidelines, provides training in radiation medicine, distributes relevant information to the medical community and the public and carries out scientific investigations on radiation effects on humans. The Center is prepared to undertake actions on medical management of possible radiation emergencies both on national and international level as a member of REMPAN network. The assistance provided by ARCERM may also include providing radiation medicine and other appropriate specialists, scientific services and expertise, equipment and medical services for diagnosis, prognosis, medical treatment and medical follow-up of persons affected by radiation. In case of radiation accident the Center has standard operating procedures at country level. It includes the system of warning and data collection, setting up special wards for receiving radiation victims, radioactivity control station, primary deactivation and treatment as well as providing personal protection for staff. WHO, as well as other co-operating international organizations, are notified and provided with relevant information through the International Atomic

  10. Variation in structure and process of care in traumatic brain injury: Provider profiles of European Neurotrauma Centers participating in the CENTER-TBI study

    NARCIS (Netherlands)

    M.C. Cnossen (Maryse); S. Polinder (Suzanne); Lingsma, H.F. (Hester F.); A.I.R. Maas (Andrew); D.K. Menon (David ); E.W. Steyerberg (Ewout); Adams, H. (Hadie); Alessandro, M. (Masala); J.E. Allanson (Judith); Amrein, K. (Krisztina); Andaluz, N. (Norberto); N. Andelic (Nada); Andrea, N. (Nanni); L. Andreassen (Lasse); Anke, A. (Audny); Antoni, A. (Anna); Ardon, H. (Hilko); G. Audibert (Gérard); Auslands, K. (Kaspars); Azouvi, P. (Philippe); Baciu, C. (Camelia); Bacon, A. (Andrew); Badenes, R. (Rafael); Baglin, T. (Trevor); Bartels, R. (Ronald); Barzó, P. (Pál); Bauerfeind, U. (Ursula); R. Beer (Ronny); Belda, F.J. (Francisco Javier); B.-M. Bellander (Bo-Michael); A. Belli (Antonio); Bellier, R. (Rémy); H. Benali (Habib); Benard, T. (Thierry); M. Berardino (Maurizio); Beretta, L. (Luigi); Beynon, C. (Christopher); Bilotta, F. (Federico); H. Binder (Harald); Biqiri, E. (Erta); Blaabjerg, M. (Morten); Borgen, L.S. (Lund Stine); Bouzat, P. (Pierre); Bragge, P. (Peter); A. Brazinova (Alexandra); F. Brehar (Felix); Brorsson, C. (Camilla); Buki, A. (Andras); M. Bullinger (Monika); Bučková, V. (Veronika); Calappi, E. (Emiliana); P. Cameron (Peter); Carbayo, L.G. (Lozano Guillermo); Carise, E. (Elsa); Carpenter, C.; Castaño-León, A.M. (Ana M.); Causin, F. (Francesco); Chevallard, G. (Giorgio); A. Chieregato (Arturo); G. Citerio (Giuseppe); M. Coburn (Mark); J.P. Coles (Jonathan P.); Cooper, J.D. (Jamie D.); Correia, M. (Marta); A. Covic (Amra); N. Curry (Nicola); E. Czeiter (Endre); M. Czosnyka (Marek); Dahyot-Fizelier, C. (Claire); F. Damas (François); P. Damas (Pierre); H. Dawes (Helen); De Keyser, V. (Véronique); F. Della Corte (Francesco); B. Depreitere (Bart); Ding, S. (Shenghao); D.W.J. Dippel (Diederik); K. Dizdarevic (Kemal); Dulière, G.-L. (Guy-Loup); Dzeko, A. (Adelaida); G. Eapen (George); Engemann, H. (Heiko); A. Ercole (Ari); P. Esser (Patrick); Ezer, E. (Erzsébet); M. Fabricius (Martin); V.L. Feigin (V.); Feng, J. (Junfeng); Foks, K. (Kelly); F. Fossi (Francesca); Francony, G. (Gilles); J. Frantzén (Janek); Freo, U. (Ulderico); S.K. Frisvold (Shirin Kordasti); Furmanov, A. (Alex); P. Gagliardo (Pablo); D. Galanaud (Damien); G. Gao (Guoyi); K. Geleijns (Karin); A. Ghuysen (Alexandre); Giraud, B. (Benoit); Glocker, B. (Ben); Gomez, P.A. (Pedro A.); Grossi, F. (Francesca); R.L. Gruen (Russell); Gupta, D. (Deepak); J.A. Haagsma (Juanita); E. Hadzic (Ermin); I. Haitsma (Iain); J.A. Hartings (Jed); R. Helbok (Raimund); E. Helseth (Eirik); Hertle, D. (Daniel); S. Hill (Sean); Hoedemaekers, A. (Astrid); S. Hoefer (Stefan); P.J. Hutchinson (Peter J.); Håberg, A.K. (Asta Kristine); B.C. Jacobs (Bart); Janciak, I. (Ivan); K. Janssens (Koen); J.-Y. Jiang (Ji-Yao); Jones, K. (Kelly); Kalala, J.-P. (Jean-Pierre); Kamnitsas, K. (Konstantinos); Karan, M. (Mladen); Karau, J. (Jana); A. Katila (Ari); M. Kaukonen (Maija); Keeling, D. (David); Kerforne, T. (Thomas); N. Ketharanathan (Naomi); J. Kettunen (Johannes); Kivisaari, R. (Riku); A.G. Kolias (Angelos G.); Kolumbán, B. (Bálint); E.J.O. Kompanje (Erwin); D. Kondziella (Daniel); L.-O. Koskinen (Lars-Owe); Kovács, N. (Noémi); F. Kalovits (Ferenc); A. Lagares (Alfonso); L. Lanyon (Linda); S. Laureys (Steven); Lauritzen, M. (Martin); F.E. Lecky (Fiona); C. Ledig (Christian); R. Lefering; V. Legrand (Valerie); Lei, J. (Jin); L. Levi (Leon); R. Lightfoot (Roger); H.F. Lingsma (Hester); D. Loeckx (Dirk); Lozano, A. (Angels); Luddington, R. (Roger); Luijten-Arts, C. (Chantal); A.I.R. Maas (Andrew I.R.); MacDonald, S. (Stephen); MacFayden, C. (Charles); M. Maegele (Marc); M. Majdan (Marek); Major, S. (Sebastian); A. Manara (Alex); Manhes, P. (Pauline); G. Manley (Geoffrey); Martin, D. (Didier); C. Martino (Costanza); Maruenda, A. (Armando); H. Maréchal (Hugues); Mastelova, D. (Dagmara); Mattern, J. (Julia); C. McMahon (Catherine); Melegh, B. (Béla); T. Menovsky (Tomas); C. Morganti-Kossmann (Cristina); Mulazzi, D. (Davide); Mutschler, M. (Manuel); H. Mühlan (Holger); Negru, A. (Ancuta); D. Nelson (David); E. Neugebauer (Eddy); V.F. Newcombe (Virginia F.); Noirhomme, Q. (Quentin); Nyirádi, J. (József); M. Oddo (Mauro); Oldenbeuving, A. (Annemarie); M. Oresic (Matej); Ortolano, F. (Fabrizio); A. Palotie (Aarno); P.M. Parizel; Patruno, A. (Adriana); J.-F. Payen (Jean-François); Perera, N. (Natascha); V. Perlbarg (Vincent); Persona, P. (Paolo); W.C. Peul (Wilco); N. Pichon (Nicolas); Piilgaard, H. (Henning); A. Piippo (Anna); Pili, F.S. (Floury Sébastien); M. Pirinen (Matti); H. Ples (Horia); Pomposo, I. (Inigo); M. Psota (Marek); P. Pullens (Pim); L. Puybasset (Louis); A. Ragauskas (Arminas); Raj, R. (Rahul); Rambadagalla, M. (Malinka); Rehorčíková, V. (Veronika); J.K.J. Rhodes (Jonathan K.J.); S. Richardson (Sylvia); S. Ripatti (Samuli); S. Rocka (Saulius); Rodier, N. (Nicolas); Roe, C. (Cecilie); Roise, O. (Olav); Roks, G. (Gerwin); Romegoux, P. (Pauline); J. Rosand (Jonathan); Rosenfeld, J. (Jeffrey); C. Rosenlund (Christina); G. Rosenthal (Guy); R. Rossaint (Rolf); S. Rossi (Sandra); Rostalski, T. (Tim); Rueckert, D.L. (Danie L.); Ruiz De Arcaute, F. (Felix); M. Rusnák (Martin); Sacchi, M. (Marco); Sahakian, B. (Barbara); J. Sahuquillo (Juan); O. Sakowitz (Oliver); Sala, F. (Francesca); Sanchez-Pena, P. (Paola); Sanchez-Porras, R. (Renan); Sandor, J. (Janos); Santos, E. (Edgar); N. Sasse (Nadine); Sasu, L. (Luminita); Savo, D. (Davide); I.B. Schipper (Inger); Schlößer, B. (Barbara); S. Schmidt (Silke); Schneider, A. (Annette); H. Schoechl (Herbert); G.G. Schoonman; R. Schou (Rico); E. Schwendenwein (Elisabeth); Schöll, M. (Michael); Sir, O. (Özcan); T. Skandsen (Toril); Smakman, L. (Lidwien); D. Smeets (Dirk); Smielewski, P. (Peter); Sorinola, A. (Abayomi); Stamatakis, E.L. (Emmanue L.); S. Stanworth (Simon); Stegemann, K. (Katrin); Steinbüchel, N. (Nicole); R. Stevens (Robert); W. Stewart (William); N. Stocchetti (Nino); Sundström, N. (Nina); Synnot, A. (Anneliese); J. Szabó (József); J. Söderberg (Jeannette); F.S. Taccone (Fabio); Tamás, V. (Viktória); Tanskanen, P. (Päivi); A. Tascu (Alexandru); Taylor, M.S. (Mark Steven); Te Ao, B. (Braden); O. Tenovuo (Olli); Teodorani, G. (Guido); A. Theadom (Alice); Thomas, M. (Matt); D. Tibboel (Dick); C.M. Tolias (Christos M.); Tshibanda, J.-F.L. (Jean-Flory Luaba); Tudora, C.M. (Cristina Maria); P. Vajkoczy (Peter); Valeinis, E. (Egils); W. van Hecke (Wim); D. Van Praag (Dominique); D. Van Roost (Dirk); Van Vlierberghe, E. (Eline); Vande Vyvere, T. (Thijs); Vanhaudenhuyse, A. (Audrey); A. Vargiolu (Alessia); E. Vega (Emmanuel); J. Verheyden (Jan); P.M. Vespa (Paul M.); A. Vik (Anne); R. Vilcinis (Rimantas); Vizzino, G. (Giacinta); C.L.A.M. Vleggeert-Lankamp (Carmen); V. Volovici (Victor); P. Vulekovic (Peter); Vámos, Z. (Zoltán); Wade, D. (Derick); Wang, K.K.W. (Kevin K.W.); Wang, L. (Lei); Wildschut, E. (Eno); G. Williams (Guy); Willumsen, L. (Lisette); Wilson, A. (Adam); L. Wilson (Lindsay); Winkler, M.K.L. (Maren K. L.); P. Ylén (Peter); Younsi, A. (Alexander); M. Zaaroor (Menashe); Zhang, Z. (Zhiqun); Zheng, Z. (Zelong); Zumbo, F. (Fabrizio); De Lange, S. (Stefanie); G.C.W. De Ruiter (Godard C.W.); Den Boogert, H. (Hugo); Van Dijck, J. (Jeroen); T.A. van Essen (T.); C.M. van Heugten (Caroline M.); M. van der Jagt (Mathieu); J. van der Naalt (Joukje)

    2016-01-01

    textabstractIntroduction: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map

  11. Evaluation of the overweight/obese child--practical tips for the primary health care provider: recommendations from the Childhood Obesity Task Force of the European Association for the Study of Obesity

    DEFF Research Database (Denmark)

    Baker, Jennifer L; Farpour-Lambert, Nathalie J; Nowicka, Paulina

    2010-01-01

    in the primary care setting. The tips and tools provided are based on data from the recent body of work that has been published in this field, official statements of several scientific societies along with expert opinion provided by the members of the Childhood Obesity Task Force (COTF) of the European......The prevalence of obesity among children and adolescents is on the rise. The majority of overweight or obese children are treated by primary health care providers including paediatricians, family practitioners, dieticians, nurses, and school health services - and not by specialists. The majority...... of obese children have no underlying medical disorder causing their obesity yet a significant proportion might suffer from obesity-related co-morbidities. This text is aimed at providing simple and practical tools for the identification and management of children with or at risk of overweight and obesity...

  12. Making a Difference: Two Case Studies Describing the Impact of a Capstone Leadership Education Experience Provided through a National Youth Leadership Training Program

    Science.gov (United States)

    Rosser, Manda; Stedman, Nicole L. P.; Elbert, Chanda; Rutherford, Tracy

    2009-01-01

    Many youth leadership organizations exist today and provide a variety of leadership experiences. One such organization provides a week long leadership experience to high school students with its primary purpose being to guide students through a process of identifying a community need and developing a plan to address that need. This article reports…

  13. Effects of water temperature on summer periphyton biomass in shallow lakes: a pan-European mesocosm experiment

    Czech Academy of Sciences Publication Activity Database

    Mahdy, A.; Hilt, S.; Filiz, N.; Beklioglu, M.; Hejzlar, Josef; Özkundakci, D.; Papastergiadou, E.; Scharfenberger, U.; Šorf, Michal; Stefanidis, K.; Tuvikene, L.; Zingel, P.; Sondergaard, M.; Jeppesen, E.; Adrian, R.

    2015-01-01

    Roč. 77, č. 3 (2015), s. 499-510 ISSN 1015-1621 R&D Projects: GA MŠk(CZ) 7E11059 EU Projects: European Commission(XE) 244121 Program:FP7 Institutional support: RVO:60077344 Keywords : climate change * eutrophication * epiphyton * grazing * top-down control Subject RIV: DA - Hydrology ; Limnology Impact factor: 2.398, year: 2015

  14. The MYCOGLOBE Project: A European Union Funded Successful Experiment in Enhancing Cooperation and Coordination Amongst Mycotoxin Researchers Worldwide

    Science.gov (United States)

    In 2004, the European Commission approved the specific support action “Integration of Mycotoxin and Toxigenic Fungi Research for Food Safety in the Global System” (MycoGlobe, contract FOOD-CT-2004-007174) within the Sixth Framework Programme, Food Quality and Safety. The aim of the MycoGlobe projec...

  15. A Qualitative Assessment of Students' Experiences of Studying Music: A Spanish Perspective on the European Credit Transfer System (ECTS)

    Science.gov (United States)

    Faubel, Jose Maria Esteve; Valero, Miguel Angel Molina; Stephens, Jonathan

    2009-01-01

    The purpose of this investigation is to evaluate whether or not the allocation of time proposed in the Music Study Guide, adapted from the Espacio Europeo de Educacion Superior (European Higher Education Area) guidelines, is consistent and adequate for students with a minimal musical knowledge. The data for this study arise from a…

  16. Climate change effects on shallow lakes: design and preliminary results of a cross-European climate gradient mesocosm experiment

    Czech Academy of Sciences Publication Activity Database

    Landkildehus, F.; Søndergaard, M.; Beklioglu, M.; Adrian, R.; Angeler, D.G.; Hejzlar, Josef; Papastergiadou, E.; Zingel, P.; Çakiroğlu, A.I.; Scharfenberger, U.; Drakare, S.; Nõges, T.; Šorf, Michal; Stefanidis, K.; Tavşanoğlu, Ü.N.; Trigal, C.; Mahdy, A.; Papadaki, C.; Tuvikene, L.; Larsen, S.E.; Kernan, M.; Jeppesen, E.

    2014-01-01

    Roč. 63, č. 2 (2014), s. 71-89 ISSN 1736-602X EU Projects: European Commission(XE) 244121 - REFRESH Institutional support: RVO:60077344 Keywords : climate change * nutrient enrichment * water level effects * macroecology * REFRESH project * macrophytes * metabolism Subject RIV: DA - Hydrology ; Limnology

  17. Providing Hands on Experiences to Museum Visitors to Explore and Learn about Earthquakes and their Impacts in the Pacific Northwest

    Science.gov (United States)

    Olds, S. E.; Schiffman, C. R.; Butler, R. F.; Farley, M.; Frankel, S.; Hunter, N.; Lillie, R. J.

    2013-12-01

    Over the past ten years, UNAVCO has developed a suite of learning materials for formal undergraduate and grades 6-12 classroom environments, integrating GPS data from the EarthScope Plate Boundary Observatory (PBO) to explore Earth science processes. To make complex Earth processes accessible to general audiences, UNAVCO has designed a multi-component visiting museum exhibit that explores the tectonic setting of the United States Pacific Northwest, hazards of living on a plate boundary, and the technologies being used to study the plate motion and in the future, help communities become more resilient to the impacts of earthquakes. This exhibit was installed in Fall 2013 at the Oregon State University (OSU) Hatfield Marine Science Center (HMSC) in Newport, Oregon. Through multiple hands-on elements, visitors to the HMSC exhibit explore and experience the build up and release of strain in the region, along with some of the technologies used to measure these changes. In one component, visitors compress a model of the Pacific Northwest to feel the build up of strain in the landscape and observe the movement of land over time. Supporting panels connect this movement to the measurements currently being observed by the network of PBO and other GPS stations in the Pacific Northwest. In another component, visitors learn about the recurrence interval for earthquakes at the Juan De Fuca - North America plate boundary by turning a handle to slowly move and compress plates until a simulated earthquake occurs. A related component explores how an earthquake early warning system (EEWS) of the future might combine seismic data collected by both seismometers and real time GPS to allow people and communities time to prepare for oncoming ground shaking and tsunami after an earthquake. Several technologies are also highlighted throughout the exhibit, including information panels that compare the accuracy of high precision GPS with smartphone technologies. Additionally, models of a full

  18. The European and Japanese outbreaks of H5N8 derive from a single source population providing evidence for the dispersal along the long distance bird migratory flyways

    Directory of Open Access Journals (Sweden)

    Andrew R. Dalby

    2015-04-01

    Full Text Available The origin of recent parallel outbreaks of the high pathogenicity H5N8 avian flu virus in Europe and in Japan can be traced to a single source population, which has most likely been spread by migratory birds. By using Bayesian coalescent methods to analyze the DNA sequences of the virus to find the times for divergence and combining this sequence data with bird migration data we can show the most likely locations and migratory pathways involved in the origin of the current outbreak. This population was most likely located in the Siberian summer breeding grounds of long-range migratory birds. These breeding grounds provide a connection between different migratory flyways and explain the current outbreaks in remote locations. By combining genetic methods and epidemiological data we can rapidly identify the sources and the dispersion pathways for novel avian influenza outbreaks.

  19. Evaluation of the overweight/obese child--practical tips for the primary health care provider: recommendations from the Childhood Obesity Task Force of the European Association for the Study of Obesity

    DEFF Research Database (Denmark)

    Baker, Jennifer L; Farpour-Lambert, Nathalie J; Nowicka, Paulina

    2010-01-01

    of obese children have no underlying medical disorder causing their obesity yet a significant proportion might suffer from obesity-related co-morbidities. This text is aimed at providing simple and practical tools for the identification and management of children with or at risk of overweight and obesity...... in the primary care setting. The tips and tools provided are based on data from the recent body of work that has been published in this field, official statements of several scientific societies along with expert opinion provided by the members of the Childhood Obesity Task Force (COTF) of the European...... Association for the Study of Obesity (EASO). We have attempted to use an evidence-based approach while allowing flexibility for the practicing clinician in domains where evidence is currently lacking and ensuring that treating the obese child involves the entire family as well....

  20. Can the confidence in long range atmospheric transport models be increased? The pan European experience of ensemble

    International Nuclear Information System (INIS)

    Galmarini, S.; Bianconi, R.; Mikkelsen, T.

    2003-01-01

    than acting an the ground of a nowcast, one can then wonder whether there is a way to reduce the risk of relying an LRAT model forecasts. In order to respond to this question in a pragmatic way, the ENSEMBLE project was carried out within the Radiation Protection DG-RTD programme of FP5. Briefly, ENSEMBLE makes use of state-of-the art technology to provide the following: a permanent internet-based platform that, upon notification of an accident, collects in real time dispersion forecasts produced by 22 models operational in the EU and around the world; a platform which allows all participating institutes (17) to consult the results of all others in real time over the Same time and space frameworks; the ability to collate model results in order to produce a pan-European ensemble dispersion forecast; statistical tools for the analysis of model results are made available that include the possibility to estimate quantitatively the variability of the forecast and the relative uncertainty. The ENSEMBLE system collects forecasts of atmospheric concentration, deposition (wet and dry) and precipitation over a domain spanning from Iceland to the Urals and from Norway to Northern Africa. The predictions can cover up to 60 h from the release start that is notified in terms of geographical coordinates, type of nuclide released and release rate. Each participating institute can submit multiple predictions obtained with different models or updated during the occurrence of the emergency as more recent weather predictions become available. The main advantage of the ENSEMBLE system is that for the first time all participating institutes in charge of technical advise to decision making for atmospheric dispersion, have practical access to the results of 22 models rather than only the one operational at their institutes. In this way the bias toward one modelling approach is reduced and the technical advice is built an a more educated judgment an the situation. In fact the multi model

  1. Commitment of involved actors in the preparation of accidental and post-accident situations: European experiments; Engagement des parties prenantes a la preparation aux situations accidentelles et post-accidentelles: experiences Europeennes

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Th. [CEPN, 28 rue de la Redoute, 92260 Fontenay-aux-Roses (France)

    2010-07-01

    The author briefly describes some approaches developed within the EURANOS European research programme between 2004 and 2009 which aims at promoting the building up of a European network (NERIS) for the management of nuclear accidental and post-accident situations. Notably, he comments the experiment which took place in the Montbeliard district where two types of radiological events have been modelled and simulated: an accident in the Fessenheim nuclear power plant with two scenarios of release, and a transportation accident with a release of radioactive caesium 137. He also evokes the Norwegian experience and some other actions in Finland, Great-Britain, Spain and Slovakia where reflections on the management of accidental and post-accident situations or crisis exercises have been organized

  2. Quantum physics of nature. Theory, experiment and interpretation. in collaboration with 6th European QIPC workshop. General Information, program, abstracts

    International Nuclear Information System (INIS)

    Arndt, M.; Aspelmeyer, M.; Brukner, C.; Weihs, G.; Jennewein, T.; Schmiedmayer, J.; Weinfurter, H.; Zukowski, M.

    2005-01-01

    Quantum information processing and communication is one of the of the key research areas within the European community. Therefore these two events were dedicated to present the advances in this area. Papers dealing with topics such as atom-photon entanglement, matter waves and quantum gases, decoherence, photonic entanglement, solid state quantum physics, cooling and trapping of atoms and molecules, quantum communication, quantum computation, quantum information and quantum cryptography were addressed. (nevyjel)

  3. The Contribution of Death-Related Experiences to Health Care Providers' Attitudes toward Dying Patients: II. Medical and Nursing Students with No Professional Experience.

    Science.gov (United States)

    Brent, Sandor B.; And Others

    1993-01-01

    Compared attitudes toward care of dying patients of beginning medical and nursing students with no professional death-related experience. On five of six attitude measures, female nursing students expressed more positive attitude than either male or female medical students. Hours of death-and-dying coursework and general life experience exerted…

  4. 4th European Turbulence Conference

    CERN Document Server

    1993-01-01

    The European Turbulence Conferences have been organized under the auspices of the European Mechanics Committee (Euromech) to provide a forum for discussion and exchange of recent and new results in the field of turbulence. The first conference was organized in Lyon in 1986 with 152 participants. The second and third conferences were held in Berlin (1988) and Stockholm (1990) with 165 and 172 participants respectively. The fourth was organized in Delft from 30 June to 3 July 1992 by the J.M. Burgers Centre. There were 214 participants from 22 countries. This steadily growing number of participants demonstrates both the success and need for this type of conference. The main topics of the Fourth European Turbulence Conference were: Dynamical Systems and Transition; Statistical Physics and Turbulence; Experiments and Novel Experimental Techniques; Particles and Bubbles in Turbulence; Simulation Methods; Coherent Structures; Turbulence Modelling and Compressibility Effects. In addition a special session was held o...

  5. A numerical experiment that provides new results regarding the inception of separation in the flow around a circular cylinder

    Science.gov (United States)

    Malamataris, Nikolaos; Liakos, Anastasios

    2015-11-01

    The exact value of the Reynolds number regarding the inception of separation in the flow around a circular cylinder is still a matter of research. This work connects the inception of separation with the calculation of a positive pressure gradient around the circumference of the cylinder. The hypothesis is that inception of separation occurs when the pressure gradient becomes positive around the circumference. From the most cited laboratory experiments that have dealt with that subject of inception of separation only Thom has measured the pressure gradient there at very low Reynolds numbers (up to Re=3.5). For this reason, the experimental conditions of his tunnel are simulated in a new numerical experiment. The full Navier Stokes equations in both two and three dimensions are solved with a home made code that utilizes Galerkin finite elements. In the two dimensional numerical experiment, inception of separation is observed at Re=4.3, which is the lowest Reynolds number where inception has been reported computationally. Currently, the three dimensional experiment is under way, in order to compare if there are effects of three dimensional theory of separation in the conditions of Thom's experiments.

  6. Experiences and concerns of family caregivers providing support to people with dementia: a cross-cultural perspective.

    Science.gov (United States)

    Ivey, Susan L; Laditka, Sarah B; Price, Anna E; Tseng, Winston; Beard, Renée L; Liu, Rui; Fetterman, David; Wu, Bei; Logsdon, Rebecca G

    2013-11-01

    We examined experiences and concerns among caregivers of community-dwelling people with dementia from two ethnic groups. We conducted a thematic analysis of responses to the question, 'What is your life like as a caregiver?' in nine focus groups (n = 75) with Filipino and non-Hispanic White caregivers. Constant comparison methods identified themes by ethnicity. Experiences and concerns expressed across groups were related to care recipient symptoms commonly associated with dementia, including severe memory loss and behavioral changes. Participants in both ethnic groups described strategies that help them cope, such as receiving help from family and friends, receiving respite support, and participating in support groups. Filipino caregivers more often emphasized positive aspects of caregiving, whereas Whites often expressed that others do not understand the daily experiences of caregiving. Filipinos more commonly described caregivers as a 'good person' or 'saint' and emphasized that caregiving made them stronger.

  7. Prospects for the Development of Scientific Libraries of Ukrainian Research Universities in the context of the Implementation of the European Experience

    Directory of Open Access Journals (Sweden)

    Serbin Oleh O.

    2018-03-01

    Full Text Available The key directions for the long-term development of scientific libraries of research universities in Ukraine are determined to improve their strategic management system on the way toward entry into the European competitive environment. The scientific ideas, practice and legislative bases in the field of the development of scientific libraries in the European Union are highlighted. There carried out comparative characteristic of the traditional library and the modern one with the purpose of revealing distinctions of their functioning and development. The content of the seventeen main contrasts that distinguish these libraries is identified and described. On the basis of the analysis of the European experience, there identified and characterized twelve key directions for the further strategic development of Ukraine’s scientific libraries, which are in the improvement of digital content; library space; systems of automation of service processes; observance of copyrights; commercialization of library services; international exchange of the library information; depository of master works; updating of equipment; a consolidated system for detecting plagiarism; introduction of new related services; alternative financing systems; systems for staff development. The results of this study will be useful for leaders of research universities and their scientific libraries, as well as scientists and practitioners in the field of strategic management of development of research universities.

  8. "Always paracetamol, they give them paracetamol for everything": a qualitative study examining Eastern European migrants' experiences of the UK health service.

    Science.gov (United States)

    Madden, Hannah; Harris, Jane; Blickem, Christian; Harrison, Rebecca; Timpson, Hannah

    2017-08-29

    The enlargement of the European Union since 2004 has led to an increase in the number of Eastern European migrants living in the UK. The health of this group is under-researched though some mixed evidence shows they are at higher risk of certain physical health conditions such as heart attacks, strokes, HIV and alcohol use and have poorer mental health. This is compounded by poor or insecure housing, low pay, isolation and prejudice. We aimed to understand the health needs and health service experiences of the Eastern European population in a town in Northern England. Five semi structured one-to-one and small group interviews and five focus groups were conducted with 42 Eastern European participants between June and September 2014. The majority of participants were Polish and other participants were from Belarus, Hungary, Latvia, Russia, Slovakia and Ukraine. The data were analysed using thematic framework analysis. Key findings included a good understanding the UK health service structure and high registration and use of general practice/primary care services. However, overall, there were high levels of dissatisfaction, frustration and distrust in General Practitioners (GP). The majority of participants viewed the GP as unhelpful and dismissive; a barrier to secondary/acute care; reluctant to prescribe antibiotics; and that GPs too often advised them to take paracetamol (acetaminophen) and rest. Overwhelmingly participants had strong opinions about access to primary care and the role of the general practitioners. Although the design of the UK health service was well understood, participants were unhappy with the system of GP as gatekeeper and felt it inferior to the consumer-focused health systems in their country of origin. More work is needed to promote the importance of self-care, reduce antibiotic and medication use, and to increase trust in the GP.

  9. Ask! Your Library at the HUB: Penn State Libraries’ Experiences Providing Reference Services at the Campus Student Union Building

    Directory of Open Access Journals (Sweden)

    Anne Charlotte Behler

    2008-06-01

    Full Text Available The Web 2.0 generation presents many service challenges to libraries. College students of today have work styles that emphasize collaboration, preference for flexible and comfortable spaces, and independent discovery of information. Given that challenge, it is important for libraries to experiment with new and unique models of service. Librarians and Staff at the Penn State University Libraries explored offering library service at the main campus’s student union building during two trials, during the Spring and Fall semesters of 2006.

  10. A 'special effort' to provide improved sounding and cloud-motion wind data for FGGE. [First GARP Global Experiment

    Science.gov (United States)

    Greaves, J. R.; Dimego, G.; Smith, W. L.; Suomi, V. E.

    1979-01-01

    Enhancement and editing of high-density cloud motion wind assessments and research satellite soundings have been necessary to improve the quality of data used in The Global Weather Experiment. Editing operations are conducted by a man-computer interactive data access system. Editing will focus on such inputs as non-US satellite data, NOAA operational sounding and wind data sets, wind data from the Indian Ocean satellite, dropwindsonde data, and tropical mesoscale wind data. Improved techniques for deriving cloud heights and higher resolution sounding in meteorologically active areas are principal parts of the data enhancement program.

  11. Experiences of sexual harassment and sexual assault in the military among OEF/OIF veterans: implications for health care providers.

    Science.gov (United States)

    Bell, Margret E; Reardon, Annemarie

    2011-01-01

    Given the frequent occurrence and significant health impact of sexual harassment and sexual assault in the military, it is important that for health care providers working with Veterans to have at least some basic knowledge in this area. Targeting providers addressing mental health and psychosocial issues, but also applicable to clinicians working with survivors in a variety of capacities, this article provides an overview of clinical care with survivors of sexual trauma in the military, particularly those who are OEF/OIF Veterans. We cover basic background information, focusing primarily on the impact of sexual trauma in the military, how survivor's reactions are shaped by various aspects of the military context, and general principles to assist clinicians in working effectively with survivors, whatever their role.

  12. Do women and providers value the same features of contraceptive products? Results of a best-worst stated preference experiment.

    Science.gov (United States)

    Weisberg, Edith; Bateson, Deborah; Knox, Stephanie; Haas, Marion; Viney, Rosalie; Street, Deborah; Fiebig, Denzil

    2013-06-01

    To determine how women and physicians rate individual characteristics of contraceptives. Discrete choice experiments are used in health economics to elicit preferences for healthcare products. A choice experiment uses hypothetical scenarios to determine which individual factors influence choice. Women and general practitioners (GPs) were shown individual characteristics of contraceptives, not always matching existing methods, and chose the best and worst features. Two hundred women, mean age 36, 71% using contraception, were presented with descriptions of 16 possible methods and asked to indicate their preference for individual characteristics. One hundred and sixty-two GPs, mostly women, also completed 16 descriptions. Longer duration of action was most favoured by both, followed by lighter periods with less pain or amenorrhoea. The least attractive features for women were heavier and more painful periods, high cost, irregular periods, low efficacy (10% failure) and weight gain of 3 kg. GPs ranked a 10% pregnancy rate as least attractive followed by heavy painful periods and a 5% failure rate. Women and GPs differed in their ranking of contraceptive characteristics. Long duration of use, high efficacy, minimal or no bleeding without pain, were preferred by both. Very undesirable were heavy periods especially with pain, and low efficacy.

  13. Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey.

    Science.gov (United States)

    Warren, Fiona C; Abel, Gary; Lyratzopoulos, Georgios; Elliott, Marc N; Richards, Suzanne; Barry, Heather E; Roland, Martin; Campbell, John L

    2015-04-29

    To investigate the experience of users of out of hours general practitioner services in England, UK. Population based cross sectional postal questionnaire survey. General Practice Patient Survey 2012-13. Potential associations between sociodemographic factors (including ethnicity and ability to take time away from work during working hours to attend a healthcare consultation) and provider organisation type (not for profit, NHS, or commercial) and service users' experience of out of hours care (timeliness, confidence and trust in the out of hours clinician, and overall experience of the service), rated on a scale of 0-100. Which sociodemographic/provider characteristics were associated with service users' experience, the extent to which any observed differences could be because of clustering of service users of a particular sociodemographic group within poorer scoring providers, and the extent to which observed differences in experience varied across types of provider. The overall response rate was 35%; 971,232/2,750,000 patients returned surveys. Data from 902,170 individual service users were mapped through their registered practice to one of 86 providers of out of hours GP care with known organisation type. Commercial providers of out of hours GP care were associated with poorer reports of overall experience of care, with a mean difference of -3.13 (95% confidence interval -4.96 to -1.30) compared with not for profit providers. Asian service users reported lower scores for all three experience outcomes than white service users (mean difference for overall experience of care -3.62, -4.36 to -2.89), as did service users who were unable to take time away from work compared with service users who did not work (mean difference for overall experience of care -4.73, -5.29 to -4.17). Commercial providers of out of hours GP care were associated with poorer experience of care. Targeted interventions aimed at improving experience for patients from ethnic minorities and

  14. Experiences of patients and service providers with out-patient rehabilitation services in a rehabilitation centre in the Western Cape Province

    Directory of Open Access Journals (Sweden)

    Anne Kumurenzi

    2015-12-01

    Full Text Available Background: Rehabilitation is important for persons with disabilities as it contributes to their sense of autonomy, self-worth and social participation, and improves their quality of life. Improving the quality of rehabilitation services requires the dialogue of patients’ perceptions with those of service providers, in order to recommend informed reform. Objective: The objective was to explore the experiences of persons with physical disabilities and service providers, regarding the multi-disciplinary rehabilitation services provided at a community-based out-patient rehabilitation centre. Methods: A qualitative, exploratory study design was used to collect the data. A focus group was conducted with conveniently selected persons with physical disabilities. Three in-depth interviews were conducted with purposively selected key informants. All ethical considerations were adhered to during the implementation of the study. Results: Patients and service providers had different experiences regarding accessibility to rehabilitation services, and similar experiences with patient education and intensity of rehabilitation. Although the patients experienced that the service providers had sufficient knowledge and skills to manage them, services providers expressed that they lacked certain skills. Conclusions: The experiences expressed highlighted the need to improve rehabilitation services in terms of increasing the capacity of service providers and providing transport services for persons with disabilities.

  15. The paradox of compassionate work: a mixed-methods study of satisfying and fatiguing experiences of animal health care providers.

    Science.gov (United States)

    Polachek, Alicia J; Wallace, Jean E

    2018-03-01

    Compassionate work appears paradoxical as it may provide great rewards, but may also come at great costs to care providers. This paper explores the paradox of compassionate work by examining what interactions contribute to compassion satisfaction and what interactions contribute to compassion fatigue. This mixed-methods, cross-sectional study uses qualitative interview data from animal health care providers (N = 20) to identify work interactions that they find satisfying or stressful. Quantitative survey data (N = 572) are used to test hypotheses generated from the interviews regarding predictors of compassion satisfaction and compassion fatigue. Interview transcripts were analyzed using a directed content analysis approach. Survey data were analyzed using ordinary least squares regression. The results highlight the complex nature of compassionate work. As hypothesized, making a difference to animals and building relationships with animal patients and human clients relate to greater compassion satisfaction. Human client barriers to animal care and witnessing client grief relate to greater compassion fatigue, as predicted. None of the predictors relate to less compassion fatigue, but forming relationships with animal patients relates to both greater compassion satisfaction and compassion fatigue. This paper enhances our understanding of provider-client-patient interactions and highlights the paradox of compassionate work.

  16. One University's Experience Partnering with an Online Program Management (OPM) Provider: A Case Study

    Science.gov (United States)

    Springer, Scott

    2018-01-01

    University and college administrators frequently choose to develop and implement online programs with the help of for-profit companies known as online program management (OPM) providers that specialize in the development and implementation of online programs. This paper reports on the partnership of a private university in the Western United…

  17. Providing Simulated Online and Mobile Learning Experiences in a Prison Education Setting: Lessons Learned from the PLEIADES Pilot Project

    Science.gov (United States)

    Farley, Helen; Murphy, Angela; Bedford, Tasman

    2014-01-01

    This article reports on the preliminary findings, design criteria and lessons learned while developing and piloting an alternative to traditional print-based education delivery within a prison environment. PLEIADES (Portable Learning Environments for Incarcerated Distance Education Students), was designed to provide incarcerated students with…

  18. Living with fibromyalgia: results from the functioning with fibro survey highlight patients' experiences and relationships with health care providers

    Directory of Open Access Journals (Sweden)

    Golden A

    2015-11-01

    Full Text Available Angela Golden,1 Yvonne D'Arcy,2 Elizabeth T Masters,3 Andrew Clair3 1NP from Home, LLC, Munds Park, AZ, 2Pain Management and Palliative Care, Suburban Hospital-Johns Hopkins Medicine, Bethesda, MD, 3Pfizer, New York, NY, USA Abstract: Fibromyalgia (FM is a chronic disorder characterized by widespread pain, which can limit patients' physical function and daily activities. FM can be challenging to treat, and the treatment approach could benefit from a greater understanding of patients' perspectives on their condition and their care. Patients with FM participated in an online survey conducted in the USA that sought to identify the symptoms that had the greatest impact on patients' daily lives. The purpose of the survey was to facilitate efforts toward improving care of patients by nurse practitioners, primary care providers, and specialists, in addition to contributing to the development of new outcome measures in both clinical trials and general practice. A total of 1,228 patients with FM completed the survey, responding to specific questions pertaining to symptoms, impact of symptoms, management of FM, and the relationship with health care providers. Chronic pain was identified as the key FM symptom, affecting personal and professional relationships, and restricting physical activity, work, and social commitments. Patients felt that the severity of their condition was underestimated by family, friends, and health care providers. The results of this survey highlight the need for nurse practitioners, primary care providers, and specialists to provide understanding and support to patients as they work together to enable effective diagnosis and management of FM. Keywords: fibromyalgia, pain, survey, impact, support

  19. Continental-scale patterns of nutrient and fish effects on shallow lakes: synthesis of a pan-European mesocosm experiment

    NARCIS (Netherlands)

    Moss, B.; Stephen, D.; Balayla, D.; Bécares, E.; Collings, S.E.; Fernández-Aláez, C.; Fernández-Aláez, M.; Ferriol, C.; García, P.; Gomá, J.; Gyllström, M.; Hansson, L-A.; Hietala, J.; Kairesalo, T.; Rosa Miracle, M.; Romo, S.; Rueda, J.; Russell, V.; Ståhl-Delbanco, A.; Svensson, M.; Vakkilainen, K.; Valentín, M.; van de Bund, W.; Van Donk, E.; Vicente, E.; Villena, M.J.

    2004-01-01

    1. Results are analysed from 11 experiments in which effects of fish addition and nutrient loading on shallow lakes were studied in mesocosms. The experiments, five in 1998, six in 1999, were carried out in six lakes, distributed from Finland to southern Spain, according to a standard protocol. 2.

  20. Association between women veterans' experiences with VA outpatient health care and designation as a women's health provider in primary care clinics.

    Science.gov (United States)

    Bastian, Lori A; Trentalange, Mark; Murphy, Terrence E; Brandt, Cynthia; Bean-Mayberry, Bevanne; Maisel, Natalya C; Wright, Steven M; Gaetano, Vera S; Allore, Heather; Skanderson, Melissa; Reyes-Harvey, Evelyn; Yano, Elizabeth M; Rose, Danielle; Haskell, Sally

    2014-01-01

    Women veterans comprise a small percentage of Department of Veterans Affairs (VA) health care users. Prior research on women veterans' experiences with primary care has focused on VA site differences and not individual provider characteristics. In 2010, the VA established policy requiring the provision of comprehensive women's health care by designated women's health providers (DWHPs). Little is known about the quality of health care delivered by DWHPs and women veterans' experience with care from these providers. Secondary data were obtained from the VA Survey of Healthcare Experience of Patients (SHEP) using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient-centered medical home (PCMH) survey from March 2012 through February 2013, a survey designed to measure patient experience with care and the DWHPs Assessment of Workforce Capacity that discerns between DWHPs versus non-DWHPs. Of the 28,994 surveys mailed to women veterans, 24,789 were seen by primary care providers and 8,151 women responded to the survey (response rate, 32%). A total of 3,147 providers were evaluated by the SHEP-CAHPS-PCMH survey (40%; n = 1,267 were DWHPs). In a multivariable model, patients seen by DWHPs (relative risk, 1.02; 95% CI, 1.01-1.04) reported higher overall experiences with care compared with patients seen by non-DWHPs. The main finding is that women veterans' overall experiences with outpatient health care are slightly better for those receiving care from DWHPs compared with those receiving care from non-DWHPs. Our findings have important policy implications for how to continue to improve women veterans' experiences. Our work provides support to increase access to DWHPs at VA primary care clinics. Published by Elsevier Inc.

  1. A MSFD complementary approach for the assessment of pressures, knowledge and data gaps in Southern European Seas: The PERSEUS experience

    DEFF Research Database (Denmark)

    Crise, A.; Kaberi, H.; Ruiz, José Luis Martinez

    2015-01-01

    PERSEUS project aims to identify the most relevant pressures exerted on the ecosystems of the Southern European Seas (SES), highlighting knowledge and data gaps that endanger the achievement of SES Good Environmental Status (GES) as mandated by the Marine Strategy Framework Directive (MSFD......). A complementary approach has been adopted, by a meta-analysis of existing literature on pressure/impact/knowledge gaps summarized in tables related to the MSFD descriptors, discriminating open waters from coastal areas. A comparative assessment of the Initial Assessments (IAs) for five SES countries has been also...... independently performed. The comparison between meta-analysis results and IAs shows similarities for coastal areas only. Major knowledge gaps have been detected for the biodiversity, marine food web, marine litter and underwater noise descriptors. The meta-analysis also allowed the identification of additional...

  2. Nuclear Waste Management in Sweden in Comparison with other European Countries - NGO Experiences of the COWAM Process

    International Nuclear Information System (INIS)

    Holmstrand, Olov

    2003-01-01

    This paper describes opinions on nuclear waste management from the viewpoint of the local NGOs in Sweden co-operating in The Waste Network (Avfallskedjan), These opinions have been encouraged and developed by active participation in the COWAM process. The COWAM process has shown both the similarities and the differences in the nuclear waste management in several European countries. However the similarities dominate concerning the key issues of decision-making and the fundamentals of the relations between operators and regulators on one side and local citizens at proposed repository sites on the other side. The mistrust between different actors is a fundamental reason for the failure to make progress in the nuclear waste management. Normally it is argued that ordinary people and NGOs distrust established operators, agencies and governments. But there is also an obvious distrust for citizens' groups and NGOs by the operators. At least, this is the opinion of the NGO groups in Sweden

  3. The use of long term agreements to improve energy efficiency in the industrial sector: Overview of the European experiences and proposal for a common framework

    International Nuclear Information System (INIS)

    Bertoldi, P.

    1999-01-01

    In the European Union efficiency improvements in the industrial sector are regarded as a key element of Member States' strategies to meet their Kyoto target. Besides the traditional policy instruments, such as fiscal and financial aids, minimum efficiency standards, R and D and technology programs, there is an increasing interest by both public authorities and industry for voluntary approaches to improve industrial energy efficiency. In the European context the term voluntary approach is often used to describe a wide range of industry actions including, inter alia: industry covenants, negotiated agreements, long term agreements, self regulations, codes of conduct, benchmarking and monitoring schemes. These voluntary approaches differ in relation to their form, legal status, provisions and enforceability. The paper provides an up-to-date overview of the present status of the different voluntary approaches for the industrial sector in several Member States (the Netherlands, Sweden, Germany, Denmark, Finland, Ireland, and the United Kingdom). The paper will focus on the particular type of voluntary approach implemented in the Netherlands and commonly called Long Term Agreements (LTA). The paper analyses the opportunities and advantages for creating a common EU framework for the conclusion and implementation of LTAs, based on the successful Dutch model. In doing so, the paper intends also to contribute to the approximation of the LTA's essential elements throughout the Community in order to reduce possible distortions of the internal market and of the competitive position of national industries, thus enlarging the acceptability of this instrument by public authorities and industry. For some industrial sectors, which are quite homogeneous throughout the Community and represent a limited number of companies, the paper analyses the advantages of having European LTAs and recommends their implementation. The paper presents the achievable results at EU level in terms of

  4. The national health insurance scheme: perceptions and experiences of health care providers and clients in two districts of Ghana

    OpenAIRE

    Dalinjong, Philip Ayizem; Laar, Alexander Suuk

    2012-01-01

    Background: Prepayments and risk pooling through social health insurance has been advocated by international development organizations. Social health insurance is seen as a mechanism that helps mobilize resources for health, pool risk, and provide more access to health care services for the poor. Hence Ghana implemented the National Health Insurance Scheme (NHIS) to help promote access to health care services for Ghanaians. The study examined the influence of the NHIS on the behavior of healt...

  5. Frontline health workers as brokers: provider perceptions, experiences and mitigating strategies to improve access to essential medicines in South Africa.

    Science.gov (United States)

    Magadzire, Bvudzai Priscilla; Budden, Ashwin; Ward, Kim; Jeffery, Roger; Sanders, David

    2014-11-05

    Front-line health providers have a unique role as brokers (patient advocates) between the health system and patients in ensuring access to medicines (ATM). ATM is a fundamental component of health systems. This paper examines in a South African context supply- and demand- ATM barriers from the provider perspective using a five dimensional framework: availability (fit between existing resources and clients' needs); accessibility (fit between physical location of healthcare and location of clients); accommodation (fit between the organisation of services and clients' practical circumstances); acceptability (fit between clients' and providers' mutual expectations and appropriateness of care) and affordability (fit between cost of care and ability to pay). This cross-sectional, qualitative study uses semi-structured interviews with nurses, pharmacy personnel and doctors. Thirty-six providers were purposively recruited from six public sector Community Health Centres in two districts in the Eastern Cape Province representing both rural and urban settings. Content analysis combined structured coding and grounded theory approaches. Finally, the five dimensional framework was applied to illustrate the interconnected facets of the issue. Factors perceived to affect ATM were identified. Availability of medicines was hampered by logistical bottlenecks in the medicines supply chain; poor public transport networks affected accessibility. Organization of disease programmes meshed poorly with the needs of patients with comorbidities and circular migrants who move between provinces searching for economic opportunities, proximity to services such as social grants and shopping centres influenced where patients obtain medicines. Acceptability was affected by, for example, HIV related stigma leading patients to seek distant services. Travel costs exacerbated by the interplay of several ATM barriers influenced affordability. Providers play a brokerage role by adopting flexible

  6. Effect of provider experience on clinician-performed ultrasonography for hydronephrosis in patients with suspected renal colic.

    Science.gov (United States)

    Herbst, Meghan K; Rosenberg, Graeme; Daniels, Brock; Gross, Cary P; Singh, Dinesh; Molinaro, Annette M; Luty, Seth; Moore, Christopher L

    2014-09-01

    Hydronephrosis is readily visible on ultrasonography and is a strong predictor of ureteral stones, but ultrasonography is a user-dependent technology and the test characteristics of clinician-performed ultrasonography for hydronephrosis are incompletely characterized, as is the effect of ultrasound fellowship training on predictive accuracy. We seek to determine the test characteristics of ultrasonography for detecting hydronephrosis when performed by clinicians with a wide range of experience under conditions of direct patient care. This was a prospective study of patients presenting to an academic medical center emergency department with suspected renal colic. Before computed tomography (CT) results, an emergency clinician performed bedside ultrasonography, recording the presence and degree of hydronephrosis. CT data were abstracted from the dictated radiology report by an investigator blinded to the bedside ultrasonographic results. Test characteristics of bedside ultrasonography for hydronephrosis were calculated with the CT scan as the reference standard, with test characteristics compared by clinician experience stratified into 4 levels: attending physicians with emergency ultrasound fellowship training, attending physicians without emergency ultrasound fellowship training, ultrasound experienced non-attending physician clinicians (at least 2 weeks of ultrasound training), and ultrasound inexperienced non-attending physician clinicians (physician assistants, nurse practitioners, off-service rotators, and first-year emergency medicine residents with fewer than 2 weeks of ultrasound training). There were 670 interpretable bedside ultrasonographic tests performed by 144 unique clinicians, 80.9% of which were performed by clinicians directly involved in the care of the patient. On CT, 47.5% of all subjects had hydronephrosis and 47.0% had a ureteral stone. Among all clinicians, ultrasonography had a sensitivity of 72.6% (95% confidence interval [CI] 65.4% to 78

  7. Quality of care provided to patients with diabetes mellitus in Puerto Rico; managed care versus fee-for-service experience.

    Science.gov (United States)

    Rodríguez-Vigil, Efraín; Kianes-Pérez, Zaira

    2005-01-01

    To evaluate and compare the quality of diabetes care in a large managed care system and fee-for-service payment system in Puerto Rico. This retrospective cross-sectional study assessed the adherence to standards of diabetes care in 1,687,202 subjects--226,210 from a fee-for-service population and 1,460,992 from a managed care group. Patients with diabetes mellitus were identified from insurance claims reports. Type of health-care provider, service location, number of visits, and laboratory utilization were also assessed. From the analysis, we identified 90,616 patients with diabetes (5.4% of the overall study group). Of these, 66,587 (73.5%) were found to have at least one encounter with a physician in a medical visit. Of the 66,586 patients with diabetes who visited a physician, only 4% were treated by an endocrinologist. General laboratory utilization was 34% for the entire population of patients with diabetes studied. In the group of patients with documented laboratory tests, 93% had a documented fasting blood glucose test; in contrast, hemoglobin A lc testing was performed in only 9% of the patients. The fee-for-service group had a higher rate of visits to medical specialists and general laboratory utilization, whereas the managed care group had a higher rate of hospital admissions and emergency department visits. The quality of diabetes management and the subsequent outcomes are related to patient and health-care provider adherence to standards of care. In this analysis, we found that patients and physicians are responsible for low compliance with recognized standards of diabetes care in Puerto Rico. The lack of adequate management will lead to increased mortality, development and severity of chronic complications, and increased emergency department utilization. Therefore, health-care providers and payers should find ways to achieve more effective promotion of adherence to accepted standards of care for patients with diabetes.

  8. Exploring new health markets: experiences from informal providers of transport for maternal health services in Eastern Uganda

    Directory of Open Access Journals (Sweden)

    Bloom Gerald

    2011-03-01

    Full Text Available Abstract Background Although a number of intermediate transport initiatives have been used in some developing countries, available evidence reveals a dearth of local knowledge on the effect of these rural informal transport mechanisms on access to maternal health care services, the cost of implementing such schemes and their scalability. This paper, attempts to provide insights into the functioning of the informal transport markets in facilitating access to maternal health care. It also demonstrates the role that higher institutions of learning can play in designing projects that can increase the utilization of maternal health services. Objectives To explore the use of intermediate transport mechanisms to improve access to maternal health services, with emphasis on the benefits and unintended consequences of the transport scheme, as well as challenges in the implementation of the scheme. Methods This paper is based on the pilot phase to inform a quasi experimental study aimed at increasing access to maternal health services using demand and supply side incentives. The data collection for this paper included qualitative and quantitative methods that included focus group interviews, review of project documents and facility level data. Results There was a marked increase in attendance of antenatal, and delivery care services, with the contracted transporters playing a leading role in mobilizing mothers to attend services. The project also had economic spill-over effects to the transport providers, their families and community generally. However, some challenges were faced including difficulty in setting prices for paying transporters, and poor enforcement of existing traffic regulations. Conclusions and implications The findings indicate that locally existing resources such as motorcycle riders, also known as “boda boda” can be used innovatively to reduce challenges caused by geographical inaccessibility and a poor transport network with

  9. The European Convention on bioethics.

    Science.gov (United States)

    Byk, C

    1993-03-01

    Benefiting from a widely recognised experience of the field of bioethics, the Council of Europe which represents all the democratic countries of Europe, has embarked on the ambitious task of drafting a European Convention on bioethics. The purpose of this text is to set out fundamental values, such as respect for human dignity, free informed consent and non-commercialisation of the human body. In addition to this task, protocols will provide specific standards for the different fields concerned with the application of biomedical sciences. The convention and the first two protocols (human experiments and organ transplants) are due to be ready for signature by mid 1994.

  10. An Evaluation of Recent Pick-up Point Experiments in European Cities: the Rise of two Competing Models?

    OpenAIRE

    AUGEREAU, V; DABLANC, L

    2007-01-01

    In this paper, we present an analysis of recent collection point/lockerbank experiments in Europe, including the history of some of the most notable experiments. Two 'models' are currently quite successful (Kiala relay points in France and Packstation locker banks in Germany), although they are quite different. As a first interpretation of these results, we propose that these two models be considered as complementary to one another.

  11. European Union

    International Nuclear Information System (INIS)

    Schaller, K.

    1995-01-01

    Different instruments used by European Commission of the European Union for financial support radioactive waste management activities in the Russian Federation are outlined. Three particular programmes in the area are described

  12. Better and more efficient care through ICT-enabled integration of social care and healthcare services: experiences from two European projects

    Science.gov (United States)

    Müller, Sonja; Meyer, Ingo; Kubitschke, Lutz; Delaney, Sarah

    2012-01-01

    Unsynchronised social and health care service delivery leads to inefficiencies, duplication of resources and reduced levels of quality of care. Older people are particularly affected by this situation. They often need both types of services, such as support with daily living activities and chronic disease management. ICT has the potential to support integrated service delivery to achieve high quality independent living and wellbeing for older people across Europe and elsewhere. Against this background, the presentation will demonstrate experiences and results derived from the development and piloting of ICT-supported integrated care services in eight sites across Europe, namely Dublin, Hull, Milton Keynes, Malaga, Veldhoven, Geldrop, Eindhoven and Bielefeld. Through innovative usage of ICT, current ‘silos’ in service delivery are broken up to allow for cooperation across relevant care sectors and participation of family members. The integrated services are to support the effective management of chronic diseases, and to address issues which affect independence, such as reduced agility, vision or hearing, in order to significantly improve the quality of life for older people and their carers. A dedicated programme of service process innovation complemented by adaptation of technology is being pursued in order to develop an integrated digital support infrastructure and related services: using appropriate existing technology to provide as many older people as possible with digital access to support services they needaugmenting and opening sectoral care platforms to enable coordinated cross-sector support deliveryadopting a clearly demand-driven inclusive approach and avoiding a technology ‘push’. Wider deployment of the services is supported by a dedicated programme of socio-economic service evaluation. The evaluation framework utilises a multi-method and multi-perspective approach, involving end users, family carers, service provider staff and key informants

  13. European mobility cultures

    DEFF Research Database (Denmark)

    Haustein, Sonja; Nielsen, Thomas A. Sick

    2016-01-01

    More targeted European policies promoting green travel patterns require better knowledge on differing mobility cultures across European regions. As a basis for this, we clustered the EU population into eight mobility styles based on Eurobarometer data. The mobility styles - including, for example...... positions on the path towards sustainable mobility and therefore different requirements towards European platforms and support measures, e.g. for 'Sustainable Urban Mobility Plans'. The country clusters can provide a starting point for future communication and targeting of European efforts in sustainable...

  14. Russian Observations of European Experience in Agricultural Development in 1840s (based on the printed output of the Imperial Agricultural Societies of Russia

    Directory of Open Access Journals (Sweden)

    Yulia I. Kuznetsova

    2016-06-01

    Full Text Available In the first half of the nineteenth century, agriculture in Russia had reached the new level of development. The Imperial Agricultural Societies paid much attention to establishing relations with the foreign agricultural societies and kept up with their periodicals, issuing translations and abridgements of texts, which could be interesting to the Russian readers. This paper examines the articles on farming industry in Great Britain, France, German countries, Italy, and the USA, released in journals and transactions of Imperial Agricultural Societies of Russia in 1840s. The research draws on both reviews of European congresses or exhibitions, written by members of agricultural societies, and the articles written by foreign authors and published in translation. Such approach made it possible to specify the certain topics appealing to Russian farmers. Moreover, the study of the articles contributed by the Imperial Agricultural Societies helped to build a complete picture representing knowledge on history, theory and practice of foreign and Russian husbandry, shared by the Russian farmers in 1840s. It is also worth to mention that the effective work of agricultural journals in fact integrated Russian farming communities into the broad network of contacts, experience and knowledge exchange, which had been functioning in Europe in the first half of the XIXth century. Nevertheless, the research revealed that the articles in question almost lacked comparisons between Russian and European agriculture. The papers dealing with comparative analysis of the different European farming systems are characterized by noticeably restrained reaction of the editors and authors to the published information. They tended to show the advantages and disadvantages of the foreign farming without furnishing the Russian reader or the Russian authorities with any specific recommendations.

  15. Regulation of solid waste management at Brazilian ports: Analysis and proposals for Brazil in light of the European experience

    International Nuclear Information System (INIS)

    Jaccoud, Cristiane; Magrini, Alessandra

    2014-01-01

    Highlights: • Analysis of the regulatory framework relating to solid waste management in Brazilian ports. • Comparison between European best practices and Brazilian structure. • Initiatives are suggested in order to improve Brazilian ports solid waste management regulation. - Abstract: With a coastline of 8500 km, Brazil has 34 public ports and various private terminals, which together in 2012 handled 809 million tonnes of goods. The solid wastes produced (from port activities, ships and cargoes) pose a highly relevant problem, both due to the quantity and diversity, requiring a complex and integrated set of practices resulting from legal requirements and proactive initiatives. The main Brazilian law on solid waste management is recent (Law 12,305/2010) and the specific rules on solid waste in ports are badly in need of revision to meet the challenges caused by expansion of the sector and to harmonize them with the best global practices. This paper analyzes the current legal/regulatory framework for solid waste management at Brazilian ports and compares this structure with the practice in Europe. At the end, we suggest initiatives to improve the regulation of solid wastes at Brazilian ports

  16. Review of European regulatory and tariff experience with the sale of heat and electricity from combined heat and power plants

    International Nuclear Information System (INIS)

    Dyrelund, A.

    1991-12-01

    The Prince Edward Island Energy Corporation, Edmonton Power, Energy, Mines and Resources Canada and the Canadian Electrical Association commissioned a study to understand how electrical power and district heat from combined heat and power (CHP) plants is priced in Europe. Four northern European countries were investigated, Denmark, Germany, Sweden and Finland. These countries produce 45.8 TWh of power from combined heat and power plants, 7.1% of their annual consumption. In the case of Denmark, CHP accounts for 37.5% of its total power production. The energy situation in each country is reviewed using published statistics, and in particular the rapidly changing situation with regard to environmental and fuel taxes is examined. In order to obtain practical insights with regard to tariffs used by the various utilities, a series of generic examples were examined, supported by specific case studies. Technologies reviewed included: CHP from coal-fuelled extraction plant, CHP from coal-fuelled back pressure plant, waste heat from a municipal waste plant, and gas turbine with waste heat recovery. The benefits and risks associated with different tariff designs are discussed in detail including tariff formulae. This should enable interested parties to develop appropriate tariffs for combined heat and power plants in the context of current electrical utility policies. As a complement to the tariffs for combined heat and power plants, the design of district heating tariffs is also addressed. The typical concepts used in different countries are presented and discussed. 23 tabs

  17. Voluntary agreements in the field of energy efficiency and emission reduction: Review and analysis of experiences in the European Union

    International Nuclear Information System (INIS)

    Rezessy, Silvia; Bertoldi, Paolo

    2011-01-01

    A number of Member States of the EU have introduced voluntary agreements (VAs) that aim to deliver energy savings and emission reductions via increased energy efficiency in different end-use sectors, mainly targeting industry. Where there is a successful track record of cooperation between public authorities and the private sector, VAs can offer advantages to public authorities in comparison to legislation, most importantly better flexibility when introduced or updated, greater acceptance by industry, possibility for tailor-made solutions e.g. at the level of industrial sectors and opportunity to overcome the information asymmetry between public authorities and private actors. Nevertheless, VAs have been criticized for lack of specific obligations and lenient targets, as well as for deficiencies in compliance monitoring and self-reporting and difficulty in establishing the policy additionality of VA activity. This paper analyses the design of existing VAs in terms of general framework, targets and sectors, obligations and commitments, motivation to join, reporting and monitoring provisions, and results of existing VAs as reported by national authorities. The paper summarizes the key characteristics of voluntary agreements and gives recommendations for the successful application of this policy tool. - Highlights: → Analyze the design of voluntary agreements (VAs) for energy efficiency. → Study national-level VAs in the European Union. → Analyze their general framework and results delivered. → Summarize the key characteristics of VAs. → Give recommendations for the successful application of this policy tool.

  18. Financial incentive approaches for reducing peak electricity demand, experience from pilot trials with a UK energy provider

    International Nuclear Information System (INIS)

    Bradley, Peter; Coke, Alexia; Leach, Matthew

    2016-01-01

    Whilst tariff-based approaches to load-shifting are common in the residential sector, incentive-based approaches are rare. This is so, even though providing customers incentives to shape their power consumption patterns has substantial potential. This paper presents findings from an exploratory UK pilot study that trials financial payments and detailed energy feedback to incentivise load-shifting of residential electricity consumption. An intervention study was implemented measuring actual energy use by individual households as well as conducting surveys and interviews. From the trials it was found that the approaches resulted in reductions in peak time energy use. Evidence from the study found that the incentives-based approaches were able to overcome some of the barriers to response experienced in Time-of-Use studies, though less good on others. Interestingly, the height of the barriers varied by the electricity-using practice and the incentivising approach applied. The height of the barriers also varied by participant. The study concludes by identifying that broad participation in demand response is likely to require a suite of incentivising approaches that appeal to different people, a key policy finding of interest to international agencies, government, public and private sector entities. - Highlights: • Novel study of financial incentive approaches for shifting residential energy. • First academic paper comprehensively identifying barriers to time of use tariffs. • First study reporting barriers to financial incentive approaches for demand response. • Incentive study design can be applied by government and energy companies.

  19. Physicians' experiences with end-of-life decision-making: Survey in 6 European countries and Australia

    Directory of Open Access Journals (Sweden)

    Mortier Freddy

    2008-02-01

    Full Text Available Abstract Background In this study we investigated (a to what extent physicians have experience with performing a range of end-of-life decisions (ELDs, (b if they have no experience with performing an ELD, would they be willing to do so under certain conditions and (c which background characteristics are associated with having experience with/or being willing to make such ELDs. Methods An anonymous questionnaire was sent to 16,486 physicians from specialities in which death is common: Australia, Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. Results The response rate differed between countries (39–68%. The experience of foregoing life-sustaining treatment ranged between 37% and 86%: intensifying the alleviation of pain or other symptoms while taking into account possible hastening of death between 57% and 95%, and experience with deep sedation until death between 12% and 46%. Receiving a request for hastening death differed between 34% and 71%, and intentionally hastening death on the explicit request of a patient between 1% and 56%. Conclusion There are differences between countries in experiences with ELDs, in willingness to perform ELDs and in receiving requests for euthanasia or physician-assisted suicide. Foregoing treatment and intensifying alleviation of pain and symptoms are practiced and accepted by most physicians in all countries. Physicians with training in palliative care are more inclined to perform ELDs, as are those who attend to higher numbers of terminal patients. Thus, this seems not to be only a matter of opportunity, but also a matter of attitude.

  20. Nitrous oxide emissions from European agriculture - an analysis of variability and drivers of emissions from field experiments

    DEFF Research Database (Denmark)

    Rees, R M; Agustin, J; Alberti, G

    2013-01-01

    Nitrous oxide emissions from a network of agricultural experiments in Europe were used to explore the relative importance of site and management controls of emissions. At each site, a selection of management interventions were compared within replicated experimental designs in plot-based experime......Nitrous oxide emissions from a network of agricultural experiments in Europe were used to explore the relative importance of site and management controls of emissions. At each site, a selection of management interventions were compared within replicated experimental designs in plot...

  1. Patients Without Borders: Using Telehealth to Provide an International Experience in Veterinary Global Health for Veterinary Students.

    Science.gov (United States)

    Mazan, Melissa R; Kay, Gigi; Souhail, Mohammed Larbi; Bubeck, Kirstin; Jenei, Thomas; Merriam, Jay

    There is an increasing need to produce veterinarians with knowledge and critical thinking skills that will allow them to participate in veterinary global health equity delivery, particularly in the developing world, where many people remain dependent on animal-based agriculture for a living. This need for veterinarians trained in global health is reflected by the demand among students for greater exposure and education. At the same time, many students are held back from on-site training in global health due to constraints of cost, time, or family obligations. The purpose of this article is to describe the use of a telemedicine approach to educating veterinary students at Tufts Cummings School of Veterinary Medicine. This approach simultaneously provides expert consultation and support for a pro bono hospital in the developing world. The development of a telemedicine teaching service is discussed, from initial ad hoc email consultation among friends and associates to a more formal use of store-and-forward delivery of data along with real-time videoconferencing on a regular basis, termed tele-rounds. The practicalities of data delivery and exchange and best use of available bandwidth are also discussed, as this very mundane information is critical to efficient and useful tele-rounds. Students are able to participate in discussion of cases that they would never see in their usual clinical sphere and to become familiar with diagnostic and treatment approaches to these cases. By having the patient "virtually" brought to us, tele-rounds also decrease the usual carbon footprint of global health delivery.

  2. Implementation of preventive mental health services for children of physically ill parents: experiences in seven European countries and health care systems.

    Science.gov (United States)

    Kühne, Franziska; Haagen, Miriam; Baldus, Christiane; Diareme, Stavroula; Grether, Andrea; Schmitt, Florence; Stanescu, Dan; Stöckl, Margit; Thastum, Mikael; Möller, Birgit; Romer, Georg

    2013-01-01

    Parental physical disease is a family issue, but families' minor children are seldom considered. The current study analyzed experiences with implementation of counseling for families with physically ill parents and minor children during a European multisite pilot project. Implementation protocols of seven European partner centers collaborating in a joint research project were analyzed by Mayring's qualitative content analysis. Both an inductive approach and a deductive approach were chosen. Satisfaction of families and therapists was considered based on information from three partner centers. Satisfaction with counseling was rather high. Mentioned problems referred to aspects related to liaison partners, family-related aspects and physicians' concerns. Recommendations related to contacting families, liaising with other professions, implementing counseling together with a research project, and training. Results are integrated in the current dissemination literature. Successful implementation was mostly determined by aspects of interdisciplinary cooperation and communication, perceived relative advantage and organizational premises. With regard to this kind of innovative child-centered family mental health services, top-down and bottom-up implementation strategies should be combined, and strategies of maintenance and sustainability should be considered from the very beginning. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. A Very Intense Neutrino Super Beam Experiment for Leptonic CP Violation Discovery based on the European Spallation Source Linac: A Snowmass 2013 White Paper

    CERN Document Server

    Baussan, E; Bogomilov, M.; Bouquerel, E.; Cederkäll, J.; Christiansen, P.; Coloma, P.; Cupial, P.; Danared, H.; Densham, C.; Dracos, M.; Ekelöf, T.; Eshraqi, M.; Fernandez Martinez, E.; Gaudiot, G.; Hall-Wilton, R.; Koutchouk, J.P.; Lindroos, M.; Matev, R.; McGinnis, D.; Mezzetto, M.; Miyamoto, R.; Mosca, L.; Ohlsson, T.; Öhman, H.; Osswald, F.; Peggs, S.; Poussot, P.; Ruber, R.; Tang, J.Y.; Tsenov, R.; Vankova-Kirilova, G.; Vassilopoulos, N.; Wildner, E.; Wurtz, J.

    2014-01-01

    Very intense neutrino beams and large neutrino detectors will be needed in order to enable the discovery of CP violation in the leptonic sector. We propose to use the proton linac of the European Spallation Source currently under construction in Lund, Sweden to deliver, in parallel with the spallation neutron production, a very intense, cost effective and high performance neutrino beam. The baseline program for the European Spallation Source linac is that it will be fully operational at 5 MW average power by 2022, producing 2 GeV 2.86 ms long proton pulses at a rate of 14 Hz. Our proposal is to upgrade the linac to 10 MW average power and 28 Hz, producing 14 pulses/s for neutron production and 14 pulses/s for neutrino production. Furthermore, because of the high current required in the pulsed neutrino horn, the length of the pulses used for neutrino production needs to be compressed to a few $\\mu$s with the aid of an accumulator ring. A long baseline experiment using this Super Beam and a megaton underground ...

  4. Public preferences for vaccination programmes during pandemics caused by pathogens transmitted through respiratory droplets - a discrete choice experiment in four European countries, 2013.

    Science.gov (United States)

    Determann, Domino; Korfage, Ida J; Fagerlin, Angela; Steyerberg, Ewout W; Bliemer, Michiel C; Voeten, Helene A; Richardus, Jan Hendrik; Lambooij, Mattijs S; de Bekker-Grob, Esther W

    2016-06-02

    This study aims to quantify and compare preferences of citizens from different European countries for vaccination programme characteristics during pandemics, caused by pathogens which are transmitted through respiratory droplets. Internet panel members, nationally representative based on age, sex, educational level and region, of four European Union Member States (Netherlands, Poland, Spain, and Sweden, n = 2,068) completed an online discrete choice experiment. These countries, from different geographical areas of Europe, were chosen because of the availability of high-quality Internet panels and because of the cooperation between members of the project entitled Effective Communication in Outbreak Management: development of an evidence-based tool for Europe (ECOM). Data were analysed using panel latent class regression models. In the case of a severe pandemic scenario, vaccine effectiveness was the most important characteristic determining vaccination preference in all countries, followed by the body that advises on vaccination. In Sweden, the advice of family and/or friends and the advice of physicians strongly affected vaccine preferences, in contrast to Poland and Spain, where the advice of (international) health authorities was more decisive. Irrespective of pandemic scenario or vaccination programme characteristics, the predicted vaccination uptakes were lowest in Sweden, and highest in Poland. To increase vaccination uptake during future pandemics, the responsible authorities should align with other important stakeholders in the country and communicate in a coordinated manner.

  5. Impact of Provider Participation in ACO Programs on Preventive Care Services, Patient Experiences, and Health Care Expenditures in US Adults Aged 18-64.

    Science.gov (United States)

    Hong, Young-Rock; Sonawane, Kalyani; Larson, Samantha; Mainous, Arch G; Marlow, Nicole M

    2018-05-15

    Little is known about the impact of accountable care organization (ACO) on US adults aged 18-64. To examine whether having a usual source of care (USC) provider participating in an ACO affects receipt of preventive care services, patient experiences, and health care expenditures among nonelderly Americans. A cross-sectional analysis of the 2015 Medical Organizations Survey linked with the Medical Expenditure Panel Survey. Survey respondents aged 18-64 with an identified USC and continuous health insurance coverage during 2015. Preventative care services (routine checkup, flu vaccination, and cancer screening), patient experiences with health care (access to care, interaction quality with providers, and global satisfaction), and health care expenditures (total and out-of-pocket expenditures) for respondents with USC by ACO and non-ACO provider groups. Among 1563, nonelderly Americans having a USC, we found that nearly 62.7% [95% confidence interval (CI), 58.6%-66.7%; representing 15,722,208 Americans] were cared for by ACO providers. Our analysis showed no significant differences in preventive care services or patient experiences between ACO and non-ACO groups. Adjusted mean total health expenditures were slightly higher for the ACO than non-ACO group [$7016 (95% CI, $4949-$9914) vs. $6796 (95% CI, $4724-$9892)]; however, this difference was not statistically significant (P=0.250). Our findings suggest that having a USC provider participating in an ACO is not associated with preventive care services use, patient experiences, or health care expenditures among a nonelderly population.

  6. Patient Experience Assessment is a Requisite for Quality Evaluation: A Discussion of the In-Center Hemodialysis Consumer Assessment of Health Care Providers and Systems (ICH CAHPS) Survey.

    Science.gov (United States)

    Cavanaugh, Kerri L

    2016-01-01

    Patient experience surveys provide a critical and unique perspective on the quality of patient-centered healthcare delivery. These surveys provide a mechanism to systematically express patients' voice on topics valued by patients to make decisions about choices in care. They also provide an assessment to healthcare organizations about their service that cannot be obtained from any other source. Regulatory agencies have mandated the assessment of patients' experience as part of healthcare value based purchasing programs and weighted the results to account for up to 30% of the total scoring. This is a testimony to the accepted importance of this metric as a fundamental assessment of quality. After more than a decade of rigorous research, there is a significant body of growing evidence supporting specifically the validity and use of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, including a version specific to in-center hemodialysis (ICH CAHPS). This review will focus on the ICH CAHPS survey including a review of its development, content, administration, and also a discussion of common criticisms. Although it is suggested that the survey assesses activities and experiences that are not modifiable by the healthcare organization (or the dialysis facility in our case) emerging evidence suggests otherwise. Dialysis providers have an exclusive opportunity to lead the advancement of understanding the implications and serviceability of the evaluation of the patient experience in health care. © 2016 Wiley Periodicals, Inc.

  7. Nitrous oxide emissions from European agriculture – an analysis of variability and drivers of emissions from field experiments

    Directory of Open Access Journals (Sweden)

    R. M. Rees

    2013-04-01

    Full Text Available Nitrous oxide emissions from a network of agricultural experiments in Europe were used to explore the relative importance of site and management controls of emissions. At each site, a selection of management interventions were compared within replicated experimental designs in plot-based experiments. Arable experiments were conducted at Beano in Italy, El Encin in Spain, Foulum in Denmark, Logården in Sweden, Maulde in Belgium, Paulinenaue in Germany, and Tulloch in the UK. Grassland experiments were conducted at Crichton, Nafferton and Peaknaze in the UK, Gödöllö in Hungary, Rzecin in Poland, Zarnekow in Germany and Theix in France. Nitrous oxide emissions were measured at each site over a period of at least two years using static chambers. Emissions varied widely between sites and as a result of manipulation treatments. Average site emissions (throughout the study period varied between 0.04 and 21.21 kg N2O-N ha−1 yr−1, with the largest fluxes and variability associated with the grassland sites. Total nitrogen addition was found to be the single most important determinant of emissions, accounting for 15% of the variance (using linear regression in the data from the arable sites (p 2O emissions within sites that occurred as a result of manipulation treatments was greater than that resulting from site-to-site and year-to-year variation, highlighting the importance of management interventions in contributing to greenhouse gas mitigation.

  8. Rapid establishment of the European Bank for induced Pluripotent Stem Cells (EBiSC - the Hot Start experience

    Directory of Open Access Journals (Sweden)

    Paul A. De Sousa

    2017-04-01

    eTOC: The report focuses on the EBiSC experience of rapidly establishing an operational capacity to procure, bank and distribute a foundational collection of established hiPSC lines. It validates the feasibility and defines the challenges of harnessing and integrating the capability and productivity of centres across Europe using commonly available resources currently in the field.

  9. Physicians' experiences with end-of-life decision-making: survey in 6 European countries and Australia

    DEFF Research Database (Denmark)

    Löfmark, Rurik; Nilstun, Tore; Cartwright, Colleen

    2008-01-01

    are associated with having experience with/or being willing to make such ELDs. METHODS: An anonymous questionnaire was sent to 16,486 physicians from specialities in which death is common: Australia, Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. RESULTS: The response rate differed between...

  10. Responses of phytoplankton to fish predation and nutrient loading in shallow lakes: a pan-European mesocosm experiment

    NARCIS (Netherlands)

    van de Bund, W.; Romo, S.; Villena, M.J.; Valentín, M.; Van Donk, E.; Vicente, E.; Vakkilainen, K.; Svensson, M.; Stephen, D.; Ståhl-Delbanco, A.; Rueda, J.; Moss, B.; Rosa Miracle, M.; Kairesalo, T.; Hansson, L-A.; Hietala, J.; Gyllström, M.; Goma, J.; García, P.; Fernández-Aláez, M.; Fernández-Aláez, C.; Ferriol, C.; Collings, S.E.; Bécares, E.; Balayla, D.; Alfonso, T.

    2004-01-01

    1. The impacts of nutrients (phosphorus and nitrogen) and planktivorous fish on phytoplankton composition and biomass were studied in six shallow, macrophyte-dominated lakes across Europe using mesocosm experiments. 2. Phytoplankton biomass was more influenced by nutrients than by densities of

  11. A social way to experience a scientific event: Twitter use at the 7th European Public Health Conference.

    Science.gov (United States)

    Bert, Fabrizio; Zeegers Paget, Dineke; Scaioli, Giacomo

    2016-03-01

    Many studies have analysed Twitter's use by attendees of scientific meetings and the characteristics of conference-related messages and most active attendees. Despite these previous reports, to date no studies have described the use of Twitter during Public Health conferences. For this reason, we decided to perform an analysis of Twitter's use during the 7th European Public Health (EPH) Conference (Glasgow, November 2014). All the tweets published from 21 July to 2 December 2014 and including the hashtag #ephglasgow were retrieved and much information (author, date, retweets, favourites, mentions, presence of pictures and/or external links, content type and topics) was analysed. A total of 1066 tweets with the hashtag #ephglasgow were retrieved; 86.3% of these were tweeted during the conference. A total of 209 single accounts tweeted, pictures were present in 29.7% tweets while external links were published in 13.8%. Conference speakers were mentioned in around 30% of tweets. Almost 60% of the tweets had a session-related content. Considering only the session-related tweets, one-third had as the main topic 'Health inequalities and migrant and ethnic minority health', while 20% were 'Health policy and health economics' oriented. The results of this study have demonstrated a massive use of Twitter by conference attendees during the 7th EPH conference, and that conference attendees are willing to share quotes and impressions particularly about conference-related topics. It is mandatory for conference organisers to promote online discussion and knowledge dissemination during conferences, especially in the public health field. © 2015 the Nordic Societies of Public Health.

  12. Scenario realism and welfare estimates in choice experiments - a non-market valuation study on the European water framework directive

    DEFF Research Database (Denmark)

    Kataria, Mitesh; Bateman, I.; Christensen, Tove

    2012-01-01

    of a water body. This information is provided prior to the valuation questions and the corresponding beliefs in the provided information are also elicited before valuation. The second type of information concerns the proposed improvements in the environmental status of the water body. We find that average...

  13. Integrated energy markets and varying degrees of liberalisation: price links, bundled sales and CHP production exemplified by Northern European experiences

    International Nuclear Information System (INIS)

    Jacobsen, H.K.; Fristrup, P.; Munksgaard, J.

    2006-01-01

    Liberalisation of energy markets has during the last 20 years been gradually introduced in many countries. The liberalisation has led to concerns regarding the markets' state of competition and fears that market power existence can result in less efficiency gains than what is expected from liberalisation. Concerns have also been raised as to whether specific consumer groups will be affected by limited competition in markets. Much of the concern has been concentrated on the electricity markets, but the development of energy sectors with integration of activities within natural gas, electricity and the oil sector creates the need to examine market power aspects across these markets. This paper examines the concentration trends in the Northern European markets for electricity and natural gas, combined with regional district heating aspects, especially with respect to the situation in Denmark. The situation with natural gas companies supplying to both small-scale CHP and to retail heat customers is discussed, for instance, which changes of regulatory regime for domestic heating customers should be considered when the natural gas market is being liberalised? The interlinked nature of the energy markets is described and examples of impacts from one market with limited competition to other markets with seemingly well-functioning competition are given. The specific case of large CHP production facilities with output on the regulated district heating market and the competitive Nordic electricity market is examined. How much of the fluctuations in price experienced in electricity markets should be reflected in the price of heating supplies? To which degree do the heating customers have to bear the burden of low-electricity market prices? Regulation of liberalised markets is discussed focusing on the interaction between one regulated market and the related energy markets that are liberalised. Existing regulation on the markets are compared to a situation where liberalisation

  14. Integrated energy markets and varying degrees of liberalisation: Price links, bundled sales and CHP production exemplified by Northern European experiences

    International Nuclear Information System (INIS)

    Klinge Jacobsen, Henrik; Fristrup, Peter; Munksgaard, Jesper

    2006-01-01

    Liberalisation of energy markets has during the last 20 years been gradually introduced in many countries. The liberalisation has led to concerns regarding the markets' state of competition and fears that market power existence can result in less efficiency gains than what is expected from liberalisation. Concerns have also been raised as to whether specific consumer groups will be affected by limited competition in markets. Much of the concern has been concentrated on the electricity markets, but the development of energy sectors with integration of activities within natural gas, electricity and the oil sector creates the need to examine market power aspects across these markets. This paper examines the concentration trends in the Northern European markets for electricity and natural gas, combined with regional district heating aspects, especially with respect to the situation in Denmark. The situation with natural gas companies supplying to both small-scale CHP and to retail heat customers is discussed, for instance, which changes of regulatory regime for domestic heating customers should be considered when the natural gas market is being liberalised? The interlinked nature of the energy markets is described and examples of impacts from one market with limited competition to other markets with seemingly well-functioning competition are given. The specific case of large CHP production facilities with output on the regulated district heating market and the competitive Nordic electricity market is examined. How much of the fluctuations in price experienced in electricity markets should be reflected in the price of heating supplies? To which degree do the heating customers have to bear the burden of low-electricity market prices? Regulation of liberalised markets is discussed focusing on the interaction between one regulated market and the related energy markets that are liberalised. Existing regulation on the markets are compared to a situation where liberalisation

  15. Estimating and mitigating post-release mortality of European eel by combining citizen science with a catch-and-release angling experiment

    NARCIS (Netherlands)

    Weltersbach, Marc Simon; Weltersbach, Marc Simon; Strehlow, Harry Vincent; Ferter, Keno; Klefoth, Thomas; Graaf, de Martin; Graaf, de Martin; Dorow, Malte

    2018-01-01

    Several anguillid eel species have experienced severe population declines over the past decades, particularly the European eel (Anguilla anguilla), which is listed as critically endangered by the International Union for Conservation of Nature. To reduce fishing mortality, many European countries

  16. A survey on the knowledge and attitudes of anaesthesia providers in the United States of America, United Kingdom and Singapore on visual experiences during cataract surgery.

    Science.gov (United States)

    Tan, C S H; Kumar, C M; Fanning, G L; Lai, Y C; Au Eong, K G

    2006-04-01

    To assess the knowledge, beliefs and attitudes of anaesthesia providers on the patients' possible intraoperative visual experiences during cataract surgery under local anaesthesia. Anaesthesia providers from the Ophthalmic Anaesthesia Society (USA); British Ophthalmic Anaesthesia Society (UK); Alexandra Hospital, National University Hospital, Tan Tock Seng Hospital, Singapore General Hospital and Changi General Hospital (Singapore) were surveyed using a structured questionnaire. A total of 146 anaesthesiologists (81.6%), 10 ophthalmologists (5.6%) and 23 nurse anaesthetists (12.8%) responded to the survey. Most respondents believed that patients would experience light perception and many also felt that patients might encounter other visual sensations such as movements, flashes, colours, surgical instruments, hands/fingers and the surgeon during the surgery. A significantly higher proportion of anaesthesia providers with previous experience of monitoring patients under topical anaesthesia believed that patients might experience the various visual sensations compared to those who have not previously monitored. For both topical and regional anaesthesia, anaesthesia providers who routinely counsel their patients are (1) more likely to believe that preoperative counselling helps or (2) were previously told by patients that they could see intraoperatively and/or that they were frightened by their visual sensations. These findings were statistically significant. The majority of anaesthesia providers in the USA, UK and Singapore are aware that patients may experience a variety of visual sensations during cataract surgery under regional or topical anaesthesia. Those who have previously managed patients undergoing cataract surgery under topical anaesthesia are more likely to believe this compared to those who have not.

  17. The social stratification of European schoolchildren’s transnational experiences: a cross-country analysis of the International Civics and Citizenship Study

    NARCIS (Netherlands)

    Kuhn, T.

    2016-01-01

    In the wake of European border removal, scholars have been puzzled by the slow and limited Europeanization of everyday life. Only a small group of Europeans with high socio-economic status regularly interact across borders. However, we do not know well how these socio-economic differences come

  18. Demographics of cleft care providers in Africa and reported experience in training and practice: direct analysis of continent-based practitioners.

    Science.gov (United States)

    Adetayo, Oluwaseun A; Martin, Mark C

    2012-05-01

    To elucidate the impact of several geographic, cultural, and socioeconomic variables on cleft care delivery in Africa, and to investigate the current status of cleft care delivery in Africa. Survey of practitioners attending the second Pan-African Congress on Cleft Lip and Palate (PACCLIP). The annual PACCLIP conference in Ibadan, Nigeria, West Africa, February 2007. To provide an analysis of the demographics and training experience of cleft care providers in Africa by collating information directly from the continent-based practitioners. Plastic surgeons and oral and maxillofacial surgeons provide the majority of cleft care. Most of the participants reported availability of formal training programs in their respective countries. The predominant practice settings were university and government-based. During training, half of the providers had encountered up to 30 cleft cases, and a quarter had managed more than 100 cases. Representation of visiting surgeons were equally distributed between African and non-African countries. This study provides initial and detailed analysis crucial to understanding the underlying framework of cleft care composition teams, demographics of providers, and training and practice experience. This awareness will further enable North American and other non-African plastic surgeons to effectively partner with African cleft care providers to have a further reaching impact in the region.

  19. Adoption and Usage of mHealth Technology on Quality and Experience of Care Provided by Frontline Workers: Observations From Rural India.

    Science.gov (United States)

    Kaphle, Sangya; Chaturvedi, Sharad; Chaudhuri, Indrajit; Krishnan, Ram; Lesh, Neal

    2015-05-28

    mHealth apps are deployed with the aim of improving access, quality, and experience of health care. It is possible that any mHealth intervention can yield differential impacts for different types of users. Mediating and determining factors, including personal and socioeconomic factors, affect technology adoption, the way health workers leverage and use the technology, and subsequently the quality and experience of care they provide. To develop a framework to assess whether mHealth platforms affect the quality and experience of care provided by frontline workers, and whether these effects on quality and experience are different depending on the level of technology adoption and individual characteristics of the health worker. Literacy, education, age, and previous mobile experience are identified as individual factors that affect technology adoption and use, as well as factors that affect the quality and experience of care directly and via the technology. Formative research was conducted with 15 community health workers (CHWs) using CommCare, an mHealth app for maternal and newborn care, in Bihar, India. CHWs were first classified on the level of CommCare adoption using data from CommCareHQ and were then shadowed on home visits to evaluate their levels of technology proficiency, and the quality and experience of care provided. Regression techniques were employed to test the relationships. Out of all the CHWs, 2 of them refused to participate in the home visits, however, we did have information on their levels of technology adoption and background characteristics, which were included in the analysis as relevant. Level of technology adoption was important for both quality and experience of care. The quality score for high users of CommCare was higher by 33.4% (P=.04), on average, compared to low users of CommCare. Those who scored higher on CommCare proficiency also provided significantly higher quality and experience of care, where an additional point in Comm

  20. Principles of European Contract Law

    DEFF Research Database (Denmark)

    Lando, Ole; Beale, Hugh

    This text provides a comprehensive guide to the principles of European contract law. They have been drawn up by an independent body of experts from each Member State of the EU, under a project supported by the European Commission and many other organizations. The principles are stated in the form...... of articles, with a detailed commentary explaining the purpose and operation of each article and its relation to the remainder. Each article also has extensive comparative notes surveying the national laws and other international provisions on the topic. "The Principles of European Contract Law Parts I &...... in developing a common European legal culture. The European Parliament has twice called for the creation of a European Civil Code. The principles of European contract law are essential steps in these projects. This text provides a comprehensive guide to the Principles of European contract law. They have been...

  1. From the Law of European Delegation to the Legislative Decree on experiments with animals: consequences for biomedical research.

    Science.gov (United States)

    Petrini, C

    2014-01-01

    The provisions contained in the Legislative Decree no.26 signed by Italy's President on 4th March 2014 will have a considerable impact on the future of experiments with animals. The article briefly describes the stages of the decree's complicated passage through Parliament and the resulting text, which includes bans on: the use of animals for xenotransplants or research on drugs of abuse; the breeding of dogs, cats and non-human primates for experimental use; research without anaesthetic or analgesics that causes pain to the animal, except when anaesthetics or analgesics are being investigated. There is widespread feeling in the scientific community that these provisions will hinder the advancement of biomedical research in Italy.

  2. The European tracer experiment ETEX: a real-time long range atmospheric dispersion model exercise in different weather conditions

    International Nuclear Information System (INIS)

    Graziani, G.; )

    1998-01-01

    Two long-range tracer experiments were conducted. An inert, non-depositing tracer was being released at Rennes in France for 12 hours. The 168 sampling ground stations were run by the National Meteorological Services. Twenty-four institutions took part in the real-time forecasting of the cloud evolution using 28 long-range dispersion models. The horizontal projection of the cloud evolution over Europe was combined with real-time aerial chemical analysis. The results of the comparison indicate that a limited group of models (7-8) were capable of obtaining a good reproduction of the cloud movement throughout Europe for the first release. Large differences were, however, found in the predicted tracer concentration at a particular location. For the second release, there were large differences between the measured and calculated cloud, particularly after a front passage, which indicates that some efforts have still to be spent before consensus on the model reliability is achieved. (P.A.)

  3. An Online Health Prevention Intervention for Youth with Addicted or Mentally Ill Parents: Experiences and Perspectives of Participants and Providers from a Randomized Controlled Trial.

    Science.gov (United States)

    Woolderink, Marla; Bindels, Jill A P M; Evers, Silvia M A A; Paulus, Aggie T G; van Asselt, Antoinette D I; van Schayck, Onno C P

    2015-12-02

    Mental illnesses affect many people around the world, either directly or indirectly. Families of persons suffering from mental illness or addiction suffer too, especially their children. In the Netherlands, 864,000 parents meet the diagnostic criteria for a mental illness or addiction. Evidence shows that offspring of mentally ill or addicted parents are at risk for developing mental disorders or illnesses themselves. The Kopstoring course is an online 8-week group course with supervision by 2 trained psychologists or social workers, aimed to prevent behavioral and psychological problems for children (aged 16 to 25 years) of parents with mental health problems or addictions. The course addresses themes such as roles in the family and mastery skills. An online randomized controlled trial (RCT) was conducted to assess the effectiveness of the Kopstoring course. The aim was to gain knowledge about expectations, experiences, and perspectives of participants and providers of the online Kopstoring course. A process evaluation was performed to evaluate the online delivery of Kopstoring and the experiences and perspectives of participants and providers of Kopstoring. Interviews were performed with members from both groups. Participants were drawn from a sample from the Kopstoring RCT. Thirteen participants and 4 providers were interviewed. Five main themes emerged from these interviews: background, the requirements for the intervention, experience with the intervention, technical aspects, and research aspects. Overall, participants and providers found the intervention to be valuable because it was online; therefore, protecting their anonymity was considered a key component. Most barriers existed in the technical sphere. Additional barriers existed with conducting the RCT, namely gathering informed consent and gathering parental consent in the case of minors. This study provides valuable insight into participants' and providers' experiences and expectations with the online

  4. A qualitative study of health care providers' perceptions and experiences of working together to care for children with medical complexity (CMC).

    Science.gov (United States)

    Altman, Lisa; Zurynski, Yvonne; Breen, Christie; Hoffmann, Tim; Woolfenden, Susan

    2018-01-31

    Children with medical complexity (CMC) have a wide range of long term health problems and disabilities that have an adverse impact on their quality of life. They have high levels of family identified health care needs and health care utilisation. There is no Australian literature on the experiences of health care providers working in the Australian tertiary, secondary and primary health care system, whilst managing CMC. This information is essential to inform the design of integrated health care systems for these children. We address this knowledge gap by exploring the perceptions and experiences of health care providers on the provision of health care for CMC aged 0 to 18 years. A qualitative research study was undertaken. Stakeholder forums, group and individual in depth interviews were undertaken using a semi-structured interview guide. The stakeholder forums were audio recorded and transcribed verbatim. Field notes of the stakeholder forums, group and individual interviews were taken. Inductive thematic analysis was undertaken to identify key themes. One hundred and three providers took part in the stakeholder forums and interviews across 3 local health districts, a tertiary paediatric hospital network, and primary health care organisations. Providers expressed concern regarding family capacity to negotiate the system, which was impacted by the medical complexity of the children and psychosocial complexity of their families. Lack of health care provider capacity in terms of their skills, time and availability to manage CMC was also a key problem. These issues occurred within a health system that had impaired capacity in terms of fragmentation of care and limited communication among health care providers. When designing integrated care models for CMC, it is essential to understand and address the challenges experienced by their health care providers. This requires adequate training of providers, additional resources and time for coordination of care, improved

  5. An European pupil project linked to the scientific aims of the experiment AQUARIUS-XENOPUS on the taxi Soyuz flight Andromede to ISS.

    Science.gov (United States)

    Dournon, Christian; Membre, Herve; Brohm, Pierre-Eric; Coince, Aurore; Cornu, Nathalie; Dreyer, Laura; Florentin, Jonathan; Jeanneau, Lydie; Henniquin, Camille; Houbre, Marie; Guerard, Marine; Lecomte, Nathalie; Maxant, Lorie; Schluraff, Marion; Venandet, Anne-Sophie; Jusyte, Aiste; Simmet, Dana; Bocking, Dominique; Flaig, Dorothee; Santak, Leo; Bolek, Steffen; Goppel, Verena; Rossignon, Jean-Paul; Trossat, Marie-Alice; Raux, Martine; Forster, Susanne; Staudenmaier, Gerd; Boser, Sybille; Horn, Eberhard

    2002-07-01

    The German-French biological experiment AQUARIUS-XENOPUS which flew on the Soyuz flight Andromede to the International Space Station ISS (launched October 21, 2001 in Baikonour/Kazakhstan) was extended by an outreach project. Pupils of class 10 to 12 from Ulm/D and Nancy-Tomblaine/F studied swimming behavior of Xenopus tadpoles on ground. They were instructed to perform all experimental steps following the protocol of similar video recordings on ISS. After the flight, they evaluated the kinetics of swimming of both ground controls and space animals. The pupil project included theoretical components to introduce them to the field of gravitational biology. One feature of the project was the exchange of ideas between pupils by meetings which took place in Ulm (June 2001), Nancy (February 2002) and Paris (May 2002). We consider our approach as a successful way to include young people in space experiments on a cheap cost level and to bring ideas of gravitational biology into the curricula of European schools.

  6. Family support and cardiac rehabilitation: a comparative study of the experiences of South Asian and White-European patients and their carer's living in the United Kingdom.

    Science.gov (United States)

    Astin, Felicity; Atkin, Karl; Darr, Aliya

    2008-03-01

    Effective lifestyle modification facilitated by cardiac rehabilitation is known to reduce the occurrence of adverse coronary events and mortality. South Asians have poorer outcomes after a myocardial infarction than the general UK population, but little is known about their experiences of family support, cardiac rehabilitation and lifestyle change. To explore the nature of family support available to a sample of South Asian and White-European cardiac patients and to highlight similarities and differences between these groups with regard to cardiac rehabilitation and lifestyle modification. Using a qualitative approach, semi-structured interviews (in 1 of 6 languages) were conducted by researchers with; 45 South Asian patients and 37 carers and 20 White-European patients and 17 carers. Interviews were conducted in a home setting, up to eighteen months after discharge from hospital following myocardial infarction, coronary artery bypass surgery or unstable angina. The main themes that emerged related to the provision of advice and information, family support and burden, dietary change and exercise regimes. Several cultural and ethnic differences were identified between patients and their families alongside similarities, irrespective of ethnicity. These may represent generic characteristics of recovery after a cardiac event. Health professionals should develop a cultural repertoire to engage with diversity and difference. Not every difficulty a person encounters as they try to access appropriate service delivery can be attributed to ethnic background. By improving services generally, support for South Asian populations can be improved. The challenge is to know when ethnicity makes a difference and mediates a person's relationship with service support and when it does not.

  7. Power imbalance and consumerism in the doctor-patient relationship: health care providers' experiences of patient encounters in a rural district in India.

    Science.gov (United States)

    Fochsen, Grethe; Deshpande, Kirti; Thorson, Anna

    2006-11-01

    The aim of this study is to explore health care providers' experiences and perceptions of their encounters with male and female patients in a rural district in India with special reference to tuberculosis (TB) care. The authors conducted semistructured interviews with 22 health care providers, 17 men and 5 women, from the public and private health care sectors. Findings reveal that doctors adopted an authoritarian as well as a consumerist approach in the medical encounter, indicating that power imbalances in the doctor-patient relationship are negotiable and subject to change. Gender was identified as an influencing factor of the doctor's dominance. A patient-centered approach, acknowledging patients' own experiences and shared decision making, is called for and should be included in TB control activities. This seems to be especially important for female patients, whose voices were not heard in the medical encounter.

  8. Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey

    OpenAIRE

    Warren, Fiona C; Abel, Gary; Lyratzopoulos, Georgios; Elliott, Marc N; Richards, Suzanne; Barry, Heather E; Roland, Martin; Campbell, John L

    2015-01-01

    Objective: To investigate the experience of users of out of hours general practitioner services in England, UK. Design: Population based cross sectional postal questionnaire survey. Setting: General Practice Patient Survey 2012-13. Main outcome measures: Potential associations between sociodemographic factors (including ethnicity and ability to take time away from work during working hours to attend a healthcare consultation) and provider organisation type (not for profit, NHS, or commercial)...

  9. Consumer providers' experiences of recovery and concerns as members of a psychiatric multidisciplinary outreach team: A qualitative descriptive study from the Japan Outreach Model Project 2011-2014.

    Directory of Open Access Journals (Sweden)

    Yoshifumi Kido

    Full Text Available The objective of this study was to clarify consumer providers (CPs subjective experiences as members of a psychiatric multidisciplinary outreach team that provided services to individuals with a mental illness living in the community.A qualitative descriptive study was conducted through semi-structured interviews. Participants were clients hired as CPs in the Japanese Outreach Model Project from September 2011 until March 2014. Of the seventeen CPs, nine participated in this study. We looked at the CPs' subjective experiences of fulfillment and difficulty.In the process of providing services, CPs experienced both achievements and concerns. They had a sense of achievement by caring for their clients and they experienced that they themselves were recovering. They were also concerned about having inadequate knowledge and skills to provide psychiatric services to their clients. Further, there were concerns about their dual role on the multidisciplinary team and being support staff while they were still using mental health services themselves.The results show that the activities of CPs included fulfillment, recovery, and dilemmas. Clarifications will likely contribute to an increase in understanding and cooperation between CPs and other professionals with whom they work. Further studies are needed to investigate policies related to mental health consumers who are also providers of mental health services.

  10. Receptor-mediated radiotherapy with Y-DOTA-DPhe-Tyr-octreotide: the experience of the European Institute of Oncology Group.

    Science.gov (United States)

    Chinol, Marco; Bodei, Lisa; Cremonesi, Marta; Paganelli, Giovanni

    2002-04-01

    High concentrations of subtype 2 somatostatin tumor receptors (sst(2)) are expressed in numerous tumors, enabling primary and metastatic masses to be localized by scintigraphy after injecting (111)In-labeled somatostatin analogue octreotide. In addition to neuroendocrine tumors, somatostatin receptors have been identified on cancers of the central nervous system, breast, lung, and lymphatic tissue, and the use of radionuclide-labeled somatostatin analogues appeared promising for therapy as well as for diagnosis of such malignancies. The somatostatin analogue [DOTA-(D)Phe(1)-Tyr(3)] octreotide (DOTATOC) possesses favorable characteristics for its potential therapeutic use in that it shows high affinity for sst(2), moderately high affinity for sst(5), and intermediate affinity for sst(3), high hydrophilicity, stable and facile labeling with (111)In and (90)Y. We began to investigate the potential therapeutic applications of (90)Y DOTATOC in 1997 by performing a thorough dosimetric study in 18 patients who were administered (111)In DOTATOC to estimate the absorbed doses during(90)Y-DOTATOC therapy. Then, we moved on and treated an overall number of 256 patients, mostly recruited in 2 distinct protocols with and without the administration of kidney protecting agents, with (90)Y DOTATOC. No major acute reactions were observed up to the activity of 5.55 GBq per cycle. The MTD per cycle was defined as 5.18 GBq. Objective therapeutic responses were documented in more than 20% of patients in terms of partial and complete responses. The present article reports in details our clinical experience (still ongoing) and outcomes with the use of (90)Y DOTATOC. Copyright 2002, Elsevier Science (USA). All rights reserved.

  11. European Institutions?

    NARCIS (Netherlands)

    Meacham, Darian

    2016-01-01

    The aim of this article is to sketch a phenomenological theory of political institutions and to apply it to some objections and questions raised by Pierre Manent about the project of the European Union and more specifically the question of “European Construction”, i.e. what is the aim of the

  12. European Whiteness?

    DEFF Research Database (Denmark)

    Blaagaard, Bolette

    2008-01-01

    Born out of the United States’ (U.S.) history of slavery and segregation and intertwined with gender studies and feminism, the field of critical whiteness studies does not fit easily into a European setting and the particular historical context that entails. In order for a field of European...

  13. Healthcare provider's attitude towards disability and experience of women with disabilities in the use of maternal healthcare service in rural Nepal.

    Science.gov (United States)

    Devkota, Hridaya Raj; Murray, Emily; Kett, Maria; Groce, Nora

    2017-06-29

    Women with disabilities are less likely to receive maternal healthcare services compared to women without disabilities. While few studies have reviewed healthcare experience of women with disabilities, no studies have been conducted to understand provider's attitude towards disability in Nepal, yet the attitude and behaviour of healthcare providers may have a significant influence on aspects of care and the use of service by women with disabilities. This study examines healthcare provider's attitudes towards disability and explores the experience of women with disabilities in maternal healthcare service utilization during pregnancy and childbirth. The study used mixed method approach. An attitude survey was conducted among 396 healthcare providers currently working in public health facilities in Rupandehi district of Nepal. For additional insight, eighteen in-depth interviews with women with disabilities who used maternal healthcare services in a healthcare facility within the study district in their last pregnancy were undertaken. The Attitude Towards Disabled Persons (ATDP) scale score was used to measure the attitudes of healthcare providers. For quantitative data, univariate and multivariate analysis using ANOVA was used to understand the association between outcome and independent variables and qualitative analysis generated and described themes. Mean ATDP score among healthcare providers (78.52; SD = 14.75), was low compared to the normative score of 100 or higher. Nurses/auxiliary nurse midwives obtained the highest mean score (85.59, SD = 13.45), followed by general clinical health workers (Mean score = 82.64, SD 15.10). The lowest score was obtained by Female Community Health Volunteers (FCHV) (Score = 73.75, SD = 13.40) (P women with disabilities. The mean score difference between those who received disability training and who did not was also found statistically insignificant (P > 0.05). This may reflect the small number of individuals

  14. The long path to pregnancy: early experience with dual anonymous gamete donation in a European in vitro fertilisation referral centre

    Directory of Open Access Journals (Sweden)

    Sills Eric

    2010-08-01

    Full Text Available Abstract Background This investigation describes features of patients undergoing in vitro fertilisation (IVF and embryo transfer (ET where both gametes were obtained from anonymous donors. Methods Gamete unsuitability or loss was confirmed in both members of seven otherwise healthy couples presenting for reproductive endocrinology consultation over a 12-month interval in Ireland. IVF was undertaken with fresh oocytes provided by anonymous donors in Ukraine; frozen sperm (anonymous donor was obtained from a licensed tissue establishment. For recipients, saline-enhanced sonography was used to assess intrauterine contour with endometrial preparation via transdermal estrogen. Results Among commissioning couples, mean±SD female and male age was 41.9 ± 3.7 and 44.6 ± 3.5 yrs, respectively. During this period, female age for non dual anonymous gamete donation IVF patients was 37.9 ± 3 yrs (p Conclusions Mean age of females undergoing dual anonymous donor gamete donation with IVF is significantly higher than the background IVF patient population. Even when neither partner is able to contribute any gametes for IVF, the clinical pregnancy rate per transfer can be satisfactory if both anonymous egg and sperm donation are used concurrently. Our report emphasises the role of pre-treatment counselling in dual anonymous gamete donation, and presents a coordinated screening and treatment approach in IVF where this option may be contemplated.

  15. Family participation during intensive care unit rounds: attitudes and experiences of parents and healthcare providers in a tertiary pediatric intensive care unit.

    Science.gov (United States)

    Stickney, Carolyn A; Ziniel, Sonja I; Brett, Molly S; Truog, Robert D

    2014-02-01

    To compare the experiences and attitudes of healthcare providers and parents regarding parental participation in morning rounds, in particular to evaluate for differences in perception of parental comprehension of rounds content and parental comfort with attendance, and to identify subgroups of parents who are more likely to report comfort with attending rounds. Cross-sectional survey of 100 parents and 131 healthcare providers in a tertiary care pediatric medical/surgical intensive care unit. Descriptive statistics were used to analyze survey responses; univariate and multivariate analyses were performed to compare parent and healthcare provider responses. Of parents, 92% reported a desire to attend rounds, and 54% of healthcare providers reported a preference for parental presence. There were significant discrepancies in perception of understanding between the 2 groups, with healthcare providers much less likely to perceive that parents understood both the format (30% vs 73%, P parents. Analysis of parent surveys did not reveal characteristics correlated with increased comfort or desire to attend rounds. A majority of parents wish to participate in morning rounds, whereas healthcare provider opinions are mixed. Important discrepancies exist between parent and healthcare provider perceptions of parental comfort and comprehension on rounds, which may be important in facilitating parental presence. Copyright © 2014 Mosby, Inc. All rights reserved.

  16. The European Location Framework - from National to European

    Science.gov (United States)

    Pauknerova, E.; Sidlichovsky, P.; Urbanas, S.; Med, M.

    2016-06-01

    EuroGeographics - their pan-European umbrella association, contribute to the ELF through an enrichment of data coverage. As a result, over 20 European countries will be covered with the ELF topo Base Map in 2016. Most countries will contribute also with other harmonized thematic data for viewing or down-loading. To overcome the heterogeneity of data resources and diversity of languages in tens of European countries, ELF builds on the existing INSPIRE rules and its own coordination and interoperability measures. ELF realisation empowers the implementation of INSPIRE in Europe and it complements related activities of European NMCAs, e.g. Czech Office for Surveying, Mapping and Cadastre (CUZK), which provides a large portfolio of spatial data/services and contributes significantly to the NSDI of Czech Republic. CUZK is also responsible for the Base Register of Territorial Identification, Addresses and Real Estates (RUIAN) - an important pillar of Czech e-Government. CUZK became an early-bird in implementing INSPIRE and it provides to the ELF a number of compliant datasets and web services. CUZK and the Polish NMCA (GUGiK) collaborate in the Central-European ELF Pilot (cluster) and test various cross-border prototypes. The presentation combines the national and crossborder view and experiences of CUZK and the European perspective of EuroGeographics.

  17. The long path to pregnancy: early experience with dual anonymous gamete donation in a European in vitro fertilisation referral centre

    LENUS (Irish Health Repository)

    Sills, Eric Scott

    2010-08-11

    Abstract Background This investigation describes features of patients undergoing in vitro fertilisation (IVF) and embryo transfer (ET) where both gametes were obtained from anonymous donors. Methods Gamete unsuitability or loss was confirmed in both members of seven otherwise healthy couples presenting for reproductive endocrinology consultation over a 12-month interval in Ireland. IVF was undertaken with fresh oocytes provided by anonymous donors in Ukraine; frozen sperm (anonymous donor) was obtained from a licensed tissue establishment. For recipients, saline-enhanced sonography was used to assess intrauterine contour with endometrial preparation via transdermal estrogen. Results Among commissioning couples, mean±SD female and male age was 41.9 ± 3.7 and 44.6 ± 3.5 yrs, respectively. During this period, female age for non dual anonymous gamete donation IVF patients was 37.9 ± 3 yrs (p < 0.001). Infertility duration was ≥3 yrs for couples enrolling in dual gamete donation, and each had ≥2 prior failed fertility treatments using native oocytes. All seven recipient couples proceeded to embryo transfer, although one patient had two transfers. Clinical pregnancy was achieved for 5\\/7 (71.4%) patients. Non-transferred cryopreserved embryos were available for all seven couples. Conclusions Mean age of females undergoing dual anonymous donor gamete donation with IVF is significantly higher than the background IVF patient population. Even when neither partner is able to contribute any gametes for IVF, the clinical pregnancy rate per transfer can be satisfactory if both anonymous egg and sperm donation are used concurrently. Our report emphasises the role of pre-treatment counselling in dual anonymous gamete donation, and presents a coordinated screening and treatment approach in IVF where this option may be contemplated.

  18. “The doctor said I didn’t look gay”: Young adults’ experiences of disclosure and non-disclosure of LGBTQ identity to healthcare providers

    Science.gov (United States)

    Rossman, Kinton; Salamanca, Paul; Macapagal, Kathryn

    2018-01-01

    Shifting cultural attitudes and legislation have increased focus on the healthcare needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients. However, patient non-disclosure of LGBTQ identity creates a barrier to accessing care. This study examined a diverse sample of LGBTQ young adults and their experiences of disclosure and non-disclosure to medical providers. Participants (N = 206, age range 18–27) completed questionnaires assessing healthcare access and use as part of a larger study. Participants’ responses to open-ended items asking about experiences of LGBTQ identity disclosure to medical providers and reasons for non-disclosure were analyzed thematically. Results revealed intra- and interpersonal factors related to patient disclosure. Reasons for participant non-disclosure included providers not asking about identity, internalized stigma, and belief that health and LGBTQ identity are not related. When participants did disclose, they experienced reactions ranging from discrimination and disbelief to affirmation and respect. Findings confirm and extend previous research on young adults’ identity disclosure and provide avenues continuing education for health professionals working with LGBTQ patients. PMID:28459379

  19. European 'Stabilisation through Association'

    DEFF Research Database (Denmark)

    Rodt, Annemarie Peen

    In 2012 the Nobel Committee awarded the European Union (EU) its Peace Prize. It commemorated the building and sustaining of peace between Europeans, a process in which the Nobel Committee proposed that the EU and its predecessors had played an important part. It explicitly commen-ded the Union......’s success in repeatedly reconciling a divided continent and complemented its efforts to build peace beyond its borders. But does the EU (continue to) deserve such praise? This contribution examines European peacebuilding from the early inte-gration of post-World War Two economies, through the uniting...... of Europe after the Cold War to contemporary conflict management efforts in the Western Balkans and the Eastern neighbourhood. The purpose of this endeavour is to examine whether lessons from the European experience can be observed that may facilitate future regional stabilisation processes – within...

  20. Experiences with disclosure of HIV-positive status to the infected child”: Perspectives of healthcare providers in Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Adellah Sariah

    2016-10-01

    Full Text Available Abstract Background The specific age to which an HIV infected child can be disclosed to is stipulated to begin between ages 4 and 6 years. It has also been documented that before disclosure of HIV positive status to the infected child. Health care providers should consider children’s cognitive-developmental ability. However, observation and situation analysis show that, health care providers still feel uncomfortable disclosing the HIV positive status to the infected child. The aim of the study was to explore healthcare providers’ experiences in disclosure of HIV-positive status to the infected child. Methods A qualitative study involving 20 health care providers who attend HIV-positive children was conducted in September, 2014 in Dar es Salaam, Tanzania. Participants were selected from ten HIV care and treatment clinics (CTC by purposive sampling. An interview guide, translated into participants’ national language (Kiswahili was used during in-depth interviews. Sampling followed the principle of data saturation. The interviews focused on perspectives of health-care providers regarding their experience with paediatric HIV disclosure. Data from in-depth interviews were transcribed into text; data analysis followed qualitative content analysis. Results The results show how complex the process of disclosure to children living with HIV can be to healthcare providers. Confusion was noted among healthcare providers about their role and responsibility in the process of disclosing to the HIV infected child. This was reported to be largely due to unclear guidelines and lack of standardized training in paediatric HIV disclosure. Furthermore, healthcare providers were concerned about parental hesitancy to disclose early to the child due to lack of disclosure skills and fear of stigma. In order to improve the disclosure process in HIV infected children, healthcare providers recommended further standardized training on paediatric HIV disclosure with

  1. Tailoring a family-based alcohol intervention for Aboriginal Australians, and the experiences and perceptions of health care providers trained in its delivery.

    Science.gov (United States)

    Calabria, Bianca; Clifford, Anton; Rose, Miranda; Shakeshaft, Anthony P

    2014-04-07

    Aboriginal Australians experience a disproportionately high burden of alcohol-related harm compared to the general Australian population. Alcohol treatment approaches that simultaneously target individuals and families offer considerable potential to reduce these harms if they can be successfully tailored for routine delivery to Aboriginal Australians. The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are two related interventions that are consistent with Aboriginal Australians' notions of health and wellbeing. This paper aims to describe the process of tailoring CRA and CRAFT for delivery to Aboriginal Australians, explore the perceptions of health care providers participating in the tailoring process, and their experiences of participating in CRA and CRAFT counsellor certification. Data sources included notes recorded from eight working group meetings with 22 health care providers of a drug and alcohol treatment agency and Aboriginal Community Controlled Health Service (November 2009-February 2013), and transcripts of semi-structured interviews with seven health care providers participating in CRA and CRAFT counsellor certification (May 2012). Qualitative content analysis was used to categorise working group meeting notes and interview transcripts were into key themes. Modifying technical language, reducing the number of treatment sessions, and including an option for treatment of clients in groups, were key recommendations by health care providers for improving the feasibility and applicability of delivering CRA and CRAFT to Aboriginal Australians. Health care providers perceived counsellor certification to be beneficial for developing their skills and confidence in delivering CRA and CRAFT, but identified time constraints and competing tasks as key challenges. The tailoring process resulted in Aboriginal Australian-specific CRA and CRAFT resources. The process also resulted in the training and certification of

  2. Spinning cylinder experiments SC-I and SC-II: A review of results and analyses provided to the FALSIRE project

    International Nuclear Information System (INIS)

    Morland, E.; Sherry, A.H.

    1993-01-01

    A series of six large-scale experiments have been carried out at AEA Technology using the Spinning Cylinder test facility. Results from two of those experiments (SC-I and SC-II) have been provided to Project FALSIRE and are reviewed in this paper. The Spinning Cylinder tests were carried out using hollow cylinders of 1.4m outer diameter, 0.2m wall thickness and 1.3m length, containing full-length axial defects and fabricated from a modified A508 Class 3 steel. The first Spinning Cylinder test (SC-I) was an investigation of stable ductile growth induced via mechanical (primary) loading and under conditions of contained yielding. Mechanical loading was provided in the hoop direction by rotating the cylinder about its major axis within an enclosed oven. The second test (SC-II) investigated stable ductile growth under severe thermal shock (secondary) loading again under conditions of contained yielding. In this case thermal shock was produced by spraying cold water on the inside surface of the heated cylinder whilst it was rotating. For each experiment, results are presented in terms of a number of variables, eg. crack growth, temperature, stress, strain and applied K and J. In addition, an overview of the analyses of the FALSIRE Phase-1 report is also presented with respect to test SC-I and SC-II. 4 refs., 14 figs., 13 tabs

  3. Selective Europeanization

    DEFF Research Database (Denmark)

    Hoch Jovanovic, Tamara; Lynggaard, Kennet

    2014-01-01

    and rules. The article examines the reasons for both resistance and selectiveness to Europeanization of the Danish minority policy through a “path dependency” perspective accentuating decision makers’ reluctance to deviate from existing institutional commitments, even in subsequently significantly altered...... political contexts at the European level. We further show how the “translation” of international norms to a domestic context has worked to reinforce the original institutional setup, dating back to the mid-1950s