WorldWideScience

Sample records for global clinical process

  1. Visual form-processing deficits: a global clinical classification.

    Science.gov (United States)

    Unzueta-Arce, J; García-García, R; Ladera-Fernández, V; Perea-Bartolomé, M V; Mora-Simón, S; Cacho-Gutiérrez, J

    2014-10-01

    Patients who have difficulties recognising visual form stimuli are usually labelled as having visual agnosia. However, recent studies let us identify different clinical manifestations corresponding to discrete diagnostic entities which reflect a variety of deficits along the continuum of cortical visual processing. We reviewed different clinical cases published in medical literature as well as proposals for classifying deficits in order to provide a global perspective of the subject. Here, we present the main findings on the neuroanatomical basis of visual form processing and discuss the criteria for evaluating processing which may be abnormal. We also include an inclusive diagram of visual form processing deficits which represents the different clinical cases described in the literature. Lastly, we propose a boosted decision tree to serve as a guide in the process of diagnosing such cases. Although the medical community largely agrees on which cortical areas and neuronal circuits are involved in visual processing, future studies making use of new functional neuroimaging techniques will provide more in-depth information. A well-structured and exhaustive assessment of the different stages of visual processing, designed with a global view of the deficit in mind, will give a better idea of the prognosis and serve as a basis for planning personalised psychostimulation and rehabilitation strategies. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  2. PET and diagnostic technology evaluation in a global clinical process. DGN's point of view

    International Nuclear Information System (INIS)

    Kotzerke, J.; Dietlein, M.; Gruenwald, F.; Bockisch, A.

    2010-01-01

    malignancies will be improved continuously. It is the claim of the health insurances to implement innovative therapeutic approaches in controlled clinical trials with tools of quality control. The monitoring committee is responsible for the safety of the patients. PET is part of the health care. Internationally accepted rules for clinical trials stipulate that any interim analyses of those trials are confidential as long as recruitment is active. The delay until evidence is documented by the published final analysis is methodologically accepted and not a characteristic of PET. (7) Procedures in nuclear medicine without the use of PET-tracers with short half-life will increase the radiation exposure of the patients; the use of non-PET-tracers with longer half-life is in contravention of the German regulation of radiation protection. (orig.)

  3. Clinical Process Intelligence

    DEFF Research Database (Denmark)

    Vilstrup Pedersen, Klaus

    2006-01-01

    .e. local guidelines. From a knowledge management point of view, this externalization of generalized processes, gives the opportunity to learn from, evaluate and optimize the processes. "Clinical Process Intelligence" (CPI), will denote the goal of getting generalized insight into patient centered health...

  4. Global economic processes and Ukraine

    Directory of Open Access Journals (Sweden)

    Svitlana Radzievska

    2014-02-01

    Full Text Available The paper presents main trends in global economic development and impact thereof on Ukraine. A characteristic feature of the contemporary world is acceleration of globalization caused by achievements of the scientific and technological progress, which have provided technical means for successful overcoming the factors of time and space, whereby making the world more compact and ensuring the possibility of functioning as a single economic mechanism. Growing of opportunities for solving global problems is accompanied by aggravation of the latter such as: population growth, depletion of natural resources, deterioration of the environment, the mounting danger of climatic changes, potential failure to provide people with foods and potable water. Growth of social inequality in the world is also observed, as is increased differentiation of population by income level, which intensifies migration processes and thereby creates new problems related to coexistence of people belonging to different civilizations, cultures and value systems. An integral part of globalization is formation of regional associations which requires Ukraine to participate in this phase of globalization by means of becoming a member of a regional integration association with the purpose of improving its competitiveness and ensuring decent living for Ukrainian people under conditions of humanity functioning as a single planetary organism

  5. PET and diagnostic technology evaluation in a global clinical process. DGN's point of view

    Energy Technology Data Exchange (ETDEWEB)

    Kotzerke, J. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Dresden (Germany); Dietlein, M. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Koeln (Germany); Gruenwald, F. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Frankfurt am Main (Germany); Bockisch, A. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Essen (Germany)

    2010-07-01

    therapy of malignancies will be improved continuously. It is the claim of the health insurances to implement innovative therapeutic approaches in controlled clinical trials with tools of quality control. The monitoring committee is responsible for the safety of the patients. PET is part of the health care. Internationally accepted rules for clinical trials stipulate that any interim analyses of those trials are confidential as long as recruitment is active. The delay until evidence is documented by the published final analysis is methodologically accepted and not a characteristic of PET. (7) Procedures in nuclear medicine without the use of PET-tracers with short half-life will increase the radiation exposure of the patients; the use of non-PET-tracers with longer half-life is in contravention of the German regulation of radiation protection. (orig.)

  6. Global tree network for computing structures enabling global processing operations

    Science.gov (United States)

    Blumrich; Matthias A.; Chen, Dong; Coteus, Paul W.; Gara, Alan G.; Giampapa, Mark E.; Heidelberger, Philip; Hoenicke, Dirk; Steinmacher-Burow, Burkhard D.; Takken, Todd E.; Vranas, Pavlos M.

    2010-01-19

    A system and method for enabling high-speed, low-latency global tree network communications among processing nodes interconnected according to a tree network structure. The global tree network enables collective reduction operations to be performed during parallel algorithm operations executing in a computer structure having a plurality of the interconnected processing nodes. Router devices are included that interconnect the nodes of the tree via links to facilitate performance of low-latency global processing operations at nodes of the virtual tree and sub-tree structures. The global operations performed include one or more of: broadcast operations downstream from a root node to leaf nodes of a virtual tree, reduction operations upstream from leaf nodes to the root node in the virtual tree, and point-to-point message passing from any node to the root node. The global tree network is configurable to provide global barrier and interrupt functionality in asynchronous or synchronized manner, and, is physically and logically partitionable.

  7. Cosmoglobalistics: Interrelation of Global and Cosmic Processes

    Directory of Open Access Journals (Sweden)

    Ursul Tatiana

    2014-03-01

    Full Text Available The paper develops the concept antropogeocosmizm, emanating from the fact that the main purpose of space activity in the short term is the historical use of space to solve global problems and in the long term socio-natural transition to the sustainable development of the planet. In this study based on the ideological origins and formation of a new direction and globalization, exploring the relationship of global and cosmic factors, the impact of the latter on the development of global processes and systems, the problem of space on the planet and escalating global processes in space. It is about the relationship of space and planetary processes, the transformation of the global response to space activities (and their interaction, and global development in the cosmic evolution. Taken as the position that global studies examining global processes and systems, and global processes are understood by the natural, social and socio-natural processes unfolding on planet Earth and have evolutionary significance. It is shown that global processes and issues affecting the world at large, is to some extent a manifestation of the global-space character of the contradictions associated with the expansion of spatial boundaries of human activity, including the conquest of space. Special attention is paid to the potential global catastrophes and geospatial software security. Considering the introduction of a substantive field cosmoglobalistiks natural processes, prospects globally exoplanet space research, as well as "global methodology" search for extraterrestrial intelligence. We consider the discovery of dark matter forms that give rise to a very substantial transformation attitude and stimulate the formation of global-cosmological research, which will consider mainly the global characteristics of matter, manifested in three main fragments of the Universe.

  8. Global Software Engineering: A Software Process Approach

    Science.gov (United States)

    Richardson, Ita; Casey, Valentine; Burton, John; McCaffery, Fergal

    Our research has shown that many companies are struggling with the successful implementation of global software engineering, due to temporal, cultural and geographical distance, which causes a range of factors to come into play. For example, cultural, project managementproject management and communication difficulties continually cause problems for software engineers and project managers. While the implementation of efficient software processes can be used to improve the quality of the software product, published software process models do not cater explicitly for the recent growth in global software engineering. Our thesis is that global software engineering factors should be included in software process models to ensure their continued usefulness in global organisations. Based on extensive global software engineering research, we have developed a software process, Global Teaming, which includes specific practices and sub-practices. The purpose is to ensure that requirements for successful global software engineering are stipulated so that organisations can ensure successful implementation of global software engineering.

  9. Miniaturization and globalization of clinical laboratory activities.

    Science.gov (United States)

    Melo, Murilo R; Clark, Samantha; Barrio, Daniel

    2011-04-01

    Clinical laboratories provide an invaluable service to millions of people around the world in the form of quality diagnostic care. Within the clinical laboratory industry the impetus for change has come from technological development (miniaturization, nanotechnology, and their collective effect on point-of-care testing; POCT) and the increasingly global nature of laboratory services. Potential technological gains in POCT include: the development of bio-sensors, microarrays, genetics and proteomics testing, and enhanced web connectivity. In globalization, prospective opportunities lie in: medical tourism, the migration of healthcare workers, cross-border delivery of testing, and the establishment of accredited laboratories in previously unexplored markets. Accompanying these impressive opportunities are equally imposing challenges. Difficulty transitioning from research to clinical use, poor infrastructure in developing countries, cultural differences and national barriers to global trade are only a few examples. Dealing with the issues presented by globalization and the impact of developing technology on POCT, and on the clinical laboratory services industry in general, will be a daunting task. Despite such concerns, with appropriate countermeasures it will be possible to address the challenges posed. Future laboratory success will be largely dependent on one's ability to adapt in this perpetually shifting landscape.

  10. Global trends in radiation processing

    International Nuclear Information System (INIS)

    Defalco, Gerry

    2002-01-01

    A global leader in radioisotope technology with three business units: - Nuclear Medicine supplies about two-thirds of the world requirements for molybdenum-99 and other isotopes used to diagnose disease - Radiation Therapy business unit supplied more than over 2,300 cobalt cancer treatment machines and is a leader in treatment planning - Ion Technologies is the world's leading supplier of cobalt 60 and innovative gamma irradiation systems About Ion Technologies · Supply over 70% of world's cobalt-60 sources · Custom-designed and built irradiation systems · Comprehensive engineering, physics, logistics, installation and marketing services · Canadian Irradiation Center for unique 'hands on' training, R and D product irradiation

  11. The global conduct of cancer clinical trials: challenges and opportunities.

    Science.gov (United States)

    Barrios, Carlos H; Werutsky, Gustavo; Martinez-Mesa, Jeovany

    2015-01-01

    The nature of clinical research has changed substantially over the last 2 decades, evolving from being centered almost exclusively in developed countries to a more global scenario that is increasingly involving less developed regions of the world. Pharmaceutical companies and some academic cooperative groups have been conducting challenging, large pivotal registration studies with multinational participation. The much more needed globalization of academic research demands particular attention and represents a worthwhile subject for a more profound discussion. The requirement of large sample sizes and the potential for fast recruitment leading to a speedy completion of clinical studies are probably the most important factors that have fueled globalization of studies. Reduced operational costs and the ability to expedite the regulatory approval of drugs in various countries or regions are also important drivers. Globalization of research should be seen as having a much wider effect in the societies involved, in particular, when we consider public health, economic, social, and ethical implications. Most importantly, the process of expanding the network of clinical research sites also fosters the integration and the development of closer relationships among investigators at a global level. We consider this an essential element that should remain a prominent element in the discussion. In this article, we address the underlying reasons for globalization and we highlight some of the scientific and ethical concerns arising as a consequence. Finally, some strategies to address and mitigate the challenges of conducting multinational clinical research are proposed.

  12. Export Processing Zones and Global Class Formation

    NARCIS (Netherlands)

    Neveling, Patrick

    2015-01-01

    This chapter is concerned with one of the most striking developments in the global political economy of capitalism after the Second World War; the rise of export processing zones and special economic zones. Building on long-term ethnohistorical research on the zones’ global spread from one zone in

  13. Global trends in radiation processing

    International Nuclear Information System (INIS)

    Defalco, G.

    2003-01-01

    There will be a brief introduction of the companies of MDS serving the Medical, Biotechnology and Pharmaceutical sectors worldwide. MDS Nordion will be introduced in more detail focused on the products and services of our Nuclear Medicine and Ion Technologies business units. World Trends and issues in Radiation Processing will be discussed on: Sterilization of Medical Devices, Pharmaceuticals, Cosmetics and Consumer products and finally I will present an overview on Food Irradiation progress worldwide

  14. EUROPEAN UNION AND THE PROCESS OF GLOBALIZATION

    Directory of Open Access Journals (Sweden)

    Mihail CARADAICĂ

    2014-05-01

    Full Text Available What is the relation between globalization and the process of European integration? Does the European integration have its own way, or is it deeply dependent on globalization? Those are the main questions I will try to answer in this paper by using an alternative critical approach: neo-gramscianism. Neo-gramscianism is a historical materialist view on the European integration process and international political economy which offers a better understanding of the social changes in terms of social forces agency and super structural influence (the neoliberal ideology of globalization and European integration. My aim is to analyze the globalization process through a neo-gramscian theoretical framework and to observe how its main components affect European Integration. I will do this by assuming the definition of globalization provided by Andreas Bieler, who understands this process through three main pillars: transnationalization of finance, transnationalization of production and ideological shift from Keynesianism to neoliberalism. Finally I will try to formulate some conclusions regarding the emergence of European Round Table of Industrialists – the first lobby group of big capital at the European Union level – and Economic and Monetary Union – the internal market program that symbolizes the shift to neo-liberalism.

  15. Multi-regional clinical trials and global drug development

    Directory of Open Access Journals (Sweden)

    Premnath Shenoy

    2016-01-01

    Full Text Available Drug development has been globalized, and multi-regional clinical trial (MRCT for regulatory submission has widely been conducted by many discovery based global pharmaceutical companies with the objective of reducing the time lag of launch in key markets and improve patient access to new and innovative treatments. Sponsors are facing several challenges while conducting multiregional clinical trials. Challenges under the heads statistics, clinical, regulatory operational, and ethics have been discussed. Regulators in different countries such as USA, EU-Japan, and China have issued guidance documents in respect of MRCT's. Lack of harmonization in the design and planning of MRCT is perceived to create a difficult situation to sponsors adversely affecting progressing MRCT in more and more discoveries. International conference on hormonisation (ICH has initiated the process for having a harmonized guidance document on MRCT. This document is likely to be issued in early 2017.

  16. Romanian Insurance Market Facing Globalization Process

    Directory of Open Access Journals (Sweden)

    Dumitru G. Badea

    2008-09-01

    Full Text Available The Romanian insurance market has passed through a permanent process of growth which ended up in 2004 to exceed the threshold of 1 billion Euros, in the frame of a small awareness and confidence of the population towards insurance, even now after 15 years. The globalization process of the financial markets affected also the Romanian market even before Romania became member of the European Union. The globalization brought about benefits (especially under the form of increase in the quality of the services provided to clients but also disadvantages for local companies (significant costs in logistics and training in order to cope with the international groups.

  17. Global processing takes time: A meta-analysis on local-global visual processing in ASD

    OpenAIRE

    Van der Hallen, Ruth; Evers, Kris; Brewaeys, K.; Van Den Noortgate, Wim; Wagemans, Johan

    2015-01-01

    What does an individual with autism spectrum disorder (ASD) perceive first: the forest or the trees? In spite of 30 years of research and influential theories like the weak central coherence (WCC) theory and the enhanced perceptual functioning (EPF) account, the interplay of local and global visual processing in ASD remains only partly understood. Research findings vary in indicating a local processing bias or a global processing deficit, and often contradict each other. We have applied a for...

  18. Spherical Process Models for Global Spatial Statistics

    KAUST Repository

    Jeong, Jaehong

    2017-11-28

    Statistical models used in geophysical, environmental, and climate science applications must reflect the curvature of the spatial domain in global data. Over the past few decades, statisticians have developed covariance models that capture the spatial and temporal behavior of these global data sets. Though the geodesic distance is the most natural metric for measuring distance on the surface of a sphere, mathematical limitations have compelled statisticians to use the chordal distance to compute the covariance matrix in many applications instead, which may cause physically unrealistic distortions. Therefore, covariance functions directly defined on a sphere using the geodesic distance are needed. We discuss the issues that arise when dealing with spherical data sets on a global scale and provide references to recent literature. We review the current approaches to building process models on spheres, including the differential operator, the stochastic partial differential equation, the kernel convolution, and the deformation approaches. We illustrate realizations obtained from Gaussian processes with different covariance structures and the use of isotropic and nonstationary covariance models through deformations and geographical indicators for global surface temperature data. To assess the suitability of each method, we compare their log-likelihood values and prediction scores, and we end with a discussion of related research problems.

  19. Globalization and Integration Processes in Europe

    Directory of Open Access Journals (Sweden)

    Beti Godnič

    2017-03-01

    Full Text Available Research Question (RQ: In the article we highlight the issue of whether Integration processes in the European Union are only a manifestation of these Globalization processes and if there are differences in the the old member States EU (15 and the new EU member states in changed micro and macro environment? Purpose: We wanted to determine how the old member States EU (15 and the new EU member states adapt to the new circumstances and other changes in the micro and macro environment. Method: Analysing complexity of the changes of the state of economic system, and complex fundamental global processes, which have been occurred in long period of time, need to supplement the pure scientific approach with other types of research work, more holistic approach, which is commonly used in Comparative economics. We have taken such an approach in this article. Results: In the article we studied the geopolitical changes in the micro and macro environment. We found that the development in the old EU member states EU-15 and in the new EU member states is different. EU havent addopted the harmonised economic policy which will solve the »North-South« problem and cross-state cultural consensus and find a way to operate systemically in global environment. Organization: The findings can be used to support undestanding of micro and macro envirnment of the companys and contribute for better strategic planning and design of the entire supply chain. Society: The findings can contribute to better understanding of integrative processes in the EU. Limitations/Future Research: The complexity of the problem and the dynamic changes in the functioning of the global market requires in-depth studiying of changes in the micro and macro environment of logistics companie

  20. Global processing takes time: A meta-analysis on local-global visual processing in ASD.

    Science.gov (United States)

    Van der Hallen, Ruth; Evers, Kris; Brewaeys, Katrien; Van den Noortgate, Wim; Wagemans, Johan

    2015-05-01

    What does an individual with autism spectrum disorder (ASD) perceive first: the forest or the trees? In spite of 30 years of research and influential theories like the weak central coherence (WCC) theory and the enhanced perceptual functioning (EPF) account, the interplay of local and global visual processing in ASD remains only partly understood. Research findings vary in indicating a local processing bias or a global processing deficit, and often contradict each other. We have applied a formal meta-analytic approach and combined 56 articles that tested about 1,000 ASD participants and used a wide range of stimuli and tasks to investigate local and global visual processing in ASD. Overall, results show no enhanced local visual processing nor a deficit in global visual processing. Detailed analysis reveals a difference in the temporal pattern of the local-global balance, that is, slow global processing in individuals with ASD. Whereas task-dependent interaction effects are obtained, gender, age, and IQ of either participant groups seem to have no direct influence on performance. Based on the overview of the literature, suggestions are made for future research. (c) 2015 APA, all rights reserved).

  1. Coalition for Global Clinical Surgical Education: The Alliance for Global Clinical Training.

    Science.gov (United States)

    Graf, Jahanara; Cook, Mackenzie; Schecter, Samuel; Deveney, Karen; Hofmann, Paul; Grey, Douglas; Akoko, Larry; Mwanga, Ali; Salum, Kitembo; Schecter, William

    Assessment of the effect of the collaborative relationship between the high-income country (HIC) surgical educators of the Alliance for Global Clinical Training (Alliance) and the low-income country surgical educators at the Muhimbili University of Health and Allied Sciences/Muhimbili National Hospital (MUHAS/MNH), Dar Es Salaam, Tanzania, on the clinical global surgery training of the HIC surgical residents participating in the program. A retrospective qualitative analysis of Alliance volunteer HIC faculty and residents' reports, volunteer case lists and the reports of Alliance academic contributions to MUHAS/MNH from 2012 to 2017. In addition, a survey was circulated in late 2016 to all the residents who participated in the program since its inception. Twelve HIC surgical educators provided rotating 1-month teaching coverage at MUHAS/MNH between academic years 2012 and 2017 for a total of 21 months. During the same time period 11 HIC residents accompanied the HIC faculty for 1-month rotations. HIC surgery residents joined the MUHAS/MNH Department of Surgery, made significant teaching contributions, performed a wide spectrum of "open procedures" including hand-sewn intestinal anastomoses. Most had had either no or limited previous exposure to hand-sewn anastomoses. All of the residents commented that this was a maturing and challenging clinical rotation due to the complexity of the cases, the limited resources available and the ethical and emotional challenges of dealing with preventable complications and death in a resource constrained environment. The Alliance provides an effective clinical global surgery rotation at MUHAS/MNH for HIC Surgery Departments wishing to provide such an opportunity for their residents and faculty. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  2. Global Precipitation Responses to Land Hydrological Processes

    Science.gov (United States)

    Lo, M.; Famiglietti, J. S.

    2012-12-01

    Several studies have established that soil moisture increases after adding a groundwater component in land surface models due to the additional supply of subsurface water. However, impacts of groundwater on the spatial-temporal variability of precipitation have received little attention. Through the coupled groundwater-land-atmosphere model (NCAR Community Atmosphere Model + Community Land Model) simulations, this study explores how groundwater representation in the model alters the precipitation spatiotemporal distributions. Results indicate that the effect of groundwater on the amount of precipitation is not globally homogeneous. Lower tropospheric water vapor increases due to the presence of groundwater in the model. The increased water vapor destabilizes the atmosphere and enhances the vertical upward velocity and precipitation in tropical convective regions. Precipitation, therefore, is inhibited in the descending branch of convection. As a result, an asymmetric dipole is produced over tropical land regions along the equator during the summer. This is analogous to the "rich-get-richer" mechanism proposed by previous studies. Moreover, groundwater also increased short-term (seasonal) and long-term (interannual) memory of precipitation for some regions with suitable groundwater table depth and found to be a function of water table depth. Based on the spatial distributions of the one-month-lag autocorrelation coefficients as well as Hurst coefficients, air-land interaction can occur from short (several months) to long (several years) time scales. This study indicates the importance of land hydrological processes in the climate system and the necessity of including the subsurface processes in the global climate models.

  3. Global simulations of aerosol processing in clouds

    Directory of Open Access Journals (Sweden)

    C. Hoose

    2008-12-01

    Full Text Available An explicit and detailed representation of in-droplet and in-crystal aerosol particles in stratiform clouds has been introduced in the global aerosol-climate model ECHAM5-HAM. The new scheme allows an evaluation of the cloud cycling of aerosols and an estimation of the relative contributions of nucleation and collision scavenging, as opposed to evaporation of hydrometeors in the global aerosol processing by clouds. On average an aerosol particle is cycled through stratiform clouds 0.5 times. The new scheme leads to important changes in the simulated fraction of aerosol scavenged in clouds, and consequently in the aerosol wet deposition. In general, less aerosol is scavenged into clouds with the new prognostic treatment than what is prescribed in standard ECHAM5-HAM. Aerosol concentrations, size distributions, scavenged fractions and cloud droplet concentrations are evaluated and compared to different observations. While the scavenged fraction and the aerosol number concentrations in the marine boundary layer are well represented in the new model, aerosol optical thickness, cloud droplet number concentrations in the marine boundary layer and the aerosol volume in the accumulation and coarse modes over the oceans are overestimated. Sensitivity studies suggest that a better representation of below-cloud scavenging, higher in-cloud collision coefficients, or a reduced water uptake by seasalt aerosols could reduce these biases.

  4. Evidence of Reduced Global Processing in Autism Spectrum Disorder

    Science.gov (United States)

    Booth, Rhonda D. L.; Happé, Francesca G. E.

    2018-01-01

    Frith's original notion of 'weak central coherence' suggested that increased local processing in autism spectrum disorder (ASD) resulted from reduced global processing. More recent accounts have emphasised superior local perception and suggested intact global integration. However, tasks often place local and global processing in direct trade-off,…

  5. The Influence of the Internet on globalization process

    Directory of Open Access Journals (Sweden)

    Artur Borcuch

    2012-06-01

    Full Text Available We are being influenced by the rush of economic and social forces. Internet is perhaps the most visible aspect of globalization and in many ways its driving force. The process of globalization can be understood as the global reach of communications technology and capital movements. The globalization of financial markets means that the movement of exchange rates, interest rates, and stock prices in various countries are intimately interconnected. From the social point of view, globalization is changing the nature of global social relations. The aim of this article is to demonstrate (in a few examples, how does Internet affect the process of globalization?

  6. India's growing clinical research sector: opportunity for global companies.

    Science.gov (United States)

    Varawalla, Nermeen

    2007-06-01

    Backed by a compelling foundation of essential requirements necessary for effective clinical trial conduct, and aided by initiatives that address concerns of data quality, regulatory timelines and IP protection, the clinical development sector in India has experienced annual revenue growth rates of 25% in the past two to three years, and is poised to participate substantially in global drug development. As both clinical trial sponsors and CROs increase their research capabilities in India, the clinical development sector is facing challenges with staff resourcing and facilities. Existing initiatives in the clinical sector must continue, and further investment must be made by stakeholders to overcome the current limitations in sector growth. Furthermore, global organizations seeking to derive long-term sustainable revenue growth and competitive advantage in the global marketplace from their business units in India must establish an appropriate organizational culture and an effective intra-organizational and industry interface for their operations.

  7. The impact of colonial legacies and globalization processes on ...

    African Journals Online (AJOL)

    The impact of colonial legacies and globalization processes on forced migration in modern Africa. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... On its part, globalization is about pauperizing and victimizing more and more people ...

  8. Spherical Process Models for Global Spatial Statistics

    KAUST Repository

    Jeong, Jaehong; Jun, Mikyoung; Genton, Marc G.

    2017-01-01

    Statistical models used in geophysical, environmental, and climate science applications must reflect the curvature of the spatial domain in global data. Over the past few decades, statisticians have developed covariance models that capture

  9. Public action in the globalization process

    Directory of Open Access Journals (Sweden)

    Ion Bucur

    2007-12-01

    Full Text Available The types of public investments change from a stage to another. The state always had economical objectives, even if these were not so explicit. However, its role of economy manager developed in the postwar period. The intervention systems diversified and their manipulation becomes more and more frequent. The establishment of intervention types and mechanisms must submit to the requirements. The essential problem is not the global reduction of the state investment, but its efficiency increase. In the current age, the characteristics of a public action are conditioned by the effects of globalization on the state sovereignty, power and capacity. At the end of the past century, debates on this subject were the main focus of the mass media and they emphasized some profound dissensions regarding the nature and implications of globalization.

  10. GLOBALIZATION AND THE POTENTIAL FOR FROZEN POTATO PROCESSING IN MEXICO

    OpenAIRE

    Phillips, Jon C.

    1998-01-01

    An analysis of the potential for the establishment and survival of frozen potato processing in Mexico is provided. Tools used include demand analysis (including demographic data and elasticities) and Porter's competitive forces model. The process of globalization is reviewed, from an agribusiness perspective. Prepared for the "Globalization and Its (Dis) Contents: Multiple Perspectives" Conference held April 3-4, 1998, East Lansing, Michigan.

  11. Cultural Variations in Global versus Local Processing: A Developmental Perspective

    Science.gov (United States)

    Oishi, Shigehiro; Jaswal, Vikram K.; Lillard, Angeline S.; Mizokawa, Ai; Hitokoto, Hidefumi; Tsutsui, Yoshiro

    2014-01-01

    We conducted 3 studies to explore cultural differences in global versus local processing and their developmental trajectories. In Study 1 ("N" = 363), we found that Japanese college students were less globally oriented in their processing than American or Argentine participants. We replicated this effect in Study 2 ("N" =…

  12. Global Envelope Tests for Spatial Processes

    DEFF Research Database (Denmark)

    Myllymäki, Mari; Mrkvička, Tomáš; Grabarnik, Pavel

    2017-01-01

    Envelope tests are a popular tool in spatial statistics, where they are used in goodness-of-fit testing. These tests graphically compare an empirical function T(r) with its simulated counterparts from the null model. However, the type I error probability α is conventionally controlled for a fixed d......) the construction of envelopes for a deviation test. These new tests allow the a priori selection of the global α and they yield p-values. We illustrate these tests using simulated and real point pattern data....

  13. Global envelope tests for spatial processes

    DEFF Research Database (Denmark)

    Myllymäki, Mari; Mrkvička, Tomáš; Grabarnik, Pavel

    Envelope tests are a popular tool in spatial statistics, where they are used in goodness-of-fit testing. These tests graphically compare an empirical function T(r) with its simulated counterparts from the null model. However, the type I error probability α is conventionally controlled for a fixed......) the construction of envelopes for a deviation test. These new tests allow the a priori selection of the global α and they yield p-values. We illustrate these tests using simulated and real point pattern data....

  14. SOLVING GLOBAL PROBLEMS USING COLLABORATIVE DESIGN PROCESSES

    DEFF Research Database (Denmark)

    Lenau, Torben Anker; Mejborn, Christina Okai

    2011-01-01

    In this paper we argue that use of collaborative design processes is a powerful means of bringing together different stakeholders and generating ideas in complex design situations. The collaborative design process was used in a workshop with international participants where the goal was to propos...

  15. Clinical report writing: Process and perspective

    Science.gov (United States)

    Ewald, H. R.

    1981-01-01

    Clinical report writing in psychology and psychiatry is addressed. Audience/use analysis and the basic procedures of information gathering, diagnosis, and prognosis are described. Two interlinking processes are involved: the process of creation and the process of communication. Techniques for good report writing are presented.

  16. Laboratory and software applications for clinical trials: the global laboratory environment.

    Science.gov (United States)

    Briscoe, Chad

    2011-11-01

    The Applied Pharmaceutical Software Meeting is held annually. It is sponsored by The Boston Society, a not-for-profit organization that coordinates a series of meetings within the global pharmaceutical industry. The meeting generally focuses on laboratory applications, but in recent years has expanded to include some software applications for clinical trials. The 2011 meeting emphasized the global laboratory environment. Global clinical trials generate massive amounts of data in many locations that must be centralized and processed for efficient analysis. Thus, the meeting had a strong focus on establishing networks and systems for dealing with the computer infrastructure to support such environments. In addition to the globally installed laboratory information management system, electronic laboratory notebook and other traditional laboratory applications, cloud computing is quickly becoming the answer to provide efficient, inexpensive options for managing the large volumes of data and computing power, and thus it served as a central theme for the meeting.

  17. Regionalism and Economic Processes with Global Impact

    Directory of Open Access Journals (Sweden)

    Marina TABAC

    2016-06-01

    Full Text Available Regionalism has become one of the most discussed topics at the moment, in recent years and become one of the central challenges of the future in the modern system of international relations. Finally, in the XIX-XX centuries, scientists have expressed it a worldwide phenomenon through a process of radical change "external environment" and significant internal changes. It can be expressed in the world in one way or another, even if it has not been shown modest form until recently. Currently, regionalism and regional integration are considered as key indicators of international developments in the research of foreign policy and international relations. Theory followed the end of the era of "Cold War" and entered the post-bipolar world, multi-faceted development stage. The attention of researchers has grown to regionalization and regional integration by increasing the role and activities of regional organizations such as the EU, ASEAN, APEC and NAFTA, which coordinates the process of decision-making at supranational level, as well as issues of international regulation.

  18. Clinical processes in behavioral couples therapy.

    Science.gov (United States)

    Fischer, Daniel J; Fink, Brandi C

    2014-03-01

    Behavioral couples therapy is a broad term for couples therapies that use behavioral techniques based on principles of operant conditioning, such as reinforcement. Behavioral shaping and rehearsal and acceptance are clinical processes found across contemporary behavioral couples therapies. These clinical processes are useful for assessment and case formulation, as well as teaching couples new methods of conflict resolution. Although these clinical processes assist therapists in achieving efficient and effective therapeutic change with distressed couples by rapidly stemming couples' corrosive affective exchanges, they also address the thoughts, emotions, and issues of trust and intimacy that are important aspects of the human experience in the context of a couple. Vignettes are provided to illustrate the clinical processes described. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  19. Global/local processing style: Explaining the relationship between trait anxiety and binge eating.

    Science.gov (United States)

    Becker, Kendra R; Plessow, Franziska; Coniglio, Kathryn A; Tabri, Nassim; Franko, Debra L; Zayas, Lazaro V; Germine, Laura; Thomas, Jennifer J; Eddy, Kamryn T

    2017-11-01

    Anxiety is a risk factor for disordered eating, but the mechanisms by which anxiety promotes disordered eating are poorly understood. One possibility is local versus global cognitive processing style, defined as a relative tendency to attend to details at the expense of the "big picture." Anxiety may narrow attention, in turn, enhancing local and/or compromising global processing. We examined relationships between global/local processing style, anxiety, and disordered eating behaviors in a transdiagnostic outpatient clinical sample. We hypothesized that local (vs. global) processing bias would mediate the relationship between anxiety and disordered eating behaviors. Ninety-three participants completed the eating disorder examination-questionnaire (EDE-Q), State-Trait Anxiety Inventory (STAI)-trait subscale, and the Navon task (a test of processing style in which large letters are composed of smaller letters both congruent and incongruent with the large letter). The sample was predominantly female (95%) with a mean age of 27.4 years (SD = 12.1 years). Binge eating, but not fasting, purging, or excessive exercise, was correlated with lower levels of global processing style. There was a significant indirect effect between anxiety and binge eating via reduced global level global/local processing. In individuals with disordered eating, being more generally anxious may encourage a detailed-oriented bias, preventing individuals from maintaining the bigger picture and making them more likely to engage in maladaptive behaviors (e.g., binge eating). © 2017 Wiley Periodicals, Inc.

  20. Global/local processing style: Explaining the relationship between trait anxiety and binge eating

    Science.gov (United States)

    Becker, Kendra R.; Plessow, Franziska; Coniglio, Kathryn A.; Tabri, Nassim; Franko, Debra L; Zayas, Lazaro V.; Germine, Laura; Thomas, Jennifer J.; Eddy, Kamryn T.

    2018-01-01

    Objective Anxiety is a risk factor for disordered eating, but the mechanisms by which anxiety promotes disordered eating are poorly understood. One possibility is local versus global cognitive processing style, defined as a relative tendency to attend to details at the expense of the “big picture.” Anxiety may narrow attention, in turn, enhancing local and/or compromising global processing. We examined relationships between global/local processing style, anxiety, and disordered eating behaviors in a transdiagnostic outpatient clinical sample. We hypothesized that local (vs. global) processing bias would mediate the relationship between anxiety and disordered eating behaviors. Method Ninety-three participants completed the eating disorder examination—questionnaire (EDE-Q), State-Trait Anxiety Inventory (STAI)—trait subscale, and the Navon task (a test of processing style in which large letters are composed of smaller letters both congruent and incongruent with the large letter). The sample was predominantly female (95%) with a mean age of 27.4 years (SD = 12.1 years). Results Binge eating, but not fasting, purging, or excessive exercise, was correlated with lower levels of global processing style. There was a significant indirect effect between anxiety and binge eating via reduced global level global/local processing. Discussion In individuals with disordered eating, being more generally anxious may encourage a detailed-oriented bias, preventing individuals from maintaining the bigger picture and making them more likely to engage in maladaptive behaviors (e.g., binge eating). PMID:28963792

  1. Delayed processing of global shape information in developmental prosopagnosia

    DEFF Research Database (Denmark)

    Gerlach, Christian; Klargaard, Solja K.; Petersen, Anders

    2017-01-01

    individuals with DP in Navon’s paradigm we find evidence of a reduced global precedence effect: The DPs are slower than controls to process global but not local shape information. Importantly, and in contrast to previous studies, we demonstrate that the DPs perform normally in a comprehensive test of visual......There is accumulating evidence suggesting that a central deficit in developmental prosopagnosia (DP), a disorder characterized by profound and lifelong difficulties with face recognition, concerns impaired holistic processing. Some of this evidence comes from studies using Navon’s paradigm where...... individuals with DP show a greater local or reduced global bias compared with controls. However, it has not been established what gives rise to this altered processing bias. Is it a reduced global precedence effect, changes in susceptibility to interference effects or both? By analyzing the performance of 10...

  2. Process of globalization and basic traits of Serbian national character

    Directory of Open Access Journals (Sweden)

    Atlagić Marko

    2010-01-01

    Full Text Available In contemporary world globalization, along with many perplexities, increasingly takes on the universal/cosmopolitan character in spite of all geographical, national, racial, religious and alignment barriers. Information exchange, scientific achievements and technology are nowadays world process. Economy increasingly becomes global. Serbia and Serbian people have their own specific character, which is defined by three significant characteristics: sovereignty and territorial integrity, aspirations to social justice, the rule of people and democracy. The creators of global society should take into consideration these three important characteristics of Serbian people with which Serbian political elite is to familiarize them, for the sake of more rapid and complete process of integration of Serbs into global processes from both Serbia and its neighboring countries would benefit.

  3. Activating clinical trials: a process improvement approach.

    Science.gov (United States)

    Martinez, Diego A; Tsalatsanis, Athanasios; Yalcin, Ali; Zayas-Castro, José L; Djulbegovic, Benjamin

    2016-02-24

    The administrative process associated with clinical trial activation has been criticized as costly, complex, and time-consuming. Prior research has concentrated on identifying administrative barriers and proposing various solutions to reduce activation time, and consequently associated costs. Here, we expand on previous research by incorporating social network analysis and discrete-event simulation to support process improvement decision-making. We searched for all operational data associated with the administrative process of activating industry-sponsored clinical trials at the Office of Clinical Research of the University of South Florida in Tampa, Florida. We limited the search to those trials initiated and activated between July 2011 and June 2012. We described the process using value stream mapping, studied the interactions of the various process participants using social network analysis, and modeled potential process modifications using discrete-event simulation. The administrative process comprised 5 sub-processes, 30 activities, 11 decision points, 5 loops, and 8 participants. The mean activation time was 76.6 days. Rate-limiting sub-processes were those of contract and budget development. Key participants during contract and budget development were the Office of Clinical Research, sponsors, and the principal investigator. Simulation results indicate that slight increments on the number of trials, arriving to the Office of Clinical Research, would increase activation time by 11 %. Also, incrementing the efficiency of contract and budget development would reduce the activation time by 28 %. Finally, better synchronization between contract and budget development would reduce time spent on batching documentation; however, no improvements would be attained in total activation time. The presented process improvement analytic framework not only identifies administrative barriers, but also helps to devise and evaluate potential improvement scenarios. The strength

  4. Process and Impact of Globalization in Nepalese Women

    Directory of Open Access Journals (Sweden)

    Manju Sharma

    2015-12-01

    Full Text Available This paper explores the impact of globalization in Nepalese women. The changes on the women’s way of life due to globalization can be seen directly in the economy, media, IT sectors, various parts of society and ultimately in the culture. When the Nepalese women entered into the globalization process the Hindu norms and values of the society (where more than 82 percent are Hindu has creolized with the global way of life. The women are becoming more self- reliant and empowered due to globalization but at the same time they are entering more risky markets to fulfill the desires that floated by the globalization. Similarly, globalization has offered various employment opportunities and exposure in international arena, but it also creates mental anxiety, depression and sexual abuse for those remaining in or outside the country. As there is very limited research and study on the impact of globalization in the Nepalese society, it is too early to conclude the impact of globalization as good or bad on Nepalese women.

  5. Promotion of Scientific Literacy on Global Warming by Process Drama

    Science.gov (United States)

    Pongsophon, Pongprapan; Yutakom, Naruemon; Boujaoude, Saouma B.

    2010-01-01

    This project aims to investigate how process drama promotes scientific literacy in the context of global warming. Thirty-one lower (n = 24) and upper (n = 7) secondary students of one secondary school in Bangkok, Thailand participated in a seven-day workshop which process drama strategy was implemented. In the workshop, the students were actively…

  6. Re-Engineering Alzheimer Clinical Trials: Global Alzheimer's Platform Network.

    Science.gov (United States)

    Cummings, J; Aisen, P; Barton, R; Bork, J; Doody, R; Dwyer, J; Egan, J C; Feldman, H; Lappin, D; Truyen, L; Salloway, S; Sperling, R; Vradenburg, G

    2016-06-01

    Alzheimer's disease (AD) drug development is costly, time-consuming, and inefficient. Trial site functions, trial design, and patient recruitment for trials all require improvement. The Global Alzheimer Platform (GAP) was initiated in response to these challenges. Four GAP work streams evolved in the US to address different trial challenges: 1) registry-to-cohort web-based recruitment; 2) clinical trial site activation and site network construction (GAP-NET); 3) adaptive proof-of-concept clinical trial design; and 4) finance and fund raising. GAP-NET proposes to establish a standardized network of continuously funded trial sites that are highly qualified to perform trials (with established clinical, biomarker, imaging capability; certified raters; sophisticated management system. GAP-NET will conduct trials for academic and biopharma industry partners using standardized instrument versions and administration. Collaboration with the Innovative Medicines Initiative (IMI) European Prevention of Alzheimer's Disease (EPAD) program, the Canadian Consortium on Neurodegeneration in Aging (CCNA) and other similar international initiatives will allow conduct of global trials. GAP-NET aims to increase trial efficiency and quality, decrease trial redundancy, accelerate cohort development and trial recruitment, and decrease trial costs. The value proposition for sites includes stable funding and uniform training and trial execution; the value to trial sponsors is decreased trial costs, reduced time to execute trials, and enhanced data quality. The value for patients and society is the more rapid availability of new treatments for AD.

  7. Factors Contributing to Exacerbating Vulnerabilities in Global Clinical Trials

    Science.gov (United States)

    da Silva, Ricardo E.; Amato, Angélica A.; Guilhem, Dirce B.; de Carvalho, Marta R.; Lima, Elisangela da C.; Novaes, Maria Rita C. G.

    2018-01-01

    Background: Although policies and guidelines make use of the concept of vulnerability, few define it. The European Union's directive for clinical trials does not include explanations for or the reasoning behind the designation of certain groups as vulnerable. Emerging economies from lower middle-income countries have, in recent years, had the largest average annual growth rate, as well as increase, in number of clinical trials registered in the US government's database. Nevertheless, careful supervision of research activities has to be ensured. Objective: To describe and analyze the features of the clinical trials involving vulnerable populations in various countries classified by development status and geographic region. Methods: Retrospective study that involved analysis of data obtained from the International Clinical Trials Registry Platform (ICTRP) database between 01/2014 and 12/2014 from countries with (i) highest trial densities during 2005 to 2012, (ii) highest average growth rate in clinical trials, and (iii) greatest trial capabilities. Results: Statistical analysis of this study showed that patients incapable of giving consent personally are 11.4 times more likely to be vulnerable patients than patients who are capable, and that patients in upper-middle-income countries are 1.7 times more likely to be vulnerable patients than patients from high-income countries when participating in global clinical trials. Malaysia (21%), Egypt (20%), Turkey (19%), Israel (18%), and Brazil (17%) had the highest percentages of vulnerable populations involving children. Conclusions: Although the inability to provide consent personally was a factor associated with vulnerability, arbitrary criteria may have been considered when classifying the populations of clinical trials as vulnerable. The EU Clinical Trials Register should provide guidance regarding exactly what aspects or factors should be taken into account to frame given populations as vulnerable, because

  8. Non-communicable diseases and global health governance: enhancing global processes to improve health development.

    Science.gov (United States)

    Magnusson, Roger S

    2007-05-22

    This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO), World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control), but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health). The paper assesses the merits of the Millennium Development Goals (MDGs) and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy.

  9. Non-communicable diseases and global health governance: enhancing global processes to improve health development

    Directory of Open Access Journals (Sweden)

    Magnusson Roger S

    2007-05-01

    Full Text Available Abstract This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO, World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control, but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health. The paper assesses the merits of the Millennium Development Goals (MDGs and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy.

  10. Conceptualizing psychological processes in response to globalization: Components, antecedents, and consequences of global orientations.

    Science.gov (United States)

    Chen, Sylvia Xiaohua; Lam, Ben C P; Hui, Bryant P H; Ng, Jacky C K; Mak, Winnie W S; Guan, Yanjun; Buchtel, Emma E; Tang, Willie C S; Lau, Victor C Y

    2016-02-01

    The influences of globalization have permeated various aspects of life in contemporary society, from technical innovations, economic development, and lifestyles, to communication patterns. The present research proposed a construct termed global orientation to denote individual differences in the psychological processes of acculturating to the globalizing world. It encompasses multicultural acquisition as a proactive response and ethnic protection as a defensive response to globalization. Ten studies examined the applicability of global orientations among majority and minority groups, including immigrants and sojourners, in multicultural and relatively monocultural contexts, and across Eastern and Western cultures. Multicultural acquisition is positively correlated with both independent and interdependent self-construals, bilingual proficiency and usage, and dual cultural identifications. Multicultural acquisition is promotion-focused, while ethnic protection is prevention-focused and related to acculturative stress. Global orientations affect individuating and modest behavior over and above multicultural ideology, predict overlap with outgroups over and above political orientation, and predict psychological adaptation, sociocultural competence, tolerance, and attitudes toward ethnocultural groups over and above acculturation expectations/strategies. Global orientations also predict English and Chinese oral presentation performance in multilevel analyses and the frequency and pleasantness of intercultural contact in cross-lagged panel models. We discuss how the psychological study of global orientations contributes to theory and research on acculturation, cultural identity, and intergroup relations. (c) 2016 APA, all rights reserved).

  11. Living is information processing: from molecules to global systems

    OpenAIRE

    Farnsworth, Keith D.; Nelson, John; Gershenson, Carlos

    2012-01-01

    We extend the concept that life is an informational phenomenon, at every level of organisation, from molecules to the global ecological system. According to this thesis: (a) living is information processing, in which memory is maintained by both molecular states and ecological states as well as the more obvious nucleic acid coding; (b) this information processing has one overall function - to perpetuate itself; and (c) the processing method is filtration (cognition) of, and synthesis of, info...

  12. Collaboration in Global Software Engineering Based on Process Description Integration

    Science.gov (United States)

    Klein, Harald; Rausch, Andreas; Fischer, Edward

    Globalization is one of the big trends in software development. Development projects need a variety of different resources with appropriate expert knowledge to be successful. More and more of these resources are nowadays obtained from specialized organizations and countries all over the world, varying in development approaches, processes, and culture. As seen with early outsourcing attempts, collaboration may fail due to these differences. Hence, the major challenge in global software engineering is to streamline collaborating organizations towards a successful conjoint development. Based on typical collaboration scenarios, this paper presents a structured approach to integrate processes in a comprehensible way.

  13. Interocular suppression in amblyopia for global orientation processing.

    Science.gov (United States)

    Zhou, Jiawei; Huang, Pi-Chun; Hess, Robert F

    2013-04-22

    We developed a dichoptic global orientation coherence paradigm to quantify interocular suppression in amblyopia. This task is biased towards ventral processing and allows comparison with two other techniques-global motion processing, which is more dorsally biased, and binocular phase combination, which most likely reflects striate function. We found a similar pattern for the relationship between coherence threshold and interocular contrast curves (thresholds vs. interocular contrast ratios or TvRs) in our new paradigm compared with those of the previous dichoptic global motion coherence paradigm. The effective contrast ratios at balance point (where the signals from the two eyes have equal weighting) in our new paradigm were larger than those of the dichoptic global motion coherence paradigm but less than those of the binocular phase combination paradigm. The measured effective contrast ratios in the three paradigms were also positively correlated with each other, with the two global coherence paradigms having the highest correlation. We concluded that: (a) The dichoptic global orientation coherence paradigm is effective in quantifying interocular suppression in amblyopia; and (b) Interocular suppression, while sharing a common suppression mechanism at the early stage in the pathway (e.g., striate cortex), may have additional extra-striate contributions that affect both dorsal and ventral streams differentially.

  14. Development and Psychometric Evaluation of a Clinical Global Impression for Schizoaffective Disorder Scale

    OpenAIRE

    Allen, Michael H; Daniel, David G; Revicki, Dennis A; Canuso, Carla M; Turkoz, Ibrahim; Fu, Dong-Jing; Alphs, Larry; Ishak, K. Jack; Bartko, John J; Lindenmayer, Jean-Pierre

    2012-01-01

    Objective: The Clinical Global Impression for Schizoaffective Disorder scale is a new rating scale adapted from the Clinical Global Impression scale for use in patients with schizoaffective disorder. The psychometric characteristics of the Clinical Global Impression for Schizoaffective Disorder are described.

  15. Delayed processing of global shape in developmental prosopagnosia

    DEFF Research Database (Denmark)

    Gerlach, Christian; Klargaard, Solja K.; Starrfelt, Randi

    2017-01-01

    and fragmented objects. In contrast, their visual short-term memory capacity, visual processing speed, efficiency of top-down selectivity, and spatial allocation of attentional resources were within the normal range. This suggests that the reduced global bias effect found in the DP-sample reflects a perceptual...... 10 subjects with DP and 20 matched controls on Navon's paradigm with compound letters. We also assessed visual attention and object recognition in both groups. The DP-group exhibited a reduced global precedence effect compared with the control group. They were also impaired recognizing silhouette...... rather than an attentional deficit. To examine whether the reduction in the global precedence effect was systematically related to the face recognition impairment of the DPs we examined the correlation between the magnitude of the global precedence effect and performance on the Cambridge Face Memory Test...

  16. Automated radiochemical processing for clinical PET

    International Nuclear Information System (INIS)

    Padgett, H.C.; Schmidt, D.G.; Bida, G.T.; Wieland, B.W.; Pekrul, E.; Kingsbury, W.G.

    1991-01-01

    With the recent emergence of positron emission tomography (PET) as a viable clinical tool, there is a need for a convenient, cost-effective source of the positron emitter-labeled radiotracers labeled with carbon-11, nitrogen-13, oxygen-15, and fluorine-18. These short-lived radioisotopes are accelerator produced and thus, require a cyclotron and radiochemistry processing instrumentation that can be operated 3 in a clinical environment by competant technicians. The basic goal is to ensure safety and reliability while setting new standards for economy and ease of operation. The Siemens Radioisotope Delivery System (RDS 112) is a fully automated system dedicated to the production and delivery of positron-emitter labeled precursors and radiochemicals required to support a clinical PET imaging program. Thus, the entire RDS can be thought of as an automated radiochemical processing apparatus

  17. Impairment in local and global processing and set-shifting in body dysmorphic disorder

    Science.gov (United States)

    Kerwin, Lauren; Hovav, Sarit; Helleman, Gerhard; Feusner, Jamie D.

    2014-01-01

    Body dysmorphic disorder (BDD) is characterized by distressing and often debilitating preoccupations with misperceived defects in appearance. Research suggests that aberrant visual processing may contribute to these misperceptions. This study used two tasks to probe global and local visual processing as well as set shifting in individuals with BDD. Eighteen unmedicated individuals with BDD and 17 non-clinical controls completed two global-local tasks. The embedded figures task requires participants to determine which of three complex figures contained a simpler figure embedded within it. The Navon task utilizes incongruent stimuli comprised of a large letter (global level) made up of smaller letters (local level). The outcome measures were response time and accuracy rate. On the embedded figures task, BDD individuals were slower and less accurate than controls. On the Navon task, BDD individuals processed both global and local stimuli slower and less accurately than controls, and there was a further decrement in performance when shifting attention between the different levels of stimuli. Worse insight correlated with poorer performance on both tasks. Taken together, these results suggest abnormal global and local processing for non-appearance related stimuli among BDD individuals, in addition to evidence of poor set-shifting abilities. Moreover, these abnormalities appear to relate to the important clinical variable of poor insight. Further research is needed to explore these abnormalities and elucidate their possible role in the development and/or persistence of BDD symptoms. PMID:24972487

  18. The effect of sadness on global-local processing.

    Science.gov (United States)

    von Mühlenen, Adrian; Bellaera, Lauren; Singh, Amrendra; Srinivasan, Narayanan

    2018-05-04

    Gable and Harmon-Jones (Psychological Science, 21(2), 211-215, 2010) reported that sadness broadens attention in a global-local letter task. This finding provided the key test for their motivational intensity account, which states that the level of spatial processing is not determined by emotional valence, but by motivational intensity. However, their finding is at odds with several other studies, showing no effect, or even a narrowing effect of sadness on attention. This paper reports two attempts to replicate the broadening effect of sadness on attention. Both experiments used a global-local letter task, but differed in terms of emotion induction: Experiment 1 used the same pictures as Gable and Harmon-Jones, taken from the IAPS dataset; Experiment 2 used a sad video underlaid with sad music. Results showed a sadness-specific global advantage in the error rates, but not in the reaction times. The same null results were also found in a South-Asian sample in both experiments, showing that effects on global/local processing were not influenced by a culturally related processing bias.

  19. The communication process in clinical settings.

    Science.gov (United States)

    Mathews, J J

    1983-01-01

    The communication of information in clinical settings is fraught with problems despite avowed common aims of practitioners and patients. Some reasons for the problematic nature of clinical communication are incongruent frames of reference about what information ought to be shared, sociolinguistic differences and social distance between practitioners and patients. Communication between doctors and nurses is also problematic, largely due to differences in ideology between the professions about what ought to be communicated to patients about their illness and who is ratified to give such information. Recent social changes, such as the Patient Bill of Rights and informed consent which assure access to information, and new conceptualizations of the nurse's role, warrant continued study of the communication process especially in regard to what constitutes appropriate and acceptable information about a patient's illness and who ought to give such information to patients. The purpose of this paper is to outline characteristics of communication in clinical settings and to provide a literature review of patient and practitioner interaction studies in order to reflect on why information exchange is problematic in clinical settings. A framework for presentation of the problems employs principles from interaction and role theory to investigate clinical communication from three viewpoints: (1) the level of shared knowledge between participants; (2) the effect of status, role and ideology on transactions; and (3) the regulation of communication imposed by features of the institution.

  20. Global regulatory developments for clinical stem cell research: diversification and challenges to collaborations.

    Science.gov (United States)

    Rosemann, Achim; Bortz, Gabriela; Vasen, Federico; Sleeboom-Faulkner, Margaret

    2016-10-01

    In this article, we explore regulatory developments in stem cell medicine in seven jurisdictions: Japan, China, India, Argentina, Brazil, the USA and the EU. We will show that the research methods, ethical standards and approval procedures for the market use of clinical stem cell interventions are undergoing an important process of global diversification. We will discuss the implications of this process for international harmonization and the conduct of multicountry clinical research collaborations. It will become clear that the increasing heterogeneity of research standards and regulations in the stem cell field presents a significant challenge to international clinical trial partnerships, especially with countries that diverge from the regulatory models that have been developed in the USA and the EU.

  1. Creative Industries: Development Processes Under Contemporary Conditions of Globalization

    Directory of Open Access Journals (Sweden)

    Valerija Kontrimienė

    2017-06-01

    Full Text Available The article deals with the processes of developing creative industries under conditions of a growth in the worldwide economy and globalization, discloses the role of the sector of creative industries and shows its place in the system of the modern global economy. The paper presents a comparative analysis of theories and theoretical approaches intended for the sector of creative industries and its development as well as defines regularities and specificities characteristic of the development of creative industries. Particular attention is shifted on the growth and development of creative industries considering the current challenges of globalization and on the most important specificities of the developing sector in the context of the challenges of economic globalization. The paper examines the trends reflecting the place of the sector of creative industries in the economy of the modern world, including the tendencies indicating changes in the export of the products created in this sector. The article considers the issues of developing creative industries and reveals priorities of future research.

  2. A Process-based Model of Global Lichen Productivity

    Science.gov (United States)

    Porada, P.; Kleidon, A.

    2012-04-01

    Lichens and biotic crusts are abundant in most ecosystems of the world. They are the main autotrophic organisms in many deserts and at high altitudes and they can also be found in large amounts as epiphytes in some forests, especially in the boreal zone. They are characterised by a great variety of physiological properties, such as growth form, productivity or color. Due to the vast land surface areas covered by lichens, they may contribute significantly to the global terrestrial net carbon uptake. Furthermore, they potentially play an important role with respect to nutrient cycles in some ecosystems and they have the ability to enhance weathering at the surface on which they grow. A possible way to quantify these processes at the global scale is presented here in form of a process-based lichen model. This approach is based on the concepts used in many dynamical vegetation models and extends these methods to account for the specific properties of lichens. Hence, processes such as photosynthesis, respiration and water exchange are implemented as well as important trade-offs like photosynthetic capacity versus respiratory load and water content versus CO2 conductivity. The great physiological variability of lichens is incorporated directly into the model through ranges of possible parameter values, which are randomly sampled. In this way, many artificial lichen "species" are created and climate then acts as a filter to determine the species which are able to survive permanently. By averaging over the surviving "species", the model predicts lichen productivity as a function of climate input data such as temperature, radiation and precipitation at the global scale. Consequently, the contribution of lichens to the global carbon balance can be quantified. Moreover, global patterns of lichen biodiversity and other properties can be illustrated. The model can be extended to account for the nutrient dynamics of lichens, such as nitrogen fixation and the acquisition and

  3. Local and global processing of music in high-functioning persons with autism: beyond central coherence?

    Science.gov (United States)

    Mottron, L; Peretz, I; Ménard, E

    2000-11-01

    A multi-modal abnormality in the integration of parts and whole has been proposed to account for a bias toward local stimuli in individuals with autism (Frith, 1989; Mottron & Belleville, 1993). In the current experiment, we examined the utility of hierarchical models in characterising musical information processing in autistic individuals. Participants were 13 high-functioning individuals with autism and 13 individuals of normal intelligence matched on chronological age, nonverbal IQ, and laterality, and without musical experience. The task consisted of same-different judgements of pairs of melodies. Differential local and global processing was assessed by manipulating the level, local or global, at which modifications occurred. No deficit was found in the two measures of global processing. In contrast, the clinical group performed better than the comparison group in the detection of change in nontransposed, contour-preserved melodies that tap local processing. These findings confirm the existence of a "local bias" in music perception in individuals with autism, but challenge the notion that it is accounted for by a deficit in global music processing. The present study suggests that enhanced processing of elementary physical properties of incoming stimuli, as found previously in the visual modality, may also exist in the auditory modality.

  4. A Clinical Update and Global Economic Burden of Rheumatoid Arthritis.

    Science.gov (United States)

    Fazal, Syed Ali; Khan, Mohammad; Nishi, Shamima E; Alam, Fahmida; Zarin, Nowshin; Bari, Mohammad T; Ashraf, Ghulam Md

    2018-02-13

    Rheumatoid arthritis (RA) is a predominant inflammatory autoimmune disorder. The incidence and prevalence of RA is increasing with considerable morbidity and mortality worldwide. The pathophysiology of RA has become clearer due to many significant research outputs during the last two decades. Many inflammatory cytokines involved in RA pathophysiology and the presence of autoantibodies are being used as potential biomarkers via the use of effective diagnostic techniques for the early diagnosis of RA. Currently, several disease-modifying anti-rheumatic drugs are being prescribed targeting RA pathophysiology, which have shown significant contributions in improving the disease outcomes. Even though innovations in treatment strategies and monitoring are helping the patients to achieve early and sustained clinical and radiographic remission, the high cost of drugs and limited health care budgets are restricting the easy access of RA treatment. Both direct and indirect high cost of treatment are creating economic burden for the patients and affecting their quality of life. The aim of this review is to describe the updated concept of RA pathophysiology and highlight current diagnostic tools used for the early detection as well as prognosis - targeting several biomarkers of RA. Additionally, we explored the updated treatment options with side effects besides discussing the global economic burden. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  5. Mobile phone based clinical microscopy for global health applications.

    Directory of Open Access Journals (Sweden)

    David N Breslauer

    Full Text Available Light microscopy provides a simple, cost-effective, and vital method for the diagnosis and screening of hematologic and infectious diseases. In many regions of the world, however, the required equipment is either unavailable or insufficiently portable, and operators may not possess adequate training to make full use of the images obtained. Counterintuitively, these same regions are often well served by mobile phone networks, suggesting the possibility of leveraging portable, camera-enabled mobile phones for diagnostic imaging and telemedicine. Toward this end we have built a mobile phone-mounted light microscope and demonstrated its potential for clinical use by imaging P. falciparum-infected and sickle red blood cells in brightfield and M. tuberculosis-infected sputum samples in fluorescence with LED excitation. In all cases resolution exceeded that necessary to detect blood cell and microorganism morphology, and with the tuberculosis samples we took further advantage of the digitized images to demonstrate automated bacillus counting via image analysis software. We expect such a telemedicine system for global healthcare via mobile phone -- offering inexpensive brightfield and fluorescence microscopy integrated with automated image analysis -- to provide an important tool for disease diagnosis and screening, particularly in the developing world and rural areas where laboratory facilities are scarce but mobile phone infrastructure is extensive.

  6. Data processing systems for clinical nuclear medicine

    International Nuclear Information System (INIS)

    Winkler, C.; Knopp, R.

    1975-01-01

    The model studies on the above mentioned data processing demonstration systems have shown that the development of a modular process computer with an applicable operation system makes it possible to meet the special demands of any nuclear-medical clinical centre corresponding to its capacity and finances. The respective first draft of the compact system described was discussed by a major circle of competent specialists at the DP-meeting of the Rheinisch-Westfaelische Gesellschaft fuer Nuklearmedizin in 1974. The positive response which the draft was met with confirmes our opinion that in the future equipment of the nuclear-medical institutions with DP-systems the universal applicability of these systems in operation with several participants and the implementation of clinically tested user's software should have priority over all other things. The development of the compact system, which is being carried out with the help of the Federal Ministry for Research and Technology will be instrumental in creating the preconditions necessary. It will be fully available in 1977 and is even expected to be completed in its partial functions (such as camera scanning, renal clearance, evaluation of laboratory data) in 1976 already. (orig.) [de

  7. The NIAID Division of AIDS enterprise information system: integrated decision support for global clinical research programs

    Science.gov (United States)

    Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

    2011-01-01

    The National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) Enterprise Information System (DAIDS-ES) is a web-based system that supports NIAID in the scientific, strategic, and tactical management of its global clinical research programs for HIV/AIDS vaccines, prevention, and therapeutics. Different from most commercial clinical trials information systems, which are typically protocol-driven, the DAIDS-ES was built to exchange information with those types of systems and integrate it in ways that help scientific program directors lead the research effort and keep pace with the complex and ever-changing global HIV/AIDS pandemic. Whereas commercially available clinical trials support systems are not usually disease-focused, DAIDS-ES was specifically designed to capture and incorporate unique scientific, demographic, and logistical aspects of HIV/AIDS treatment, prevention, and vaccine research in order to provide a rich source of information to guide informed decision-making. Sharing data across its internal components and with external systems, using defined vocabularies, open standards and flexible interfaces, the DAIDS-ES enables NIAID, its global collaborators and stakeholders, access to timely, quality information about NIAID-supported clinical trials which is utilized to: (1) analyze the research portfolio, assess capacity, identify opportunities, and avoid redundancies; (2) help support study safety, quality, ethics, and regulatory compliance; (3) conduct evidence-based policy analysis and business process re-engineering for improved efficiency. This report summarizes how the DAIDS-ES was conceptualized, how it differs from typical clinical trial support systems, the rationale for key design choices, and examples of how it is being used to advance the efficiency and effectiveness of NIAID's HIV/AIDS clinical research programs. PMID:21816958

  8. Adjusting process count on demand for petascale global optimization

    KAUST Repository

    Sosonkina, Masha; Watson, Layne T.; Radcliffe, Nicholas R.; Haftka, Rafael T.; Trosset, Michael W.

    2013-01-01

    There are many challenges that need to be met before efficient and reliable computation at the petascale is possible. Many scientific and engineering codes running at the petascale are likely to be memory intensive, which makes thrashing a serious problem for many petascale applications. One way to overcome this challenge is to use a dynamic number of processes, so that the total amount of memory available for the computation can be increased on demand. This paper describes modifications made to the massively parallel global optimization code pVTdirect in order to allow for a dynamic number of processes. In particular, the modified version of the code monitors memory use and spawns new processes if the amount of available memory is determined to be insufficient. The primary design challenges are discussed, and performance results are presented and analyzed.

  9. Delayed processing of global shape information in developmental prosopagnosia

    DEFF Research Database (Denmark)

    Gerlach, Christian; Klargaard, Solja K.; Petersen, Anders

    2017-01-01

    There is accumulating evidence suggesting that a central deficit in developmental prosopagnosia (DP), a disorder characterized by profound and lifelong difficulties with face recognition, concerns impaired holistic processing. Some of this evidence comes from studies using Navon’s paradigm where...... that this reduced global precedence effect correlates both with the DPs’ face recognition abilities, as well as their ability to recognize degraded (non-face) objects. We suggest that the DPs’ impaired performance in all three domains (Navon, face and object recognition) may be related to the same dysfunction...

  10. The geographical distribution of leadership in globalized clinical trials.

    Directory of Open Access Journals (Sweden)

    Jarno Hoekman

    manuscript writing is modest. This division of labor has significant implications for the scientific and ethical integrity of global clinical research.

  11. The geographical distribution of leadership in globalized clinical trials.

    Science.gov (United States)

    Hoekman, Jarno; Frenken, Koen; de Zeeuw, Dick; Heerspink, Hiddo Lambers

    2012-01-01

    significant implications for the scientific and ethical integrity of global clinical research.

  12. Decision Making Processes for Global Product Development - a Case Study

    DEFF Research Database (Denmark)

    Søndergaard, Erik Stefan; Ahmed-Kristensen, Saeema

    2015-01-01

    Global Product Development (GPD), outsourcing and offshoring of product development is a widespread phenomenon on today’s global economy, and consequently most engineering manufacturing companies will have to make decisions regarding how to organise their product development activities globally...

  13. Build Locally, Link Globally: The Social Forum Process in Italy

    Directory of Open Access Journals (Sweden)

    Donatella della Porta

    2015-08-01

    Full Text Available Considered an innovation because of its capacity to develop transnational processes, the World Social Forum however also has strong local roots as well as effects on organizational models and collective identities at the domestic level. Focusing on the Italian case, this article shows how local social forums, as arenas for exchanges of ideas, played a cognitive role in the import, but also the translation of new ideas, as well as helping the emergence of dense network structures and tolerant identities. The first section of the article examines how local social forums contributed to innovation in the organizational formulas of the Global Justice Movement—considering both structure (organizations and process (methodologies aspects—through the development of different, more participatory conceptions of internal decision making. It then addresses the innovations in the definition of collective identities, stressing the linkages of local struggles and global framing as well as the development of a cross-issue discourse around an anti-neoliberal frame. The final section will discuss the contribution of local social forums to contemporary social movements, stressing the role of these new arenas for the cross-fertilization among different movement families and spreading a method of working together that becomes part of the repertoire of action of local social movement organizations. The empirical research consists mainly of in-depth interviews and focus groups with activists from social movement organizations which were involved in local social forums.

  14. Physical Processes for Driving Ionospheric Outflows in Global Simulations

    Science.gov (United States)

    Moore, Thomas Earle; Strangeway, Robert J.

    2009-01-01

    We review and assess the importance of processes thought to drive ionospheric outflows, linking them as appropriate to the solar wind and interplanetary magnetic field, and to the spatial and temporal distribution of their magnetospheric internal responses. These begin with the diffuse effects of photoionization and thermal equilibrium of the ionospheric topside, enhancing Jeans' escape, with ambipolar diffusion and acceleration. Auroral outflows begin with dayside reconnexion and resultant field-aligned currents and driven convection. These produce plasmaspheric plumes, collisional heating and wave-particle interactions, centrifugal acceleration, and auroral acceleration by parallel electric fields, including enhanced ambipolar fields from electron heating by precipitating particles. Observations and simulations show that solar wind energy dissipation into the atmosphere is concentrated by the geomagnetic field into auroral regions with an amplification factor of 10-100, enhancing heavy species plasma and gas escape from gravity, and providing more current carrying capacity. Internal plasmas thus enable electromagnetic driving via coupling to the plasma, neutral gas and by extension, the entire body " We assess the Importance of each of these processes in terms of local escape flux production as well as global outflow, and suggest methods for their implementation within multispecies global simulation codes. We complete 'he survey with an assessment of outstanding obstacles to this objective.

  15. Local and global limits on visual processing in schizophrenia.

    Directory of Open Access Journals (Sweden)

    Marc S Tibber

    Full Text Available Schizophrenia has been linked to impaired performance on a range of visual processing tasks (e.g. detection of coherent motion and contour detection. It has been proposed that this is due to a general inability to integrate visual information at a global level. To test this theory, we assessed the performance of people with schizophrenia on a battery of tasks designed to probe voluntary averaging in different visual domains. Twenty-three outpatients with schizophrenia (mean age: 40±8 years; 3 female and 20 age-matched control participants (mean age 39±9 years; 3 female performed a motion coherence task and three equivalent noise (averaging tasks, the latter allowing independent quantification of local and global limits on visual processing of motion, orientation and size. All performance measures were indistinguishable between the two groups (ps>0.05, one-way ANCOVAs, with one exception: participants with schizophrenia pooled fewer estimates of local orientation than controls when estimating average orientation (p = 0.01, one-way ANCOVA. These data do not support the notion of a generalised visual integration deficit in schizophrenia. Instead, they suggest that distinct visual dimensions are differentially affected in schizophrenia, with a specific impairment in the integration of visual orientation information.

  16. Global process industry initiatives to reduce major accident hazards

    Energy Technology Data Exchange (ETDEWEB)

    Pitblado, Robin [DNV Energy Houston, TX (United States). SHE Risk Management; Pontes, Jose [DNV Energy Rio de Janeiro, RJ (Brazil). Americas Region; Oliveira, Luiz [DNV Energy Rio de Janeiro, RJ (Brazil)

    2008-07-01

    Since 2000, disasters at Texas City, Toulouse, Antwerp, Buncefield, P-36 and several near total loss events offshore in Norway have highlighted that major accident process safety is still a serious issue. Hopes that Process Safety Management or Safety Case regulations would solve these issues have not proven true. The Baker Panel recommended to BP several actions mainly around leadership, incentives, metrics, safety culture and more effective implementation of PSM systems. In Europe, an approach built around mechanical integrity and safety barriers, especially relating to technical safety systems, is being widely adopted. DNV has carried out a global survey of process industry initiatives, by interview and by literature review, for both upstream and downstream activities, to identify what the industry itself is planning to implement to enhance process safety in the next 5 - 10 years. This shows that an approach combining Baker Panel and EU barrier approaches and some nuclear industry real-time risk management approaches might be the best means to achieve a factor of 3-4 improvement in process safety. (author)

  17. The factor of local cultural specificity and process of globalization.

    Science.gov (United States)

    Rudnev, Viacheslav

    2012-12-01

    is important today. Actually, Glocalization can assist in adaptation process of harmonizing local and global needs to a way of Sustainability. Glocalization puts globalization problems down to the human scale. The age of Globalization has made the problem of cultural dialog extra actual, otherwise the Mankind has no chance to survive. The Glocalization is the process of creation of a harmony in Nature, Society and Humans system in the context of Sustainability.

  18. Life Courses in the Globalization Process : The Development of Social Inequalities in Modern Societies

    NARCIS (Netherlands)

    Buchholz, Sandra; Hofaecker, Dirk; Mills, Melinda; Blossfeld, Hans-Peter; Kurz, Karin; Hofmeister, Heather; Hofäcker, D.

    This article examines the impact of the globalization process on individual life courses and employment careers in modern societies from an international comparative perspective. Empirical results are summarized from the GLOBALIFE research project (Life Courses in the Globalization Process), which

  19. How does Software Process Improvement Address Global Software Engineering?

    DEFF Research Database (Denmark)

    Kuhrmann, Marco; Diebold, Philipp; Münch, Jürgen

    2016-01-01

    a systematic mapping study on the state-of-the-art in SPI from a general perspective, we observed Global Software Engineering (GSE) becoming a topic of interest in recent years. Therefore, in this paper, we provide a detailed investigation of those papers from the overall systematic mapping study that were......For decades, Software Process Improvement (SPI) programs have been implemented, inter alia, to improve quality and speed of software development. To set up, guide, and carry out SPI projects, and to measure SPI state, impact, and success, a multitude of different SPI approaches and considerable...... experience are available. SPI addresses many aspects ranging from individual developer skills to entire organizations. It comprises for instance the optimization of specific activities in the software lifecycle as well as the creation of organization awareness and project culture. In the course of conducting...

  20. Impact of global investment processes on ukrainian share market

    Directory of Open Access Journals (Sweden)

    O.К. Zotsenko

    2015-03-01

    Full Text Available The paper investigates the effects of financial and investment processes on the Ukrainian share market. The research analyzed and estimated investment climate in Ukraine. The study highlights a comparison of the domestic share market with share markets of other countries. In terms of share capitalization of listed companies in the GDP determined that equity is the most developed in the USA and UK. Largest share markets with highest capitalization rate characterized. The regional distribution of the share market capitalization by continents are shown. The study of the dynamics of Ukrainian and global share indexes revealed that the Ukrainian share market indexes show a constant volatility and unpredictability. Correlation Ukrainian stock indexes with indexes in Europe, Russia and America is very weak, which is a very negative trend of the stock market of Ukraine. The key problems and risks of the domestic investments are defined which are consequences of downturn in the Ukrainian share market.

  1. Global optimization numerical strategies for rate-independent processes

    Czech Academy of Sciences Publication Activity Database

    Benešová, Barbora

    2011-01-01

    Roč. 50, č. 2 (2011), s. 197-220 ISSN 0925-5001 R&D Projects: GA ČR GAP201/10/0357 Grant - others:GA MŠk(CZ) LC06052 Program:LC Institutional research plan: CEZ:AV0Z20760514 Keywords : rate-independent processes * numerical global optimization * energy estimates based algorithm Subject RIV: BA - General Mathematics Impact factor: 1.196, year: 2011 http://math.hnue.edu.vn/portal/rss.viewpage.php?id=0000037780&ap=L3BvcnRhbC9ncmFiYmVyLnBocD9jYXRpZD0xMDEyJnBhZ2U9Mg==

  2. Local and global processing in block design tasks in children with dyslexia or nonverbal learning disability.

    Science.gov (United States)

    Cardillo, Ramona; Mammarella, Irene C; Garcia, Ricardo Basso; Cornoldi, Cesare

    2017-05-01

    Visuo-constructive and perceptual abilities have been poorly investigated in children with learning disabilities. The present study focused on local or global visuospatial processing in children with nonverbal learning disability (NLD) and dyslexia compared with typically-developing (TD) controls. Participants were presented with a modified block design task (BDT), in both a typical visuo-constructive version that involves reconstructing figures from blocks, and a perceptual version in which respondents must rapidly match unfragmented figures with a corresponding fragmented target figure. The figures used in the tasks were devised by manipulating two variables: the perceptual cohesiveness and the task uncertainty, stimulating global or local processes. Our results confirmed that children with NLD had more problems with the visuo-constructive version of the task, whereas those with dyslexia showed only a slight difficulty with the visuo-constructive version, but were in greater difficulty with the perceptual version, especially in terms of response times. These findings are interpreted in relation to the slower visual processing speed of children with dyslexia, and to the visuo-constructive problems and difficulty in using flexibly-experienced global vs local processes of children with NLD. The clinical and educational implications of these findings are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Development and psychometric evaluation of a clinical global impression for schizoaffective disorder scale.

    Science.gov (United States)

    Allen, Michael H; Daniel, David G; Revicki, Dennis A; Canuso, Carla M; Turkoz, Ibrahim; Fu, Dong-Jing; Alphs, Larry; Ishak, K Jack; Bartko, John J; Lindenmayer, Jean-Pierre

    2012-01-01

    The Clinical Global Impression for Schizoaffective Disorder scale is a new rating scale adapted from the Clinical Global Impression scale for use in patients with schizoaffective disorder. The psychometric characteristics of the Clinical Global Impression for Schizoaffective Disorder are described. Content validity was assessed using an investigator questionnaire. Inter-rater reliability was determined with 12 sets of videotaped interviews rated independently by two trained individuals. Test-retest reliability was assessed using 30 randomly selected raters from clinical trials who evaluated the same videos on separate occasions two weeks apart. Convergent and divergent validity and effect size were evaluated by comparing scores between the Clinical Global Impression for Schizoaffective Disorder and the Positive and Negative Syndrome Scale, 21-item Hamilton Rating Scale for Depression, and Young Mania Rating Scale scales using pooled patient data from two clinical trials. Clinical Global Impression for Schizoaffective Disorder scores were then linked to corresponding Positive and Negative Syndrome Scale scores. Content validity was strong. Inter-rater agreement was good to excellent for most scales and subscales (intra-class correlation coefficient ≥ 0.50). Test-retest showed good reproducibility, with intraclass correlation coefficients ranging from 0.444 to 0.898. Spearman correlations between Clinical Global Impression for Schizoaffective Disorder domains and corresponding symptom scales were 0.60 or greater, and effect sizes for Clinical Global Impression for Schizoaffective Disorder overall and domain scores were similar to Positive and Negative Syndrome Scale Young Mania Rating Scale, and 21-item Hamilton Rating Scale for Depression scores. Raters anticipated that the scale might be less effective in distinguishing negative from depressive symptoms, and, in fact, the results here may reflect that clinical reality. Multiple lines of evidence support the

  4. Evaluation process of global environmental impact: assessment guidelines

    International Nuclear Information System (INIS)

    Memon, A.R.; Mahar, R.B.

    2001-01-01

    In developed and developing countries, the EIA (Environmental Impact Assessment) is becoming mandatory for the approval of Industrial projects and projects of Environmental hazards. The approving authority of each country has its own guidelines to get projects approved and make project proponents responsible to submit Environmental Impact Statement for the its detailed assessment. In this paper authors have studied an existing EIA Global guidelines and its evaluation process of altogether 40 countries from four continents, Asia, Pacific/Middle East, Europe, Australia and America/Canada. This evaluation process is recorded in the tabulation form and it has been formulated stage wise in which stage one highlights the inception of EIA guidelines of each country and stage two and three gives implementation process. The inception stage of guidelines gives an idea that when EIA was started and an implementation stages provide all information that when EIA become a part of legislation that provide an opportunity to the reader to understand the decision making process for project approvals. The main objective of writing EIA guidelines is to monitor the sustain ability of various types of the projects under different sectoral guidelines, therefore Projects related with different Sectors have been chosen and a detailed record in tabulation form gives an idea to understand the interaction of these guidelines. To make this paper more comprehensive, authors have gone thorough the sectoral guidelines of altogether 64 countries and studied 21 sector oriented project fields. These are of Agriculture/Irrigation, Biodiversity, Coastal/Marine, Community Participation, Extractive industries, Fisheries, Forestry, Hazard Risk, Health, Human settlement, Industry, Multi sectorial, Ports and Harbors, Power, refugees/resettlement, Social, Strategies/Planning, Tourism/Recreational, transportation, Waste Pollution and Wetlands/Water resources. (author)

  5. The synergy of the whole: building a global system for clinical trials to accelerate medicines development.

    Science.gov (United States)

    Koski, Greg; Tobin, Mary F; Whalen, Matthew

    2014-10-01

    The pharmaceutical industry, once highly respected, productive, and profitable, is in the throes of major change driven by many forces, including economics, science, regulation, and ethics. A variety of initiatives and partnerships have been launched to improve efficiency and productivity but without significant effect because they have failed to consider the process as a system. Addressing the challenges facing this complex endeavor requires more than modifications of individual processes; it requires a fully integrated application of systems thinking and an understanding of the desired goals and complex interactions among essential components and stakeholders of the whole. A multistakeholder collaborative effort, led by the Alliance for Clinical Research Excellence and Safety (ACRES), a global nonprofit organization operating in the public interest, is now under way to build a shared global system for clinical research. Its systems approach focuses on the interconnection of stakeholders at critical points of interaction within 4 operational domains: site development and support, quality management, information technology, and safety. The ACRES initiatives, Site Accreditation and Standards, Product Safety Culture, Global Ethical Review and Regulatory Innovation, and Quality Assurance and Safety, focus on building and implementing systems solutions. Underpinning these initiatives is an open, shared, integrated technology (site and optics and quality informatics initiative). We describe the rationale, challenges, progress, and successes of this effort to date and lessons learned. The complexity and fragmentation of the intensely proprietary ecosystem of drug development, challenging regulatory climate, and magnitude of the endeavor itself pose significant challenges, but the economic, social, and scientific rewards will more than justify the effort. An effective alliance model requires a willingness of multiple stakeholders to work together to build a shared system

  6. Calculating Clinically Significant Change: Applications of the Clinical Global Impressions (CGI) Scale to Evaluate Client Outcomes in Private Practice

    Science.gov (United States)

    Kelly, Peter James

    2010-01-01

    The Clinical Global Impressions (CGI) scale is a therapist-rated measure of client outcome that has been widely used within the research literature. The current study aimed to develop reliable and clinically significant change indices for the CGI, and to demonstrate its application in private psychological practice. Following the guidelines…

  7. Biopharmaceutical industry-sponsored global clinical trials in emerging countries.

    Science.gov (United States)

    Alvarenga, Lenio Souza; Martins, Elisabeth Nogueira

    2010-01-01

    To evaluate biopharmaceutical industry-sponsored clinical trials placed in countries previously described as emerging regions for clinical research, and potential differences for those placed in Brazil. Data regarding recruitment of subjects for clinical trials were retrieved from www.clinicaltrials.gov on February 2nd 2009. Proportions of sites in each country were compared among emerging countries. Multiple logistic regressions were performed to evaluate whether trial placement in Brazil could be predicted by trial location in other countries and/or by trial features. A total of 8,501 trials were then active and 1,170 (13.8%) included sites in emerging countries (i.e., Argentina, Brazil, China, Czech Republic, Hungary, India, Mexico, Poland, Russia, South Korea, and South Africa). South Korea and China presented a significantly higher proportion of sites when compared to other countries (pattractiveness for biopharmaceutical industry-sponsored clinical trials.

  8. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study

    DEFF Research Database (Denmark)

    Bucuras, Viorel; Gopalakrishnam, Ganesh; Wolf, J Stuart

    2012-01-01

    The study compared characteristics and outcomes in patients with solitary and bilateral kidneys who were treated with percutaneous nephrolithotomy (PCNL) in the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study.......The study compared characteristics and outcomes in patients with solitary and bilateral kidneys who were treated with percutaneous nephrolithotomy (PCNL) in the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study....

  9. Current globalization of drug interventional clinical trials: characteristics and associated factors, 2011-2013.

    Science.gov (United States)

    Jeong, Sohyun; Sohn, Minji; Kim, Jae Hyun; Ko, Minoh; Seo, Hee-Won; Song, Yun-Kyoung; Choi, Boyoon; Han, Nayoung; Na, Han-Sung; Lee, Jong Gu; Kim, In-Wha; Oh, Jung Mi; Lee, Euni

    2017-06-21

    Clinical trial globalization is a major trend for industry-sponsored clinical trials. There has been a shift in clinical trial sites towards emerging regions of Eastern Europe, Latin America, Asia, the Middle East, and Africa. Our study objectives were to evaluate the current characteristics of clinical trials and to find out the associated multiple factors which could explain clinical trial globalization and its implications for clinical trial globalization in 2011-2013. The data elements of "phase," "recruitment status," "type of sponsor," "age groups," and "design of trial" from 30 countries were extracted from the ClinicalTrials.gov website. Ten continental representative countries including the USA were selected and the design elements were compared to those of the USA. Factors associated with trial site distribution were chosen for a multilinear regression analysis. The USA, Germany, France, Canada, and United Kingdom were the "top five" countries which frequently held clinical trials. The design elements from nine continental representative countries were quite different from those of the USA; phase 1 trials were more prevalent in India (OR 1.517, p globalization of clinical trials in the emerging regions of Asia, South Africa, and Eastern Europe developed in parallel with the factors of economic drive, population for recruitment, and regulatory constraints.

  10. Drowning unconformities: Palaeoenvironmental significance and involvement of global processes

    Science.gov (United States)

    Godet, Alexis

    2013-07-01

    level rise and fall cycles, and may be linked to strengthened upwelling currents. With the return to more oligotrophic conditions during the late Barremian, photozoan, Urgonian-type communities took up again. Their development has been abruptly stopped at the end of the early Aptian by a major emersion phase. The subsequent drowning is documented in various peritethyan areas. This initial crisis is followed by three other drowning phases that ultimately led to the replacement of shallow ecosystems by a deeper marine sedimentation in the Cenomanian. This long-term trend in the evolution of the Helvetic carbonate platform and of other peritethyan ecosystems may have been driven by more global phenomena. In particular, the progressive opening of the northern and equatorial Atlantic may have impacted sea level by creating new oceanic basins. The emplacement of submarine volcanic plateaus may have triggered sea level rise and fertilized deep oceanic waters through hydrothermal processes. Drowning unconformities thus record the interplay of local with long-term processes, and constitute regional sedimentary archives of global phenomena.

  11. Global Optimization Employing Gaussian Process-Based Bayesian Surrogates

    Directory of Open Access Journals (Sweden)

    Roland Preuss

    2018-03-01

    Full Text Available The simulation of complex physics models may lead to enormous computer running times. Since the simulations are expensive it is necessary to exploit the computational budget in the best possible manner. If for a few input parameter settings an output data set has been acquired, one could be interested in taking these data as a basis for finding an extremum and possibly an input parameter set for further computer simulations to determine it—a task which belongs to the realm of global optimization. Within the Bayesian framework we utilize Gaussian processes for the creation of a surrogate model function adjusted self-consistently via hyperparameters to represent the data. Although the probability distribution of the hyperparameters may be widely spread over phase space, we make the assumption that only the use of their expectation values is sufficient. While this shortcut facilitates a quickly accessible surrogate, it is somewhat justified by the fact that we are not interested in a full representation of the model by the surrogate but to reveal its maximum. To accomplish this the surrogate is fed to a utility function whose extremum determines the new parameter set for the next data point to obtain. Moreover, we propose to alternate between two utility functions—expected improvement and maximum variance—in order to avoid the drawbacks of each. Subsequent data points are drawn from the model function until the procedure either remains in the points found or the surrogate model does not change with the iteration. The procedure is applied to mock data in one and two dimensions in order to demonstrate proof of principle of the proposed approach.

  12. Global health training and international clinical rotations during residency: current status, needs, and opportunities.

    Science.gov (United States)

    Drain, Paul K; Holmes, King K; Skeff, Kelley M; Hall, Thomas L; Gardner, Pierce

    2009-03-01

    Increasing international travel and migration have contributed to globalization of diseases. Physicians today must understand the global burden and epidemiology of diseases, the disparities and inequities in global health systems, and the importance of cross-cultural sensitivity. To meet these needs, resident physicians across all specialties have expressed growing interest in global health training and international clinical rotations. More residents are acquiring international experience, despite inadequate guidance and support from most accreditation organizations and residency programs. Surveys of global health training, including international clinical rotations, highlight the benefits of global health training as well as the need for a more coordinated approach. In particular, international rotations broaden a resident's medical knowledge, reinforce physical examination skills, and encourage practicing medicine among underserved and multicultural populations. As residents recognize these personal and professional benefits, a strong majority of them seek to gain international clinical experience. In conclusion, with feasible and appropriate administrative steps, all residents can receive global health training and be afforded the accreditation and programmatic support to participate in safe international rotations. The next steps should address accreditation for international rotations and allowance for training away from continuity clinics by residency accreditation bodies, and stipend and travel support for six or more weeks of call-free elective time from residency programs.

  13. Personalized Symptom Goals and Patient Global Impression on Clinical Changes in Advanced Cancer Patients.

    Science.gov (United States)

    Mercadante, Sebastiano; Adile, Claudio; Lanzetta, Gaetano; Mystakidou, Kyriaki; Maltoni, Marco; Soares, Luiz Guilherme; De Santis, Stefano; Ferrera, Patrizia; Valenti, Marco; Rosati, Marta; Rossi, Romina; Cortegiani, Andrea; Masedu, Francesco; Marinangeli, Franco; Aielli, Federica

    2018-05-16

    The aim of this study was to assess the patients' global impression (PGI) after symptom management, as well as the achievement of personalized symptom goals (PSG). The secondary outcome was to assess related factors. Subjects, Materials, and Methods . Advanced cancer patients admitted to palliative care units rated symptom intensity by using the Edmonton Symptom Assessment Score (ESAS) at admission and then after 1 week. For each symptom, patient-reported PGI and PSG, as well as the rate of PSG response, were evaluated. Eight hundred seventy-six patients were taken into consideration for this study. A mean of 1.71-2.16 points was necessary to perceive a bit better improvement of symptom intensity. Most patients had a PSG of ≤3. A statistically significant number of patients achieved their PSG after starting palliative care. Patients with high intensity of ESAS items at admission achieved a more favorable PGI response. In the multivariate analysis, symptom intensity and PSG were the most frequent factors independently associated to a best PGI, whereas high levels of Karnofsky had a lower odd ratio. PSG and PGI seem to be relevant for patients' assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response. Personalized symptom goals and global impression of change are relevant for patients' assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response. © AlphaMed Press 2018.

  14. Real-time monitoring of clinical processes using complex event processing and transition systems.

    Science.gov (United States)

    Meinecke, Sebastian

    2014-01-01

    Dependencies between tasks in clinical processes are often complex and error-prone. Our aim is to describe a new approach for the automatic derivation of clinical events identified via the behaviour of IT systems using Complex Event Processing. Furthermore we map these events on transition systems to monitor crucial clinical processes in real-time for preventing and detecting erroneous situations.

  15. Global Fluoroquinolone Resistance Epidemiology and Implictions for Clinical Use

    Science.gov (United States)

    Dalhoff, Axel

    2012-01-01

    This paper on the fluoroquinolone resistance epidemiology stratifies the data according to the different prescription patterns by either primary or tertiary caregivers and by indication. Global surveillance studies demonstrate that fluoroquinolone resistance rates increased in the past years in almost all bacterial species except S. pneumoniae and H. influenzae, causing community-acquired respiratory tract infections. However, 10 to 30% of these isolates harbored first-step mutations conferring low level fluoroquinolone resistance. Fluoroquinolone resistance increased in Enterobacteriaceae causing community acquired or healthcare associated urinary tract infections and intraabdominal infections, exceeding 50% in some parts of the world, particularly in Asia. One to two-thirds of Enterobacteriaceae producing extended spectrum β-lactamases were fluoroquinolone resistant too. Furthermore, fluoroquinolones select for methicillin resistance in Staphylococci. Neisseria gonorrhoeae acquired fluoroquinolone resistance rapidly; actual resistance rates are highly variable and can be as high as almost 100%, particularly in Asia, whereas resistance rates in Europe and North America range from 30% in established sexual networks. In general, the continued increase in fluoroquinolone resistance affects patient management and necessitates changes in some guidelines, for example, treatment of urinary tract, intra-abdominal, skin and skin structure infections, and traveller's diarrhea, or even precludes the use in indications like sexually transmitted diseases and enteric fever. PMID:23097666

  16. Global optimization of silicon nanowires for efficient parametric processes

    DEFF Research Database (Denmark)

    Vukovic, Dragana; Xu, Jing; Mørk, Jesper

    2013-01-01

    We present a global optimization of silicon nanowires for parametric single-pump mixing. For the first time, the effect of surface roughness-induced loss is included in the analysis, significantly influencing the optimum waveguide dimensions.......We present a global optimization of silicon nanowires for parametric single-pump mixing. For the first time, the effect of surface roughness-induced loss is included in the analysis, significantly influencing the optimum waveguide dimensions....

  17. Clinical Application of "The Change Process".

    Science.gov (United States)

    Thompson, Mary L.

    A change process described in the work of Yochelson and Samenow was adapted to students committed as delinquents to a state correctional facility. Their criminal profile accurately described the majority of the offenders. While minor problems continued, their frequency was reduced by as much as nine times. Serious incidents occurred only after the…

  18. Ensuring on-time quality data management deliverables from global clinical data management teams

    Directory of Open Access Journals (Sweden)

    Zia Haque

    2010-01-01

    Full Text Available The growing emphasis on off-site and off-shore clinical data management activities mandates a paramount need for adequate solutions geared toward on-time, quality deliverables. The author has been leading large teams that have been involved in successful global clinical data management endeavors. While each study scenario is unique and has to be approached as such, there are several elements in defining strategy and team structure in global clinical data management that can be applied universally. In this article, key roles, practices, and high-level procedures are laid out as a road map to ensure success with the model.

  19. Higher levels of depression are associated with reduced global bias in visual processing.

    Science.gov (United States)

    de Fockert, Jan W; Cooper, Andrew

    2014-04-01

    Negative moods have been associated with a tendency to prioritise local details in visual processing. The current study investigated the relation between depression and visual processing using the Navon task, a standard task of local and global processing. In the Navon task, global stimuli are presented that are made up of many local parts, and the participants are instructed to report the identity of either a global or a local target shape. Participants with a low self-reported level of depression showed evidence of the expected global processing bias, and were significantly faster at responding to the global, compared with the local level. By contrast, no such difference was observed in participants with high levels of depression. The reduction of the global bias associated with high levels of depression was only observed in the overall speed of responses to global (versus local) targets, and not in the level of interference produced by the global (versus local) distractors. These results are in line with recent findings of a dissociation between local/global processing bias and interference from local/global distractors, and support the claim that depression is associated with a reduction in the tendency to prioritise global-level processing.

  20. Applying Statistical Process Control to Clinical Data: An Illustration.

    Science.gov (United States)

    Pfadt, Al; And Others

    1992-01-01

    Principles of statistical process control are applied to a clinical setting through the use of control charts to detect changes, as part of treatment planning and clinical decision-making processes. The logic of control chart analysis is derived from principles of statistical inference. Sample charts offer examples of evaluating baselines and…

  1. Finite element meshing approached as a global minimization process

    Energy Technology Data Exchange (ETDEWEB)

    WITKOWSKI,WALTER R.; JUNG,JOSEPH; DOHRMANN,CLARK R.; LEUNG,VITUS J.

    2000-03-01

    The ability to generate a suitable finite element mesh in an automatic fashion is becoming the key to being able to automate the entire engineering analysis process. However, placing an all-hexahedron mesh in a general three-dimensional body continues to be an elusive goal. The approach investigated in this research is fundamentally different from any other that is known of by the authors. A physical analogy viewpoint is used to formulate the actual meshing problem which constructs a global mathematical description of the problem. The analogy used was that of minimizing the electrical potential of a system charged particles within a charged domain. The particles in the presented analogy represent duals to mesh elements (i.e., quads or hexes). Particle movement is governed by a mathematical functional which accounts for inter-particles repulsive, attractive and alignment forces. This functional is minimized to find the optimal location and orientation of each particle. After the particles are connected a mesh can be easily resolved. The mathematical description for this problem is as easy to formulate in three-dimensions as it is in two- or one-dimensions. The meshing algorithm was developed within CoMeT. It can solve the two-dimensional meshing problem for convex and concave geometries in a purely automated fashion. Investigation of the robustness of the technique has shown a success rate of approximately 99% for the two-dimensional geometries tested. Run times to mesh a 100 element complex geometry were typically in the 10 minute range. Efficiency of the technique is still an issue that needs to be addressed. Performance is an issue that is critical for most engineers generating meshes. It was not for this project. The primary focus of this work was to investigate and evaluate a meshing algorithm/philosophy with efficiency issues being secondary. The algorithm was also extended to mesh three-dimensional geometries. Unfortunately, only simple geometries were tested

  2. MANAGING TRANSITION PROCESSES OF MANUFACTURING NETWORKS OF GLOBAL OPERATIONS

    DEFF Research Database (Denmark)

    Adeyemi, Oluseyi

    2012-01-01

    rather than the pure product. Incidentally, products and services are often inseparable and the sale of a product would lead to a relationship where services could be sold over an extended period of time (Levitt, 1983). Thereby, many manufacturers have sought growth through the increased sale of products......Western companies have now started to compete on the basis of value delivered by shifting their market focus from manufacturing to more product-service oriented systems. This is linked to the view that manufacturing companies are becoming more oriented to the use of the product-service offering......-services offerings. Localizing and globalizing these products-services offerings have inherent complexities which have been under researched. Facing the intense global competition, companies are seeking higher levels of efficiency and effectiveness by configuring their discrete value-added activities on a global...

  3. Clinical implications of globally emerging azole resistance in Aspergillus fumigatus

    Science.gov (United States)

    Verweij, Paul E.

    2016-01-01

    Aspergillus fungi are the cause of an array of diseases affecting humans, animals and plants. The triazole antifungal agents itraconazole, voriconazole, isavuconazole and posaconazole are treatment options against diseases caused by Aspergillus. However, resistance to azoles has recently emerged as a new therapeutic challenge in six continents. Although de novo azole resistance occurs occasionally in patients during azole therapy, the main burden is the aquisition of resistance through the environment. In this setting, the evolution of resistance is attributed to the widespread use of azole-based fungicides. Although ubiquitously distributed, A. fumigatus is not a phytopathogen. However, agricultural fungicides deployed against plant pathogenic moulds such as Fusarium, Mycospaerella and A. flavus also show activity against A. fumigatus in the environment and exposure of non-target fungi is inevitable. Further, similarity in molecule structure between azole fungicides and antifungal drugs results in cross-resistance of A. fumigatus to medical azoles. Clinical studies have shown that two-thirds of patients with azole-resistant infections had no previous history of azole therapy and high mortality rates between 50% and 100% are reported in azole-resistant invasive aspergillosis. The resistance phenotype is associated with key mutations in the cyp51A gene, including TR34/L98H, TR53 and TR46/Y121F/T289A resistance mechanisms. Early detection of resistance is of paramount importance and if demonstrated, either with susceptibility testing or through molecular analysis, azole monotherapy should be avoided. Liposomal amphotericin B or a combination of voriconazole and an echinocandin are recomended for azole-resistant aspergillosis. This article is part of the themed issue ‘Tackling emerging fungal threats to animal health, food security and ecosystem resilience’. PMID:28080986

  4. Three Eras in Global Tobacco Control: How Global Governance Processes Influenced Online Tobacco Control Networking.

    Science.gov (United States)

    Wipfli, Heather; Chu, Kar-Hai; Lancaster, Molly; Valente, Thomas

    2016-01-01

    Online networks can serve as a platform to diffuse policy innovations and enhance global health governance. This study focuses on how shifts in global health governance may influence related online networks. We compare social network metrics (average degree centrality [AVGD], density [D] and clustering coefficient [CC]) of Globalink, an online network of tobacco control advocates, across three eras in global tobacco control governance; pre-Framework Convention on Tobacco Control (FCTC) policy transfer (1992-1998), global regime formation through the FCTC negotiations (1999-2005), and philanthropic funding through the Bloomberg Initiative (2006-2012). Prior to 1999, Globalink was driven by a handful of high-income countries (AVGD=1.908 D=0.030, CC=0.215). The FCTC negotiations (1999-2005) corresponded with a rapid uptick in the number of countries represented within Globalink and new members were most often brought into the network through relationships with regional neighbors (AVGD=2.824, D=0.021, CC=0.253). Between 2006 and 2012, the centrality of the US in the network increases significantly (AVGD=3.414, D=0.023, CC=0.310). The findings suggest that global institutionalization through WHO, as with the FCTC, can lead to the rapid growth of decentralized online networks. Alternatively, private initiatives, such as the Bloomberg Initiative, can lead to clustering in which a single source of information gains increasing influence over an online network.

  5. Stimuli & Task characteristics in the global and local processing

    Directory of Open Access Journals (Sweden)

    Caridad Zalabarod

    2001-01-01

    Full Text Available La primacía de los rasgos globales de una forma visual sobre los locales, o viceversa, es todavía una cuestión sin resolver. Algunos autores han señalado que la precedencia global sucede cuando se iguala la excentricidad de los niveles global y local mediante la utilización de estímulos concéntricos. Sin embargo, otras investigaciones con patrones visuales similares han obtenido precedencia local. El presente trabajo incluye dos experimentos planificados para arrojar luz sobre la interpretación de estos resultados inconsistentes. En conjunto, se pretende analizar si la diferencia en la densidad estimular utilizada en los distintos experimentos o la diferencia en el tipo de tarea pueden ser hipótesis plausibles para explicar la obtención de los resultados contradictorios. En el primer experimento, bajo condiciones de atención selectiva y dividida, se incluye una tarea de detección de una figura-objetivo en el estímulo con un tiempo de exposición de 150 msg. y con estímulos concéntricos con mayor número de elementos locales que los empleados en experimentos previos (Blanca, López, Luna, Zalabardo y Rando, 2000; 2001. Los resultados apuntan a una ausencia de ventaja global o local y a una interferencia bidireccional para la condición de atención selectiva, y bidreccional pero asimétrica para la condición de atención dividida, siendo mayor la interferencia global. En el segundo experimento, se instruye a los sujetos para que indiquen la dirección, izquierda o derecha, de la apertura de un semicírculo en el nivel pertinente, según la condición de dirección de la atención. Los estímulos se presentan con un tiempo de exposición de 150 msg. o ilimitado. Los resultados muestran una ventaja global, tanto bajo condiciones de atención dividida como selectiva, la cual es independiente del tiempo de exposición del estímulo. La comparación de los resultados extraídos de los dos experimentos, junto

  6. Regulatory challenges in the review of data from global clinical trials: the PMDA perspective.

    Science.gov (United States)

    Asano, K; Tanaka, A; Sato, T; Uyama, Y

    2013-08-01

    Regulatory agencies face challenges in reviewing data from global clinical trials (GCTs) in the era of globalization of drug development. One major challenge is consideration of ethnic factors in evaluating GCT data so as to extrapolate foreign population data to one's own national population. Here, we present the Pharmaceuticals and Medical Devices Agency (PMDA) perspective in reviewing GCT data in new drug applications (NDAs) and discuss future challenges for new drug approval.

  7. Orienting and Onboarding Clinical Nurse Specialists: A Process Improvement Project.

    Science.gov (United States)

    Garcia, Mayra G; Watt, Jennifer L; Falder-Saeed, Karie; Lewis, Brennan; Patton, Lindsey

    Clinical nurse specialists (CNSs) have a unique advanced practice role. This article describes a process useful in establishing a comprehensive orientation and onboarding program for a newly hired CNS. The project team used the National Association of Clinical Nurse Specialists core competencies as a guide to construct a process for effectively onboarding and orienting newly hired CNSs. Standardized documents were created for the orientation process including a competency checklist, needs assessment template, and professional evaluation goals. In addition, other documents were revised to streamline the orientation process. Standardizing the onboarding and orientation process has demonstrated favorable results. As of 2016, 3 CNSs have successfully been oriented and onboarded using the new process. Unique healthcare roles require special focus when onboarding and orienting into a healthcare system. The use of the National Association of Clinical Nurse Specialists core competencies guided the project in establishing a successful orientation and onboarding process for newly hired CNSs.

  8. Animated-simulation modeling facilitates clinical-process costing.

    Science.gov (United States)

    Zelman, W N; Glick, N D; Blackmore, C C

    2001-09-01

    Traditionally, the finance department has assumed responsibility for assessing process costs in healthcare organizations. To enhance process-improvement efforts, however, many healthcare providers need to include clinical staff in process cost analysis. Although clinical staff often use electronic spreadsheets to model the cost of specific processes, PC-based animated-simulation tools offer two major advantages over spreadsheets: they allow clinicians to interact more easily with the costing model so that it more closely represents the process being modeled, and they represent cost output as a cost range rather than as a single cost estimate, thereby providing more useful information for decision making.

  9. CURRENT PERSPECTIVES OF POTTER'S GLOBAL BIOETHICS AS A BRIDGE BETWEEN CLINICAL (PERSONALIZED) AND PUBLIC HEALTH ETHICS.

    Science.gov (United States)

    Turina, Iva Sorta-Bilajac; Brkljacić, Morana; Grgas-Bile, Cecilija; Gajski, Domagoj; Racz, Aleksandar; Cengić, Tomislav

    2015-12-01

    In the context of modern scientific and technological developments in biomedicine and health care, and the potential consequences of their application on humans and the environment, Potter's global bioethics concept resurfaces. By actualizing Potter's original thoughts on individual bioethical issues, the universality of two of his books, which today represent the backbone of the world bioethical literature, "Bioethics--Bridge to the Future" and "Global Bioethics: Building on the Leopold Legacy", is emphasized. Potter's global bioethics today can legitimately be viewed as a bridge between clinical personalized ethics on the one hand and ethics of public health on the other.

  10. Global Consultation Processes: Lessons Learned from Refugee Teacher Consultation Research in Malaysia

    Science.gov (United States)

    O'Neal, Colleen R.; Gosnell, Nicole M.; Ng, Wai Sheng; Clement, Jennifer; Ong, Edward

    2018-01-01

    The process of global consultation has received little attention despite its potential for promoting international mutual understanding with marginalized communities. This article details theory, entry, implementation, and evaluation processes for global consultation research, including lessons learned from our refugee teacher intervention. The…

  11. Reflections on the Process of Bilingual Education in Latin America: A Perspective from Globalization

    Science.gov (United States)

    Joya, Magdalena; Cerón, Alejandra

    2013-01-01

    This paper intends to explain how education can be understood as a process that involves the transmission of culture, knowledge, manners and values; meanwhile, globalization implies an evolving process of constructing a global system of languages. In this way, the relationship between the educational and economic systems can become stronger…

  12. A common type system for clinical natural language processing

    Directory of Open Access Journals (Sweden)

    Wu Stephen T

    2013-01-01

    Full Text Available Abstract Background One challenge in reusing clinical data stored in electronic medical records is that these data are heterogenous. Clinical Natural Language Processing (NLP plays an important role in transforming information in clinical text to a standard representation that is comparable and interoperable. Information may be processed and shared when a type system specifies the allowable data structures. Therefore, we aim to define a common type system for clinical NLP that enables interoperability between structured and unstructured data generated in different clinical settings. Results We describe a common type system for clinical NLP that has an end target of deep semantics based on Clinical Element Models (CEMs, thus interoperating with structured data and accommodating diverse NLP approaches. The type system has been implemented in UIMA (Unstructured Information Management Architecture and is fully functional in a popular open-source clinical NLP system, cTAKES (clinical Text Analysis and Knowledge Extraction System versions 2.0 and later. Conclusions We have created a type system that targets deep semantics, thereby allowing for NLP systems to encapsulate knowledge from text and share it alongside heterogenous clinical data sources. Rather than surface semantics that are typically the end product of NLP algorithms, CEM-based semantics explicitly build in deep clinical semantics as the point of interoperability with more structured data types.

  13. A common type system for clinical natural language processing.

    Science.gov (United States)

    Wu, Stephen T; Kaggal, Vinod C; Dligach, Dmitriy; Masanz, James J; Chen, Pei; Becker, Lee; Chapman, Wendy W; Savova, Guergana K; Liu, Hongfang; Chute, Christopher G

    2013-01-03

    One challenge in reusing clinical data stored in electronic medical records is that these data are heterogenous. Clinical Natural Language Processing (NLP) plays an important role in transforming information in clinical text to a standard representation that is comparable and interoperable. Information may be processed and shared when a type system specifies the allowable data structures. Therefore, we aim to define a common type system for clinical NLP that enables interoperability between structured and unstructured data generated in different clinical settings. We describe a common type system for clinical NLP that has an end target of deep semantics based on Clinical Element Models (CEMs), thus interoperating with structured data and accommodating diverse NLP approaches. The type system has been implemented in UIMA (Unstructured Information Management Architecture) and is fully functional in a popular open-source clinical NLP system, cTAKES (clinical Text Analysis and Knowledge Extraction System) versions 2.0 and later. We have created a type system that targets deep semantics, thereby allowing for NLP systems to encapsulate knowledge from text and share it alongside heterogenous clinical data sources. Rather than surface semantics that are typically the end product of NLP algorithms, CEM-based semantics explicitly build in deep clinical semantics as the point of interoperability with more structured data types.

  14. Nonlinear dynamics of global atmospheric and earth system processes

    Science.gov (United States)

    Zhang, Taiping; Verbitsky, Mikhail; Saltzman, Barry; Mann, Michael E.; Park, Jeffrey; Lall, Upmanu

    1995-01-01

    During the grant period, the authors continued ongoing studies aimed at enhancing their understanding of the operation of the atmosphere as a complex nonlinear system interacting with the hydrosphere, biosphere, and cryosphere in response to external radiative forcing. Five papers were completed with support from the grant, representing contributions in three main areas of study: (1) theoretical studies of the interactive atmospheric response to changed biospheric boundary conditions measurable from satellites; (2) statistical-observational studies of global-scale temperature variability on interannual to century time scales; and (3) dynamics of long-term earth system changes associated with ice sheet surges.

  15. Application of structured flowsheets to global evaluation of tank waste processing alternatives

    International Nuclear Information System (INIS)

    Jansen, G.; Knutson, B.J.; Niccoli, L.G.; Frank, D.D.

    1994-01-01

    Remediation of the Hanford waste tanks requires integration of chemical technologies and evaluation of alternatives from the perspective of the overall Hanford cleanup purpose. The use of Design/IDEF (R) logic to connect chemical process functions to the overall cleanup mission in the Hanford Strategic Analysis (HSA) and to Aspen Plus (R) process models can show the effect of each process step on global performance measures such as safety, cost, and public perception. This hybrid of chemical process analysis and systems engineering produces structured material balance flowsheets at any level of process aggregation within the HSA. Connectivity and consistent process and stream nomenclature are automatically transferred between detailed process models, the HSA top purpose, and the global material balance flowsheet evaluation. Applications to separation processes is demonstrated for a generic Truex-Sludge Wash flowsheet with many process options and for the aggregation of a Clean Option flowsheet from a detailed chemical process level to a global evaluation level

  16. Globalization

    Directory of Open Access Journals (Sweden)

    Tulio Rosembuj

    2006-12-01

    Full Text Available There is no singular globalization, nor is the result of an individual agent. We could start by saying that global action has different angles and subjects who perform it are different, as well as its objectives. The global is an invisible invasion of materials and immediate effects.

  17. Globalization

    OpenAIRE

    Tulio Rosembuj

    2006-01-01

    There is no singular globalization, nor is the result of an individual agent. We could start by saying that global action has different angles and subjects who perform it are different, as well as its objectives. The global is an invisible invasion of materials and immediate effects.

  18. Financial security of the state in terms of globalization processes escalation

    Directory of Open Access Journals (Sweden)

    Svitlana Tkalenko

    2013-02-01

    Full Text Available The article provides review of the globalization and global integration processes impact on the financial sector formation characterized by an increase in financial flows with the lead role played by transnational corporations and transnational banks. The globalization study has been already reflected by numerous scientific publications and various issues of reputable international academic journals describing the process as irreversible and objective along with demonstrating globalization merits and demerits, etc. In the 21st century, globalization is an issue discussed by everyone: ranging from presidents, prime ministers and members of parliament supposed to solve problems of any scale taking into consideration the global development phenomenon, to ordinary citizens. Today, globalization has obviously become a major trend of the modern world development, which is why issues implying sound development assurance become pressing for each country. The article dwells upon the main component of economic security — the financial one (Ukraine case study. Thus, we are engaged in studying the global development trend in terms of assuring security of the state under conditions of financial flows globalization and existence of global integration processes.

  19. The clinical research office of the endourological society percutaneous nephrolithotomy global study

    DEFF Research Database (Denmark)

    Desai, Mahesh; De Lisa, Antonello; Turna, Burak

    2011-01-01

    PURPOSE: The study compared characteristics and outcomes in patients with staghorn or nonstaghorn stones who were treated with percutaneous nephrolithotomy (PCNL) within the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study. PATIENTS AND METHODS: Data over a 1-year ...

  20. Risk Based Monitoring (RBM: A global study focusing on perception and merits among clinical investigational sites

    Directory of Open Access Journals (Sweden)

    Prajna P. Kumar

    2016-12-01

    Conclusion: This unique study performed across ten emerging and developed countries strongly supported the need for systematic global training, education, and implementation of RBM regulatory guidance, with an aim for better safety of subjects and improved quality of clinical trial data. Furthermore, studies with larger sample sizes are recommended to provide an evidence-based approach.

  1. Development of international labor migration in the dynamics of globalization processes

    Directory of Open Access Journals (Sweden)

    Rubinskaya Eteri, D.

    2015-03-01

    Full Text Available The current characteristics of international migration caused by the qualitative changes that occur in the global economy under influence of increasing globalization. The paper attempts to suggest periodization of the global economy development and to identify features of international labor migration occurred under the influence of deep changes in the world economy. During this period, the author identifies three stages in the formation of globalization, the transition criterion from one to other is the degree of world economy changes under the influence of the productive forces development and the major social and political transformations resulted in qualitative changes in the processes of international labor migration. At the same time in the context of globalization the place and role of international labor migration changes in the global economy system: migration becomes a means of promoting the globalization of countries and regions, the most important factor of demographic development and economic growth.

  2. [Description of clinical thinking by the dual-process theory].

    Science.gov (United States)

    Peña G, Luis

    2012-06-01

    Clinical thinking is a very complex process that can be described by the dual-process theory, it has an intuitive part (that recognizes patterns) and an analytical part (that tests hypotheses). It is vulnerable to cognitive bias that professionals must be aware of, to minimize diagnostic errors.

  3. Errors in the Total Testing Process in the Clinical Chemistry ...

    African Journals Online (AJOL)

    2018-03-01

    Mar 1, 2018 ... testing processes impair the clinical decision-making process. Such errors are ... and external quality control exceeding the target range, (14.4%) and (51.4%) .... version 3.5.3 and transferred to Statistical. Package for the ...

  4. The process and challenges of obtaining and sustaining clinical placements for nursing and allied health students.

    Science.gov (United States)

    Taylor, Christine; Angel, Liz; Nyanga, Lucy; Dickson, Cathy

    2017-10-01

    To describe the process and challenges from a project that aimed to develop processes, source new placements and place students primarily in the discipline of nursing, but also occupational therapy, physiotherapy, podiatry, social work, and speech therapy. Clinical experience in health facilities is an essential element of health professional education, yet globally, there is a lack of clinical placements to meet demands. Educational providers are seeking placements in nontraditional facilities, yet little has been reported on the challenges in the process of procuring clinical placements. The project used a descriptive approach within a quality implementation framework. The project was guided by the quality implementation framework that included four critical steps: considerations of the host setting, structuring the implementation, supporting the implementation and improving future applications. A total of 115 new student placements were finalised across six health disciplines, including elderly care, nongovernment organisations and general practice. Sixty-two nursing students were placed in the new placements during the project. Challenges included communication, the time-consuming nature of the process and 'gatekeeping' blocks to obtaining placements. Recommendations included the importance of personal interaction in developing and maintaining relationships, and the need for clear communication processes and documentation. Potential areas for research are also given. There is great potential for growth in establishing new placements outside the traditional placement facilities for nursing and allied health and for expanding already existing nonhospital placements. Clinical professional experiences are essential to any nursing or allied health programme. There is an increasing demand for, and global lack of, clinical placements for nursing and allied health students. The results provide nursing and allied health educators and managers a framework for planning

  5. Something has shifted: Nursing students' global perspective following international clinical placements.

    Science.gov (United States)

    Gower, Shelley; Duggan, Ravani; Dantas, Jaya A R; Boldy, Duncan

    2017-10-01

    To examine understandings of global health issues among nursing students following participation in an international clinical placement during their pre-registration university education. Universities use international clinical placements, especially in developing countries, to develop cultural awareness in students; however, little is known about the longer term influences on students' understandings of global nursing. A retrospective cross-sectional design was used, using an exploratory, descriptive qualitative approach. Individual semi-structured interviews were conducted in 2014 with a purposive sample of 25 pre-registration nursing students from four Western Australian universities who undertook clinical placements across five countries. Data were analysed using inductive thematic analysis. Findings highlight that students developed new understandings around health systems including fragility of resource access, differences in clinical practice and variances in nursing roles between settings. Students also experienced challenges but were able to appreciate alternative world viewpoints. International clinical placements can develop greater awareness and help students form realistic strategies for using their nursing skills globally. Pre-placement training in cultural awareness and health system realities, along with strong supervisory support, is critical to success. © 2017 John Wiley & Sons Ltd.

  6. Impact of Site Selection and Study Conduct on Outcomes in Global Clinical Trials.

    Science.gov (United States)

    Sarwar, Chaudhry M S; Vaduganathan, Muthiah; Butler, Javed

    2017-08-01

    There are over 25 million patients living with heart failure globally. Overall, and especially post-discharge, clinical outcomes have remained poor in heart failure despite multiple trials, with both successes and failures over the last two decades. Matching therapies to the right patient population, identifying high-quality sites, and ensuring optimal trial design and execution represent important considerations in the development of novel therapeutics in this space. While clinical trials have undergone rapid globalization, this has come with regional variation in comorbidities, clinical parameters, and even clinical outcomes and treatment effects across international sites. These issues have now highlighted knowledge gaps about the conduct of trials, selection of study sites, and an unmet need to develop and identify "ideal" sites. There is a need for all stakeholders, including academia, investigators, healthcare organizations, patient advocacy groups, industry sponsors, research organizations, and regulatory authorities, to work as a multidisciplinary group to address these problems and develop practical solutions to improve trial conduct, efficiency, and execution. We review these trial-level issues using examples from contemporary studies to inform and optimize the design of future global clinical trials in heart failure.

  7. Process control analysis of IMRT QA: implications for clinical trials

    International Nuclear Information System (INIS)

    Pawlicki, Todd; Rice, Roger K; Yoo, Sua; Court, Laurence E; McMillan, Sharon K; Russell, J Donald; Pacyniak, John M; Woo, Milton K; Basran, Parminder S; Boyer, Arthur L; Bonilla, Claribel

    2008-01-01

    The purpose of this study is two-fold: first is to investigate the process of IMRT QA using control charts and second is to compare control chart limits to limits calculated using the standard deviation (σ). Head and neck and prostate IMRT QA cases from seven institutions in both academic and community settings are considered. The percent difference between the point dose measurement in phantom and the corresponding result from the treatment planning system (TPS) is used for analysis. The average of the percent difference calculations defines the accuracy of the process and is called the process target. This represents the degree to which the process meets the clinical goal of 0% difference between the measurements and TPS. IMRT QA process ability defines the ability of the process to meet clinical specifications (e.g. 5% difference between the measurement and TPS). The process ability is defined in two ways: (1) the half-width of the control chart limits, and (2) the half-width of ±3σ limits. Process performance is characterized as being in one of four possible states that describes the stability of the process and its ability to meet clinical specifications. For the head and neck cases, the average process target across institutions was 0.3% (range: -1.5% to 2.9%). The average process ability using control chart limits was 7.2% (range: 5.3% to 9.8%) compared to 6.7% (range: 5.3% to 8.2%) using standard deviation limits. For the prostate cases, the average process target across the institutions was 0.2% (range: -1.8% to 1.4%). The average process ability using control chart limits was 4.4% (range: 1.3% to 9.4%) compared to 5.3% (range: 2.3% to 9.8%) using standard deviation limits. Using the standard deviation to characterize IMRT QA process performance resulted in processes being preferentially placed in one of the four states. This is in contrast to using control charts for process characterization where the IMRT QA processes were spread over three of the

  8. Globalization

    OpenAIRE

    Andru?cã Maria Carmen

    2013-01-01

    The field of globalization has highlighted an interdependence implied by a more harmonious understanding determined by the daily interaction between nations through the inducement of peace and the management of streamlining and the effectiveness of the global economy. For the functioning of the globalization, the developing countries that can be helped by the developed ones must be involved. The international community can contribute to the institution of the development environment of the gl...

  9. How Does Software Process Improvement Address Global Software Engineering?

    DEFF Research Database (Denmark)

    Kuhrmann, Marco; Diebold, Philipp; Münch, Jürgen

    2016-01-01

    For decades, Software Process Improvement (SPI) programs have been implemented, inter alia, to improve quality and speed of software development. To set up, guide, and carry out SPI projects, and to measure SPI state, impact, and success, a multitude of different SPI approaches and considerable...

  10. The Role of Musical Experience in Hemispheric Lateralization of Global and Local Auditory Processing.

    Science.gov (United States)

    Black, Emily; Stevenson, Jennifer L; Bish, Joel P

    2017-08-01

    The global precedence effect is a phenomenon in which global aspects of visual and auditory stimuli are processed before local aspects. Individuals with musical experience perform better on all aspects of auditory tasks compared with individuals with less musical experience. The hemispheric lateralization of this auditory processing is less well-defined. The present study aimed to replicate the global precedence effect with auditory stimuli and to explore the lateralization of global and local auditory processing in individuals with differing levels of musical experience. A total of 38 college students completed an auditory-directed attention task while electroencephalography was recorded. Individuals with low musical experience responded significantly faster and more accurately in global trials than in local trials regardless of condition, and significantly faster and more accurately when pitches traveled in the same direction (compatible condition) than when pitches traveled in two different directions (incompatible condition) consistent with a global precedence effect. In contrast, individuals with high musical experience showed less of a global precedence effect with regards to accuracy, but not in terms of reaction time, suggesting an increased ability to overcome global bias. Further, a difference in P300 latency between hemispheres was observed. These findings provide a preliminary neurological framework for auditory processing of individuals with differing degrees of musical experience.

  11. Communication Policies Reflection on Globalization Process and the Role of Advertisement in Integrated Communication Environment

    OpenAIRE

    ÖZKAN, Abdullah

    2012-01-01

    Globalization process has created important changes and transformations across the world. These political, social, economic and cultural changes have considerably affected communication. The number of mass media instruments have increased, informatics has improved and also reaching information has become easier after the globalization of communication. New communication instruments and environments have been created. Globalised communication has also affected people, reaching the information ...

  12. Global food chains and environment: agro-food production and processing in Thailand

    NARCIS (Netherlands)

    Sriwichailamphan, T.H.

    2007-01-01

    In this study on the global food chain and the environment, the objective is to understand the dynamics of food safety and environmental improvements among the large and medium-sized agro-food processing industries and farmers in Thailand that operate in the global market. This study assesses

  13. A Global Vision over Benchmarking Process: Benchmarking Based Enterprises

    OpenAIRE

    Sitnikov, Catalina; Giurca Vasilescu, Laura

    2008-01-01

    Benchmarking uses the knowledge and the experience of others to improve the enterprise. Starting from the analysis of the performance and underlying the strengths and weaknesses of the enterprise it should be assessed what must be done in order to improve its activity. Using benchmarking techniques, an enterprise looks at how processes in the value chain are performed. The approach based on the vision “from the whole towards the parts” (a fragmented image of the enterprise’s value chain) redu...

  14. Processes for Quality Improvements in Radiation Oncology Clinical Trials

    International Nuclear Information System (INIS)

    FitzGerald, T.J.; Urie, Marcia; Ulin, Kenneth; Laurie, Fran; Yorty, Jeffrey C.; Hanusik, Richard; Kessel, Sandy; Jodoin, Maryann Bishop; Osagie, Gani; Cicchetti, M. Giulia; Pieters, Richard; McCarten, Kathleen; Rosen, Nancy

    2008-01-01

    Quality assurance in radiotherapy (RT) has been an integral aspect of cooperative group clinical trials since 1970. In early clinical trials, data acquisition was nonuniform and inconsistent and computational models for radiation dose calculation varied significantly. Process improvements developed for data acquisition, credentialing, and data management have provided the necessary infrastructure for uniform data. With continued improvement in the technology and delivery of RT, evaluation processes for target definition, RT planning, and execution undergo constant review. As we move to multimodality image-based definitions of target volumes for protocols, future clinical trials will require near real-time image analysis and feedback to field investigators. The ability of quality assurance centers to meet these real-time challenges with robust electronic interaction platforms for imaging acquisition, review, archiving, and quantitative review of volumetric RT plans will be the primary challenge for future successful clinical trials

  15. Estimating the global clinical burden of Plasmodium falciparum malaria in 2007.

    Directory of Open Access Journals (Sweden)

    Simon I Hay

    2010-06-01

    Full Text Available The epidemiology of malaria makes surveillance-based methods of estimating its disease burden problematic. Cartographic approaches have provided alternative malaria burden estimates, but there remains widespread misunderstanding about their derivation and fidelity. The aims of this study are to present a new cartographic technique and its application for deriving global clinical burden estimates of Plasmodium falciparum malaria for 2007, and to compare these estimates and their likely precision with those derived under existing surveillance-based approaches.In seven of the 87 countries endemic for P. falciparum malaria, the health reporting infrastructure was deemed sufficiently rigorous for case reports to be used verbatim. In the remaining countries, the mapped extent of unstable and stable P. falciparum malaria transmission was first determined. Estimates of the plausible incidence range of clinical cases were then calculated within the spatial limits of unstable transmission. A modelled relationship between clinical incidence and prevalence was used, together with new maps of P. falciparum malaria endemicity, to estimate incidence in areas of stable transmission, and geostatistical joint simulation was used to quantify uncertainty in these estimates at national, regional, and global scales. Combining these estimates for all areas of transmission risk resulted in 451 million (95% credible interval 349-552 million clinical cases of P. falciparum malaria in 2007. Almost all of this burden of morbidity occurred in areas of stable transmission. More than half of all estimated P. falciparum clinical cases and associated uncertainty occurred in India, Nigeria, the Democratic Republic of the Congo (DRC, and Myanmar (Burma, where 1.405 billion people are at risk. Recent surveillance-based methods of burden estimation were then reviewed and discrepancies in national estimates explored. When these cartographically derived national estimates were ranked

  16. Matérn-based nonstationary cross-covariance models for global processes

    KAUST Repository

    Jun, Mikyoung

    2014-01-01

    -covariance models, based on the Matérn covariance model class, that are suitable for describing prominent nonstationary characteristics of the global processes. In particular, we seek nonstationary versions of Matérn covariance models whose smoothness parameters

  17. The improved Clinical Global Impression Scale (iCGI: development and validation in depression

    Directory of Open Access Journals (Sweden)

    Kadouri Alane

    2007-02-01

    Full Text Available Abstract Background The Clinical Global Impression scale (CGI is frequently used in medical care and clinical research because of its face validity and practicability. This study proposes to improve the reliability of the Clinical Global Impression (CGI scale in depressive disorders by the use of a semi-standardized interview, a new response format, and a Delphi procedure. Methods Thirty patients hospitalised for a major depressive episode were filmed at T1 (first week in hospital and at T2 (2 weeks later during a 5' specific interview. The Hamilton Depressive Rating Scale and the Symptom Check List were also rated. Eleven psychiatrists rated these videos using either the usual CGI response format or an improved response format, with or without a Delphi procedure. Results The new response format slightly improved (but not significantly the interrater agreement, the Delphi procedure did not. The best results were obtained when ratings by 4 independent raters were averaged. In this situation, intraclass correlation coefficients were about 0.9. Conclusion The Clinical Global Impression is a useful approach in psychiatry since it apprehends patients in their entirety. This study shows that it is possible to quantify such impressions with a high level of interrater agreement.

  18. Global land-atmosphere coupling associated with cold climate processes

    OpenAIRE

    Dutra, Emanuel, 1983-

    2011-01-01

    Tese de doutoramento, Ciências Geofísicas e da Geoinformação (Meteorologia), Universidade de Lisboa, Faculdade de Ciências, 2011 This dissertation constitutes an assessment of the role of cold processes, associated with snow cover, in controlling the land-atmosphere coupling. The work was based on model simulations, including offline simulations with the land surface model HTESSEL, and coupled atmosphere simulations with the EC-EARTH climate model. A revised snow scheme was developed and t...

  19. Monitoring of global geodynamic processes using satellite observations

    Directory of Open Access Journals (Sweden)

    S.K. Tatevian

    2014-06-01

    One of the active tectonic zones of Egypt located in Aswan, is characterized by regional basement rock uplift and regional faulting. In 1997, the African Regional Geodynamic Network was developed around the northern part of Lake Nasser, consists of 11 points, on both sides of the Lake. Its main goal is to study the geodynamical behavior around the northern part of the lake. The collected data were processed using the Bernese software version 5.0. From the velocity results, including also the African plate motion, it can be noticed that all stations of this network are moved to the northeast direction and it is typically the direction of the African plate motion.

  20. Analysing the Outbound logistics process enhancements in Nokia-Siemens Networks Global Distribution Center

    OpenAIRE

    Marjeta, Katri

    2011-01-01

    Marjeta, Katri. 2011. Analysing the outbound logistics process enhancements in Nokia-Siemens Networks Global Distribution Center. Master´s thesis. Kemi-Tornio University of Applied Sciences. Business and Culture. Pages 57. Due to confidentiality issues, this work has been modified from its original form. The aim of this Master Thesis work is to describe and analyze the outbound logistics process enhancement projects executed in Nokia-Siemens Networks Global Distribution Center after the N...

  1. Caffeine promotes global spatial processing in habitual and non-habitual caffeine consumers

    OpenAIRE

    Grace E. Giles; Caroline R. Mahoney; Tad T. Brunye; Holly A. Taylor; Robin B. Kanarek

    2013-01-01

    Information processing is generally biased toward global cues, often at the expense of local information. Equivocal extant data suggests that arousal states may accentuate either a local or global processing bias, at least partially dependent on the nature of the manipulation, task, and stimuli. To further differentiate the conditions responsible for such equivocal results we varied caffeine doses to alter physiological arousal states and measured their effect on tasks requiring the retrieval...

  2. Dynamic global model of oxide Czochralski process with weighing control

    Science.gov (United States)

    Mamedov, V. M.; Vasiliev, M. G.; Yuferev, V. S.

    2011-03-01

    A dynamic model of oxide Czochralski growth with weighing control has been developed for the first time. A time-dependent approach is used for the calculation of temperature fields in different parts of a crystallization set-up and convection patterns in a melt, while internal radiation in crystal is considered in a quasi-steady approximation. A special algorithm is developed for the calculation of displacement of a triple point and simulation of a crystal surface formation. To calculate variations in the heat generation, a model of weighing control with a commonly used PID regulator is applied. As an example, simulation of the growth process of gallium-gadolinium garnet (GGG) crystals starting from the stage of seeding is performed.

  3. Global land-atmosphere coupling associated with cold climate processes

    Science.gov (United States)

    Dutra, Emanuel

    This dissertation constitutes an assessment of the role of cold processes, associated with snow cover, in controlling the land-atmosphere coupling. The work was based on model simulations, including offline simulations with the land surface model HTESSEL, and coupled atmosphere simulations with the EC-EARTH climate model. A revised snow scheme was developed and tested in HTESSEL and EC-EARTH. The snow scheme is currently operational at the European Centre for Medium-Range Weather Forecasts integrated forecast system, and in the default configuration of EC-EARTH. The improved representation of the snowpack dynamics in HTESSEL resulted in improvements in the near surface temperature simulations of EC-EARTH. The new snow scheme development was complemented with the option of multi-layer version that showed its potential in modeling thick snowpacks. A key process was the snow thermal insulation that led to significant improvements of the surface water and energy balance components. Similar findings were observed when coupling the snow scheme to lake ice, where lake ice duration was significantly improved. An assessment on the snow cover sensitivity to horizontal resolution, parameterizations and atmospheric forcing within HTESSEL highlighted the role of the atmospheric forcing accuracy and snowpack parameterizations in detriment of horizontal resolution over flat regions. A set of experiments with and without free snow evolution was carried out with EC-EARTH to assess the impact of the interannual variability of snow cover on near surface and soil temperatures. It was found that snow cover interannual variability explained up to 60% of the total interannual variability of near surface temperature over snow covered regions. Although these findings are model dependent, the results showed consistency with previously published work. Furthermore, the detailed validation of the snow dynamics simulations in HTESSEL and EC-EARTH guarantees consistency of the results.

  4. Attentional selection of relative SF mediates global versus local processing: evidence from EEG.

    Science.gov (United States)

    Flevaris, Anastasia V; Bentin, Shlomo; Robertson, Lynn C

    2011-06-13

    Previous research on functional hemispheric differences in visual processing has associated global perception with low spatial frequency (LSF) processing biases of the right hemisphere (RH) and local perception with high spatial frequency (HSF) processing biases of the left hemisphere (LH). The Double Filtering by Frequency (DFF) theory expanded this hypothesis by proposing that visual attention selects and is directed to relatively LSFs by the RH and relatively HSFs by the LH, suggesting a direct causal relationship between SF selection and global versus local perception. We tested this idea in the current experiment by comparing activity in the EEG recorded at posterior right and posterior left hemisphere sites while participants' attention was directed to global or local levels of processing after selection of relatively LSFs versus HSFs in a previous stimulus. Hemispheric asymmetry in the alpha band (8-12 Hz) during preparation for global versus local processing was modulated by the selected SF. In contrast, preparatory activity associated with selection of SF was not modulated by the previously attended level (global/local). These results support the DFF theory that top-down attentional selection of SF mediates global and local processing.

  5. Rapid Globalization of Medical Device Clinical Development Programs in Japan - The Case of Drug-Eluting Stents.

    Science.gov (United States)

    Murakami, Madoka; Suzuki, Yuka; Tominaga, Toshiyoshi

    2018-02-23

    Delays in the introduction to the Japanese market of drug-eluting stents (DES) developed overseas (i.e., "device lag") decreased sharply between 2004 and 2012. The reduction accompanied a shift in clinical development from a succession pattern (initial product development and approval overseas followed by eventual entrance into the Japanese market) to parallel development (employing multiregional clinical trials (MRCTs)). Although resource-intensive in the short-term, MRCTs are proving to be an effective tool in simultaneous global product development. Creative study designs and the absence of significant ethnic differences in Japanese subjects regarding DES safety and efficacy and the pharmacokinetic behavior of their coating drugs propel this process. More general factors such as medical need and industry incentivization also encourage this shift. Physicians' preference for DES over other percutaneous coronary interventions, the expanding global DES market, and streamlined development and approval prospects each motivate industry to continue investing in DES product development. The efforts of various stakeholders were also integral to overcoming practical obstacles, and contributions by 'Harmonization by Doing' and a premarket collaboration initiative between the USA and Japan were particularly effective. Today, USA/Japan regulatory cooperation is routine, and Japan is now integrated into global medical device development. MRCTs including Japanese subjects, sites, and investigators are now commonplace.

  6. Global Production Planning Process considering the Supply Risk of Overseas Manufacturing Sites

    Directory of Open Access Journals (Sweden)

    Hosang Jung

    2015-01-01

    Full Text Available Although global manufacturers can produce most of their final products in local plants, they need to source components or parts from desirable overseas manufacturing partners at low cost in order to fulfill customer orders. In this global manufacturing environment, capacity information for planning is usually imprecise owing to the various risks of overseas plants (e.g., foreign governments’ policies and labor stability. It is therefore not easy for decision-makers to generate a global production plan showing the production amounts at local plants and overseas manufacturing facilities operated by manufacturing partners. In this paper, we present a new global production planning process considering the supply risk of overseas manufacturing sites. First, local experts estimate the supply capacity of an overseas plant using their judgment to determine when the risk could occur and how large the risk impact would be. Next, we run a global production planning model with the estimated supply capacities. The proposed process systematically adopts the qualitative judgments of local experts in the global production planning process and thus can provide companies with a realistic global production plan. We demonstrate the applicability of the proposed process with a real world case.

  7. Global Trends in Alzheimer Disease Clinical Development: Increasing the Probability of Success.

    Science.gov (United States)

    Sugino, Haruhiko; Watanabe, Akihito; Amada, Naoki; Yamamoto, Miho; Ohgi, Yuta; Kostic, Dusan; Sanchez, Raymond

    2015-08-01

    Alzheimer disease (AD) is a growing global health and economic issue as elderly populations increase dramatically across the world. Despite the many clinical trials conducted, currently no approved disease-modifying treatment exists. In this commentary, the present status of AD drug development and the grounds for collaborations between government, academia, and industry to accelerate the development of disease-modifying AD therapies are discussed. Official government documents, literature, and news releases were surveyed by MEDLINE and website research. Currently approved anti-AD drugs provide only short-lived symptomatic improvements, which have no effect on the underlying pathogenic mechanisms or progression of the disease. The failure to approve a disease-modifying drug for AD may be because the progression of AD in the patient populations enrolled in clinical studies was too advanced for drugs to demonstrate cognitive and functional improvements. The US Food and Drug Administration and the European Medicines Agency recently published draft guidance for industry which discusses approaches for conducting clinical studies with patients in early AD stages. For successful clinical trials in early-stage AD, however, it will be necessary to identify biomarkers highly correlated with the clinical onset and the longitudinal progress of AD. In addition, because of the high cost and length of clinical AD studies, support in the form of global initiatives and collaborations between government, industry, and academia is needed. In response to this situation, national guidance and international collaborations have been established. Global initiatives are focusing on 2025 as a goal to provide new treatment options, and early signs of success in biomarker and drug development are already emerging. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  8. Global gas processing will strengthen to meet expanding markets

    International Nuclear Information System (INIS)

    Haun, R.R.; Otto, K.W.; Whitley, S.C.; Gist, R.L.

    1996-01-01

    The worldwide LPG industry continues to expand faster than the petroleum industry -- 4%/year for LPG vs. 2%/year for petroleum in 1995 and less than 1%/year in the early 1990s. This rapid expansion of LPG markets is occurring in virtually every region of the world, including such developing countries as China. The Far East is the focus of much of the LPG industry's attention, but many opportunities exist in other regions such as the Indian subcontinent, Southeast Asia, and Latin America. The investment climate is improving in all phases of downstream LPG marketing, including terminaling, storage, and wholesale and retail distribution. The world LPG supply/demand balance has been relatively tight since the Gulf War and should remain so. Base demand (the portion of demand that is not highly price-sensitive) is expanding more rapidly than supplies. As a result, the proportion of total LPG supplies available for price-sensitive petrochemical feedstock markets is declining, at least in the short term. The paper discusses importers, price patterns, world LPG demand, world LPG supply, US NGL supply, US gas processing, ethane and propane supply, butane, isobutane, and natural gasoline supply, and US NGL demand

  9. Dust: Small-scale processes with global consequences

    Science.gov (United States)

    Okin, G.S.; Bullard, J.E.; Reynolds, R.L.; Ballantine, J.-A.C.; Schepanski, K.; Todd, M.C.; Belnap, J.; Baddock, M.C.; Gill, T.E.; Miller, M.E.

    2011-01-01

    Desert dust, both modern and ancient, is a critical component of the Earth system. Atmospheric dust has important effects on climate by changing the atmospheric radiation budget, while deposited dust influences biogeochemical cycles in the oceans and on land. Dust deposited on snow and ice decreases its albedo, allowing more light to be trapped at the surface, thus increasing the rate of melt and influencing energy budgets and river discharge. In the human realm, dust contributes to the transport of allergens and pathogens and when inhaled can cause or aggravate respiratory diseases. Dust storms also represent a significant hazard to road and air travel. Because it affects so many Earth processes, dust is studied from a variety of perspectives and at multiple scales, with various disciplines examining emissions for different purposes using disparate strategies. Thus, the range of objectives in studying dust, as well as experimental approaches and results, has not yet been systematically integrated. Key research questions surrounding the production and sources of dust could benefit from improved collaboration among different research communities. These questions involve the origins of dust, factors that influence dust production and emission, and methods through which dust can be monitored. ?? Author(s) 2011.

  10. Dust emission: small-scale processes with global consequences

    Science.gov (United States)

    Okin, Gregory S.; Bullard, Joanna E.; Reynolds, Richard L.; Ballantine, John-Andrew C.; Schepanski, Kerstin; Todd, Martin C.; Belnap, Jayne; Baddock, Matthew C.; Gill, Thomas E.; Miller, Mark E.

    2011-01-01

    Desert dust, both modern and ancient, is a critical component of the Earth system. Atmospheric dust has important effects on climate by changing the atmospheric radiation budget, while deposited dust influences biogeochemical cycles in the oceans and on land. Dust deposited on snow and ice decreases its albedo, allowing more light to be trapped at the surface, thus increasing the rate of melt and influencing energy budgets and river discharge. In the human realm, dust contributes to the transport of allergens and pathogens and when inhaled can cause or aggravate respiratory diseases. Dust storms also represent a significant hazard to road and air travel. Because it affects so many Earth processes, dust is studied from a variety of perspectives and at multiple scales, with various disciplines examining emissions for different purposes using disparate strategies. Thus, the range of objectives in studying dust, as well as experimental approaches and results, has not yet been systematically integrated. Key research questions surrounding the production and sources of dust could benefit from improved collaboration among different research communities. These questions involve the origins of dust, factors that influence dust production and emission, and methods through which dust can be monitored.

  11. Spiral Structure and Global Star Formation Processes in M 51

    Science.gov (United States)

    Gruendl, Robert A.

    1994-12-01

    The nearby grand design spiral galaxy, M 51, is an obvious proving ground for studies of spiral structure and large scale star formation processes. New near--infrared observations of M 51 made with COB (Cryogenic Optical Bench) on the Kitt Peak 1.3m allow us to examine the stellar distribution and the young star formation regions as well as probe regions of high extinction such as dust lanes. We also present an analysis of the kinematics of the ionized gas observed with the Maryland--Caltech Imaging Fabry Perot. The color information we derive from the near--infrared bands provides a more accurate tracer of extinction than optical observations. We find that the dust extinction and CO emission in the arms are well correlated. Our kinematic data show unambiguously that these dense gas concentrations are associated with kinematic perturbations. In the inner disk, these perturbations are seen to be consistent with the streaming motions predicted by classical density wave theory. The dust lanes, and presumably the molecular arms, form a narrow ridge that matches these velocity perturbations wherever the viewing angle is appropriate. This interpretation requires that the corotation radius be inward of the outer tidal arms. The outer tidal arms however show streaming velocities of the sign that would be expected interior to the corotation point. This can be reconciled if the outer arms are part of a second spiral pattern, most likely due to the interaction with the companion NGC 5195. The near--infrared observations also show emission from the massive star forming regions. These observations are less affected by extinction than optical observations of H II regions and show clearly that the sites of massive star formation are correlated with but downstream from the concentrations of dense molecular material. This provides clear evidence that the ISM has been organized by the streaming motions which have in turn triggered massive star formation.

  12. Clinical symptoms predict concurrent social and global functioning in an early psychosis sample.

    Science.gov (United States)

    Cacciotti-Saija, Cristina; Langdon, Robyn; Ward, Philip B; Hickie, Ian B; Guastella, Adam J

    2018-04-01

    Although well established in chronic schizophrenia, the key determinants of functioning remain unknown during the early phase of a psychotic disorder. The aim of this study was to comprehensively examine the social cognitive, basic neurocognitive and clinical predictors of concurrent social functioning and global functioning in an early psychosis sample. This study examined the relationship between social cognition, basic neurocognition and clinical symptoms with concurrent functioning in 51 early psychosis individuals. Assessments included a range of self-report, observational and clinician-rated measures of cognitive, symptom severity and functioning domains. Results revealed a significant association between self-reported social function and lower levels of both social interaction anxiety and negative psychotic symptoms. A significant association was also observed between lower levels of negative psychotic symptoms and observed social functioning. Lastly, results demonstrated a significant association between reduced negative psychotic symptoms and clinician-rated global functioning. Clinical domains such as negative symptoms and social interaction anxiety significantly contribute to an optimal model predicting outcome during the early phase of a psychotic disorder. These clinical features may also provide useful markers of an individual's capacity for social participation. Clinical implications include the need for early targeted intervention to address social anxiety and negative psychotic symptoms to facilitate optimum patient outcome. © 2015 Wiley Publishing Asia Pty Ltd.

  13. Semantic processing of EHR data for clinical research.

    Science.gov (United States)

    Sun, Hong; Depraetere, Kristof; De Roo, Jos; Mels, Giovanni; De Vloed, Boris; Twagirumukiza, Marc; Colaert, Dirk

    2015-12-01

    There is a growing need to semantically process and integrate clinical data from different sources for clinical research. This paper presents an approach to integrate EHRs from heterogeneous resources and generate integrated data in different data formats or semantics to support various clinical research applications. The proposed approach builds semantic data virtualization layers on top of data sources, which generate data in the requested semantics or formats on demand. This approach avoids upfront dumping to and synchronizing of the data with various representations. Data from different EHR systems are first mapped to RDF data with source semantics, and then converted to representations with harmonized domain semantics where domain ontologies and terminologies are used to improve reusability. It is also possible to further convert data to application semantics and store the converted results in clinical research databases, e.g. i2b2, OMOP, to support different clinical research settings. Semantic conversions between different representations are explicitly expressed using N3 rules and executed by an N3 Reasoner (EYE), which can also generate proofs of the conversion processes. The solution presented in this paper has been applied to real-world applications that process large scale EHR data. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Systems Factorial Technology provides new insights on global-local information processing in autism spectrum disorders.

    Science.gov (United States)

    Johnson, Shannon A; Blaha, Leslie M; Houpt, Joseph W; Townsend, James T

    2010-02-01

    Previous studies of global-local processing in autism spectrum disorders (ASDs) have indicated mixed findings, with some evidence of a local processing bias, or preference for detail-level information, and other results suggesting typical global advantage, or preference for the whole or gestalt. Findings resulting from this paradigm have been used to argue for or against a detail focused processing bias in ASDs, and thus have important theoretical implications. We applied Systems Factorial Technology, and the associated Double Factorial Paradigm (both defined in the text), to examine information processing characteristics during a divided attention global-local task in high-functioning individuals with an ASD and typically developing controls. Group data revealed global advantage for both groups, contrary to some current theories of ASDs. Information processing models applied to each participant revealed that task performance, although showing no differences at the group level, was supported by different cognitive mechanisms in ASD participants compared to controls. All control participants demonstrated inhibitory parallel processing and the majority demonstrated a minimum-time stopping rule. In contrast, ASD participants showed exhaustive parallel processing with mild facilitatory interactions between global and local information. Thus our results indicate fundamental differences in the stopping rules and channel dependencies in individuals with an ASD.

  15. [Description of the mental processes occurring during clinical reasoning].

    Science.gov (United States)

    Pottier, P; Planchon, B

    2011-06-01

    Clinical reasoning is a highly complex system with multiple inter-dependent mental activities. Gaining a better understanding of those cognitive processes has two practical implications: for physicians, being able to analyse their own reasoning method may prove to be helpful in diagnostic dead end; for medical teachers, identifying problem-solving strategies used by medical students may foster an appropriate individual feed-back aiming at improving their clinical reasoning skills. On the basis of a detailed literature review, the main diagnostic strategies and their related pattern of mental processes are described and illustrated with a concrete example, going from the patient's complaint to the chosen solution. Inductive, abductive and deductive diagnostic approaches are detailed. Different strategies for collecting data (exhaustive or oriented) and for problem-building are described. The place of problem solving strategies such as pattern-recognition, scheme inductive process, using of clinical script, syndrome grouping and mental hypotheses test is considered. This work aims at breaking up mental activities in process within clinical reasoning reminding that expert reasoning is characterised by the ability to use and structure the whole of these activities in a coherent system, using combined strategies in order to guarantee a better accuracy of their diagnosis. Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  16. Student Reflection Papers on a Global Clinical Experience: A Qualitative Study.

    Science.gov (United States)

    Margolis, Carmi Z; Rohrbaugh, Robert M; Tsang, Luisa; Fleischer, Jennifer; Graham, Mark J; Kellett, Anne; Hafler, Janet P

    Many of the 70,000 graduating US medical students [per year] have reported participating in a global health activity at some stage of medical school. This case study design provided a method for understanding the student's experience that included student's learning about culture, health disparities, exposure and reaction to a range of diseases actually encountered. The broad diversity of themes among students indicated that the GCE provided a flexible, personalized experience. We need to understand the student's experience in order to help design appropriate curricular experiences [and valid student assessment]. Our research aim was to analyze medical student reflection papers to understand how they viewed their Global Clinical Experience (GCE). A qualitative case study design was used to analyze student reflection papers. All 28 students who participated in a GCE from 2008-2010 and in 2014-2015 and submitted a reflection paper on completion of the GCE were eligible to participate in the study. One student did not submit a reflection paper and was not included in the study. All 27 papers were coded by paragraph for reflection and for themes. System of Care/Range of Care was mentioned most often, Aids to Adjustment Process was mentioned least. The theme, "Diseases," referred to any mention of a disease in the reflection papers, and 44 diseases were mentioned in the papers. The analysis for depth of reflection yielded the following data: Observation, 81/248 paragraphs; Observation and Interpretation, 130/248 paragraphs; and Observation, Interpretation, and Suggestions for change, 36/248 paragraphs; 9 reflection papers contained 27 separate accounts of a transformational experience. This study provided a method for understanding the student's experience that included student's learning about culture, health disparities, and exposure and reaction to a range of diseases actually encountered. The broad diversity of themes among students indicated that the GCE provided a

  17. Effects of global and local contexts on chord processing: An ERP study.

    Science.gov (United States)

    Zhang, Jingjing; Zhou, Xuefeng; Chang, Ruohan; Yang, Yufang

    2018-01-31

    In real life, the processing of an incoming event is continuously influenced by prior information at multiple timescales. The present study investigated how harmonic contexts at both local and global levels influence the processing of an incoming chord in an event-related potentials experiment. Chord sequences containing two phrases were presented to musically trained listeners, with the last critical chord either harmonically related or less related to its preceding context at local and/or global levels. ERPs data showed an ERAN-like effect for local context in early time window and a N5-like component for later interaction between the local context and global context. These results suggest that both the local and global contexts influence the processing of an incoming music event, and the local effect happens earlier than the global. Moreover, the interaction between the local context and global context in N5 may suggest that music syntactic integration at local level takes place prior to the integration at global level. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Providing Context for Complexity: Using Infographics and Conceptual Models to Teach Global Change Processes

    Science.gov (United States)

    Bean, J. R.; White, L. D.

    2015-12-01

    Understanding modern and historical global changes requires interdisciplinary knowledge of the physical and life sciences. The Understanding Global Change website from the UC Museum of Paleontology will use a focal infographic that unifies diverse content often taught in separate K-12 science units. This visualization tool provides scientists with a structure for presenting research within the broad context of global change, and supports educators with a framework for teaching and assessing student understanding of complex global change processes. This new approach to teaching the science of global change is currently being piloted and refined based on feedback from educators and scientists in anticipation of a 2016 website launch. Global change concepts are categorized within the infographic as causes of global change (e.g., burning of fossil fuels, volcanism), ongoing Earth system processes (e.g., ocean circulation, the greenhouse effect), and the changes scientists measure in Earth's physical and biological systems (e.g., temperature, extinctions/radiations). The infographic will appear on all website content pages and provides a template for the creation of flowcharts, which are conceptual models that allow teachers and students to visualize the interdependencies and feedbacks among processes in the atmosphere, hydrosphere, biosphere, and geosphere. The development of this resource is timely given that the newly adopted Next Generation Science Standards emphasize cross-cutting concepts, including model building, and Earth system science. Flowchart activities will be available on the website to scaffold inquiry-based lessons, determine student preconceptions, and assess student content knowledge. The infographic has already served as a learning and evaluation tool during professional development workshops at UC Berkeley, Stanford University, and the Smithsonian National Museum of Natural History. At these workshops, scientists and educators used the infographic

  19. Improving a Dental School's Clinic Operations Using Lean Process Improvement.

    Science.gov (United States)

    Robinson, Fonda G; Cunningham, Larry L; Turner, Sharon P; Lindroth, John; Ray, Deborah; Khan, Talib; Yates, Audrey

    2016-10-01

    The term "lean production," also known as "Lean," describes a process of operations management pioneered at the Toyota Motor Company that contributed significantly to the success of the company. Although developed by Toyota, the Lean process has been implemented at many other organizations, including those in health care, and should be considered by dental schools in evaluating their clinical operations. Lean combines engineering principles with operations management and improvement tools to optimize business and operating processes. One of the core concepts is relentless elimination of waste (non-value-added components of a process). Another key concept is utilization of individuals closest to the actual work to analyze and improve the process. When the medical center of the University of Kentucky adopted the Lean process for improving clinical operations, members of the College of Dentistry trained in the process applied the techniques to improve inefficient operations at the Walk-In Dental Clinic. The purpose of this project was to reduce patients' average in-the-door-to-out-the-door time from over four hours to three hours within 90 days. Achievement of this goal was realized by streamlining patient flow and strategically relocating key phases of the process. This initiative resulted in patient benefits such as shortening average in-the-door-to-out-the-door time by over an hour, improving satisfaction by 21%, and reducing negative comments by 24%, as well as providing opportunity to implement the electronic health record, improving teamwork, and enhancing educational experiences for students. These benefits were achieved while maintaining high-quality patient care with zero adverse outcomes during and two years following the process improvement project.

  20. Non tumoral intracranial expansive processes: clinical tomographic correlation

    International Nuclear Information System (INIS)

    Campos, P.; Herrera, G.; Valneica, F.

    1991-01-01

    Presentation of clinical-tomographic correlation in 111 cases of non tumoral intracranial expansive processes seen between 1984-1988 in the Hospital Cayetano Heredia (Lima, Peru). Emphasis is given fundamentally to: the importance of establishing the organicity of partial and late epilepsy; the high incidence rate of inflammatory infectious processes with CNS compromise in under developing countries; the necessity of making public the importance of two parasitic diseases in the differential diagnosis of non tumoral intracranial expansive processes: free living amebiasis, and toxoplasmosis (especially in association with AIDS). (author)

  1. Fostering new relational experience: clinical process in couple psychotherapy.

    Science.gov (United States)

    Marmarosh, Cheri L

    2014-03-01

    One of the most critical goals for couple psychotherapy is to foster a new relational experience in the session where the couple feels safe enough to reveal more vulnerable emotions and to explore their defensive withdrawal, aggressive attacking, or blaming. The lived intimate experience in the session offers the couple an opportunity to gain integrative insight into their feelings, expectations, and behaviors that ultimately hinder intimacy. The clinical processes that are necessary include empathizing with the couple and facilitating safety within the session, looking for opportunities to explore emotions, ruptures, and unconscious motivations that maintain distance in the relationship, and creating a new relational experience in the session that has the potential to engender integrative insight. These clinical processes will be presented with empirical support. Experts from a session will be used to highlight how these processes influence the couple and promote increased intimacy. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  2. Globalization

    DEFF Research Database (Denmark)

    Plum, Maja

    Globalization is often referred to as external to education - a state of affair facing the modern curriculum with numerous challenges. In this paper it is examined as internal to curriculum; analysed as a problematization in a Foucaultian sense. That is, as a complex of attentions, worries, ways...... of reasoning, producing curricular variables. The analysis is made through an example of early childhood curriculum in Danish Pre-school, and the way the curricular variable of the pre-school child comes into being through globalization as a problematization, carried forth by the comparative practices of PISA...

  3. Globalization

    OpenAIRE

    F. Gerard Adams

    2008-01-01

    The rapid globalization of the world economy is causing fundamental changes in patterns of trade and finance. Some economists have argued that globalization has arrived and that the world is “flat†. While the geographic scope of markets has increased, the author argues that new patterns of trade and finance are a result of the discrepancies between “old†countries and “new†. As the differences are gradually wiped out, particularly if knowledge and technology spread worldwide, the t...

  4. Diagnostic outcome following routine genetics clinic referral for the assessment of global developmental delay.

    LENUS (Irish Health Repository)

    Shahdadpuri, R

    2012-02-01

    The aim of this study was to ascertain the diagnostic yield following a routine genetics clinic referral for the assessment of global developmental delay. Detailed retrospective review of 119 complete consecutive case notes of patients referred to one single clinical geneticist over a 14 month time period was undertaken (n = 119; 54 males, 65 females). The age at initial review ranged from 2 months to 37 years 3 months (mean 8 y 3 mo [SD 7 y 10 mo]). We made a diagnosis in 36\\/119 (30%); 21\\/36 were new diagnoses and 15\\/36 were confirmations of diagnoses. We removed a wrong diagnostic label in 8\\/119 (7%). In 3\\/8 we were able to achieve a diagnosis but in 5\\/8 no alternative diagnosis was reached. We had a better diagnostic rate where the patients were dysmorphic (odds ratio [OR] 1.825; 95% confidence interval [CI] 1.065 to 3.128, p = 0.044). In the majority, the diagnosis was made by clinical examination only. Molecular diagnosis was reached in seven cases. Five cases were confirmed by cytogenetic analysis. Brain magnetic resonance imaging (MRI) revealed a diagnosis in three cases. This study confirms the importance of a clinical genetics assessment in the investigation of global developmental delay.

  5. A Typology for Modeling Processes in Clinical Guidelines and Protocols

    Science.gov (United States)

    Tu, Samson W.; Musen, Mark A.

    We analyzed the graphical representations that are used by various guideline-modeling methods to express process information embodied in clinical guidelines and protocols. From this analysis, we distilled four modeling formalisms and the processes they typically model: (1) flowcharts for capturing problem-solving processes, (2) disease-state maps that link decision points in managing patient problems over time, (3) plans that specify sequences of activities that contribute toward a goal, (4) workflow specifications that model care processes in an organization. We characterized the four approaches and showed that each captures some aspect of what a guideline may specify. We believe that a general guideline-modeling system must provide explicit representation for each type of process.

  6. Global Processing Speed as a Mediator of Developmental Changes in Children's Auditory Memory Span

    Science.gov (United States)

    Ferguson, A.N.; Bowey, J.A.

    2005-01-01

    This study examined the role of global processing speed in mediating age increases in auditory memory span in 5- to 13-year-olds. Children were tested on measures of memory span, processing speed, single-word speech rate, phonological sensitivity, and vocabulary. Structural equation modeling supported a model in which age-associated increases in…

  7. Rapid and coordinated processing of global motion images by local clusters of retinal ganglion cells.

    Science.gov (United States)

    Matsumoto, Akihiro; Tachibana, Masao

    2017-01-01

    Even when the body is stationary, the whole retinal image is always in motion by fixational eye movements and saccades that move the eye between fixation points. Accumulating evidence indicates that the brain is equipped with specific mechanisms for compensating for the global motion induced by these eye movements. However, it is not yet fully understood how the retina processes global motion images during eye movements. Here we show that global motion images evoke novel coordinated firing in retinal ganglion cells (GCs). We simultaneously recorded the firing of GCs in the goldfish isolated retina using a multi-electrode array, and classified each GC based on the temporal profile of its receptive field (RF). A moving target that accompanied the global motion (simulating a saccade following a period of fixational eye movements) modulated the RF properties and evoked synchronized and correlated firing among local clusters of the specific GCs. Our findings provide a novel concept for retinal information processing during eye movements.

  8. Nonconsensual clinical trials: a foreseeable risk of offshoring under global corporatism.

    Science.gov (United States)

    Spielman, Bethany

    2015-03-01

    This paper explores the connection of offshoring and outsourcing to nonconsensual global pharmaceutical trials in low-income countries. After discussing reasons why the topic of nonconsensual offshored clinical trials may be overlooked in bioethics literature, I suggest that when pharmaceutical corporations offshore clinical trials today, nonconsensual experiments are often foreseeable and not simply the result of aberrant ethical conduct by a few individuals. Offshoring of clinical trials is structured so that experiments can be presented as health care in a unique form of outsourcing from the host country to pharmaceutical corporations. Bioethicists' assessments of the risks and potential benefits of offshore corporate pharmaceutical trials should therefore systematically include not only the hoped for benefits and the risks of the experimental drug but also the risk that subjects will not have consented, as well as the broader international consequences of nonconsensual experimentation.

  9. Constructing Consistent Multiscale Scenarios by Transdisciplinary Processes: the Case of Mountain Regions Facing Global Change

    OpenAIRE

    Fridolin Simon. Brand; Roman Seidl; Quang Bao. Le; Julia Maria. Brändle; Roland Werner. Scholz

    2013-01-01

    Alpine regions in Europe, in particular, face demanding local challenges, e.g., the decline in the agriculture and timber industries, and are also prone to global changes, such as in climate, with potentially severe impacts on tourism. We focus on the Visp region in the Upper Valais, Switzerland, and ask how the process of stakeholder involvement in research practice can contribute to a better understanding of the specific challenges and future development of mountainous regions under global ...

  10. Integrating utilization-focused evaluation with business process modeling for clinical research improvement.

    Science.gov (United States)

    Kagan, Jonathan M; Rosas, Scott; Trochim, William M K

    2010-10-01

    New discoveries in basic science are creating extraordinary opportunities to design novel biomedical preventions and therapeutics for human disease. But the clinical evaluation of these new interventions is, in many instances, being hindered by a variety of legal, regulatory, policy and operational factors, few of which enhance research quality, the safety of study participants or research ethics. With the goal of helping increase the efficiency and effectiveness of clinical research, we have examined how the integration of utilization-focused evaluation with elements of business process modeling can reveal opportunities for systematic improvements in clinical research. Using data from the NIH global HIV/AIDS clinical trials networks, we analyzed the absolute and relative times required to traverse defined phases associated with specific activities within the clinical protocol lifecycle. Using simple median duration and Kaplan-Meyer survival analysis, we show how such time-based analyses can provide a rationale for the prioritization of research process analysis and re-engineering, as well as a means for statistically assessing the impact of policy modifications, resource utilization, re-engineered processes and best practices. Successfully applied, this approach can help researchers be more efficient in capitalizing on new science to speed the development of improved interventions for human disease.

  11. Executive functioning and local-global visual processing: candidate endophenotypes for autism spectrum disorder?

    Science.gov (United States)

    Van Eylen, Lien; Boets, Bart; Cosemans, Nele; Peeters, Hilde; Steyaert, Jean; Wagemans, Johan; Noens, Ilse

    2017-03-01

    Heterogeneity within autism spectrum disorder (ASD) hampers insight in the etiology and stimulates the search for endophenotypes. Endophenotypes should meet several criteria, the most important being the association with ASD and the higher occurrence rate in unaffected ASD relatives than in the general population. We evaluated these criteria for executive functioning (EF) and local-global (L-G) visual processing. By administering an extensive cognitive battery which increases the validity of the measures, we examined which of the cognitive anomalies shown by ASD probands also occur in their unaffected relatives (n = 113) compared to typically developing (TD) controls (n = 100). Microarrays were performed, so we could exclude relatives from probands with a de novo mutation in a known ASD susceptibility copy number variant, thus increasing the probability that genetic risk variants are shared by the ASD relatives. An overview of studies investigating EF and L-G processing in ASD relatives was also provided. For EF, ASD relatives - like ASD probands - showed impairments in response inhibition, cognitive flexibility and generativity (specifically, ideational fluency), and EF impairments in daily life. For L-G visual processing, the ASD relatives showed no anomalies on the tasks, but they reported more attention to detail in daily life. Group differences were similar for siblings and for parents of ASD probands, and yielded larger effect sizes in a multiplex subsample. The group effect sizes for the comparison between ASD probands and TD individuals were generally larger than those of the ASD relatives compared to TD individuals. Impaired cognitive flexibility, ideational fluency and response inhibition are strong candidate endophenotypes for ASD. They could help to delineate etiologically more homogeneous subgroups, which is clinically important to allow assigning ASD probands to different, more targeted, interventions. © 2016 Association for Child and Adolescent

  12. Association of global weather changes with acute coronary syndromes: gaining insights from clinical trials data

    Science.gov (United States)

    Bakal, Jeffrey A.; Ezekowitz, Justin A.; Westerhout, Cynthia M.; Boersma, Eric; Armstrong, Paul W.

    2013-05-01

    The aim of this study was to develop a method for the identification of global weather parameters and patient characteristics associated with a type of heart attack in which there is a sudden partial blockage of a coronary artery. This type of heart attack does not demonstrate an elevation of the ST segment on an electrocardiogram and is defined as a non-ST elevation acute coronary syndrome (NSTE-ACS). Data from the Global Summary of the Day database was linked with the enrollment and baseline data for a phase III international clinical trial in NSTE-ACS in four 48-h time periods covering the week prior to the clinical event that prompted enrollment in the study. Meteorological events were determined by standardizing the weather data from enrollment dates against an empirical distribution from the month prior. These meteorological events were then linked to the patients' geographic region, demographics and comorbidities to identify potential susceptible populations. After standardization, changes in temperature and humidity demonstrated an association with the enrollment event. Additionally there appeared to be an association with gender, region and a history of stroke. This methodology may provide a useful global insight into assessing the biometeorologic component of diseases from international data.

  13. Information processing speed as a mediator between psychosocial stress and global cognition in older adults.

    Science.gov (United States)

    Foong, Hui F; Hamid, Tengku A; Ibrahim, Rahimah; Haron, Sharifah A

    2018-01-01

    The link between psychosocial stress and cognitive function is complex, and previous studies have indicated that it may be mediated by processing speed. Therefore, the main aim of this study was to examine whether processing speed mediates the association between psychosocial stress and global cognition in older adults. Moreover, the moderating role of gender in this model is examined as well. The study included 2322 community-dwelling older adults in Malaysia who were randomly selected through a multistage proportional cluster random sampling technique. Global cognition construct was measured by the Mini-Mental State Examination and Montreal Cognitive Assessment; psychosocial stress construct was measured by perceived stress, depression, loneliness, and neuroticism; and processing speed was assessed by the Digit Symbol Substitution Test. Structural equation modelling was used to analyze the mediation and moderation tests. Processing speed was found to partially mediate the relationship between psychosocial stress and global cognition (β in the direct model = -0.15, P cognition was found to be significant in men only, whereas the association between processing speed and global cognition was significant in men and women. Psychosocial stress may increase the likelihood that older adults will experience poor processing capacity, which could reduce their higher level cognition. Results indicate that there is a need to develop processing capacity intervention programmes for psychologically distressed older adults to prevent them from suffering cognitive decline. © 2018 Japanese Psychogeriatric Society.

  14. Towards an Understanding of Enabling Process Knowing in Global Software Development: A Case Study

    DEFF Research Database (Denmark)

    Zahedi, Mansooreh; Babar, Muhammad Ali

    2014-01-01

    Shared understanding of Software Engineering (SE) processes, that we call process knowing, is required for effective communication and coordination and communication within a team in order to improve team performance. SE Process knowledge can include roles, responsibilities and flow of informatio...... challenges of lack of process knowing and how an organization can enable process knowing for achieving the desired results that also help in increasing social interactions and positive behavioral changes......Shared understanding of Software Engineering (SE) processes, that we call process knowing, is required for effective communication and coordination and communication within a team in order to improve team performance. SE Process knowledge can include roles, responsibilities and flow of information...... over a project lifecycle. Developing and sustaining process knowledge can be more challenging in Global Software Development (GSD). GSD distances can limit the ability of a team to develop a common understanding of processes. Anecdotes of the problems caused by lack of common understanding of processes...

  15. Adaptive digital image processing in real time: First clinical experiences

    International Nuclear Information System (INIS)

    Andre, M.P.; Baily, N.A.; Hier, R.G.; Edwards, D.K.; Tainer, L.B.; Sartoris, D.J.

    1986-01-01

    The promise of computer image processing has generally not been realized in radiology, partly because the methods advanced to date have been expensive, time-consuming, or inconvenient for clinical use. The authors describe a low-cost system which performs complex image processing operations on-line at video rates. The method uses a combination of unsharp mask subtraction (for low-frequency suppression) and statistical differencing (which adjusts the gain at each point of the image on the basis of its variation from a local mean). The operator interactively adjusts aperture size, contrast gain, background subtraction, and spatial noise reduction. The system is being evaluated for on-line fluoroscopic enhancement, for which phantom measurements and clinical results, including lithotripsy, are presented. When used with a video camera, postprocessing of radiographs was advantageous in a variety of studies, including neonatal chest studies. Real-time speed allows use of the system in the reading room as a ''variable view box.''

  16. Which Parts of a Clinical Process EPR Needs Special Configuration

    DEFF Research Database (Denmark)

    Barlach, Anders; Simonsen, Jesper

    2007-01-01

    Subject: Which parts of an electronic patient record (EPR) can initially form a stable standard solution to be used by all clinicians? And which parts of an EPR can we predict needs initial as well as on-going re-configuration to meet the needs from diverse medical specialties. Purpose: To analyze...... which screen types in a clinical process that can be standard configured and which are subject to initial as well as on-going re-configuration. Methods and results: A pilot-project implementing a fully functional clinical process EPR was configured and used at a neurological ward, replacing all paper...... records 24/7. The analysis characterizes the different types of screens, a total of 243 included in the EPR solution. All screens have been extracted from the application and analyzed for changes – in total 222 changes. Discussion and conclusion: Most screens (87%) are very stable. Few (13%) are subjected...

  17. Detecting fast, online reasoning processes in clinical decision making.

    Science.gov (United States)

    Flores, Amanda; Cobos, Pedro L; López, Francisco J; Godoy, Antonio

    2014-06-01

    In an experiment that used the inconsistency paradigm, experienced clinical psychologists and psychology students performed a reading task using clinical reports and a diagnostic judgment task. The clinical reports provided information about the symptoms of hypothetical clients who had been previously diagnosed with a specific mental disorder. Reading times of inconsistent target sentences were slower than those of control sentences, demonstrating an inconsistency effect. The results also showed that experienced clinicians gave different weights to different symptoms according to their relevance when fluently reading the clinical reports provided, despite the fact that all the symptoms were of equal diagnostic value according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000). The diagnostic judgment task yielded a similar pattern of results. In contrast to previous findings, the results of the reading task may be taken as direct evidence of the intervention of reasoning processes that occur very early, rapidly, and online. We suggest that these processes are based on the representation of mental disorders and that these representations are particularly suited to fast retrieval from memory and to making inferences. They may also be related to the clinicians' causal reasoning. The implications of these results for clinician training are also discussed.

  18. Management of business process design in global implementation of enterprise resource planning systems

    DEFF Research Database (Denmark)

    Rahimi, Fatemeh

    on process standardization with corporate international management strategy and structural characteristics. Furthermore, business process design can be supported by establishing permanent central governance for BPM and horizontally integrating the BPM function with the IT function at the strategic......Investments in global enterprise resource planning (ERP) systems are typically carried out as a part of the globalization process in multinational corporations (MNCs). Global ERP systems support integration and control in MNCs in an important way by establishing a common language across an MNC...... and findings from case studies in nine organizations, the study addresses the three prescriptive research questions through five descriptive studies. First, by deploying alternative theories, this study explores the strategic, institutional, organizational, and relational factors that influence business...

  19. Use of global assays to understand clinical phenotype in congenital factor VII deficiency.

    Science.gov (United States)

    Greene, L A; Goldenberg, N A; Simpson, M L; Villalobos-Menuey, E; Bombardier, C; Acharya, S S; Santiago-Borrero, P J; Cambara, A; DiMichele, D M

    2013-09-01

    Congenital factor VII (FVII) deficiency is characterized by genotypic variability and phenotypic heterogeneity. Traditional screening and factor assays are unable to reliably predict clinical bleeding phenotype and guide haemorrhage prevention strategy. Global assays of coagulation and fibrinolysis may better characterize overall haemostatic balance and aid in haemorrhagic risk assessment. We evaluated the ability of novel global assays to better understand clinical bleeding severity in congenital FVII deficiency. Subjects underwent central determination of factor VII activity (FVII:C) as well as clot formation and lysis (CloFAL) and simultaneous thrombin and plasmin generation (STP) global assay analysis. A bleeding score was assigned to each subject through medical chart review. Global assay parameters were analysed with respect to bleeding score and FVII:C. Subgroup analyses were performed on paediatric subjects and subjects with FVII ≥ 1 IU dL(-1). CloFAL fibrinolytic index (FI2 ) inversely correlated with FVII:C while CloFAL maximum amplitude (MA) and STP maximum velocity of thrombin generation (VT max) varied directly with FVII:C. CloFAL FI2 directly correlated with bleeding score among subjects in both the total cohort and paediatric subcohort, but not among subjects with FVII ≥ 1 IU dL(-1) . Among subjects with FVII ≥ 1 IU dL(-1), STP time to maximum velocity of thrombin generation and time to maximum velocity of plasmin generation inversely correlated with bleeding score. These preliminary findings suggest a novel potential link between a hyperfibrinolytic state in bleeding severity and congenital FVII deficiency, an observation that should be further explored. © 2013 John Wiley & Sons Ltd.

  20. Characteristics of Volunteer Coaches in a Clinical Process Improvement Program.

    Science.gov (United States)

    Morley, Katharine E; Barysauskas, Constance M; Carballo, Victoria; Kalibatas, Orinta; Rao, Sandhya K; Jacobson, Joseph O; Cummings, Brian M

    The Partners Clinical Process Improvement Leadership Program provides quality improvement training for clinicians and administrators, utilizing graduates as volunteer peer coaches for mentorship. We sought to understand the factors associated with volunteer coach participation and gain insight into how to improve and sustain this program. Review of coach characteristics from course database and survey of frequent coaches. Out of 516 Partners Clinical Process Improvement Leadership Program graduates from March 2010 to June 2015, 117 (23%) individuals volunteered as coaches. Sixty-one (52%) individuals coached once, 31 (27%) coached twice, and 25 (21%) coached 3 or more times. There were statistically significant associations between coaching and occupation (P = .005), Partners Clinical Process Improvement Leadership Program course taken (P = .001), and course location (P = .007). Administrators were more likely to coach than physicians (odds ratio: 1.75, P = .04). Reasons for volunteering as a coach included further development of skills, desire to stay involved with program, and enjoying mentoring. Reasons for repeated coaching included maintaining quality improvement skills, expanding skills to a wider variety of projects, and networking. A peer graduate volunteer coach model is a viable strategy for interprofessional quality improvement mentorship. Strategies that support repeat coaching and engage clinicians should be promoted to ensure an experienced and diversified group of coaches.

  1. Driving clinical study efficiency by using a productivity breakdown model: comparative evaluation of a global clinical study and a similar Japanese study.

    Science.gov (United States)

    Takahashi, K; Sengoku, S; Kimura, H

    2011-02-01

    A fundamental management imperative of pharmaceutical companies is to contain surging costs of developing and launching drugs globally. Clinical studies are a research and development (R&D) cost driver. The objective of this study was to develop a productivity breakdown model, or a key performance indicator (KPI) tree, for an entire clinical study and to use it to compare a global clinical study with a similar Japanese study. We, thereby, hope to identify means of improving study productivity. We developed the new clinical study productivity breakdown model, covering operational aspects and cost factors. Elements for improving clinical study productivity were assessed from a management viewpoint by comparing empirical tracking data from a global clinical study with a Japanese study with similar protocols. The following unique and material differences, beyond simple international difference in cost of living, that could affect the efficiency of future clinical trials were identified: (i) more frequent site visits in the Japanese study, (ii) head counts at the Japanese study sites more than double those of the global study and (iii) a shorter enrollment time window of about a third that of the global study at the Japanese study sites. We identified major differences in the performance of the two studies. These findings demonstrate the potential of the KPI tree for improving clinical study productivity. Trade-offs, such as those between reduction in head count at study sites and expansion of the enrollment time window, must be considered carefully. © 2010 Blackwell Publishing Ltd.

  2. Differential Globalization of Industry- and Non-Industry-Sponsored Clinical Trials.

    Science.gov (United States)

    Atal, Ignacio; Trinquart, Ludovic; Porcher, Raphaël; Ravaud, Philippe

    2015-01-01

    Mapping the international landscape of clinical trials may inform global health research governance, but no large-scale data are available. Industry or non-industry sponsorship may have a major influence in this mapping. We aimed to map the global landscape of industry- and non-industry-sponsored clinical trials and its evolution over time. We analyzed clinical trials initiated between 2006 and 2013 and registered in the WHO International Clinical Trials Registry Platform (ICTRP). We mapped single-country and international trials by World Bank's income groups and by sponsorship (industry- vs. non- industry), including its evolution over time from 2006 to 2012. We identified clusters of countries that collaborated significantly more than expected in industry- and non-industry-sponsored international trials. 119,679 clinical trials conducted in 177 countries were analysed. The median number of trials per million inhabitants in high-income countries was 100 times that in low-income countries (116.0 vs. 1.1). Industry sponsors were involved in three times more trials per million inhabitants than non-industry sponsors in high-income countries (75.0 vs. 24.5) and in ten times fewer trials in low- income countries (0.08 vs. 1.08). Among industry- and non-industry-sponsored trials, 30.3% and 3.2% were international, respectively. In the industry-sponsored network of collaboration, Eastern European and South American countries collaborated more than expected; in the non-industry-sponsored network, collaboration among Scandinavian countries was overrepresented. Industry-sponsored international trials became more inter-continental with time between 2006 and 2012 (from 54.8% to 67.3%) as compared with non-industry-sponsored trials (from 42.4% to 37.2%). Based on trials registered in the WHO ICTRP we documented a substantial gap between the globalization of industry- and non-industry-sponsored clinical research. Only 3% of academic trials but 30% of industry trials are

  3. Differential Globalization of Industry- and Non-Industry–Sponsored Clinical Trials

    Science.gov (United States)

    Atal, Ignacio; Trinquart, Ludovic; Porcher, Raphaël; Ravaud, Philippe

    2015-01-01

    Background Mapping the international landscape of clinical trials may inform global health research governance, but no large-scale data are available. Industry or non-industry sponsorship may have a major influence in this mapping. We aimed to map the global landscape of industry- and non-industry–sponsored clinical trials and its evolution over time. Methods We analyzed clinical trials initiated between 2006 and 2013 and registered in the WHO International Clinical Trials Registry Platform (ICTRP). We mapped single-country and international trials by World Bank's income groups and by sponsorship (industry- vs. non- industry), including its evolution over time from 2006 to 2012. We identified clusters of countries that collaborated significantly more than expected in industry- and non-industry–sponsored international trials. Results 119,679 clinical trials conducted in 177 countries were analysed. The median number of trials per million inhabitants in high-income countries was 100 times that in low-income countries (116.0 vs. 1.1). Industry sponsors were involved in three times more trials per million inhabitants than non-industry sponsors in high-income countries (75.0 vs. 24.5) and in ten times fewer trials in low- income countries (0.08 vs. 1.08). Among industry- and non-industry–sponsored trials, 30.3% and 3.2% were international, respectively. In the industry-sponsored network of collaboration, Eastern European and South American countries collaborated more than expected; in the non-industry–sponsored network, collaboration among Scandinavian countries was overrepresented. Industry-sponsored international trials became more inter-continental with time between 2006 and 2012 (from 54.8% to 67.3%) as compared with non-industry–sponsored trials (from 42.4% to 37.2%). Conclusions Based on trials registered in the WHO ICTRP we documented a substantial gap between the globalization of industry- and non-industry–sponsored clinical research. Only 3% of

  4. Information Processing and Firm-Internal Environment Contingencies: Performance Impact on Global New Product Development

    DEFF Research Database (Denmark)

    Kleinschmidt, Elko; de Brentani, Ulrike; Salomo, Søren

    2010-01-01

    , functionally, geographically and culturally. To this end, an IT-communication strength is essential, one that is nested in an internal organizational environment that ensures its effective functioning. Using organizational information processing (OIP) theory as a framework, superior global NPD program......Innovation in its essence is an information processing activity. Thus, a major factor impacting the success of new product development (NPD) programs, especially those responding to global markets, is the firm's ability to access, share and apply NPD information, which is often widely dispersed...

  5. Circuit Mechanisms Governing Local vs. Global Motion Processing in Mouse Visual Cortex

    DEFF Research Database (Denmark)

    Rasmussen, Rune; Yonehara, Keisuke

    2017-01-01

    components represented by component direction-selective (CDS) cells. However, how PDS and CDS cells develop their distinct response properties is still unresolved. The visual cortex of the mouse is an attractive model for experimentally solving this issue due to the large molecular and genetic toolbox...... literature on global motion processing based on works in primates and mice. Lastly, we propose what types of experiments could illuminate what circuit mechanisms are governing cortical global visual motion processing. We propose that PDS cells in mouse visual cortex appear as the perfect arena...

  6. The Process of Clinical Reasoning among Medical Students

    Directory of Open Access Journals (Sweden)

    Djon Machado Lopes

    Full Text Available ABSTRACT Introduction: Research in the field of medical reasoning has shed light on the reasoning process used by medical students. The strategies in this process are related to the analytical [hypothetical-deductive (HD] and nonanalytic [scheme-inductive (SI] systems, and pattern recognition (PR]. Objective: To explore the clinical reasoning process of students from the fifth year of medical school at the end of the clinical cycle of medical internship, and to identify the strategies used in preparing diagnostic hypotheses, knowledge organization and content. Method: Qualitative research conducted in 2014 at a Brazilian public university with medical interns. Following Stamm's method, a case in internal medicine (IM was built based on the theory of prototypes (Group 1 = 47 interns, in which the interns listed, according to their own perceptions, the signs, symptoms, syndromes, and diseases typical of internal medicine. This case was used for evaluating the clinical reasoning process of Group 2 (30 students = simple random sample obtained with the "think aloud" process. The verbalizations were transcribed and evaluated by Bardin's thematic analysis. The content analysis were approved by two experts at the beginning and at the end of the analysis process. Results: The interns developed 164 primary and secondary hypotheses when solving the case. The SI strategy prevailed with 48.8%, followed by PR (35.4%, HD (12.2%, and mixed (1.8 % each: SI + HD and HD + PR. The students built 146 distinct semantic axes, resulting in an average of 4.8/ participant. During the analysis, 438 interpretation processes were executed (average of 14.6/participant, and 124 combination processes (average of 4.1/participant. Conclusions: The nonanalytic strategies prevailed with the PR being the most used in the development of primary hypotheses (46.8% and the SI in secondary hypotheses (93%. The interns showed a strong semantic network and did three and a half times more

  7. How Can the Evidence from Global Large-scale Clinical Trials for Cardiovascular Diseases be Improved?

    Science.gov (United States)

    Sawata, Hiroshi; Tsutani, Kiichiro

    2011-06-29

    Clinical investigations are important for obtaining evidence to improve medical treatment. Large-scale clinical trials with thousands of participants are particularly important for this purpose in cardiovascular diseases. Conducting large-scale clinical trials entails high research costs. This study sought to investigate global trends in large-scale clinical trials in cardiovascular diseases. We searched for trials using clinicaltrials.gov (URL: http://www.clinicaltrials.gov/) using the key words 'cardio' and 'event' in all fields on 10 April, 2010. We then selected trials with 300 or more participants examining cardiovascular diseases. The search revealed 344 trials that met our criteria. Of 344 trials, 71% were randomized controlled trials, 15% involved more than 10,000 participants, and 59% were funded by industry. In RCTs whose results were disclosed, 55% of industry-funded trials and 25% of non-industry funded trials reported statistically significant superiority over control (p = 0.012, 2-sided Fisher's exact test). Our findings highlighted concerns regarding potential bias related to funding sources, and that researchers should be aware of the importance of trial information disclosures and conflicts of interest. We should keep considering management and training regarding information disclosures and conflicts of interest for researchers. This could lead to better clinical evidence and further improvements in the development of medical treatment worldwide.

  8. How Can the Evidence from Global Large-scale Clinical Trials for Cardiovascular Diseases be Improved?

    Directory of Open Access Journals (Sweden)

    Tsutani Kiichiro

    2011-06-01

    Full Text Available Abstract Background Clinical investigations are important for obtaining evidence to improve medical treatment. Large-scale clinical trials with thousands of participants are particularly important for this purpose in cardiovascular diseases. Conducting large-scale clinical trials entails high research costs. This study sought to investigate global trends in large-scale clinical trials in cardiovascular diseases. Findings We searched for trials using clinicaltrials.gov (URL: http://www.clinicaltrials.gov/ using the key words 'cardio' and 'event' in all fields on 10 April, 2010. We then selected trials with 300 or more participants examining cardiovascular diseases. The search revealed 344 trials that met our criteria. Of 344 trials, 71% were randomized controlled trials, 15% involved more than 10,000 participants, and 59% were funded by industry. In RCTs whose results were disclosed, 55% of industry-funded trials and 25% of non-industry funded trials reported statistically significant superiority over control (p = 0.012, 2-sided Fisher's exact test. Conclusions Our findings highlighted concerns regarding potential bias related to funding sources, and that researchers should be aware of the importance of trial information disclosures and conflicts of interest. We should keep considering management and training regarding information disclosures and conflicts of interest for researchers. This could lead to better clinical evidence and further improvements in the development of medical treatment worldwide.

  9. Global distribution of Chelonid fibropapilloma-associated herpesvirus among clinically healthy sea turtles

    DEFF Research Database (Denmark)

    Alfaro Nuñez, Luis Alonso; Bertelsen, Mads Frost; Bojesen, Anders Miki

    2014-01-01

    BackgroundFibropapillomatosis (FP) is a neoplastic disease characterized by cutaneous tumours that has been documented to infect all sea turtle species. Chelonid fibropapilloma-associated herpesvirus (CFPHV) is believed to be the aetiological agent of FP, based principally on consistent PCR......-based detection of herpesvirus DNA sequences from FP tumours. We used a recently described PCR-based assay that targets 3 conserved CFPHV genes, to survey 208 green turtles (Chelonia mydas). This included both FP tumour exhibiting and clinically healthy individuals. An additional 129 globally distributed...

  10. Re-engineering of Products and Processes How to Achieve Global Success in the Changing Marketplace

    CERN Document Server

    Rotini, Federico; Cascini, Gaetano

    2012-01-01

    Whilst previous methods for business process re-engineering have focused on time and cost reduction policies to preserve competitive services and products, Re-engineering of Products and Processes: How to Achieve Global Success in the Changing Marketplace presents a new approach which aims to include aspects that impact the customer perceived value. This method supports business re-engineering initiatives by identifying process bottlenecks as well as new products and services available to overcome market competition. This original approach is described step-by-step, explaining the theory through examples of performable tasks and the selection of relevant tools according to the nature of the problem. Supported by illustrations, tables and diagrams, Re-engineering of Products and Processes: How to Achieve Global Success in the Changing Marketplace clearly explains a method which is then applied to several case studies across different industrial sectors. Re-engineering of Products and Processes: How to Achieve...

  11. The impact of global nuclear mass model uncertainties on r-process abundance predictions

    Directory of Open Access Journals (Sweden)

    Mumpower M.

    2015-01-01

    Full Text Available Rapid neutron capture or ‘r-process’ nucleosynthesis may be responsible for half the production of heavy elements above iron on the periodic table. Masses are one of the most important nuclear physics ingredients that go into calculations of r-process nucleosynthesis as they enter into the calculations of reaction rates, decay rates, branching ratios and Q-values. We explore the impact of uncertainties in three nuclear mass models on r-process abundances by performing global monte carlo simulations. We show that root-mean-square (rms errors of current mass models are large so that current r-process predictions are insufficient in predicting features found in solar residuals and in r-process enhanced metal poor stars. We conclude that the reduction of global rms errors below 100 keV will allow for more robust r-process predictions.

  12. [Clinical application of artificial condylar process for reconstructing temporomandibular joint].

    Science.gov (United States)

    Huang, Xiangdao; Shao, Zhanying; Wang, Fasheng; Duan, Yi

    2012-01-01

    To assess the feasibility and clinical outcomes of artificial condylar process in reconstruction of the temporomandibular joint. Between January 2005 and January 2010, the reconstructions of the temporomandibular joints with artificial condylar process were performed in 10 cases (11 sides, including 7 left sides and 4 right sides). There were 7 males and 3 females with an average age of 50 years (range, 40-68 years). Mandibular condyle defects were caused by mandible tumor in 7 patients with a mean disease duration of 15 months (range, 9-24 months) and by bilateral condylar fractures in 3 patients with the disease duration of 2, 3, and 2 days respectively. According to Neff classification, there were type M and A in 1 case, type M and B in 1 case, and type M in one side and subcondylar fracture in the other side in 1 case. Incisions in all patients healed by first intention, and no complication occurred. All cases were followed up 1 to 4 years, showed facial symmetry and good occluding relation, and the mouth opening was 22-38 mm (mean, 30 mm). No temporomandibular joint clicking or pain and no recurrence of tumor were observed. Most of the artificial condylar process were in good position except 1 deviated from the correct angle slightly. All the patients could have diet normally. The results of temporomandibular joint reconstruction after tumor resection with artificial condylar process are good, but the clinical outcome for intracapsular condylar fracture is expected to be further verified.

  13. Impaired global, and compensatory local, biological motion processing in people with high levels of autistic traits.

    Science.gov (United States)

    van Boxtel, Jeroen J A; Lu, Hongjing

    2013-01-01

    People with Autism Spectrum Disorder (ASD) are hypothesized to have poor high-level processing but superior low-level processing, causing impaired social recognition, and a focus on non-social stimulus contingencies. Biological motion perception provides an ideal domain to investigate exactly how ASD modulates the interaction between low and high-level processing, because it involves multiple processing stages, and carries many important social cues. We investigated individual differences among typically developing observers in biological motion processing, and whether such individual differences associate with the number of autistic traits. In Experiment 1, we found that individuals with fewer autistic traits were automatically and involuntarily attracted to global biological motion information, whereas individuals with more autistic traits did not show this pre-attentional distraction. We employed an action adaptation paradigm in the second study to show that individuals with more autistic traits were able to compensate for deficits in global processing with an increased involvement in local processing. Our findings can be interpreted within a predictive coding framework, which characterizes the functional relationship between local and global processing stages, and explains how these stages contribute to the perceptual difficulties associated with ASD.

  14. Impaired global, and compensatory local, biological motion processing in people with high levels of autistic traits

    Directory of Open Access Journals (Sweden)

    Jeroen J A Van Boxtel

    2013-04-01

    Full Text Available People with Autism Spectrum Disorder (ASD are hypothesized to have poor high-level processing but superior low-level processing, causing impaired social recognition, and a focus on non-social stimulus contingencies. Biological motion perception provides an ideal domain to investigate exactly how ASD modulates the interaction between low and high-level processing, because it involves multiple processing stages, and carries many important social cues. We investigated individual differences among typically developing observers in biological motion processing, and whether such individual differences associate with the number of autistic traits. In Experiment 1, we found that individuals with fewer autistic traits were automatically and involuntarily attracted to global biological motion information, whereas individuals with more autistic traits did not show this pre-attentional distraction. We employed an action adaptation paradigm in the second study to show that individuals with more autistic traits were able to compensate for deficits in global processing with an increased involvement in local processing. Our findings can be interpreted within a predictive coding framework, which characterizes the functional relationship between local and global processing stages, and explains how these stages contribute to the perceptual difficulties associated with ASD.

  15. The Clinical Nurse Leader--new nursing role with global implications.

    Science.gov (United States)

    Baernholdt, M; Cottingham, S

    2011-03-01

    This paper describes the development of the Clinical Nurse Leader (CNL ©) role and education, the CNL's impact and potential to improve quality globally. The need for clinical nurse leadership to improve the quality of health care systems while controlling costs is recognized in reports internationally. In the USA, a new nursing role, the CNL, was developed in response to such reports. CNLs are master's level nurse graduates (although not necessarily recruited from a nursing background) with the skills and knowledge to create change within complex systems and improve outcomes while they remain direct care providers. This innovative role can be adapted worldwide to improve the quality of health care systems. © 2010 The Authors. International Nursing Review © 2010 International Council of Nurses.

  16. NASA/MSFC FY88 Global Scale Atmospheric Processes Research Program Review

    Science.gov (United States)

    Wilson, Greg S. (Editor); Leslie, Fred W. (Editor); Arnold, J. E. (Editor)

    1989-01-01

    Interest in environmental issues and the magnitude of the environmental changes continues. One way to gain more understanding of the atmosphere is to make measurements on a global scale from space. The Earth Observation System is a series of new sensors to measure globally atmospheric parameters. Analysis of satellite data by developing algorithms to interpret the radiance information improves the understanding and also defines requirements for these sensors. One measure of knowledge of the atmosphere lies in the ability to predict its behavior. Use of numerical and experimental models provides a better understanding of these processes. These efforts are described in the context of satellite data analysis and fundamental studies of atmospheric dynamics which examine selected processes important to the global circulation.

  17. The American Society of Clinical Oncology's Efforts to Support Global Cancer Medicine

    Science.gov (United States)

    El-Saghir, Nagi S.; Cufer, Tanja; Cazap, Eduardo; de Guzman, Roselle; Othieno-Abinya, Nicholas Anthony; Sanchez, Jose Angel; Pyle, Doug

    2016-01-01

    Despite much progress in the management of malignant diseases, the number of new cases and cancer-related deaths continues to rise around the world. More than half of new cases occur in economically developing countries, where more than two thirds of cancer deaths are expected. However, implementation of all necessary steps to accomplish the dissemination of state-of-the-art prevention, diagnosis, and management will require increased allocation of resources, and, more importantly, harmonization of the efforts of hundreds of national and international public health agencies, policy-setting bodies, governments, pharmaceutical companies, and philanthropic organizations. More than 30% of the members of the American Society of Clinical Oncology (ASCO) reside and practice outside US borders, and more than half of attendees at all of the scientific congresses and symposia organized by ASCO are international. As cancer has become an increasingly global disease, ASCO has evolved as a global organization. The ASCO Board of Directors currently includes members from France, Brazil, and Canada. In 2013, the ASCO Board of Directors identified a number of strategic priorities for the future. Recognizing the importance of non-US members to the society, their first strategic priority was improving the society's service to non-US members and defining these members' identity in the international oncology community. This article reviews current ASCO activities in the international arena and its future plans in global oncology. PMID:26578614

  18. Alterations to global but not local motion processing in long-term ecstasy (MDMA) users.

    Science.gov (United States)

    White, Claire; Brown, John; Edwards, Mark

    2014-07-01

    Growing evidence indicates that the main psychoactive ingredient in the illegal drug "ecstasy" (methylendioxymethamphetamine) causes reduced activity in the serotonin and gamma-aminobutyric acid (GABA) systems in humans. On the basis of substantial serotonin input to the occipital lobe, recent research investigated visual processing in long-term users and found a larger magnitude of the tilt aftereffect, interpreted to reflect broadened orientation tuning bandwidths. Further research found higher orientation discrimination thresholds and reduced long-range interactions in the primary visual area of ecstasy users. The aim of the present research was to investigate whether serotonin-mediated V1 visual processing deficits in ecstasy users extend to motion processing mechanisms. Forty-five participants (21 controls, 24 drug users) completed two psychophysical studies: A direction discrimination study directly measured local motion processing in V1, while a motion coherence task tested global motion processing in area V5/MT. "Primary" ecstasy users (n = 18), those without substantial polydrug use, had significantly lower global motion thresholds than controls [p = 0.027, Cohen's d = 0.78 (large)], indicating increased sensitivity to global motion stimuli, but no difference in local motion processing (p = 0.365). These results extend on previous research investigating the long-term effects of illicit drugs on visual processing. Two possible explanations are explored: defuse attentional processes may be facilitating spatial pooling of motion signals in users. Alternatively, it may be that a GABA-mediated disruption to V5/MT processing is reducing spatial suppression and therefore improving global motion perception in ecstasy users.

  19. The clinical nurse specialist as resuscitation process manager.

    Science.gov (United States)

    Schneiderhahn, Mary Elizabeth; Fish, Anne Folta

    2014-01-01

    The purpose of this article was to describe the history and leadership dimensions of the role of resuscitation process manager and provide specific examples of how this role is implemented at a Midwest medical center. In 1992, a medical center in the Midwest needed a nurse to manage resuscitation care. This role designation meant that this nurse became central to all quality improvement efforts in resuscitation care. The role expanded as clinical resuscitation guidelines were updated and as the medical center grew. The role became known as the critical care clinical nurse specialist as resuscitation process manager. This clinical care nurse specialist was called a manager, but she had no direct line authority, so she accomplished her objectives by forming a multitude of collaborative networks. Based on a framework by Finkelman, the manager role incorporated specific leadership abilities in quality improvement: (1) coordination of medical center-wide resuscitation, (2) use of interprofessional teams, (3) integration of evidence into practice, and (4) staff coaching to develop leadership. The manager coordinates resuscitation care with the goals of prevention of arrests if possible, efficient and effective implementation of resuscitation protocols, high quality of patient and family support during and after the resuscitation event, and creation or revision of resuscitation policies for in-hospital and for ambulatory care areas. The manager designs a comprehensive set of meaningful and measurable process and outcome indicators with input from interprofessional teams. The manager engages staff in learning, reflecting on care given, and using the evidence base for resuscitation care. Finally, the manager role is a balance between leading quality improvement efforts and coaching staff to implement and sustain these quality improvement initiatives. Revisions to clinical guidelines for resuscitation care since the 1990s have resulted in medical centers developing improved

  20. The process of clinical assessment: cognitions of the evaluator

    Directory of Open Access Journals (Sweden)

    Carmelo Ibáñez Aguirre

    2013-08-01

    Full Text Available The cognitive paradigm of the past few decades opens several new possibilities for psychological evaluation.  The objective of this essay is to emphasize the possibilities related to the quality of self-evaluation, specifically professional self-assessment, meaning a critical analysis of one’s own evaluation process. In this essay, metacognition activities and strategies are examined, as are the ways in which these activities and strategies relate to metacognition and cognitive skills. The intent of this theoretical essay is to offer answers to the clinical evaluator’s professional experience. The results indicate that the clinical professional must consider strategies to improve metacognition and cognitive skills through reflection, self-analysis and self-criticism to improve the quality and efficiency of their work.

  1. Global Distribution, Public Health and Clinical Impact of the Protozoan Pathogen Cryptosporidium

    Directory of Open Access Journals (Sweden)

    Lorenza Putignani

    2010-01-01

    Full Text Available Cryptosporidium spp. are coccidians, oocysts-forming apicomplexan protozoa, which complete their life cycle both in humans and animals, through zoonotic and anthroponotic transmission, causing cryptosporidiosis. The global burden of this disease is still underascertained, due to a conundrum transmission modality, only partially unveiled, and on a plethora of detection systems still inadequate or only partially applied for worldwide surveillance. In children, cryptosporidiosis encumber is even less recorded and often misidentified due to physiological reasons such as early-age unpaired immunological response. Furthermore, malnutrition in underdeveloped countries or clinical underestimation of protozoan etiology in developed countries contribute to the underestimation of the worldwide burden. Principal key indicators of the parasite distribution were associated to environmental (e.g., geographic and temporal clusters, etc. and host determinants of the infection (e.g., age, immunological status, travels, community behaviours. The distribution was geographically mapped to provide an updated picture of the global parasite ecosystems. The present paper aims to provide, by a critical analysis of existing literature, a link between observational epidemiological records and new insights on public health, and diagnostic and clinical impact of cryptosporidiosis.

  2. Rééducation Posturale Globale in musculoskeletal diseases: scientific evidence and clinical practice

    Directory of Open Access Journals (Sweden)

    D. Tosarelli

    2011-09-01

    Full Text Available Several studies on the treatment of musculoskeletal diseases with physiotherapy and clinical experiences on the basis of a method called Rééducation Posturale Globale (RPG, have highlighted the usefulness of this treatment. Although such treatment technique is commonly used in physical therapy practice, only few studies support its therapeutic effectiveness. Objective: To search the literature for evidence of RPG effectiveness, in order to identify the most appropriate therapeutic contexts for its use. Methods: A review of the literature through the following databases: PubMed, Embase, Cinahl, Pedro, and Medscape. The keywords used for the search in the databases are: Rééducation Posturale Globale, Souchard, Posture, and Manual Therapy. The following clinical studies were selected: randomized controlled studies, non-randomized controlled studies, observation studies, and case reports, in English, Spanish, Portuguese, and Italian. Results: Out of 18 studies found, 9 were analyzed: 2 randomized controlled studies, 2 non-randomized controlled studies, 3 non-controlled studies, and 2 case reports. Conclusions: The RPG method has been shown to be an effective treatment technique for musculoskeletal diseases, in particular for ankylosing spondylitis, acute and chronic low back pain, and lumbar discherniation. Although the scarcity of rigorous experimental trials on a large scale does not allow the drawing of undisputable conclusions, the results gathered up to now are an encouragement to carry on research in the field of conservative treatment.

  3. Assessment of global expected warming contribution to desertification process development in Kazakhstan

    International Nuclear Information System (INIS)

    Dolgih, S.A.; Eserkepova, I.B.; Shamen, A.M.

    1997-01-01

    Assessment of moistening condition change in Kazakhstan and its role in processes of desertification at global expected climate warming are cited. Results of numerical experiments by models of common circulation of atmosphere have been used in capacity of potential regional climate change characteristics. (author)

  4. Navon's classical paradigm concerning local and global processing relates systematically to visual object classification performance.

    Science.gov (United States)

    Gerlach, Christian; Poirel, Nicolas

    2018-01-10

    Forty years ago David Navon tried to tackle a central problem in psychology concerning the time course of perceptual processing: Do we first see the details (local level) followed by the overall outlay (global level) or is it rather the other way around? He did this by developing a now classical paradigm involving the presentation of compound stimuli; large letters composed of smaller letters. Despite the usefulness of this paradigm it remains uncertain whether effects found with compound stimuli relate directly to visual object recognition. It does so because compound stimuli are not actual objects but rather formations of elements and because the elements that form the global shape of compound stimuli are not features of the global shape but rather objects in their own right. To examine the relationship between performance on Navon's paradigm and visual object processing we derived two indexes from Navon's paradigm that reflect different aspects of the relationship between global and local processing. We find that individual differences on these indexes can explain a considerable amount of variance in two standard object classification paradigms; object decision and superordinate categorization, suggesting that Navon's paradigm does relate to visual object processing.

  5. The impact of recreational MDMA 'ecstasy' use on global form processing.

    Science.gov (United States)

    White, Claire; Edwards, Mark; Brown, John; Bell, Jason

    2014-11-01

    The ability to integrate local orientation information into a global form percept was investigated in long-term ecstasy users. Evidence suggests that ecstasy disrupts the serotonin system, with the visual areas of the brain being particularly susceptible. Previous research has found altered orientation processing in the primary visual area (V1) of users, thought to be due to disrupted serotonin-mediated lateral inhibition. The current study aimed to investigate whether orientation deficits extend to higher visual areas involved in global form processing. Forty-five participants completed a psychophysical (Glass pattern) study allowing an investigation into the mechanisms underlying global form processing and sensitivity to changes in the offset of the stimuli (jitter). A subgroup of polydrug-ecstasy users (n=6) with high ecstasy use had significantly higher thresholds for the detection of Glass patterns than controls (n=21, p=0.039) after Bonferroni correction. There was also a significant interaction between jitter level and drug-group, with polydrug-ecstasy users showing reduced sensitivity to alterations in jitter level (p=0.003). These results extend previous research, suggesting disrupted global form processing and reduced sensitivity to orientation jitter with ecstasy use. Further research is needed to investigate this finding in a larger sample of heavy ecstasy users and to differentiate the effects of other drugs. © The Author(s) 2014.

  6. Parallel processing and non-uniform grids in global air quality modeling

    NARCIS (Netherlands)

    Berkvens, P.J.F.; Bochev, Mikhail A.

    2002-01-01

    A large-scale global air quality model, running efficiently on a single vector processor, is enhanced to make more realistic and more long-term simulations feasible. Two strategies are combined: non-uniform grids and parallel processing. The communication through the hierarchy of non-uniform grids

  7. Kenya public weather processed by the Global Yield Gap Atlas project

    NARCIS (Netherlands)

    Groot, de Hugo; Adimo, Ochieng; Claessens, Lieven; Wart, Van Justin; Bussel, van Lenny G.J.; Grassini, Patricio; Wolf, Joost; Guilpart, Nicolas; Boogaard, Hendrik; Oort, van Pepijn A.J.; Yang, Haishun S.; Ittersum, van Martin K.; Cassman, Kenneth G.

    2017-01-01

    The Global Yield Gap Atlas project (GYGA - http://yieldgap.org) has undertaken a yield gap assessment following the protocol recommended by van Ittersum et al. (2013). One part of the activities consists of collecting and processing weather data as an input for crop simulation models in sub-Saharan

  8. Navon's classical paradigm concerning local and global processing relates systematically to visual object classification performance

    DEFF Research Database (Denmark)

    Gerlach, Christian; Poirel, Nicolas

    2018-01-01

    Forty years ago David Navon tried to tackle a central problem in psychology concerning the time course of perceptual processing: Do we first see the details (local level) followed by the overall outlay (global level) or is it rather the other way around? He did this by developing a now classical ...

  9. Globalisation and the foreignisation of space: The seven processes driving the current global land grab.

    NARCIS (Netherlands)

    Zoomers, E.B.

    2010-01-01

    The current global land grab is causing radical changes in the use and ownership of land. The main process driving the land grab, or ‘foreignisation of space’, as highlighted in the media and the emerging literature is the production of food and biofuel for export in the aftermath of recent food

  10. Preparing for novel versus familiar events: shifts in global and local processing

    NARCIS (Netherlands)

    Förster, J.; Liberman, N.; Shapiro, O.

    2009-01-01

    Six experiments examined whether novelty versus familiarity influences global versus local processing styles. Novelty and familiarity were manipulated by either framing a task as new versus familiar or by asking participants to reflect upon novel versus familiar events prior to the task (i.e.,

  11. The Influence of Globalization, Integration and Regionalization Processes on the European States and Regions

    Directory of Open Access Journals (Sweden)

    T V Bazarenko

    2013-12-01

    Full Text Available The article deals with the impact of globalization, regionalization and integration in European countries and regions. It discusses the distinctive features and factors of influence of each of these processes on the European countries and sub national entities.

  12. Kenya public weather processed by the Global Yield Gap Atlas project (old version)

    NARCIS (Netherlands)

    Groot, de H.L.E.; Adimo, A.O.; Claessens, L.F.G.; Wart, van J.; Bussel, van L.G.J.; Grassini, P.; Wolf, J.; Guilpart, Nicolas; Boogaard, H.L.; Oort, van P.A.J.; Yang, H.; Ittersum, van M.K.; Cassman, K.G.

    2015-01-01

    The Global Yield Gap Atlas project (GYGA - http://yieldgap.org ) has undertaken a yield gap assessment following the protocol recommended by van Ittersum et. al. (van Ittersum et. al., 2013). One part of the activities consists of collecting and processing weather data as an input for crop

  13. Handbook of natural language processing and machine translation DARPA global autonomous language exploitation

    CERN Document Server

    Olive, Joseph P; McCary, John

    2011-01-01

    This comprehensive handbook, written by leading experts in the field, details the groundbreaking research conducted under the breakthrough GALE program - The Global Autonomous Language Exploitation within the Defense Advanced Research Projects Agency (DARPA), while placing it in the context of previous research in the fields of natural language and signal processing, artificial intelligence and machine translation. The most fundamental contrast between GALE and its predecessor programs was its holistic integration of previously separate or sequential processes. In earlier language research pro

  14. Research on Remote Sensing Image Template Processing Based on Global Subdivision Theory

    OpenAIRE

    Xiong Delan; Du Genyuan

    2013-01-01

    Aiming at the questions of vast data, complex operation, and time consuming processing for remote sensing image, subdivision template was proposed based on global subdivision theory, which can set up high level of abstraction and generalization for remote sensing image. The paper emphatically discussed the model and structure of subdivision template, and put forward some new ideas for remote sensing image template processing, key technology and quickly applied demonstration. The research has ...

  15. Global distribution of Chelonid fibropapilloma-associated herpesvirus among clinically healthy sea turtles.

    Science.gov (United States)

    Alfaro-Núñez, Alonzo; Frost Bertelsen, Mads; Bojesen, Anders Miki; Rasmussen, Isabel; Zepeda-Mendoza, Lisandra; Tange Olsen, Morten; Gilbert, Marcus Thomas Pius

    2014-10-25

    Fibropapillomatosis (FP) is a neoplastic disease characterized by cutaneous tumours that has been documented to infect all sea turtle species. Chelonid fibropapilloma-associated herpesvirus (CFPHV) is believed to be the aetiological agent of FP, based principally on consistent PCR-based detection of herpesvirus DNA sequences from FP tumours. We used a recently described PCR-based assay that targets 3 conserved CFPHV genes, to survey 208 green turtles (Chelonia mydas). This included both FP tumour exhibiting and clinically healthy individuals. An additional 129 globally distributed clinically healthy individual sea turtles; representing four other species were also screened. CFPHV DNA sequences were obtained from 37/37 (100%) FP exhibiting green turtles, and 45/300 (15%) clinically healthy animals spanning all five species. Although the frequency of infected individuals per turtle population varied considerably, most global populations contained at least one CFPHV positive individual, with the exception of various turtle species from the Arabian Gulf, Northern Indian Ocean and Puerto Rico. Haplotype analysis of the different gene markers clustered the CFPHV DNA sequences for two of the markers (UL18 and UL22) in turtles from Turks and Caicos separate to all others, regardless of host species or geographic origin. Presence of CFPHV DNA within globally distributed samples for all five species of sea turtle was confirmed. While 100% of the FP exhibiting green turtles yielded CFPHV sequences, surprisingly, so did 15% of the clinically healthy turtles. We hypothesize that turtle populations with zero (0%) CFPHV frequency may be attributed to possible environmental differences, diet and/or genetic resistance in these individuals. Our results provide first data on the prevalence of CFPHV among seemingly healthy turtles; a factor that may not be directly correlated to the disease incidence, but may suggest of a long-term co-evolutionary latent infection interaction between

  16. Understanding Global Change: Tools for exploring Earth processes and biotic change through time

    Science.gov (United States)

    Bean, J. R.; White, L. D.; Berbeco, M.

    2014-12-01

    Teaching global change is one of the great pedagogical challenges of our day because real understanding entails integrating a variety of concepts from different scientific subject areas, including chemistry, physics, and biology, with a variety of causes and impacts in the past, present, and future. With the adoption of the Next Generation Science Standards, which emphasize climate change and other human impacts on natural systems, there has never been a better time to provide instructional support to educators on these topics. In response to this clear need, the University of California Museum of Paleontology, in collaboration with the National Center for Science Education, developed a new web resource for teachers and students titled "Understanding Global Change" (UGC) that introduces the drivers and impacts of global change. This website clarifies the connections among deep time, modern Earth system processes, and anthropogenic influences, and provides K-16 instructors with a wide range of easy-to-use tools, strategies, and lesson plans for communicating these important concepts regarding global change and the basic Earth systems processes. In summer 2014, the UGC website was field-tested during a workshop with 25 K-12 teachers and science educators. Feedback from participants helped the UGC team develop and identify pedagogically sound lesson plans and instructional tools on global change. These resources are accessible through UGC's searchable database, are aligned with NGSS and Common Core, and are categorized by grade level, subject, and level of inquiry-based instruction (confirmation, structured, guided, open). Providing a range of content and tools at levels appropriate for teachers is essential because our initial needs assessment found that educators often feel that they lack the content knowledge and expertise to address complex, but relevant global change issues, such as ocean acidification and deforestation. Ongoing needs assessments and surveys of

  17. Redesigning ambulatory care business processes supporting clinical care delivery.

    Science.gov (United States)

    Patterson, C; Sinkewich, M; Short, J; Callas, E

    1997-04-01

    The first step in redesigning the health care delivery process for ambulatory care begins with the patient and the business processes that support the patient. Patient-related business processes include patient access, service documentation, billing, follow-up, collection, and payment. Access is the portal to the clinical delivery and care management process. Service documentation, charge capture, and payment and collection are supporting processes to care delivery. Realigned provider networks now demand realigned patient business services to provide their members/customers/patients with improved service delivery at less cost. Purchaser mandates for cost containment, health maintenance, and enhanced quality of care have created an environment where every aspect of the delivery system, especially ambulatory care, is being judged. Business processes supporting the outpatient are therefore being reexamined for better efficiency and customer satisfaction. Many health care systems have made major investments in their ambulatory care environment, but have pursued traditional supporting business practices--such as multiple access points, lack of integrated patient appointment scheduling and registration, and multiple patient bills. These are areas that are appropriate for redesign efforts--all with the customer's needs and convenience in mind. Similarly, setting unrealistic expectations, underestimating the effort required, and ignoring the human elements of a patient-focused business service redesign effort can sabotage the very sound reasons for executing such an endeavor. Pitfalls can be avoided if a structured methodology, coupled with a change management process, are employed. Deloitte & Touche Consulting Group has been involved in several major efforts, all with ambulatory care settings to assist with the redesign of their business practices to consider the patient as the driver, instead of the institution providing the care.

  18. Caffeine promotes global spatial processing in habitual and non-habitual caffeine consumers

    Directory of Open Access Journals (Sweden)

    Grace E. Giles

    2013-10-01

    Full Text Available Information processing is generally biased toward global cues, often at the expense of local information. Equivocal extant data suggests that arousal states may accentuate either a local or global processing bias, at least partially dependent on the nature of the manipulation, task and stimuli. To further differentiate the conditions responsible for such equivocal results we varied caffeine doses to alter physiological arousal states and measured their effect on tasks requiring the retrieval of local versus global spatial knowledge. In a double-blind, repeated-measures design, non-habitual (Exp. 1; N=36, M=42.5±29 mg/day caffeine and habitual (Exp. 2; N=34, M=579.5±311.5 mg/day caffeine caffeine consumers completed four test sessions corresponding to each of four caffeine doses (0 mg, 100 mg, 200 mg, 400 mg. During each test session, participants consumed a capsule containing one of the three doses of caffeine or placebo, waited sixty minutes, and then completed two spatial tasks, one involving memorizing maps and one spatial descriptions. A spatial statement verification task tested local versus global spatial knowledge by differentially probing memory for proximal versus distal landmark relationships. On the map learning task, results indicated that caffeine enhanced memory for distal (i.e. global compared to proximal (i.e. local comparisons at 100 (marginal, 200, and 400 mg caffeine in non-habitual consumers, and marginally beginning at 200 mg caffeine in habitual consumers. On the spatial descriptions task, caffeine enhanced memory for distal compared to proximal comparisons beginning at 100 mg in non-habitual but not habitual consumers. We thus provide evidence that caffeine-induced physiological arousal amplifies global spatial processing biases, and these effects are at least partially driven by habitual caffeine consumption.

  19. Reduce energy use and greenhouse gas emissions from global dairy processing facilities

    Energy Technology Data Exchange (ETDEWEB)

    Xu Tengfang, E-mail: ttxu@lbl.go [International Energy Studies Group, Environmental Energy Technologies Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720 (United States); Flapper, Joris [International Energy Studies Group, Environmental Energy Technologies Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720 (United States); Centre for Energy and Environmental Studies, University of Groningen, IVEM, Nijenborgh 4, 9747, AG Groningen (Netherlands)

    2011-01-15

    Global butter, concentrated milk, and milk powder products use approximately 15% of annual raw milk production. Similar to cheese and fluid milk, dairy processing of these products can be energy intensive. In this paper, we analyzed production and energy data compiled through extensive literature reviews on butter, concentrated milk, milk and whey powder processing across various countries and plants. Magnitudes of national final and primary specific energy consumption (SEC) exhibited large variations across dairy products; in addition, the final SEC of individual plants and products exhibited significant variations within a country and between countries. Furthermore, we quantified national energy intensity indicators (EIIs) accounting for dairy product mixes and technological advancement. The significant variations of SEC and EII values indicate a high degree of likelihood that there is significant potential for energy savings in the global dairy processing industry. Based upon the study samples, we estimate potential energy savings for dairy processing industry in selected countries, and estimates annual reduction of 9-14 million metric-ton carbon-equivalent could be achieved if measures are implemented to lower SEC values by 50-80% in half of global dairy plants. The paper calls for publication of more energy data from the dairy processing industry. - Research highlights: {yields} The specific energy consumption exhibited large variations across dairy products, plants, and countries. {yields} National energy intensity indicators also exhibited significant variations. {yields} There is a large global potential for energy savings and carbon reduction in dairy processing plants. {yields} The paper calls for publication of more energy data from the dairy processing industry.

  20. Reduce energy use and greenhouse gas emissions from global dairy processing facilities

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Tengfang [International Energy Studies Group, Environmental Energy Technologies Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720 (United States); Flapper, Joris [International Energy Studies Group, Environmental Energy Technologies Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720 (United States); Centre for Energy and Environmental Studies, University of Groningen, IVEM, Nijenborgh 4, 9747, AG Groningen (Netherlands)

    2011-01-15

    Global butter, concentrated milk, and milk powder products use approximately 15% of annual raw milk production. Similar to cheese and fluid milk, dairy processing of these products can be energy intensive. In this paper, we analyzed production and energy data compiled through extensive literature reviews on butter, concentrated milk, milk and whey powder processing across various countries and plants. Magnitudes of national final and primary specific energy consumption (SEC) exhibited large variations across dairy products; in addition, the final SEC of individual plants and products exhibited significant variations within a country and between countries. Furthermore, we quantified national energy intensity indicators (EIIs) accounting for dairy product mixes and technological advancement. The significant variations of SEC and EII values indicate a high degree of likelihood that there is significant potential for energy savings in the global dairy processing industry. Based upon the study samples, we estimate potential energy savings for dairy processing industry in selected countries, and estimates annual reduction of 9-14 million metric-ton carbon-equivalent could be achieved if measures are implemented to lower SEC values by 50-80% in half of global dairy plants. The paper calls for publication of more energy data from the dairy processing industry. (author)

  1. Constructing Consistent Multiscale Scenarios by Transdisciplinary Processes: the Case of Mountain Regions Facing Global Change

    Directory of Open Access Journals (Sweden)

    Fridolin Simon. Brand

    2013-06-01

    Full Text Available Alpine regions in Europe, in particular, face demanding local challenges, e.g., the decline in the agriculture and timber industries, and are also prone to global changes, such as in climate, with potentially severe impacts on tourism. We focus on the Visp region in the Upper Valais, Switzerland, and ask how the process of stakeholder involvement in research practice can contribute to a better understanding of the specific challenges and future development of mountainous regions under global change. Based on a coupled human-environment system (HES perspective, we carried out a formative scenario analysis to develop a set of scenarios for the future directions of the Visp region. In addition, we linked these regional scenarios to context scenarios developed at the global and Swiss levels via an external consistency analysis. This method allows the coupling of both the scenario building process and the scenarios as such. We used a functional-dynamic approach to theory-practice cooperation, i.e., the involvement of key stakeholders from, for example, tourism, forestry, and administration, differed in type and intensity during the steps of the research process. In our study, we experienced strong problem awareness among the stakeholders concerning the impacts of global change and local challenges. The guiding research question was commonly defined and problem ownership was more or less balanced. We arrived at six multiscale scenarios that open up future trajectories for the Visp region, and present generic strategies to cope with global and local challenges. The results show that local identity, spatial planning, community budget, and demographic development are important steering elements in the region's future development. We suggest that method-guided transdisciplinary processes result in a richer picture and a more systemic understanding, which enable a discussion of critical and surprising issues.

  2. Self-Orientation Modulates the Neural Correlates of Global and Local Processing.

    Science.gov (United States)

    Liddell, Belinda J; Das, Pritha; Battaglini, Eva; Malhi, Gin S; Felmingham, Kim L; Whitford, Thomas J; Bryant, Richard A

    2015-01-01

    Differences in self-orientation (or "self-construal") may affect how the visual environment is attended, but the neural and cultural mechanisms that drive this remain unclear. Behavioral studies have demonstrated that people from Western backgrounds with predominant individualistic values are perceptually biased towards local-level information; whereas people from non-Western backgrounds that support collectivist values are preferentially focused on contextual and global-level information. In this study, we compared two groups differing in predominant individualistic (N = 15) vs collectivistic (N = 15) self-orientation. Participants completed a global/local perceptual conflict task whilst undergoing functional Magnetic Resonance Imaging (fMRI) scanning. When participants high in individualistic values attended to the global level (ignoring the local level), greater activity was observed in the frontoparietal and cingulo-opercular networks that underpin attentional control, compared to the match (congruent) baseline. Participants high in collectivistic values activated similar attentional control networks o only when directly compared with global processing. This suggests that global interference was stronger than local interference in the conflict task in the collectivistic group. Both groups showed increased activity in dorsolateral prefrontal regions involved in resolving perceptual conflict during heightened distractor interference. The findings suggest that self-orientation may play an important role in driving attention networks to facilitate interaction with the visual environment.

  3. The Globalization of Pediatric Research: An Analysis of Clinical Trials Completed for Pediatric Exclusivity

    Science.gov (United States)

    Pasquali, Sara K.; Burstein, Danielle S.; Benjamin, Daniel K.; Smith, P. Brian; Li, Jennifer S.

    2010-01-01

    Background Recent studies have examined the globalization of clinical research. These studies focused on adult trials, and the globalization of pediatric research has not been examined to date. We evaluated the setting of published studies conducted under the US Pediatric Exclusivity Program, which provides economic incentives to pharmaceutical companies to conduct drug studies in children. Methods Published studies containing the main results of trials conducted from 1998–2007 under the Pediatric Exclusivity Provision were included. Data were extracted from each study and described, including the therapeutic area of drug studied, number of patients enrolled, number of sites, and location where the study was conducted, if reported. Results Overall, 174 trials were included (sample size 8–27,065 patients); 9% did not report any information regarding the location or number of sites where the study was conducted. Of those that did report this information, 65% were conducted in at least one country outside the US, and 11% did not have any sites in the US. Fifty-four different countries were represented and 38% of trials enrolled patients in at least one site located in a developing/transition country, including more than one third of infectious disease, cardiovascular, and allergy/immunology trials. Conclusions The majority of published pediatric trials conducted under the Pediatric Exclusivity Provision included sites outside of the US, and over a third of trials enrolled patients in developing/transition countries. While there are many potential benefits to the globalization of pediatric research, this trend also raises certain scientific and ethical concerns which require further evaluation. PMID:20732941

  4. Autoverification process improvement by Six Sigma approach: Clinical chemistry & immunoassay.

    Science.gov (United States)

    Randell, Edward W; Short, Garry; Lee, Natasha; Beresford, Allison; Spencer, Margaret; Kennell, Marina; Moores, Zoë; Parry, David

    2018-05-01

    This study examines effectiveness of a project to enhance an autoverification (AV) system through application of Six Sigma (DMAIC) process improvement strategies. Similar AV systems set up at three sites underwent examination and modification to produce improved systems while monitoring proportions of samples autoverified, the time required for manual review and verification, sample processing time, and examining characteristics of tests not autoverified. This information was used to identify areas for improvement and monitor the impact of changes. Use of reference range based criteria had the greatest impact on the proportion of tests autoverified. To improve AV process, reference range based criteria was replaced with extreme value limits based on a 99.5% test result interval, delta check criteria were broadened, and new specimen consistency rules were implemented. Decision guidance tools were also developed to assist staff using the AV system. The mean proportion of tests and samples autoverified improved from 90% for samples and >95% for tests across all three sites. The new AV system significantly decreased turn-around time and total sample review time (to about a third), however, time spent for manual review of held samples almost tripled. There was no evidence of compromise to the quality of testing process and process improvement methodology was successfully applied to AV systems resulting in an increase in overall test and sample AV by >90%, improved turn-around time, reduced time for manual verification, and with no obvious compromise to quality or error detection. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  5. International clinical volunteering in Tanzania: A postcolonial analysis of a Global Health business.

    Science.gov (United States)

    Sullivan, Noelle

    2018-03-01

    This article traces how scarcities characteristic of health systems in low-income countries (LICs), and increasing popular interest in Global Health, have inadvertently contributed to the popularisation of a specific Global Health business: international clinical volunteering through private volunteer placement organisations (VPOs). VPOs market neglected health facilities as sites where foreigners can 'make a difference', regardless of their skill set. Drawing on online investigation and ethnographic research in Tanzania over four field seasons from 2011 to 2015, including qualitative interviews with 41 foreign volunteers and 90 Tanzanian health workers, this article offers a postcolonial analysis of VPO marketing and volunteer action in health facilities of LICs. Two prevalent postcolonial racialised tropes inform both VPO marketing and foreign volunteers' discourses and practices in Tanzania. The first trope discounts Tanzanian expertise in order to envision volunteers in expert roles despite lacking training, expertise, or contextual knowledge. The second trope envisions Tanzanian patients as so impoverished that insufficiently trained volunteer help is 'better than nothing at all'. These two postcolonial racialised tropes inform the conceptual work undertaken by VPO marketing schemes and foreign volunteers in order to remake Tanzanian health professionals and patients into appropriate and justifiable sites for foreign volunteer intervention.

  6. Matérn-based nonstationary cross-covariance models for global processes

    KAUST Repository

    Jun, Mikyoung

    2014-07-01

    Many spatial processes in environmental applications, such as climate variables and climate model errors on a global scale, exhibit complex nonstationary dependence structure, in not only their marginal covariance but also their cross-covariance. Flexible cross-covariance models for processes on a global scale are critical for an accurate description of each spatial process as well as the cross-dependences between them and also for improved predictions. We propose various ways to produce cross-covariance models, based on the Matérn covariance model class, that are suitable for describing prominent nonstationary characteristics of the global processes. In particular, we seek nonstationary versions of Matérn covariance models whose smoothness parameters vary over space, coupled with a differential operators approach for modeling large-scale nonstationarity. We compare their performance to the performance of some existing models in terms of the aic and spatial predictions in two applications: joint modeling of surface temperature and precipitation, and joint modeling of errors in climate model ensembles. © 2014 Elsevier Inc.

  7. Integration and disintegration processes of ethnic communities in a globalized world: challenges and trends

    Directory of Open Access Journals (Sweden)

    A. A. Paronikian

    2016-06-01

    Full Text Available The article examines the challenges and trends in integration and disintegration processes of ethnic communities in the world of globalization. Established that ethnic disintegration is inevitable consequence of ethnic integration, and its intensity depends on what method is carried Integration: voluntary or forced. What is important is the fact that in the era of globalization integration and disintegration processes of ethnic communities that are inherent in the very essence of ethnicity, greatly amplified. It was found that entering to the cultural field of ethnic communities of other ethnic entities, penalized sustainable ethnic balance, contributes to the phenomenon of «rejection of other» causes of ethnic conflict and the consequent threat of disintegration of ethnic communities. Disintegration often leads to weakening of the linkages and interactions between components of the integrated system in a multi-ethnic society. However, the author concludes that the process of disintegration cannot be regarded as unambiguously negative because, on the one hand, it contributes to the weakening and decline; and sometimes division of multi-ethnic countries, but on the other hand - it contributes to the birth of the new and revival of the old nation-states, which is particularly important in conditions of transformation of the global community towards the post-industrial and information epoch in the future. In general, the integration and disintegration change each other depending on global processes and their transformations. Therefore, in the era of globalization’s challenges it is important is the effective management of these processes to prevent adverse effects.

  8. 78 FR 60885 - Proposed Collection; 60-Day Notice Request: Application Process for Clinical Research Training...

    Science.gov (United States)

    2013-10-02

    ... Notice Request: Application Process for Clinical Research Training and Medical Education at the Clinical... Research Training and Medical Education, NIH Clinical Center, 10 Center Drive, MSC 1158, Bethesda, MD 20892... Process for Clinical Research Training and Medical Education at the Clinical Center and its Impact on...

  9. Ultra-processed products are becoming dominant in the global food system.

    Science.gov (United States)

    Monteiro, C A; Moubarac, J-C; Cannon, G; Ng, S W; Popkin, B

    2013-11-01

    The relationship between the global food system and the worldwide rapid increase of obesity and related diseases is not yet well understood. A reason is that the full impact of industrialized food processing on dietary patterns, including the environments of eating and drinking, remains overlooked and underestimated. Many forms of food processing are beneficial. But what is identified and defined here as ultra-processing, a type of process that has become increasingly dominant, at first in high-income countries, and now in middle-income countries, creates attractive, hyper-palatable, cheap, ready-to-consume food products that are characteristically energy-dense, fatty, sugary or salty and generally obesogenic. In this study, the scale of change in purchase and sales of ultra-processed products is examined and the context and implications are discussed. Data come from 79 high- and middle-income countries, with special attention to Canada and Brazil. Results show that ultra-processed products dominate the food supplies of high-income countries, and that their consumption is now rapidly increasing in middle-income countries. It is proposed here that the main driving force now shaping the global food system is transnational food manufacturing, retailing and fast food service corporations whose businesses are based on very profitable, heavily promoted ultra-processed products, many in snack form. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

  10. ROLE OF MEGALOPOLISES IN SOCIO-PHILOSOPHICAL COMPREHENSION OF GLOBALIZATION PROCESS

    Directory of Open Access Journals (Sweden)

    Nistarova Anna Aleksandrovna

    2013-01-01

    Full Text Available In her article the author tries to establish linkage between the events that took place at the turn of the 20th – 21st centuries and the aspiration of some countries for negating or limiting their jurisdiction with respect to international law due to the international bipolar system disintegration. It should be noted that the globalization, regionalization and glocalization processes are detected as new phenomenon that arouse as a result of international relations system evolution. The article reveals socio-philosophical content of globalization phenomenon in the nature of both spatial and civilization development of the modern world. The author highlights the necessity of theoretical basis generation so that to favour scientific discourse on the globalization issues in the light of new actors (megalopolises in the international relations system. Laying stress on the major cities as the international activity centers, the author emphasizes the requirement for comprehensive analysis of their involvement into the transformation processes. The intensification of local against global actors’ position is indicated by the author in the article. It points to the research of their social and political role as a new not yet generated investigation form within the bounds of philosophical science, and it favors preservation of peace integrity.

  11. ROLE OF MEGALOPOLISES IN SOCIO-PHILOSOPHICAL COMPREHENSION OF GLOBALIZATION PROCESS

    Directory of Open Access Journals (Sweden)

    Анна Александровна Нистарова

    2013-04-01

    Full Text Available In her article the author tries to establish linkage between the events that took place at the turn of the 20th – 21st centuries and the aspiration of some countries for negating or limiting their jurisdiction with respect to international law due to the international bipolar system disintegration. It should be noted that the globalization, regionalization and glocalization processes are detected as new phenomenon that arouse as a result of international relations system evolution. The article reveals socio-philosophical content of globalization phenomenon in the nature of both spatial and civilization development of the modern world. The author highlights the necessity of theoretical basis generation so that to favour scientific discourse on the globalization issues in the light of new actors (megalopolises in the international relations system. Laying stress on the major cities as the international activity centers, the author emphasizes the requirement for comprehensive analysis of their involvement into the transformation processes. The intensification of local against global actors’ position is indicated by the author in the article. It points to the research of their social and political role as a new not yet generated investigation form within the bounds of philosophical science, and it favors preservation of peace integrity.DOI: http://dx.doi.org/10.12731/2218-7405-2013-1-4

  12. [Innovation in healthcare processes and patient safety using clinical simulation].

    Science.gov (United States)

    Rojo, E; Maestre, J M; Díaz-Mendi, A R; Ansorena, L; Del Moral, I

    2016-01-01

    Many excellent ideas are never implemented or generalised by healthcare organisations. There are two related paradigms: thinking that individuals primarily change through accumulating knowledge, and believing that the dissemination of that knowledge within the organisation is the key element to facilitate change. As an alternative, a description and evaluation of a simulation-based inter-professional team training program conducted in a Regional Health Service to promote and facilitate change is presented. The Department of Continuing Education completed the needs assessment using the proposals presented by clinical units and management. Skills and behaviors that could be learned using simulation were selected, and all personnel from the units participating were included. Experiential learning principles based on clinical simulation and debriefing, were used for the instructional design. The Kirkpatrick model was used to evaluate the program. Objectives included: a) decision-making and teamwork skills training in high prevalence diseases with a high rate of preventable complications; b) care processes reorganisation to improve efficiency, while maintaining patient safety; and, c) implementation of new complex techniques with a long learning curve, and high preventable complications rate. Thirty clinical units organised 39 training programs in the 3 public hospitals, and primary care of the Regional Health Service during 2013-2014. Over 1,559 healthcare professionals participated, including nursing assistants, nurses and physicians. Simulation in healthcare to train inter-professional teams can promote and facilitate change in patient care, and organisational re-engineering. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Advanced Bayesian processing of clinical data in nuclear medicine

    International Nuclear Information System (INIS)

    Jirsa, L.

    1999-11-01

    The Bayesian methodology was applied with a view to improving the quality of thyroid gland disease treatment at a nuclear medicine department. The specific tasks included: formulation of the estimation tasks from the theoretical point of view; elaborating algorithms to estimate various physical, medical and dosimetric quantities used in radiodiagnosis and radiotherapy of thyroid gland diseases; testing their numerical precision; testing their numerical stability on a large set of clinical data; implementation of the algorithms at a level applicable in routine conditions of the nuclear medicine department and replace by them the data processing methods used there so far; exploring and testing the quality improvement of the estimates; and in dependence on the results, proposing hints where improvement of the data measurement methodology is necessary

  14. Clinical process in an integrative psychotherapy for self-wounds.

    Science.gov (United States)

    Wolfe, Barry E

    2013-09-01

    In this article, I will briefly describe the clinical process of an integrative psychotherapy for the healing of self-wounds, including its intended interventions and the variability of their application and outcome. Four specific strategies will be considered, including (a) the role of empathy throughout the course of therapy; (b) exposure therapy as a paradigmatic treatment for the treatment of feared thoughts, behavior, and emotions; (c) focusing and other experiential interventions for eliciting self-wounds; and (d) modification and healing of self-wounds with an individualized array of psychodynamic, experiential, and cognitive-behavioral strategies. In addition, we will briefly consider the impact of transference and countertransference on the trajectory of therapy. 2013 APA, all rights reserved

  15. Guide to deliver the elements of the Clinical Caritas Process

    Directory of Open Access Journals (Sweden)

    Luana Tonin

    2017-09-01

    Full Text Available Abstract Objective: To introduce a guide to apply the elements of the Clinical Caritas Process. Methods: It is a study introducing a guide developed to identify the necessary caring actions, aiming to provide transpersonal care. It was designed from a bibliographic review and discussion with peers, who apply the theory underpinning the present study. Results: The instrument features a layout with ten lines and two columns, decoding each structural component in its enunciation with its respective care manifestations. Additionally, it showed to be a facilitator for the use of the Human Caring Theory. Conclusion: It is believed that the guide can be reproduced in order to direct the practice of transpersonal care in different settings of Brazilian nursing. Moreover, it can also be used to teach this theory.

  16. Clinical evaluation of 64-slice CT assessment of global left ventricular function using automated cardiac phase selection

    International Nuclear Information System (INIS)

    Joemai, Raoul M.S.; Geleijns, Joemai; Veldkamp, Wouter J.H.; Kroft, Lucia J.M.

    2008-01-01

    Left ventricular (LV) function provides prognostic information regarding the morbidity and mortality of patients. An automated cardiac phase selection algorithm has the potential to support the assessment of LV function with computed tomography (CT). This algorithm is clinically evaluated for 64-slice cardiac CT. Examinations of twenty consecutive patients were selected. Electrocardiogram gated contrast-enhanced CT was performed. Reconstructions were performed using an automated and a manual method, followed by the determination of the global LV function. Significances were tested using 2-sided Student's t-tests. Reduction in post processing time and storage capacity were estimated. A slightly smaller mean end-systolic volume was found with the automated method (52±18 ml vs 54±17 ml, p=0.02, r=0.99). The mean LV ejection fraction was slightly larger with the automated method (65±8% vs 64±8%, p=0.004, r=0.99). The estimated reduction in post processing time was maximal 5 min per patient with a potential 80% data storage reduction. Results of the automated phase selection algorithm are similar to the manual method. The automated tool reduces post processing time, reconstruction time and transfer time. (author)

  17. Dystrophic Cardiomyopathy: Complex Pathobiological Processes to Generate Clinical Phenotype

    Directory of Open Access Journals (Sweden)

    Takeshi Tsuda

    2017-09-01

    Full Text Available Duchenne muscular dystrophy (DMD, Becker muscular dystrophy (BMD, and X-linked dilated cardiomyopathy (XL-DCM consist of a unique clinical entity, the dystrophinopathies, which are due to variable mutations in the dystrophin gene. Dilated cardiomyopathy (DCM is a common complication of dystrophinopathies, but the onset, progression, and severity of heart disease differ among these subgroups. Extensive molecular genetic studies have been conducted to assess genotype-phenotype correlation in DMD, BMD, and XL-DCM to understand the underlying mechanisms of these diseases, but the results are not always conclusive, suggesting the involvement of complex multi-layers of pathological processes that generate the final clinical phenotype. Dystrophin protein is a part of dystrophin-glycoprotein complex (DGC that is localized in skeletal muscles, myocardium, smooth muscles, and neuronal tissues. Diversity of cardiac phenotype in dystrophinopathies suggests multiple layers of pathogenetic mechanisms in forming dystrophic cardiomyopathy. In this review article, we review the complex molecular interactions involving the pathogenesis of dystrophic cardiomyopathy, including primary gene mutations and loss of structural integrity, secondary cellular responses, and certain epigenetic and other factors that modulate gene expressions. Involvement of epigenetic gene regulation appears to lead to specific cardiac phenotypes in dystrophic hearts.

  18. NASA/MSFC FY91 Global Scale Atmospheric Processes Research Program Review

    Science.gov (United States)

    Leslie, Fred W. (Editor)

    1991-01-01

    The reports presented at the annual Marshall Research Review of Earth Science and Applications are compiled. The following subject areas are covered: understanding of atmospheric processes in a variety of spatial and temporal scales; measurements of geophysical parameters; measurements on a global scale from space; the Mission to Planet Earth Program (comprised of and Earth Observation System and the scientific strategy to analyze these data); and satellite data analysis and fundamental studies of atmospheric dynamics.

  19. Optimization Case Study: ISR Allocation in the Global Force Management Process

    Science.gov (United States)

    2016-09-01

    assets available to meet the GCC requirements. The Joint Staff, in concert with USSTRATCOM, use many factors to prioritize allocation of assets to...include determining which GCC gets the assets and for how long. The decision influencers recommend a resource allocation solution based on experience...The allocation process illustrated in Figure 1 is the OV-1 diagram from the Joint Staff Global Force Management Enterprise Integration

  20. Global and Local Page Replacement Algorithms on Virtual Memory Systems for Image Processing

    OpenAIRE

    WADA, Ben Tsutom

    1985-01-01

    Three virtual memory systems for image processing, different one another in frame allocation algorithms and page replacement algorithms, were examined experimentally upon their page-fault characteristics. The hypothesis, that global page replacement algorithms are susceptible to thrashing, held in the raster scan experiment, while it did not in another non raster-scan experiment. The results of the experiments may be useful also in making parallel image processors more efficient, while they a...

  1. Processes of social flourishing and their liminal collapse: elements to a genealogy of globalization.

    Science.gov (United States)

    Szakolczai, Arpad

    2016-09-01

    This article aims at exploring a long-term historical perspective on which contemporary globalization can be more meaningfully situated. A central problem with established approaches to globalization is that they are even more presentist than the literature on modernization was. Presentism not only means the ignoring of history, but also the unreflective application to history of concepts taken from the study of the modern world. In contrast, it is argued that contemporary globalization is not a unique development, but rather is a concrete case of a historical type. Taking as its point of departure the spirit, rather than the word, of Max Weber, this article extends the scope of sociological investigation into archaeological evidence. Having a genealogical design and introducing the concept of 'liminality', the article approaches the modern process of globalization through reconstructing the internal dynamics of another type of historical change called 'social flourishing'. Taking up the Weberian approach continued by Eisenstadt in his writings on 'axial age', it moves away from situations of crisis as reference point, shifting attention to periods of revival by introducing the term 'epiphany'. Through the case of early Mesopotamia, it shows how social flourishing can be transmogrified into globalizing growth, gaining a new perspective concerning the kind of 'animating spirit' that might have driven the shift from Renaissance to Reformation, the rise of modern colonialism, or contemporary globalization. More generally, it will retrieve the long-term historical background of the axial age and demonstrate the usefulness and importance of archaeological evidence for sociology. © London School of Economics and Political Science 2016.

  2. The global chemical systematics of arc front stratovolcanoes: Evaluating the role of crustal processes

    Science.gov (United States)

    Turner, Stephen J.; Langmuir, Charles H.

    2015-07-01

    Petrogenetic models for convergent margins should be consistent with the global systematics of convergent margin volcanic compositions. A newly developed tool for compiling and screening data from the GEOROC database was used to generate a global dataset of whole rock chemical analyses from arc front stratovolcano samples. Data from 227 volcanoes within 31 volcanic arc segments were first averaged by volcano and then by arc to explore global systematics. Three different methods of data normalization produce consistent results that persist across a wide range of Mg# [Mg# =Mg / (Mg +Fe) ]. Remarkably coherent systematics are present among major and trace element concentrations and ratios, with the exception of three arcs influenced by mantle plumes and Peru/N. Chile, which is built on exceptionally thick crust. Chemical parameters also correlate with the thickness of the overlying arc crust. In addition to previously established correlations of Na6.0 with Ca6.0 and crustal thickness, correlations are observed among major elements, trace elements, and trace element ratios (e.g. La/Yb, Dy/Yb, Zr/Sm, Zr/Ti). Positive correlations include "fluid mobile," "high field strength," and "large ion lithophile" element groups, with concentrations that vary by a factor of five in all groups. Incompatible element enrichments also correlate well with crustal thickness, with the greatest enrichment found at arcs with the thickest crust. Intra-crustal processes, however, do not reproduce the global variations. High pressure fractionation produces intermediate magmas enriched in aluminum, but such magmas are rare. Furthermore, differences among magma compositions at various volcanic arcs persist from primitive to evolved compositions, which is inconsistent with the possibility that global variations are produced by crystal fractionation at any pressure. Linear relationships among elements appear to be consistent with mixing between depleted primary magma and an enriched contaminant

  3. Measuring Early Cortical Visual Processing in the Clinic

    Directory of Open Access Journals (Sweden)

    Linda Bowns

    2017-05-01

    Full Text Available We describe a mobile app that measures early cortical visual processing suitable for use in clinics. The app is called Component Extraction and Motion Integration Test (CEMIT. Observers are asked to respond to the direction of translating plaids that move in one of two very different directions. The plaids have been selected so that the plaid components move in one of the directions and the plaid pattern moves in the other direction. In addition to correctly responding to the pattern motion, observers demonstrate their ability to correctly extract the movement (and therefore the orientation of the underlying components at specific spatial frequencies. We wanted to test CEMIT by seeing if we could replicate the broader tuning observed at low spatial frequencies for this type of plaid. Results from CEMIT were robust and successfully replicated this result for 50 typical observers. We envisage that it will be of use to researchers and clinicians by allowing them to investigate specific deficits at this fundamental level of cortical visual processing. CEMIT may also be used for screening purposes where visual information plays an important role, for example, air traffic controllers.

  4. Relations between perceptual and conceptual scope: how global versus local processing fits a focus on similarity versus dissimilarity

    NARCIS (Netherlands)

    Förster, J.

    2009-01-01

    Nine studies showed a bidirectional link (a) between a global processing style and generation of similarities and (b) between a local processing style and generation of dissimilarities. In Experiments 1-4, participants were primed with global versus local perception styles and then asked to work on

  5. Performance of Globally Linearized Controller and Two Region Fuzzy Logic Controller on a Nonlinear Process

    Directory of Open Access Journals (Sweden)

    N. Jaya

    2008-10-01

    Full Text Available In this work, a design and implementation of a Conventional PI controller, single region fuzzy logic controller, two region fuzzy logic controller and Globally Linearized Controller (GLC for a two capacity interacting nonlinear process is carried out. The performance of this process using single region FLC, two region FLC and GLC are compared with the performance of conventional PI controller about an operating point of 50 %. It has been observed that GLC and two region FLC provides better performance. Further, this procedure is also validated by real time experimentation using dSPACE.

  6. [Sex differences in relationship between creativity and hemispheric information processing in global and local levels].

    Science.gov (United States)

    Razumnikova, O M; Vol'f, N V

    2012-01-01

    Sex differences in creativity related global-local hemispheric selective processing were examined by hierarchical letter presenting in conditions of their perception and comparison. Fifty-six right-handed males and 68 females (aged 17-22 years) participated in the experiments. Originality-imagery was assessed by a computer-based Torrance 'Incomplete Figures' test software. Verbal creativity was valued by original sentence using of three nouns from remote semantic categories. The results show that irrespectively of the sex factor and the type of creative thinking, its originality is provided by high speed of right-hemispheric processes of information selection on the global level and delay in the interhemispheric communication. Relationships between originality of ideas and hemispheric attentional characteristics are presented mostly in men while verbal creative problem solving, and in women while figurative original thinking. Originality of verbal activity in men is more associated with success of selective processes in the left hemisphere, but in women--with selective functions of both hemispheres. Figurative thinking in men is less related to hemispheric characteristics of attention compared with women. Increase of figurative originality in women is accompanied acceleration of processes of selection of the information in the right hemisphere, and also higher efficiency of local attention as well as speeds ofglobal processing in the left hemisphere.

  7. The US Food and Drug Administration's tentative approval process and the global fight against HIV.

    Science.gov (United States)

    Chahal, Harinder Singh; Murray, Jeffrey S; Shimer, Martin; Capella, Peter; Presto, Ryan; Valdez, Mary Lou; Lurie, Peter G

    2017-12-01

    In 2004, the US government began to utilize the Food and Drug Administration's (USFDA) tentative approval process (tFDA) as a basis to determine which HIV drugs are appropriate to be purchased and used in resource-constrained settings. This process permits products that are not approved for marketing in the US, including medicines with active patents or marketing restrictions in the US, to be purchased and distributed in resource-constrained settings. Although the tFDA was originally intended to support the United States' President's Emergency Plan for AIDS Relief (PEPFAR), the USFDA list has become a cornerstone of international HIV programmes that support procurement of ARVs, such as the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. Our objective in this article is to help the global HIV policy makers and implementers of HIV programmes better understand the benefits and limitations of the tFDA by providing an in-depth review of the relevant legal and regulatory processes. USFDA's dedicated tFDA process for ARVs used by the PEPFAR programme has a wide impact globally; however, the implementation and the regulatory processes governing the programme have not been thoroughly described in the medical literature. This paper seeks to help stakeholders better understand the legal and regulatory aspects associated with review of ARVs under the tFDA by describing the following: (1) the tFDA and its importance to global ARV procurement; (2) the regulatory pathways for applications under tFDA for the PEPFAR programme, including modifications to applications, review timelines and costs; (3) the role of US patents, US marketing exclusivity rights, and the Medicines Patents Pool in tFDA; and (4) an overview of how applications for PEPFAR programme are processed through the USFDA. We also provide a case study of a new ARV, tenofovir alafenamide fumarate (TAF), not yet reviewed by USFDA for PEPFAR use. In this paper, we describe the

  8. Circuit Mechanisms Governing Local vs. Global Motion Processing in Mouse Visual Cortex

    Directory of Open Access Journals (Sweden)

    Rune Rasmussen

    2017-12-01

    Full Text Available A withstanding question in neuroscience is how neural circuits encode representations and perceptions of the external world. A particularly well-defined visual computation is the representation of global object motion by pattern direction-selective (PDS cells from convergence of motion of local components represented by component direction-selective (CDS cells. However, how PDS and CDS cells develop their distinct response properties is still unresolved. The visual cortex of the mouse is an attractive model for experimentally solving this issue due to the large molecular and genetic toolbox available. Although mouse visual cortex lacks the highly ordered orientation columns of primates, it is organized in functional sub-networks and contains striate- and extrastriate areas like its primate counterparts. In this Perspective article, we provide an overview of the experimental and theoretical literature on global motion processing based on works in primates and mice. Lastly, we propose what types of experiments could illuminate what circuit mechanisms are governing cortical global visual motion processing. We propose that PDS cells in mouse visual cortex appear as the perfect arena for delineating and solving how individual sensory features extracted by neural circuits in peripheral brain areas are integrated to build our rich cohesive sensory experiences.

  9. Social Movements Facing the Processes of Globalization: Beyond the Paradigms of Class and Identity

    Directory of Open Access Journals (Sweden)

    Verónica Alfaro

    2004-08-01

    Full Text Available This essay focuses on a particular expression of globalization and regionalization that entails social, political, cultural and economic dimensions: social movements. I argue that current social movements are not necessarily articulated only in terms of class struggle-as the major labor movements were for the last two centuries. Neither do they articulate their protests only in terms of identity and recognition-such as women's movements did in the 1960s. Social movements are now most commonly organized around a discourse that combines those two dimensions. Contemporary social movements are expanding from the structural economic and industrial system (and thus abandoning the form of traditional class struggles to cultural and identity grounds. New social movements are now seen more and more as symbolic challengers, because power-that affects everyday life and tries to manipulate and give social meaning to things-is being contested by individuals in both the public and private spheres. Thus movements have a more symbolic function: they are a new kind of media, fighting for symbolic and cultural stakes, and for a different meaning and orientation of social action. However, constructing a collective identity within a social movement is not definitive. A movement's identity is constructed on an everyday basis, and within the process of globalization, the contact and social interaction with others -with the other, which allows the definition of one's own identity-is not only possible but also necessary. This paper considers the Zapatista rebellion in Chiapas as an empirical approach to social movements expanding from regional, local mobilizations and discourse, to more global oriented contentious activities. I argue that the Zapatista movement's identity in 1994 was quite different from the one it has now: the Ejército Zapatista de Liberación Nacional (EZLN, or Zapatista National Liberation Army discourse has been transformed, from having an ethnic

  10. Introduction to a Special Issue of the Journal of Immunological Methods: Building global resource programs to support HIV/AIDS clinical trial studies.

    Science.gov (United States)

    Sanchez, Ana M; Denny, Thomas N; O'Gorman, Maurice

    2014-07-01

    This Special Issue of the Journal of Immunological Methods includes 16 manuscripts describing quality assurance activities related to virologic and immunologic monitoring of six global laboratory resource programs that support international HIV/AIDS clinical trial studies: Collaboration for AIDS Vaccine Discovery (CAVD); Center for HIV/AIDS Vaccine Immunology (CHAVI); External Quality Assurance Program Oversight Laboratory (EQAPOL); HIV Vaccine Trial Network (HVTN); International AIDS Vaccine Initiative (IAVI); and Immunology Quality Assessment (IQA). The reports from these programs address the many components required to develop comprehensive quality control activities and subsequent quality assurance programs for immune monitoring in global clinical trials including: all aspects of processing, storing, and quality assessment of PBMC preparations used ubiquitously in HIV clinical trials, the development and optimization of assays for CD8 HIV responses and HIV neutralization, a comprehensive global HIV virus repository, and reports on the development and execution of novel external proficiency testing programs for immunophenotyping, intracellular cytokine staining, ELISPOT and luminex based cytokine measurements. In addition, there are articles describing the implementation of Good Clinical Laboratory Practices (GCLP) in a large quality assurance laboratory, the development of statistical methods specific for external proficiency testing assessment, a discussion on the ability to set objective thresholds for measuring rare events by flow cytometry, and finally, a manuscript which addresses a framework for the structured reporting of T cell immune function based assays. It is anticipated that this series of manuscripts covering a wide range of quality assurance activities associated with the conduct of global clinical trials will provide a resource for individuals and programs involved in improving the harmonization, standardization, accuracy, and sensitivity of

  11. Energy use and implications for efficiency strategies in global fluid-milk processing industry

    International Nuclear Information System (INIS)

    Xu Tengfang; Flapper, Joris

    2009-01-01

    The fluid-milk processing industry around the world processes approximately 60% of total raw milk production to create diverse fresh fluid-milk products. This paper reviews energy usage in existing global fluid-milk markets to identify baseline information that allows comparisons of energy performance of individual plants and systems. In this paper, we analyzed energy data compiled through extensive literature reviews on fluid-milk processing across a number of countries and regions. The study has found that the average final energy intensity of individual plants exhibited significant large variations, ranging from 0.2 to 12.6 MJ per kg fluid-milk product across various plants in different countries and regions. In addition, it is observed that while the majority of larger plants tended to exhibit higher energy efficiency, some exceptions existed for smaller plants with higher efficiency. These significant differences have indicated large potential energy-savings opportunities in the sector across many countries. Furthermore, this paper illustrates a positive correlation between implementing energy-monitoring programs and curbing the increasing trend in energy demand per equivalent fluid-milk product over time in the fluid-milk sector, and suggests that developing an energy-benchmarking framework, along with promulgating new policy options should be pursued for improving energy efficiency in global fluid-milk processing industry.

  12. Improved parameterization of managed grassland in a global process-based vegetation model using Bayesian statistics

    Science.gov (United States)

    Rolinski, S.; Müller, C.; Lotze-Campen, H.; Bondeau, A.

    2010-12-01

    More than a quarter of the Earth’s land surface is covered by grassland, which is also the major part (~ 70 %) of the agricultural area. Most of this area is used for livestock production in different degrees of intensity. The dynamic global vegetation model LPJmL (Sitch et al., Global Change Biology, 2003; Bondeau et al., Global Change Biology, 2007) is one of few process-based model that simulates biomass production on managed grasslands at the global scale. The implementation of managed grasslands and its evaluation has received little attention so far, as reference data on grassland productivity are scarce and the definition of grassland extent and usage are highly uncertain. However, grassland productivity is related to large areas, and strongly influences global estimates of carbon and water budgets and should thus be improved. Plants are implemented in LPJmL in an aggregated form as plant functional types assuming that processes concerning carbon and water fluxes are quite similar between species of the same type. Therefore, the parameterization of a functional type is possible with parameters in a physiologically meaningful range of values. The actual choice of the parameter values from the possible and reasonable phase space should satisfy the condition of the best fit of model results and measured data. In order to improve the parameterization of managed grass we follow a combined procedure using model output and measured data of carbon and water fluxes. By comparing carbon and water fluxes simultaneously, we expect well-balanced refinements and avoid over-tuning of the model in only one direction. The comparison of annual biomass from grassland to data from the Food and Agriculture Organization of the United Nations (FAO) per country provide an overview about the order of magnitude and the identification of deviations. The comparison of daily net primary productivity, soil respiration and water fluxes at specific sites (FluxNet Data) provides

  13. Modeling of ETL-Processes and Processed Information in Clinical Data Warehousing.

    Science.gov (United States)

    Tute, Erik; Steiner, Jochen

    2018-01-01

    Literature describes a big potential for reuse of clinical patient data. A clinical data warehouse (CDWH) is a means for that. To support management and maintenance of processes extracting, transforming and loading (ETL) data into CDWHs as well as to ease reuse of metadata between regular IT-management, CDWH and secondary data users by providing a modeling approach. Expert survey and literature review to find requirements and existing modeling techniques. An ETL-modeling-technique was developed extending existing modeling techniques. Evaluation by exemplarily modeling existing ETL-process and a second expert survey. Nine experts participated in the first survey. Literature review yielded 15 included publications. Six existing modeling techniques were identified. A modeling technique extending 3LGM2 and combining it with openEHR information models was developed and evaluated. Seven experts participated in the evaluation. The developed approach can help in management and maintenance of ETL-processes and could serve as interface between regular IT-management, CDWH and secondary data users.

  14. Selection, processing and clinical application of muscle-skeletal tissue

    International Nuclear Information System (INIS)

    Luna Z, D.; Reyes F, M.L.; Lavalley E, C.; Castaneda J, G.

    2007-01-01

    Due to the increase in the average of the world population's life, people die each time to more age, this makes that the tissues of support of the human body, as those muscle-skeletal tissues, when increasing the individual's age go weakening, this in turn leads to the increment of the illnesses like the osteoporosis and the arthritis, that undoubtedly gives as a result more injure of the muscle-skeletal tissues joined a greater number of traffic accidents where particularly these tissues are affected, for that the demand of tissues muscle-skeletal for transplant every day will be bigger. The production of these tissues in the Bank of Radio sterilized Tissues, besides helping people to improve its quality of life saved foreign currencies because most of the muscle-skeletal tissues transplanted in Mexico are of import. The use of the irradiation to sterilize tissues for transplant has shown to be one of the best techniques with that purpose for what the International Atomic Energy Agency believes a Technical cooperation program to establish banks of tissues using the nuclear energy, helping mainly to countries in development. In this work the stages that follows the bank of radio sterilized tissues of the National Institute of Nuclear Research for the cadaverous donor's of muscle-skeletal tissue selection are described, as well as the processing and the clinical application of these tissues. (Author)

  15. Global Harmonization of Quality Assurance Naming Conventions in Radiation Therapy Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Melidis, Christos, E-mail: christos.melidis@eortc.be [European Organization for the Research and Treatment of Cancer–Radiation Oncology Group (EORTC-ROG), Radiation Therapy Quality Assurance (RTQA), Brussels (Belgium); Bosch, Walther R. [Washington University, representing Advanced Technology Consortium, Radiation Oncology, St. Louis, Missouri (United States); Izewska, Joanna [Dosimetry Laboratory, International Atomic Energy Agency, Vienna (Austria); Fidarova, Elena; Zubizarreta, Eduardo [Applied Radiation Biology and Radiotherapy Section, International Atomic Energy Agency, Vienna (Austria); Ulin, Kenneth [Department of Radiation Oncology, University of Massachusetts Medical School, Representing Quality Assurance Review Center, Worcester, Massachusetts (United States); Ishikura, Satoshi [Department of Radiation Oncology, Juntendo University, Representing Japan Clinical Oncology Group, RTQA, Tokyo (Japan); Followill, David [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Representing Radiological Physics Center, RTQA, Houston, Texas (United States); Galvin, James [Department of Radiation Oncology, Thomas Jefferson University, Representing Radiation Therapy Oncology Group, RTQA, Philadelphia, Pennsylvania (United States); Haworth, Annette [Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, representing TransTasman Radiation Oncology Group (TROG) Cancer Research, Newcastle (Australia); Besuijen, Deidre [North West Cancer Centre, Representing TROG Cancer Research, Newcastle (Australia); Clark, Clark H. [Department of Medical Physics, St. Luke' s Cancer Centre, Royal Surrey County Hospital, Guildford, Surrey and National Physical Laboratory, Teddington, Middlesex, representing Radiation Therapy Trials Quality Assurance (RTTQA) (United Kingdom); Miles, Elizabeth; Aird, Edwin [Mount Vernon Cancer Centre, Northwood, Middlesex representing RTTQA (United Kingdom); and others

    2014-12-01

    Purpose: To review the various radiation therapy quality assurance (RTQA) procedures used by the Global Clinical Trials RTQA Harmonization Group (GHG) steering committee members and present the harmonized RTQA naming conventions by amalgamating procedures with similar objectives. Methods and Materials: A survey of the GHG steering committee members' RTQA procedures, their goals, and naming conventions was conducted. The RTQA procedures were classified as baseline, preaccrual, and prospective/retrospective data capture and analysis. After all the procedures were accumulated and described, extensive discussions took place to come to harmonized RTQA procedures and names. Results: The RTQA procedures implemented within a trial by the GHG steering committee members vary in quantity, timing, name, and compliance criteria. The procedures of each member are based on perceived chances of noncompliance, so that the quality of radiation therapy planning and treatment does not negatively influence the trial measured outcomes. A comparison of these procedures demonstrated similarities among the goals of the various methods, but the naming given to each differed. After thorough discussions, the GHG steering committee members amalgamated the 27 RTQA procedures to 10 harmonized ones with corresponding names: facility questionnaire, beam output audit, benchmark case, dummy run, complex treatment dosimetry check, virtual phantom, individual case review, review of patients' treatment records, and protocol compliance and dosimetry site visit. Conclusions: Harmonized RTQA harmonized naming conventions, which can be used in all future clinical trials involving radiation therapy, have been established. Harmonized procedures will facilitate future intergroup trial collaboration and help to ensure comparable RTQA between international trials, which enables meta-analyses and reduces RTQA workload for intergroup studies.

  16. 78 FR 79703 - Submission for OMB Review; 30-Day Comment Request: Application Process for Clinical Research...

    Science.gov (United States)

    2013-12-31

    ...; 30-Day Comment Request: Application Process for Clinical Research Training and Medical Education at..., MD, Deputy Director, Office of Clinical Research Training and Medical Education, NIH Clinical Center... Clinical Research Training and Medical Education at the Clinical Center and its Impact on Course and...

  17. Examining Pediatric Cases From the Clinical Research Office of the Endourological Society Ureteroscopy Global Study.

    Science.gov (United States)

    Guven, Selcuk; Basiri, Abbas; Varshney, Anil Kumar; Aridogan, Ibrahim Atilla; Miura, Hiroyasu; White, Mark; Kilinc, Mehmet; de la Rosette, Jean

    2017-03-01

    To evaluate the characteristics and outcomes of ureteroscopy (URS) in children treated in several hospitals participating in the Clinical Research Office of the Endourological Society (CROES) Study, and to present the overall results of pediatric URS compared with adults. The CROES Study collected data on consecutive patients treated with URS for urolithiasis at each participating center over a 1-year period. The collected prospective global database includes data for 11,885 patients who received URS at 114 centers in 32 countries. Of these URS-treated patients, 192 were ≤18 years old. Of the 114 centers participating in the study, 42% had conducted pediatric URS. Among the pediatric cases, 7 were infants, 53 were small children, 59 were school-aged children, and 73 were adolescents. A considerable number (37%) of the pediatric cases had previously undergone URS treatment. No differences in the surgical outcomes of the adults and children were reported. The URS-treated children had a greater number of positive preoperative urine cultures when compared with adult cases treated. A semirigid scope was used in the vast majority of pediatric cases (85%). According to the present data, within the group of URS-treated children, the younger the child, the more readmissions occurred. URS is as efficient and safe in children as it is in adults. The data suggest that readmissions among URS-treated children are associated with age, with the likelihood of readmissions greater among younger age groups. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Harmonization of accounting in the process of globalization of economic activities

    Directory of Open Access Journals (Sweden)

    Floarea Georgescu

    2014-03-01

    Full Text Available Abstract. Once with the Romania adhering at the European Union the public accounting system was transformed and adapted according to the requirements imposed by the international public sector accounting standards (IPSAS.This fact had imposed the appearance of legislative norms and provisions adapted to the actual requirements, by taking into account the growing and complex level of economic activities where the irreversible process of globalization takes place. The changes due to the economic politics, especially the new configuration of the international economic relations, relations characterized by an intense and irreversible process of globalization, have conducted to the implementation of a unitary and uniform legislation, particularly for the member states of EU. The accounting reform has begun through the harmonization of legislation according to the requirements and provisions of International Accounting Standards and European Directives.  The ampleness and the rapid rhythm of informational society’s development have implicitly leaded to the development of accounting information’s importance and dimension. The decisive role of the accounting information had conducted to the accentuated growth of the interest, manifested at all informational society’s level, from the development of activities in financial and economical domain point of view. The accounting normalization process imposed the development of norms and provisions necessary to the drawing up of accounting documents, by defying methods and a specialized terminology, applied in the activity of entities and accounting specialists.

  19. Globalization process and its impact on Kosovo’s tourism development

    Directory of Open Access Journals (Sweden)

    MSc. Petrit Hasanaj

    2016-01-01

    Full Text Available Unlike modernization, globalization is a process somewhat independent from the will of its adhering participants. This thesis represents Robertson sociologist giving a description based on which capital, ideas and cultural codes, with the help of new communication tools, expand worldwide. With rapid development of media and mass electronic communications is eliminated the importance of space and leads to shrinking (narrowing of time and space which is a serious threat to national cultural identities. Fukuyama in his apology of liberal democracy warns "final political neutralization of nationalism" in terms of overall centralization and linguistic unity of the world.

  20. Future gender relations in global restructuring processes case study evidence from knowledge-intensive, manufacturing and service occupations

    OpenAIRE

    Linda Nierling

    2008-01-01

    Global restructuring processes have not only strong implications for European working and living realities, but also have specific outcomes with regard to gender relations. The following contribution analyses in which way global restructuring shapes current gender relations in order to identify important trends and developments for future gender (in)equalities at the workplace. On the basis of a large qualitative study on global restructuring and impacts on different occupational groups it ar...

  1. Evaluating Global Health Partnerships: A Case Study of a Gavi HPV Vaccine Application Process in Uganda

    Directory of Open Access Journals (Sweden)

    Carol Kamya

    2017-06-01

    Full Text Available Background Global health partnerships have grown rapidly in number and scope, yet there has been less emphasis on their evaluation. Gavi, the Vaccine Alliance, is one such public-private partnership; in Gavi-eligible countries partnerships are dynamic networks of immunization actors who work together to support all stages and aspects of Gavi support. This paper describes a conceptual framework – the partnership framework – and analytic approach for evaluating the perceptions of partnerships’ added value as well as the results from an application to one case in Uganda. Methods We used a mixed-methods case study design embedded in the Gavi Full Country Evaluations (FCE to test the partnership framework on Uganda’s human papillomavirus (HPV vaccine application partnership. Data from document review, interviews, and social network surveys enabled the testing of the relationships between partnership framework domains (context, structure, practices, performance, and outcomes. Topic guides were based on the framework domains and network surveys identified working together relationships, professional trust, and perceptions of the effectiveness, efficiency, and legitimacy of the partnership’s role in this process. Results Data from seven in-depth interviews, 11 network surveys and document review were analyzed according to the partnership framework, confirming relationships between the framework domains. Trust was an important contributor to the perceived effectiveness of the process. The network was structured around the EPI program, who was considered the leader of this process. While the structure and composition of the network was largely viewed as supporting an effective and legitimate process, the absence of the Ministry of Education (MoE may have had downstream consequences if this study’s results had not been shared with the Ministry of Health (MoH and acted upon. The partnership was not perceived to have increased the efficiency of

  2. Electronic processing of informed consents in a global pharmaceutical company environment.

    Science.gov (United States)

    Vishnyakova, Dina; Gobeill, Julien; Oezdemir-Zaech, Fatma; Kreim, Olivier; Vachon, Therese; Clade, Thierry; Haenning, Xavier; Mikhailov, Dmitri; Ruch, Patrick

    2014-01-01

    We present an electronic capture tool to process informed consents, which are mandatory recorded when running a clinical trial. This tool aims at the extraction of information expressing the duration of the consent given by the patient to authorize the exploitation of biomarker-related information collected during clinical trials. The system integrates a language detection module (LDM) to route a document into the appropriate information extraction module (IEM). The IEM is based on language-specific sets of linguistic rules for the identification of relevant textual facts. The achieved accuracy of both the LDM and IEM is 99%. The architecture of the system is described in detail.

  3. 77 FR 42003 - TA-W-81,263, Chartis Global Services, Inc., a Subsidiary of Chartis, Inc., Regional Processing...

    Science.gov (United States)

    2012-07-17

    ... DEPARTMENT OF LABOR Employment and Training Administration TA-W-81,263, Chartis Global Services..., Houston, TX; TA-W-81,263A, Chartis Global Services, Inc., a Subsidiary of Chartis, Inc., Regional... is amending the certification (TA-W-81,263) to add ``Regional Processing Organization'' and to add...

  4. The nuclear safeguards system and the process of global governance accountability

    International Nuclear Information System (INIS)

    Xavier, Roberto Salles

    2011-01-01

    Due to rising energy costs and climate concerns, nuclear energy is again being seriously considered as an energy source for several countries. Along with the resurgence of nuclear energy comes the concern of the world if these countries will develop their programs for the peaceful use of nuclear energy. If on one hand the growth potential of nuclear energy should not be stifled, on the other hand it is imperative that a climate of mutual trust is developed, respecting the right of each country to develop its nuclear program without taking a climate of mistrust to a possible 'intention' behind the pursuit of peaceful use of nuclear energy. Therefore, it is essential that appropriate mechanisms of accountability of global governance are institutionalized at the institutional architecture of the international process of nuclear safeguards, more specifically to the nuclear fuel cycle, so that abuses of power in this sphere does not happen, both by countries that aspire to develop projects nuclear, and by the suppliers of technology. In this context, the case study of Brazil and Argentina gained importance, because these two countries have a single binational organization of nuclear safeguards in the world: Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials - ABACC. In the theoretical question, the paper tries to understand what happens with the process of legitimacy and authority of the organizations of global governance by analyzing the degree of publicness and constrictiveness. This work intends to focus on the role of ABACC as an interstate institution of accountability, which has a key role to control the nation States of Brazil and Argentina regarding the appropriate use of nuclear material used in their programs, and analyze how this Agency behaves within of tension legitimacy-authority, taking into account existing studies on accountability in global governance. (author)

  5. The nuclear safeguards system and the process of global governance accountability

    Energy Technology Data Exchange (ETDEWEB)

    Xavier, Roberto Salles, E-mail: xavier@cnen.gov.b [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil). Coordenacao Geral de Planejamento e Avaliacao

    2011-07-01

    Due to rising energy costs and climate concerns, nuclear energy is again being seriously considered as an energy source for several countries. Along with the resurgence of nuclear energy comes the concern of the world if these countries will develop their programs for the peaceful use of nuclear energy. If on one hand the growth potential of nuclear energy should not be stifled, on the other hand it is imperative that a climate of mutual trust is developed, respecting the right of each country to develop its nuclear program without taking a climate of mistrust to a possible 'intention' behind the pursuit of peaceful use of nuclear energy. Therefore, it is essential that appropriate mechanisms of accountability of global governance are institutionalized at the institutional architecture of the international process of nuclear safeguards, more specifically to the nuclear fuel cycle, so that abuses of power in this sphere does not happen, both by countries that aspire to develop projects nuclear, and by the suppliers of technology. In this context, the case study of Brazil and Argentina gained importance, because these two countries have a single binational organization of nuclear safeguards in the world: Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials - ABACC. In the theoretical question, the paper tries to understand what happens with the process of legitimacy and authority of the organizations of global governance by analyzing the degree of publicness and constrictiveness. This work intends to focus on the role of ABACC as an interstate institution of accountability, which has a key role to control the nation States of Brazil and Argentina regarding the appropriate use of nuclear material used in their programs, and analyze how this Agency behaves within of tension legitimacy-authority, taking into account existing studies on accountability in global governance. (author)

  6. Seasonality of global and Arctic black carbon processes in the Arctic Monitoring and Assessment Programme models: Global and Arctic Black Carbon Processes

    Energy Technology Data Exchange (ETDEWEB)

    Mahmood, Rashed [School of Earth and Ocean Sciences, University of Victoria, Victoria British Columbia Canada; Department of Meteorology, COMSATS Institute of Information Technology, Islamabad Pakistan; von Salzen, Knut [School of Earth and Ocean Sciences, University of Victoria, Victoria British Columbia Canada; Canadian Center for Climate Modelling and Analysis, Environment and Climate Change Canada, University of Victoria, Victoria British Columbia Canada; Flanner, Mark [Department of Atmospheric, Oceanic and Space Sciences, University of Michigan, Ann Arbor Michigan USA; Sand, Maria [Center for International Climate and Environmental Research-Oslo, Oslo Norway; Langner, Joakim [Swedish Meteorological and Hydrological Institute, Norrköping Sweden; Wang, Hailong [Atmospheric Sciences and Global Change Division, Pacific Northwest National Laboratory, Richland Washington USA; Huang, Lin [Climate Chemistry Measurements and Research, Environment and Climate Change Canada, Toronto Ontario Canada

    2016-06-22

    This study quantifies black carbon (BC) processes in three global climate models and one chemistry transport model, with focus on the seasonality of BC transport, emissions, wet and dry deposition in the Arctic. In the models, transport of BC to the Arctic from lower latitudes is the major BC source for this region while Arctic emissions are very small. All models simulated a similar annual cycle of BC transport from lower latitudes to the Arctic, with maximum transport occurring in July. Substantial differences were found in simulated BC burdens and vertical distributions, with CanAM (NorESM) producing the strongest (weakest) seasonal cycle. CanAM also has the shortest annual mean residence time for BC in the Arctic followed by SMHI-MATCH, CESM and NorESM. The relative contribution of wet and dry deposition rates in removing BC varies seasonally and is one of the major factors causing seasonal variations in BC burdens in the Arctic. Overall, considerable differences in wet deposition efficiencies in the models exist and are a leading cause of differences in simulated BC burdens. Results from model sensitivity experiments indicate that scavenging of BC in convective clouds acts to substantially increase the overall efficiency of BC wet deposition in the Arctic, which leads to low BC burdens and a more pronounced seasonal cycle compared to simulations without convective BC scavenging. In contrast, the simulated seasonality of BC concentrations in the upper troposphere is only weakly influenced by wet deposition in stratiform (layer) clouds whereas lower tropospheric concentrations are highly sensitive.

  7. Systematic framework for carbon dioxide capture and utilization processes to reduce the global carbon dioxide emissions

    DEFF Research Database (Denmark)

    Frauzem, Rebecca; Plaza, Cristina Calvera; Gani, Rafiqul

    information-data on various carbon dioxide emission sources and available capture-utilization technologies; the model and solution libraries [2]; and the generic 3-stage approach for determining more sustainable solutions [3] through superstructure (processing networks) based optimization – adopted for global...... need to provide, amongst other options: useful data from in-house databases on carbon dioxide emission sources; mathematical models from a library of process-property models; numerical solvers from library of implemented solvers; and, work-flows and data-flows for different benefit scenarios...... to be investigated. It is useful to start by developing a prototype framework and then augmenting its application range by increasing the contents of its databases, libraries and work-flows and data-flows. The objective is to present such a prototype framework with its implemented database containing collected...

  8. The Effect of Improved Sub-Daily Earth Rotation Models on Global GPS Data Processing

    Science.gov (United States)

    Yoon, S.; Choi, K. K.

    2017-12-01

    Throughout the various International GNSS Service (IGS) products, strong periodic signals have been observed around the 14 day period. This signal is clearly visible in all IGS time-series such as those related to orbit ephemerides, Earth rotation parameters (ERP) and ground station coordinates. Recent studies show that errors in the sub-daily Earth rotation models are the main factors that induce such noise. Current IGS orbit processing standards adopted the IERS 2010 convention and its sub-daily Earth rotation model. Since the IERS convention had published, recent advances in the VLBI analysis have made contributions to update the sub-daily Earth rotation models. We have compared several proposed sub-daily Earth rotation models and show the effect of using those models on orbit ephemeris, Earth rotation parameters and ground station coordinates generated by the NGS global GPS data processing strategy.

  9. Levels-of-processing effects on recollection and familiarity during transient global amnesia and after recovery.

    Science.gov (United States)

    Thoma, Patrizia; Schwarz, Michael; Daum, Irene

    2010-11-01

    The aim of the present study was to investigate the pattern of recollection and familiarity deficits and the modulation of recognition memory performance by the depth of encoding (deep vs. shallow) in transient global amnesia (TGA). Ten patients with TGA and 11 control subjects were assessed during the acute stage and after recovery 7 to 19 days later. Both recollection and familiarity were impaired in the acute stage and showed significant, albeit not complete, recovery by the time of the postacute assessment. The patients did, however, show a significant levels-of-processing effect, which was significantly reduced in acute TGA, but not at follow-up. The significant levels-of-processing effect during acute TGA might be linked to recruitment of the prefrontal cortex. (c) 2010 APA, all rights reserved

  10. Stepping back to see the big picture: when obstacles elicit global processing.

    Science.gov (United States)

    Marguc, Janina; Förster, Jens; Van Kleef, Gerben A

    2011-11-01

    Can obstacles prompt people to look at the "big picture" and open up their minds? Do the cognitive effects of obstacles extend beyond the tasks with which they interfere? These questions were addressed in 6 studies involving both physical and nonphysical obstacles and different measures of global versus local processing styles. Perceptual scope increased after participants solved anagrams in the presence, rather than the absence, of an auditory obstacle (random words played in the background; Study 1), particularly among individuals low in volatility (i.e., those who are inclined to stay engaged and finish what they do; Study 4). It also increased immediately after participants encountered a physical obstacle while navigating a maze (Study 3A) and when compared with doing nothing (Study 3B). Conceptual scope increased after participants solved anagrams while hearing random numbers framed as an "obstacle to overcome" rather than a "distraction to ignore" (Study 2) and after participants navigated a maze with a physical obstacle, compared with a maze without a physical obstacle, but only when trait (Study 5) or state (Study 6) volatility was low. Results suggest that obstacles trigger an "if obstacle, then start global processing" response, primarily when people are inclined to stay engaged and finish ongoing activities. Implications for dealing with life's obstacles and related research are discussed.

  11. Evaluation of factors controlling global secondary organic aerosol production from cloud processes

    Directory of Open Access Journals (Sweden)

    C. He

    2013-02-01

    Full Text Available Secondary organic aerosols (SOA exert a significant influence on ambient air quality and regional climate. Recent field, laboratorial and modeling studies have confirmed that in-cloud processes contribute to a large fraction of SOA production with large space-time heterogeneity. This study evaluates the key factors that govern the production of cloud-process SOA (SOAcld on a global scale based on the GFDL coupled chemistry-climate model AM3 in which full cloud chemistry is employed. The association between SOAcld production rate and six factors (i.e., liquid water content (LWC, total carbon chemical loss rate (TCloss, temperature, VOC/NOx, OH, and O3 is examined. We find that LWC alone determines the spatial pattern of SOAcld production, particularly over the tropical, subtropical and temperate forest regions, and is strongly correlated with SOAcld production. TCloss ranks the second and mainly represents the seasonal variability of vegetation growth. Other individual factors are essentially uncorrelated spatiotemporally to SOAcld production. We find that the rate of SOAcld production is simultaneously determined by both LWC and TCloss, but responds linearly to LWC and nonlinearly (or concavely to TCloss. A parameterization based on LWC and TCloss can capture well the spatial and temporal variability of the process-based SOAcld formation (R2 = 0.5 and can be easily applied to global three dimensional models to represent the SOA production from cloud processes.

  12. Fast simulation of reconstructed phylogenies under global time-dependent birth-death processes.

    Science.gov (United States)

    Höhna, Sebastian

    2013-06-01

    Diversification rates and patterns may be inferred from reconstructed phylogenies. Both the time-dependent and the diversity-dependent birth-death process can produce the same observed patterns of diversity over time. To develop and test new models describing the macro-evolutionary process of diversification, generic and fast algorithms to simulate under these models are necessary. Simulations are not only important for testing and developing models but play an influential role in the assessment of model fit. In the present article, I consider as the model a global time-dependent birth-death process where each species has the same rates but rates may vary over time. For this model, I derive the likelihood of the speciation times from a reconstructed phylogenetic tree and show that each speciation event is independent and identically distributed. This fact can be used to simulate efficiently reconstructed phylogenetic trees when conditioning on the number of species, the time of the process or both. I show the usability of the simulation by approximating the posterior predictive distribution of a birth-death process with decreasing diversification rates applied on a published bird phylogeny (family Cettiidae). The methods described in this manuscript are implemented in the R package TESS, available from the repository CRAN (http://cran.r-project.org/web/packages/TESS/). Supplementary data are available at Bioinformatics online.

  13. Global transcriptional profiling of longitudinal clinical isolates of Mycobacterium tuberculosis exhibiting rapid accumulation of drug resistance.

    Directory of Open Access Journals (Sweden)

    Anirvan Chatterjee

    Full Text Available The identification of multidrug resistant (MDR, extensively and totally drug resistant Mycobacterium tuberculosis (Mtb, in vulnerable sites such as Mumbai, is a grave threat to the control of tuberculosis. The current study aimed at explaining the rapid expression of MDR in Directly Observed Treatment Short Course (DOTS compliant patients, represents the first study comparing global transcriptional profiles of 3 pairs of clinical Mtb isolates, collected longitudinally at initiation and completion of DOTS. While the isolates were drug susceptible (DS at onset and MDR at completion of DOTS, they exhibited identical DNA fingerprints at both points of collection. The whole genome transcriptional analysis was performed using total RNA from H37Rv and 3 locally predominant spoligotypes viz. MANU1, CAS and Beijing, hybridized on MTBv3 (BuG@S microarray, and yielded 36, 98 and 45 differentially expressed genes respectively. Genes encoding transcription factors (sig, rpoB, cell wall biosynthesis (emb genes, protein synthesis (rpl and additional central metabolic pathways (ppdK, pknH, pfkB were found to be down regulated in the MDR isolates as compared to the DS isolate of the same genotype. Up regulation of drug efflux pumps, ABC transporters, trans-membrane proteins and stress response transcriptional factors (whiB in the MDR isolates was observed. The data indicated that Mtb, without specific mutations in drug target genes may persist in the host due to additional mechanisms like drug efflux pumps and lowered rate of metabolism. Furthermore this population of Mtb, which also showed reduced DNA repair activity, would result in selection and stabilization of spontaneous mutations in drug target genes, causing selection of a MDR strain in the presence of drug pressures. Efflux pump such as drrA may play a significant role in increasing fitness of low level drug resistant cells and assist in survival of Mtb till acquisition of drug resistant mutations with

  14. The Role of Global University Rankings in the Process of Increasing the Competitiveness of Russian Education in the Context of Globalization and the Export of Educational Technologies

    Science.gov (United States)

    Avralev, Nikita; Efimova, Irina

    2015-01-01

    Article is devoted to the new conditions for the development of society characterized by the reconstruction of the course of higher education by increasing the competitiveness of Russian universities in the world scientific and educational space and the global university rankings as indicators of the implementation of the integration process and…

  15. China's proposing behavior in Global Governance: the cases of the WTO Doha Round negotiation and G-20 process

    Directory of Open Access Journals (Sweden)

    Hongsong Liu

    2014-01-01

    Full Text Available This article examines China's proposals on the reform of global governance, and discusses the main features of China's proposing behavior in the cases of the WTO Doha Round negotiation and G-20 Process. The main findings are: (1 in the critical junctures of global governance reform, China engaged the reform of the global governance institutions proactively, and put forward a series of reform proposals; (2 in proposing behavior, China argued the global governance institutions should be properly adjusted without intention to change the basic principles, refrained from playing a leadership role while proposing jointly with other countries, and upheld the principled idea of pro-development.

  16. Undergraduate nursing students' experience related to their clinical learning environment and factors affecting to their clinical learning process.

    Science.gov (United States)

    Arkan, Burcu; Ordin, Yaprak; Yılmaz, Dilek

    2018-03-01

    Clinical education is an essential part of nursing education. The purpose of this study was to explore nurse students' experiences related to cinical learning environments, factors effecting to clinical learning process. Descriptive qualitative design was used in this study, and data were collected from 2nd class nursing student (n = 14). The study took the form of in-depth interviews between August-October 2015. The qualitative interviews were analyzed by using simple content analysis. Data were analyzed manually. Experiences nurse students are described five themes. The themes of the study are (1) effecting persons to clinical learning, (2) educational atmosphere, (3) students' personal charactering, (4) the impact of education in school, and (5) students' perceptions related to clinical learning. Participants stated that they experienced many difficulties during clinical learning process. All students importantly stated that nurse teacher is very effecting to clinical learning. This study contributes to the literature by providing data on beginner nursing student' experiences about clinical learning process. The data of this present study show to Turkish nursing student is affecting mostly from persons in clinical learning. The data of this present study will guide nurse teacher when they plan to interventions to be performed to support student during clinical learning process. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Republic Scientific-practical Conference 'The Youth Role in solving the most important issues of globalization process' Proceedings

    International Nuclear Information System (INIS)

    2015-01-01

    Present collection comprises of materials of Republic Scientific-practical Conference 'The Youth Role in solving the most important issues of globalization process'. Present collection is intended for scientific and technical staff, postgraduates, and students of institutes of higher education.

  18. Clinical Laboratory Data Management: A Distributed Data Processing Solution

    OpenAIRE

    Levin, Martin; Morgner, Raymond; Packer, Bernice

    1980-01-01

    Two turn-key systems, one for patient registration and the other for the clinical laboratory have been installed and linked together at the Hospital of the University of Pennsylvania, forming the nucleus of an evolving distributed Hospital Information System.

  19. Global sensitivity analysis of Alkali-Surfactant-Polymer enhanced oil recovery processes

    Energy Technology Data Exchange (ETDEWEB)

    Carrero, Enrique; Queipo, Nestor V.; Pintos, Salvador; Zerpa, Luis E. [Applied Computing Institute, Faculty of Engineering, University of Zulia, Zulia (Venezuela)

    2007-08-15

    After conventional waterflooding processes the residual oil in the reservoir remains as a discontinuous phase in the form of oil drops trapped by capillary forces and is likely to be around 70% of the original oil in place (OOIP). The EOR method so-called Alkaline-Surfactant-Polymer (ASP) flooding has been proved to be effective in reducing the oil residual saturation in laboratory experiments and field projects through reduction of interfacial tension and mobility ratio between oil and water phases. A critical step for the optimal design and control of ASP recovery processes is to find the relative contributions of design variables such as, slug size and chemical concentrations, in the variability of given performance measures (e.g., net present value, cumulative oil recovery), considering a heterogeneous and multiphase petroleum reservoir (sensitivity analysis). Previously reported works using reservoir numerical simulation have been limited to local sensitivity analyses because a global sensitivity analysis may require hundreds or even thousands of computationally expensive evaluations (field scale numerical simulations). To overcome this issue, a surrogate-based approach is suggested. Surrogate-based analysis/optimization makes reference to the idea of constructing an alternative fast model (surrogate) from numerical simulation data and using it for analysis/optimization purposes. This paper presents an efficient global sensitivity approach based on Sobol's method and multiple surrogates (i.e., Polynomial Regression, Kriging, Radial Base Functions and a Weighed Adaptive Model), with the multiple surrogates used to address the uncertainty in the analysis derived from plausible alternative surrogate-modeling schemes. The proposed approach was evaluated in the context of the global sensitivity analysis of a field scale Alkali-Surfactant-Polymer flooding process. The design variables and the performance measure in the ASP process were selected as slug size

  20. Peculiarities of spreading separatist trends in the Modern World in the context of development of the global processes

    Directory of Open Access Journals (Sweden)

    Bostan Sergii Ivanovich

    2016-04-01

    Full Text Available The international collaboration is entering the new era of globalization revealing not only the new ways of development and quantum growth for humanity but also new threats, problems and global conflicts. There is now doubt that humanity is facing new global range of problems, agenda of the 21st century and urgent issues of global organization of the world order and systems of global administration acceptable for all states. Preventing distribution of international confrontation between the major political players through advancement of separatist and terrorist trends must become the main priority for the international system of collective security, which should be changed according to the realities of the modern global processes.

  1. THE INTEGRATION PROCESS MERCOSUR IN 2007 BY MODEL OF GLOBAL DIMENSION OF REGIONAL INTEGRATION

    Directory of Open Access Journals (Sweden)

    André Bechlin

    2013-04-01

    Full Text Available This paper aimed to analyze the advance of the regional integration process in the MERCOSUR (Southern Common Market, using a model developed for Professor Mario Ruiz Estrada, of the College of Economy and Administration of the University of Kuala Lumpur in Malaysia, the GDRI (Global Dimension of Regional Integration Model and that as characteristic has differentiated the use of other variable for analysis, that not specifically of economic origin, derivatives of the evolution of the commerce processes. When inferring and comparing the external performance of the economies that compose the Mercosur, evaluating itself the impacts of the advance of the process of regional and commercial integration, are evidents the inequalities that exist in the block. However, a common evolution is observed, in the direction of intensification of the integration between the economies, mainly after the process of opening lived for the continent, beyond the advance of the integration in the context of the Mercosur, from the decade of 1990. The analyzed data show that, in the generality, these economies are if integrating to the world-wide market, and in parallel, accenting the integration degree enters the members of the block.

  2. Process-based modelling of phosphorus transformations and retention in global rivers

    Science.gov (United States)

    Vilmin, Lauriane; Mogollon, Jose; Beusen, Arthur; Bouwman, Lex

    2016-04-01

    Phosphorus (P) plays a major role in the biogeochemical functioning of aquatic systems. It typically acts as the limiting nutrient for primary productivity in freshwater bodies, and thus the increase in anthropogenic P loads during the XXth century has fuelled the eutrophication of these systems. Total P retention in global rivers has also escalated over this timeframe as demonstrated via a global model that implements the spiralling method at a spatial resolution of 0.5° (IMAGE-GNM, Beusen et al., 2015). Here, we refine this coupled hydrological - nutrient model by including mechanistic biogeochemical interactions that govern the P cycle. Special attention is paid to the representation of particle processes (i.e. particle loading, sedimentation and erosion), which play a major role in P transport and accumulation in aquatic systems. Our preliminary results are compared to measurements of suspended sediments, total P and orthophosphates in selected river basins. Initial model results show that P concentrations are particularly sensitive to particulate load distribution in the river network within a grid cell. This novel modelling approach will eventually allow a better assessment of the amounts of different forms of P (organic P, soluble reactive P, and particulate inorganic P), of P transformation rates and retention in inland waters. References Beusen, A.H.W., Van Beek, L.P.H., Bouwman, A.F., Mogollón, J.M., Middelburg, J.J. 2015. Coupling global models for hydrology and nutrient loading to simulate nitrogen and phosphorus retention in surface water - description of the IMAGE-GNM and analysis of performance. Geosci. Model Dev. 8, 4045-4067

  3. Challenges in clinical natural language processing for automated disorder normalization.

    Science.gov (United States)

    Leaman, Robert; Khare, Ritu; Lu, Zhiyong

    2015-10-01

    Identifying key variables such as disorders within the clinical narratives in electronic health records has wide-ranging applications within clinical practice and biomedical research. Previous research has demonstrated reduced performance of disorder named entity recognition (NER) and normalization (or grounding) in clinical narratives than in biomedical publications. In this work, we aim to identify the cause for this performance difference and introduce general solutions. We use closure properties to compare the richness of the vocabulary in clinical narrative text to biomedical publications. We approach both disorder NER and normalization using machine learning methodologies. Our NER methodology is based on linear-chain conditional random fields with a rich feature approach, and we introduce several improvements to enhance the lexical knowledge of the NER system. Our normalization method - never previously applied to clinical data - uses pairwise learning to rank to automatically learn term variation directly from the training data. We find that while the size of the overall vocabulary is similar between clinical narrative and biomedical publications, clinical narrative uses a richer terminology to describe disorders than publications. We apply our system, DNorm-C, to locate disorder mentions and in the clinical narratives from the recent ShARe/CLEF eHealth Task. For NER (strict span-only), our system achieves precision=0.797, recall=0.713, f-score=0.753. For the normalization task (strict span+concept) it achieves precision=0.712, recall=0.637, f-score=0.672. The improvements described in this article increase the NER f-score by 0.039 and the normalization f-score by 0.036. We also describe a high recall version of the NER, which increases the normalization recall to as high as 0.744, albeit with reduced precision. We perform an error analysis, demonstrating that NER errors outnumber normalization errors by more than 4-to-1. Abbreviations and acronyms are found

  4. Optimising the diagnostic imaging process through clinical history documentation

    International Nuclear Information System (INIS)

    Egan, I.; Baird, M.

    2003-01-01

    In the United Kingdom the 1990s were characterised by radiographer role extension including radiographic reporting and the performance of a variety of contrast examinations. In Australia where a privatised health system constrains the role of radiographers, other ways need to be found to improve professional practice and enhance patient care. One such way is for radiographers to develop knowledge and skills in clinical history taking. The paper advocates the development of a formalised approach to clinical history taking that portrays the radiographer as a professional and advocate of patient rights and welfare. The paper examines history taking approaches used by other health care professionals and proposes a clinical history template using five key areas of interview: area and type of symptoms, current history, past history, special considerations and psychosocial/occupational history. Copyright (2003) Australian Institute of Radiography

  5. Analysis of changing bank services in globalization process of financial business

    Directory of Open Access Journals (Sweden)

    A.Mumi

    2017-12-01

    Full Text Available The process of economic development of every country is closely connected with the functioning of effective infrastructure of financial market, in the carter of which is a bank system. The success of market relations, the provision of intensive economic growth, the increasing country’s competitiveness at the world market and the growth of population well-being are determined by the fact of how much effectively banks are able to act at different segments of bank services. The innovations in the bank field are closely connected with the innovations in the global and world financial sector. The issues about the influence of globalization on bank activities, the development of market of bank services, empirical researches are of great interest nowadays. Special attention is paid to the Ukrainian market of bank services. The analysis of the current state of the bank sector of the Ukrainian economy gives an opportunity to disclose some problems in the bank sphere as: political and financial instability in the country, the low quality of bank assets, the decrease of liquidity of bank assets, the low credit to the bank system among population, unstable legal framework in the state, the high level of vulnerability of the bank system to the country’s currency policy conducted by NBU.

  6. The formation of transnational elite as a factor of modern globalization processes

    Directory of Open Access Journals (Sweden)

    M. A. Artemenko

    2014-10-01

    Full Text Available This article deals with the characteristics of the formation of transnational elite and its influence on contemporary political and economic processes in the world, the problems of existence and communication with the Ukrainian national elite. The emergence of transnational elites due to the logic of globalization –transformation of the world in a certain social integrity. In this context, there is a loss of current national elites completeness of legitimacy and the emergence of new transnational subject of history, extending its authority throughout the world space and creates a new format of authority. The author gives his own definition of this phenomenon and proposes to consider the transnational elite association as the most influential members of certain 3 classes. In this article are identified the determinants of the formation of a transnational elite, as well as the basic platforms of its interaction (World Economic Forum, the Bilderberg Group, the Asian forum, and so on. Particular attention is paid to the analysis of communication transnational elite with the Ukrainian national elite, which is directly linked to the future political development of Ukraine, forced to adapt to the challenges of globalization and seek answers to them. In this context, the author notes the importance of the Yalta European Strategy, which is a platform of convergence Ukrainian elite with the worldwide elite. In the article is also reviewed the program «promoting democracy» as an example of conscious realization different political and economic projects around the world by transnational elite.

  7. Global quantitative indices reflecting provider process-of-care: data-base derivation.

    Science.gov (United States)

    Moran, John L; Solomon, Patricia J

    2010-04-19

    Controversy has attended the relationship between risk-adjusted mortality and process-of-care. There would be advantage in the establishment, at the data-base level, of global quantitative indices subsuming the diversity of process-of-care. A retrospective, cohort study of patients identified in the Australian and New Zealand Intensive Care Society Adult Patient Database, 1993-2003, at the level of geographic and ICU-level descriptors (n = 35), for both hospital survivors and non-survivors. Process-of-care indices were established by analysis of: (i) the smoothed time-hazard curve of individual patient discharge and determined by pharmaco-kinetic methods as area under the hazard-curve (AUC), reflecting the integrated experience of the discharge process, and time-to-peak-hazard (TMAX, in days), reflecting the time to maximum rate of hospital discharge; and (ii) individual patient ability to optimize output (as length-of-stay) for recorded data-base physiological inputs; estimated as a technical production-efficiency (TE, scaled [0,(maximum)1]), via the econometric technique of stochastic frontier analysis. For each descriptor, multivariate correlation-relationships between indices and summed mortality probability were determined. The data-set consisted of 223129 patients from 99 ICUs with mean (SD) age and APACHE III score of 59.2(18.9) years and 52.7(30.6) respectively; 41.7% were female and 45.7% were mechanically ventilated within the first 24 hours post-admission. For survivors, AUC was maximal in rural and for-profit ICUs, whereas TMAX (>or= 7.8 days) and TE (>or= 0.74) were maximal in tertiary-ICUs. For non-survivors, AUC was maximal in tertiary-ICUs, but TMAX (>or= 4.2 days) and TE (>or= 0.69) were maximal in for-profit ICUs. Across descriptors, significant differences in indices were demonstrated (analysis-of-variance, P variance, for survivors (0.89) and non-survivors (0.89), was maximized by combinations of indices demonstrating a low correlation with

  8. Global quantitative indices reflecting provider process-of-care: data-base derivation

    Directory of Open Access Journals (Sweden)

    Solomon Patricia J

    2010-04-01

    Full Text Available Abstract Background Controversy has attended the relationship between risk-adjusted mortality and process-of-care. There would be advantage in the establishment, at the data-base level, of global quantitative indices subsuming the diversity of process-of-care. Methods A retrospective, cohort study of patients identified in the Australian and New Zealand Intensive Care Society Adult Patient Database, 1993-2003, at the level of geographic and ICU-level descriptors (n = 35, for both hospital survivors and non-survivors. Process-of-care indices were established by analysis of: (i the smoothed time-hazard curve of individual patient discharge and determined by pharmaco-kinetic methods as area under the hazard-curve (AUC, reflecting the integrated experience of the discharge process, and time-to-peak-hazard (TMAX, in days, reflecting the time to maximum rate of hospital discharge; and (ii individual patient ability to optimize output (as length-of-stay for recorded data-base physiological inputs; estimated as a technical production-efficiency (TE, scaled [0,(maximum1], via the econometric technique of stochastic frontier analysis. For each descriptor, multivariate correlation-relationships between indices and summed mortality probability were determined. Results The data-set consisted of 223129 patients from 99 ICUs with mean (SD age and APACHE III score of 59.2(18.9 years and 52.7(30.6 respectively; 41.7% were female and 45.7% were mechanically ventilated within the first 24 hours post-admission. For survivors, AUC was maximal in rural and for-profit ICUs, whereas TMAX (≥ 7.8 days and TE (≥ 0.74 were maximal in tertiary-ICUs. For non-survivors, AUC was maximal in tertiary-ICUs, but TMAX (≥ 4.2 days and TE (≥ 0.69 were maximal in for-profit ICUs. Across descriptors, significant differences in indices were demonstrated (analysis-of-variance, P ≤ 0.0001. Total explained variance, for survivors (0.89 and non-survivors (0.89, was maximized by

  9. Global seismic inversion as the next standard step in the processing sequence

    Energy Technology Data Exchange (ETDEWEB)

    Maver, Kim G.; Hansen, Lars S.; Jepsen, Anne-Marie; Rasmussen, Klaus B.

    1998-12-31

    Seismic inversion of post stack seismic data has until recently been regarded as a reservoir oriented method since the standard inversion techniques rely on extensive well control and a detailed user derived input model. Most seismic inversion techniques further requires a stable wavelet. As a consequence seismic inversion is mainly utilised in mature areas focusing of specific zones only after the seismic data has been interpreted and is well understood. By using an advanced 3-D global technique, seismic inversion is presented as the next standard step in the processing sequence. The technique is robust towards noise within the seismic data, utilizes a time variant wavelet, and derives a low frequency model utilizing the stacking velocities and only limited well control. 4 figs.

  10. Influence of cirrus clouds on weather and climate processes A global perspective

    Science.gov (United States)

    Liou, K.-N.

    1986-01-01

    Current understanding and knowledge of the composition and structure of cirrus clouds are reviewed and documented in this paper. In addition, the radiative properties of cirrus clouds as they relate to weather and climate processes are described in detail. To place the relevance and importance of cirrus composition, structure and radiative properties into a global perspective, pertinent results derived from simulation experiments utilizing models with varying degrees of complexity are presented; these have been carried out for the investigation of the influence of cirrus clouds on the thermodynamics and dynamics of the atmosphere. In light of these reviews, suggestions are outlined for cirrus-radiation research activities aimed toward the development and improvement of weather and climate models for a physical understanding of cause and effect relationships and for prediction purposes.

  11. Soil Response to Global Change: Soil Process Domains and Pedogenic Thresholds (Invited)

    Science.gov (United States)

    Chadwick, O.; Kramer, M. G.; Chorover, J.

    2013-12-01

    The capacity of soil to withstand perturbations, whether driven by climate, land use change, or spread of invasive species, depends on its chemical composition and physical state. The dynamic interplay between stable, well buffered soil process domains and thresholds in soil state and function is a strong determinant of soil response to forcing from global change. In terrestrial ecosystems, edaphic responses are often mediated by availability of water and its flux into and through soils. Water influences soil processes in several ways: it supports biological production, hence proton-donor, electron-donor and complexing-ligand production; it determines the advective removal of dissolution products, and it can promote anoxia that leads microorganisms to utilize alternative electron acceptors. As a consequence climate patterns strongly influence global distribution of soil, although within region variability is governed by other factors such as landscape age, parent material and human land use. By contrast, soil properties can vary greatly among climate regions, variation which is guided by the functioning of a suite of chemical processes that tend to maintain chemical status quo. This soil 'buffering' involves acid-base reactions as minerals weather and oxidation-reduction reactions that are driven by microbial respiration. At the planetary scale, soil pH provides a reasonable indicator of process domains and varies from about 3.5 to10, globally, although most soils lie between about 4.5 and 8.5. Those that are above 7.5 are strongly buffered by the carbonate system, those that are characterized by neutral pH (7.5-6) are buffered by release of non-hydrolyzing cations from primary minerals and colloid surfaces, and those that are buffered by hydrolytic aluminum on colloidal surfaces. Alkali and alkaline (with the exception of limestone parent material) soils are usually associated with arid and semiarid conditions, neutral pH soils with young soils in both dry and wet

  12. Born Again Globals and the reconfiguration of Resources in the Internationalization Process

    DEFF Research Database (Denmark)

    Servais, Per; Decker, Arnim

    perspective in depth in the context of international new ventures (INVs) and particularly toward their marketing activities, but even fewer studies has research the very same in ”born-again” globals firms (Bell et al. 2001). Internationalization is recognized as a valuable strategy for organizations’ growth......Internationalization has become an issue in most small and medium sized enterprises (SMEs), and literature has emphasized the role of strategic choices focusing on several aspects, such as motivations, entry mode choices, internationalization process. Few studies have examined the social capital...... pathways taken by the family firm are identified eg. the level of commitment toward internationalization, the resources available, and the ability to commit and use those resources to develop the required capabilities. Furthermore, how the owner makes international decisions is explored and four...

  13. Errors in the Total Testing Process in the Clinical Chemistry ...

    African Journals Online (AJOL)

    2018-03-01

    Mar 1, 2018 ... Analytical errors related to internal and external quality control exceeding the target range, (14.4%) ... indicators to assess errors in the total testing process. The. University ... Evidence showed that the risk of .... Data management and quality control: Pre-test ..... indicators and specifications for key processes.

  14. Defining and reconstructing clinical processes based on IHE and BPMN 2.0.

    Science.gov (United States)

    Strasser, Melanie; Pfeifer, Franz; Helm, Emmanuel; Schuler, Andreas; Altmann, Josef

    2011-01-01

    This paper describes the current status and the results of our process management system for defining and reconstructing clinical care processes, which contributes to compare, analyze and evaluate clinical processes and further to identify high cost tasks or stays. The system is founded on IHE, which guarantees standardized interfaces and interoperability between clinical information systems. At the heart of the system there is BPMN, a modeling notation and specification language, which allows the definition and execution of clinical processes. The system provides functionality to define healthcare information system independent clinical core processes and to execute the processes in a workflow engine. Furthermore, the reconstruction of clinical processes is done by evaluating an IHE audit log database, which records patient movements within a health care facility. The main goal of the system is to assist hospital operators and clinical process managers to detect discrepancies between defined and actual clinical processes and as well to identify main causes of high medical costs. Beyond that, the system can potentially contribute to reconstruct and improve clinical processes and enhance cost control and patient care quality.

  15. A multiplex PCR mini-barcode assay to identify processed shark products in the global trade.

    Directory of Open Access Journals (Sweden)

    Diego Cardeñosa

    Full Text Available Protecting sharks from overexploitation has become global priority after widespread population declines have occurred. Tracking catches and trade on a species-specific basis has proven challenging, in part due to difficulties in identifying processed shark products such as fins, meat, and liver oil. This has hindered efforts to implement regulations aimed at promoting sustainable use of commercially important species and protection of imperiled species. Genetic approaches to identify shark products exist but are typically based on sequencing or amplifying large DNA regions and may fail to work on heavily processed products in which DNA is degraded. Here, we describe a novel multiplex PCR mini-barcode assay based on two short fragments of the cytochrome oxidase I (COI gene. This assay can identify to species all sharks currently listed on the Convention of International Trade of Endangered Species (CITES and most shark species present in the international trade. It achieves species diagnosis based on a single PCR and one to two downstream DNA sequencing reactions. The assay is capable of identifying highly processed shark products including fins, cooked shark fin soup, and skin-care products containing liver oil. This is a straightforward and reliable identification method for data collection and enforcement of regulations implemented for certain species at all governance levels.

  16. Experiences with a dialogue process between policy makers and global modellers

    International Nuclear Information System (INIS)

    Van Daalen, C.E.; Thissen, W.A.H.; Berk, M.M.

    1998-01-01

    Between 1995 and 1997, a series of five workshops, henceforth called the Delft process, took place with the aim to explore and enhance use of the IMAGE 2 model to support international climate negotiations. The IMAGE 2 model is a multi-disciplinary, integrated model designed to simulate the dynamics of the global society-biosphere-climate system. The workshops facilitated a dialogue between policy makers and scientists involved in the development and applications of the IMAGE 2 model. In this way, policy makers would benefit from the policy makers on how to improve the policy relevance of the IMAGE 2 model. The evaluation at the end of the workshop series showed that participants have used information from the workshop at international negotiation conferences and in preparation of policy documents. The process shows that creating a forum for direct science-policy interactions can be very useful and productive, and has confirmed the importance of creating an open and constructive atmosphere between policy makers, and between policy makers and analysts, to enhance utilisation of scientific knowledge. The authors' analysis also suggests that many factors have to be 'in the right position at the right time and place' to achieve such a success, and that it is difficult to prevent the occurrence of biases in processes like this. 33 refs

  17. Aerosol activation and cloud processing in the global aerosol-climate model ECHAM5-HAM

    Directory of Open Access Journals (Sweden)

    G. J. Roelofs

    2006-01-01

    Full Text Available A parameterization for cloud processing is presented that calculates activation of aerosol particles to cloud drops, cloud drop size, and pH-dependent aqueous phase sulfur chemistry. The parameterization is implemented in the global aerosol-climate model ECHAM5-HAM. The cloud processing parameterization uses updraft speed, temperature, and aerosol size and chemical parameters simulated by ECHAM5-HAM to estimate the maximum supersaturation at the cloud base, and subsequently the cloud drop number concentration (CDNC due to activation. In-cloud sulfate production occurs through oxidation of dissolved SO2 by ozone and hydrogen peroxide. The model simulates realistic distributions for annually averaged CDNC although it is underestimated especially in remote marine regions. On average, CDNC is dominated by cloud droplets growing on particles from the accumulation mode, with smaller contributions from the Aitken and coarse modes. The simulations indicate that in-cloud sulfate production is a potentially important source of accumulation mode sized cloud condensation nuclei, due to chemical growth of activated Aitken particles and to enhanced coalescence of processed particles. The strength of this source depends on the distribution of produced sulfate over the activated modes. This distribution is affected by uncertainties in many parameters that play a direct role in particle activation, such as the updraft velocity, the aerosol chemical composition and the organic solubility, and the simulated CDNC is found to be relatively sensitive to these uncertainties.

  18. Global warming potential of the sulfur-iodine process using life cycle assessment methodology

    International Nuclear Information System (INIS)

    Lattin, William C.; Utgikar, Vivek P.

    2009-01-01

    A life cycle assessment (LCA) of one proposed method of hydrogen production - thermochemical water-splitting using the sulfur-iodine cycle couple with a very high-temperature nuclear reactor - is presented in this paper. Thermochemical water-splitting theoretically offers a higher overall efficiency than high-temperature electrolysis of water because heat from the nuclear reactor is provided directly to the hydrogen generation process, instead of using the intermediate step of generating electricity. The primary heat source for the S-I cycle is an advanced nuclear reactor operating at temperatures corresponding to those required by the sulfur-iodine process. This LCA examines the environmental impact of the combined advanced nuclear and hydrogen generation plants and focuses on quantifying the emissions of carbon dioxide per kilogram of hydrogen produced. The results are presented in terms of global warming potential (GWP). The GWP of the system is 2500 g carbon dioxide-equivalent (CO 2 -eq) per kilogram of hydrogen produced. The GWP of this process is approximately one-sixth of that for hydrogen production by steam reforming of natural gas, and is comparable to producing hydrogen from wind- or hydro-electric conventional electrolysis. (author)

  19. ICT-Enabled Time-Critical Clinical Practices: Examining the Affordances of an Information Processing Solution

    Directory of Open Access Journals (Sweden)

    Leonard Hoon

    2015-11-01

    Full Text Available In this paper, we present a case study of a decision-support system deployment at The Alfred Hospital, in Melbourne, Australia. This work outlines Information and Communications Technology (ICT affordances and their actualisations in time-critical clinical practices to enable better information processing. From our study findings, we present a stage-wise model describing the role played by ICT in the context of the Trauma Centre practices. This addresses a knowledge gap surrounding the role and impact of ICT in the delivery of quality improvements to processes and culture in time-critical environments, amid increasing expenditure on ICT globally. Our model has implications for research and practice, such that we observe for the first time how information standards, synergy and renewal are developed between the system and its users in order to reduce error rates in the healthcare context. Through the study findings, we demonstrate that healthcare quality can be further refined as ICT allows for knowledge dissemination and informs existing practices.

  20. Can modeling of HIV treatment processes improve outcomes? Capitalizing on an operations research approach to the global pandemic

    Directory of Open Access Journals (Sweden)

    Hollingsworth Eric B

    2008-08-01

    Full Text Available Abstract Background Mathematical modeling has been applied to a range of policy-level decisions on resource allocation for HIV care and treatment. We describe the application of classic operations research (OR techniques to address logistical and resource management challenges in HIV treatment scale-up activities in resource-limited countries. Methods We review and categorize several of the major logistical and operational problems encountered over the last decade in the global scale-up of HIV care and antiretroviral treatment for people with AIDS. While there are unique features of HIV care and treatment that pose significant challenges to effective modeling and service improvement, we identify several analogous OR-based solutions that have been developed in the service, industrial, and health sectors. Results HIV treatment scale-up includes many processes that are amenable to mathematical and simulation modeling, including forecasting future demand for services; locating and sizing facilities for maximal efficiency; and determining optimal staffing levels at clinical centers. Optimization of clinical and logistical processes through modeling may improve outcomes, but successful OR-based interventions will require contextualization of response strategies, including appreciation of both existing health care systems and limitations in local health workforces. Conclusion The modeling techniques developed in the engineering field of operations research have wide potential application to the variety of logistical problems encountered in HIV treatment scale-up in resource-limited settings. Increasing the number of cross-disciplinary collaborations between engineering and public health will help speed the appropriate development and application of these tools.

  1. The Clinical Research Office of the Endourological Society Ureteroscopy Global Study: Indications, Complications, and Outcomes in 11885 Patients

    DEFF Research Database (Denmark)

    De La Rosette, Jean; Denstedt, John D; Geavlete, Petrisor A

    2013-01-01

    Purpose: To assess the current indications for ureteroscopy (URS) treatment, outcome in terms of stone-free rate, and intra- and postoperative complications using the modified Clavien grading system. Patients and Methods: The Clinical Research Office of the Endourological Society (CROES) collected...... prospective data as part of the URS Global Study for consecutive patients treated with URS at centers around the world for 1 year. URS was performed according to study protocol and local clinical practice guidelines. Stone size and location were recorded and postoperative outcome and complications, graded...

  2. Bilateral elongated styloid process: Its anatomical, embryological and clinical implications

    OpenAIRE

    Bagoji Ishwar B, Hadimani Gavishiddappa A, Patil Balasaheb G, Bannur Balappa M,Ambadasu B

    2013-01-01

    The styloid process is a slender, elongated, cylindrical bony projection from temporal bone. It normally varies in length from 2 cm to 3 cm. During a routine demonstration of skull for MBBS students we found the bilateral elongated styloid process in dry human skull. The length of elongation measured on the right and left side was 6.0 & 5.9 cms respectively. Such abnormal elongation of the styloid process may cause compression on a number of vital vessels and nerves related to it, producing i...

  3. Prediction of renal mass aggressiveness using clinical and radiographic features: a global, multicentre prospective study

    NARCIS (Netherlands)

    Golan, Shay; Eggener, Scott; Subotic, Svetozar; Barret, Eric; Cormio, Luigi; Naito, Seiji; Tefekli, Ahmet; Pilar Laguna Pes, M.

    2016-01-01

    To examine the ability of preoperative clinical characteristics to predict histological features of renal masses (RMs). Data from consecutive patients with clinical stage I RMs treated surgically between 2010 and 2011 in the Clinical Research Office of Endourology Society (CROES) Renal Mass Registry

  4. Data Synthesis and Data Assimilation at Global Change Experiments and Fluxnet Toward Improving Land Process Models

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Yiqi [Univ. of Oklahoma, Norman, OK (United States). Dept. of Microbiology and Plant Biology

    2017-09-12

    The project was conducted during the period from 7/1/2012 to 6/30/2017 with three major tasks: (1) data synthesis and development of data assimilation (DA) techniques to constrain modeled ecosystem feedback to climate change; (2) applications of DA techniques to improve process models at different scales from ecosystem to regions and the globe; and 3) improvements of modeling soil carbon (C) dynamics by land surface models. During this period, we have synthesized published data from soil incubation experiments (e.g., Chen et al., 2016; Xu et al., 2016; Feng et al., 2016), global change experiments (e.g., Li et al., 2013; Shi et al., 2015, 2016; Liang et al., 2016) and fluxnet (e.g., Niu et al., 2012., Xia et al., 2015; Li et al., 2016). These data have been organized into multiple data products and have been used to identify general mechanisms and estimate parameters for model improvement. We used the data sets that we collected and the DA techniques to improve model performance of both ecosystem models and global land models. The objectives are: 1) to improve model simulations of litter and soil carbon storage (e.g., Schädel et al., 2013; Hararuk and Luo, 2014; Hararuk et al., 2014; Liang et al., 2015); 2) to explore the effects of CO2, warming and precipitation on ecosystem processes (e.g., van Groenigen et al., 2014; Shi et al., 2015, 2016; Feng et al., 2017); and 3) to estimate parameters variability in different ecosystems (e.g., Li et al., 2016). We developed a traceability framework, which was based on matrix approaches and decomposed the modeled steady-state terrestrial ecosystem carbon storage capacity into four can trace the difference in ecosystem carbon storage capacity among different biomes to four traceable components: net primary productivity (NPP), baseline C residence times, environmental scalars and climate forcing (Xia et al., 2013). With this framework, we can diagnose the differences in modeled carbon storage across ecosystems

  5. [Clinical decision making and critical thinking in the nursing diagnostic process].

    Science.gov (United States)

    Müller-Staub, Maria

    2006-10-01

    The daily routine requires complex thinking processes of nurses, but clinical decision making and critical thinking are underestimated in nursing. A great demand for educational measures in clinical judgement related with the diagnostic process was found in nurses. The German literature hardly describes nursing diagnoses as clinical judgements about human reactions on health problems / life processes. Critical thinking is described as an intellectual, disciplined process of active conceptualisation, application and synthesis of information. It is gained through observation, experience, reflection and communication and leads thinking and action. Critical thinking influences the aspects of clinical decision making a) diagnostic judgement, b) therapeutic reasoning and c) ethical decision making. Human reactions are complex processes and in their course, human behavior is interpreted in the focus of health. Therefore, more attention should be given to the nursing diagnostic process. This article presents the theoretical framework of the paper "Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies".

  6. Bilateral elongated styloid process: Its anatomical, embryological and clinical implications

    Directory of Open Access Journals (Sweden)

    Bagoji Ishwar B, Hadimani Gavishiddappa A, Patil Balasaheb G, Bannur Balappa M,Ambadasu B

    2013-04-01

    Full Text Available The styloid process is a slender, elongated, cylindrical bony projection from temporal bone. It normally varies in length from 2 cm to 3 cm. During a routine demonstration of skull for MBBS students we found the bilateral elongated styloid process in dry human skull. The length of elongation measured on the right and left side was 6.0 & 5.9 cms respectively. Such abnormal elongation of the styloid process may cause compression on a number of vital vessels and nerves related to it, producing inflammatory changes that include continuous chronic pain in the pharyngeal region. Mechanical stresses stretching the second brachial arch during fetal development probably induce variable involvement of Reichert’s cartilage in morphogenesis of the styloid process. It is important that clinicians especially dentists and otolaryngologists are aware of the natural variations of the styloid process and do not consider the styloid process with a length of 30 mm as an abnormality or as an anomaly.

  7. Implications of process evaluation for clinical effectiveness and clinical practice in a trial on chronic shoulder complaints.

    NARCIS (Netherlands)

    Geraets, J.J.; Goossens, M.E.J.B.; Haastregt, J.C. van; Groot, I.J.M. de; Bruijn, C.P. de; Bie, R.A. de; Koke, A.J.; Heuvel, W.J.A. van den

    2006-01-01

    OBJECTIVE: The intervention process was evaluated in a randomised clinical trial on the effectiveness of a behavioural Graded Exercise Therapy (GET) programme for patients with chronic shoulder complaints in primary care settings. This process evaluation was done for three reasons: first, to know

  8. Institutions and Cultural Diversity: Effects of Democratic and Propaganda Processes on Local Convergence and Global Diversity.

    Science.gov (United States)

    Ulloa, Roberto; Kacperski, Celina; Sancho, Fernando

    2016-01-01

    In a connected world where people influence each other, what can cause a globalized monoculture, and which measures help to preserve the coexistence of cultures? Previous research has shown that factors such as homophily, population size, geography, mass media, and type of social influence play important roles. In the present paper, we investigate for the first time the impact that institutions have on cultural diversity. In our first three studies, we extend existing agent-based models and explore the effects of institutional influence and agent loyalty. We find that higher institutional influence increases cultural diversity, while individuals' loyalty to their institutions has a small, preserving effect. In three further studies, we test how bottom-up and top-down processes of institutional influence impact our model. We find that bottom-up democratic practices, such as referenda, tend to produce convergence towards homogeneity, while top-down information dissemination practices, such as propaganda, further increase diversity. In our last model--an integration of bottom-up and top-down processes into a feedback loop of information--we find that when democratic processes are rare, the effects of propaganda are amplified, i.e., more diversity emerges; however, when democratic processes are common, they are able to neutralize or reverse this propaganda effect. Importantly, our models allow for control over the full spectrum of diversity, so that a manipulation of our parameters can result in preferred levels of diversity, which will be useful for the study of other factors in the future. We discuss possible mechanisms behind our results, applications, and implications for political and social sciences.

  9. Evaluation of clinical image processing algorithms used in digital mammography.

    Science.gov (United States)

    Zanca, Federica; Jacobs, Jurgen; Van Ongeval, Chantal; Claus, Filip; Celis, Valerie; Geniets, Catherine; Provost, Veerle; Pauwels, Herman; Marchal, Guy; Bosmans, Hilde

    2009-03-01

    Screening is the only proven approach to reduce the mortality of breast cancer, but significant numbers of breast cancers remain undetected even when all quality assurance guidelines are implemented. With the increasing adoption of digital mammography systems, image processing may be a key factor in the imaging chain. Although to our knowledge statistically significant effects of manufacturer-recommended image processings have not been previously demonstrated, the subjective experience of our radiologists, that the apparent image quality can vary considerably between different algorithms, motivated this study. This article addresses the impact of five such algorithms on the detection of clusters of microcalcifications. A database of unprocessed (raw) images of 200 normal digital mammograms, acquired with the Siemens Novation DR, was collected retrospectively. Realistic simulated microcalcification clusters were inserted in half of the unprocessed images. All unprocessed images were subsequently processed with five manufacturer-recommended image processing algorithms (Agfa Musica 1, IMS Raffaello Mammo 1.2, Sectra Mamea AB Sigmoid, Siemens OPVIEW v2, and Siemens OPVIEW v1). Four breast imaging radiologists were asked to locate and score the clusters in each image on a five point rating scale. The free-response data were analyzed by the jackknife free-response receiver operating characteristic (JAFROC) method and, for comparison, also with the receiver operating characteristic (ROC) method. JAFROC analysis revealed highly significant differences between the image processings (F = 8.51, p < 0.0001), suggesting that image processing strongly impacts the detectability of clusters. Siemens OPVIEW2 and Siemens OPVIEW1 yielded the highest and lowest performances, respectively. ROC analysis of the data also revealed significant differences between the processing but at lower significance (F = 3.47, p = 0.0305) than JAFROC. Both statistical analysis methods revealed that the

  10. Functional Hemispheric Asymmetries of Global/Local Processing Mirrored by the Steady-State Visual Evoked Potential

    Science.gov (United States)

    Martens, Ulla; Hubner, Ronald

    2013-01-01

    While hemispheric differences in global/local processing have been reported by various studies, it is still under dispute at which processing stage they occur. Primarily, it was assumed that these asymmetries originate from an early perceptual stage. Instead, the content-level binding theory (Hubner & Volberg, 2005) suggests that the hemispheres…

  11. [Public-private partnerships (PPPs) in the health sector: global processes and national dynamics].

    Science.gov (United States)

    Almeida, Celia

    2017-10-02

    This essay addresses several dimensions that promote and consolidate the growing participation by private stakeholders in the decision-making process in health, emphasizing international and domestic factors that have facilitated and sustained the persistence of the neoliberal political and ideological perspective over the course of nearly thirty years (since the 1990s). The article emphasizes the role of intergovernmental organizations in this process, highlighting public-private interactions at the global and domestic levels, with a specific focus on so-called public-private partnerships (PPPs). The working premise is that such linkages alter the power relations in policy formulation and implementation, with a predominance of private stakeholders. The article presents an overview of the development of PPPs in Europe, Latin America, and Brazil, identifying their specific origins and the simultaneity of triggering events. The text reiterates the importance of not overlooking the power of these actors in dislodging them from this political position, whether in multilateral organizations or national health systems. The aim is to emphasize the importance of more in-depth reflection on the subject, backing debates within the sector. This entire dynamic requires rethinking strategies of resistance to preserve the rights won through centuries of struggle.

  12. Process-Oriented Diagnostics of Tropical Cyclones in Global Climate Models

    Science.gov (United States)

    Moon, Y.; Kim, D.; Camargo, S. J.; Wing, A. A.; Sobel, A. H.; Bosilovich, M. G.; Murakami, H.; Reed, K. A.; Vecchi, G. A.; Wehner, M. F.; Zarzycki, C. M.; Zhao, M.

    2017-12-01

    Simulating tropical cyclone (TC) activity with global climate models (GCMs) remains a challenging problem. While some GCMs are able to simulate TC activity that is in good agreement with the observations, many other models exhibit strong biases. Decreasing horizontal grid spacing of the GCM simulations tends to improve the characteristics of simulated TCs, but this enhancement alone does not necessarily lead to greater skill in simulating TC activity. This study uses process-based diagnostics to identify model characteristics that could explain why some GCM simulations are able to produce more realistic TC activity than others. The diagnostics examine how convection, moisture, clouds and related processes are coupled at individual grid points, which yields useful information into how convective parameterizations interact with resolved model dynamics. These diagnostics share similarities with those originally developed to examine the Madden-Julian Oscillations in climate models. This study will examine TCs in eight different GCM simulations performed at NOAA/GFDL, NCAR and NASA that have different horizontal resolutions and ocean coupling. Preliminary results suggest that stronger TCs are closely associated with greater rainfall - thus greater diabatic heating - in the inner-core regions of the storms, which is consistent with previous theoretical studies. Other storm characteristics that can be used to infer why GCM simulations with comparable horizontal grid spacings produce different TC activity will be examined.

  13. Proposals for the Negotiation Process on the United Nations Global Compact for Migration

    Directory of Open Access Journals (Sweden)

    Victor Genina

    2017-09-01

    • builds a cooperation-oriented, peer-review mechanism to review migration policies.    The paper has been conceived as an input for those who will take part in the negotiation of the global compact for migration, as well as those who will closely follow those negotiations. Thus, the paper assumes a level of knowledge on how international migration has been addressed within the United Nations during the last several years and of the complexities of these negotiation processes. The author took part in different UN negotiation processes on international migration from 2004 to 2013. The paper is primarily based on this experience.[4] [1] G.A. Res. 71/1, ¶ 21 (Sept. 19, 2016. [2] G.A. Res. 68/4 (Oct. 3, 2013. [3] A mixed flow, according to UNHCR (n.d., is the migratory flow comprised by both asylum seekers and migrants: “Migrants and refugees increasingly make use of the same routes and means of transport to get to an overseas destination.” [4] During that period, the author was a staff member of the Mexican delegation to the United Nations, both in Geneva and New York.

  14. Geophysical constraints on geodynamic processes at convergent margins: A global perspective

    Science.gov (United States)

    Artemieva, Irina; Thybo, Hans; Shulgin, Alexey

    2016-04-01

    Convergent margins, being the boundaries between colliding lithospheric plates, form the most disastrous areas in the world due to intensive, strong seismicity and volcanism. We review global geophysical data in order to illustrate the effects of the plate tectonic processes at convergent margins on the crustal and upper mantle structure, seismicity, and geometry of subducting slab. We present global maps of free-air and Bouguer gravity anomalies, heat flow, seismicity, seismic Vs anomalies in the upper mantle, and plate convergence rate, as well as 20 profiles across different convergent margins. A global analysis of these data for three types of convergent margins, formed by ocean-ocean, ocean-continent, and continent-continent collisions, allows us to recognize the following patterns. (1) Plate convergence rate depends on the type of convergent margins and it is significantly larger when, at least, one of the plates is oceanic. However, the oldest oceanic plate in the Pacific ocean has the smallest convergence rate. (2) The presence of an oceanic plate is, in general, required for generation of high-magnitude (M N 8.0) earthquakes and for generating intermediate and deep seismicity along the convergent margins. When oceanic slabs subduct beneath a continent, a gap in the seismogenic zone exists at depths between ca. 250 km and 500 km. Given that the seismogenic zone terminates at ca. 200 km depth in case of continent-continent collision, we propose oceanic origin of subducting slabs beneath the Zagros, the Pamir, and the Vrancea zone. (3) Dip angle of the subducting slab in continent-ocean collision does not correlate neither with the age of subducting oceanic slab, nor with the convergence rate. For ocean-ocean subduction, clear trends are recognized: steeply dipping slabs are characteristic of young subducting plates and of oceanic plates with high convergence rate, with slab rotation towards a near-vertical dip angle at depths below ca. 500 km at very high

  15. Effects of Wegener-Bergeron-Findeisen Process on Global Black Carbon Distribution

    Science.gov (United States)

    Qi, L.

    2016-12-01

    In mixed-phase clouds, the Wegener-Bergeron-Findeisen (WBF) process (ice crystals may grow while water drops evaporate, thereby releasing black carbon (BC) particles into the interstitial air) slows down wet scavenging of BC. Rimming (snowflakes fall and collect cloud water drops and the BC in them along their pathways), in contrast, results in more efficient wet scavenging. We systematically investigate the effects of WBF on BC scavenging efficiency, surface BCair, deposition flux, concentration in snow, and washout ratio using a global 3D chemical transport model. We differentiate riming- vs WBF-dominated in-cloud scavenging based on liquid water content and temperature. Specifically, we relate WBF to either temperature or ice mass fraction in mixed-phase clouds. We find that at Jungfraujoch, Switzerland and Abisko, Sweden, where WBF dominates, the discrepancies of simulated BC scavenging efficiency and washout ratio are significantly reduced (from a factor of 3 to 10% and from a factor of 4-5 to a factor of two). However, at Zeppelin, Norway, where riming dominates, simulation of BC scavenging efficiency, BCair, and washout ratio become worse (relative to observations) when WBF is included. There is thus an urgent need for extensive observations to distinguish and characterize riming- versus WBF-dominated aerosol scavenging in mixed-phase clouds and the associated BC scavenging efficiency. We find the reduction resulting from WBF to global BC scavenging efficiency varies substantially, from 8% in the tropics to 76% in the Arctic. The resulting annual mean BCair increases by up to 156% at high altitudes and at northern high latitudes. Overall, WBF halves the model-observation discrepancy (from -65% to -30%) of BCair across North America, Europe, China and the Arctic. Globally WBF increases BC burden from 0.22 to 0.29-0.35 mg m-2 yr-1, which partially explains the gap between observed and previous model simulated BC burdens over land (Bond et al., 2013). In

  16. Attributional processes in the learned helplessness paradigm: behavioral effects of global attributions.

    Science.gov (United States)

    Mikulincer, M

    1986-12-01

    Following the learned helplessness paradigm, I assessed in this study the effects of global and specific attributions for failure on the generalization of performance deficits in a dissimilar situation. Helplessness training consisted of experience with noncontingent failures on four cognitive discrimination problems attributed to either global or specific causes. Experiment 1 found that performance in a dissimilar situation was impaired following exposure to globally attributed failure. Experiment 2 examined the behavioral effects of the interaction between stable and global attributions of failure. Exposure to unsolvable problems resulted in reduced performance in a dissimilar situation only when failure was attributed to global and stable causes. Finally, Experiment 3 found that learned helplessness deficits were a product of the interaction of global and internal attribution. Performance deficits following unsolvable problems were recorded when failure was attributed to global and internal causes. Results were discussed in terms of the reformulated learned helplessness model.

  17. On the integration developmental characteristics as a form of international policy in the context of modern globalization processes

    Directory of Open Access Journals (Sweden)

    Bostan Sergii Ivanovich

    2014-12-01

    Full Text Available Under globalization of the world community, there are new opportunities and potential threats to the current system of international relations, collective security and geopolitical development of different regions. Integration and regionalization, consolidation and separatism entered upon the agenda of the political present. The integration process becomes one of the variations of peaceful and mutually beneficial solution to the question of the globalization influence of uneven development of the world regions, the fight against global problems of humanity, discrimination and intolerance, spread the values of democracy, rights, freedom and equality.

  18. Systematic review of the global epidemiology, clinical and laboratory profile of enteric fever

    Directory of Open Access Journals (Sweden)

    Asma Azmatullah

    2015-12-01

    Full Text Available Children suffer the highest burden of enteric fever among populations in South Asian countries. The clinical features are non–specific, vary in populations, and are often difficult to distinguish clinically from other febrile illnesses, leading to delayed or inappropriate diagnosis and treatment. We undertook a systematic review to assess the clinical profile and laboratory features of enteric fever across age groups, economic regions, level of care and antibiotic susceptibility patterns.

  19. IRSN global process for leading a comprehensive fire safety analysis for nuclear installations

    International Nuclear Information System (INIS)

    Ormieres, Yannick; Lacoue, Jocelyne

    2013-01-01

    A fire safety analysis (FSA) is requested to justify the adequacy of fire protection measures set by the operator. A recent document written by IRSN outlines a global process for such a comprehensive fire safety analysis. Thanks to the French nuclear fire safety regulation evolutions, from prescriptive requirements to objective requirements, the proposed fire safety justification process focuses on compliance with performance criteria for fire protection measures. These performance criteria are related to the vulnerability of targets to effects of fire, and not only based upon radiological consequences out side the installation caused by a fire. In his FSA, the operator has to define the safety functions that should continue to ensure its mission even in the case of fire in order to be in compliance with nuclear safety objectives. Then, in order to maintain these safety functions, the operator has to justify the adequacy of fire protection measures, defined according to defence in depth principles. To reach the objective, the analysis process is based on the identification of targets to be protected in order to maintain safety functions, taken into account facility characteristics. These targets include structures, systems, components and personal important to safety. Facility characteristics include, for all operating conditions, potential ignition sources and fire protections systems. One of the key points of the fire analysis is the assessment of possible fire scenarios in the facility. Given the large number of possible fire scenarios, it is then necessary to evaluate 'reference fires' which are the worst case scenarios of all possible fire scenarios and which are used by the operator for the design of fire protection measures. (authors)

  20. From elements to perception: local and global processing in visual neurons.

    Science.gov (United States)

    Spillmann, L

    1999-01-01

    Gestalt psychologists in the early part of the century challenged psychophysical notions that perceptual phenomena can be understood from a punctate (atomistic) analysis of the elements present in the stimulus. Their ideas slowed later attempts to explain vision in terms of single-cell recordings from individual neurons. A rapprochement between Gestalt phenomenology and neurophysiology seemed unlikely when the first ECVP was held in Marburg, Germany, in 1978. Since that time, response properties of neurons have been discovered that invite an interpretation of visual phenomena (including illusions) in terms of neuronal processing by long-range interactions, as first proposed by Mach and Hering in the last century. This article traces a personal journey into the early days of neurophysiological vision research to illustrate the progress that has taken place from the first attempts to correlate single-cell responses with visual perceptions. Whereas initially the receptive-field properties of individual classes of cells--e.g., contrast, wavelength, orientation, motion, disparity, and spatial-frequency detectors--were used to account for relatively simple visual phenomena, nowadays complex perceptions are interpreted in terms of long-range interactions, involving many neurons. This change in paradigm from local to global processing was made possible by recent findings, in the cortex, on horizontal interactions and backward propagation (feedback loops) in addition to classical feedforward processing. These mechanisms are exemplified by studies of the tilt effect and tilt aftereffect, direction-specific motion adaptation, illusory contours, filling-in and fading, figure--ground segregation by orientation and motion contrast, and pop-out in dynamic visual-noise patterns. Major questions for future research and a discussion of their epistemological implications conclude the article.

  1. An integrated model of clinical reasoning: dual-process theory of cognition and metacognition.

    Science.gov (United States)

    Marcum, James A

    2012-10-01

    Clinical reasoning is an important component for providing quality medical care. The aim of the present paper is to develop a model of clinical reasoning that integrates both the non-analytic and analytic processes of cognition, along with metacognition. The dual-process theory of cognition (system 1 non-analytic and system 2 analytic processes) and the metacognition theory are used to develop an integrated model of clinical reasoning. In the proposed model, clinical reasoning begins with system 1 processes in which the clinician assesses a patient's presenting symptoms, as well as other clinical evidence, to arrive at a differential diagnosis. Additional clinical evidence, if necessary, is acquired and analysed utilizing system 2 processes to assess the differential diagnosis, until a clinical decision is made diagnosing the patient's illness and then how best to proceed therapeutically. Importantly, the outcome of these processes feeds back, in terms of metacognition's monitoring function, either to reinforce or to alter cognitive processes, which, in turn, enhances synergistically the clinician's ability to reason quickly and accurately in future consultations. The proposed integrated model has distinct advantages over other models proposed in the literature for explicating clinical reasoning. Moreover, it has important implications for addressing the paradoxical relationship between experience and expertise, as well as for designing a curriculum to teach clinical reasoning skills. © 2012 Blackwell Publishing Ltd.

  2. A Health Science Process Framework for Comprehensive Clinical Functional Assessment

    Science.gov (United States)

    2014-02-01

    Adaptability Inventory-4 • Rancho Los Amigos Cognitive Scale - Inpatient • Rancho Los Amigos Cognitive Scale - Outpatient • Satisfaction with Life...and policies e580 Health services, systems and policies e585 Education and training services, systems and policies e590 Labour and employment services...consistently reported a high degree of satisfaction with the process, and demonstrated a high level of interest in the exercise. In conjunction with the

  3. Flight and Operational Medicine Clinic (FOMC) Task Process Mapping

    Science.gov (United States)

    2014-03-01

    AHLTA YES 81 Signs off on the paperwork Tailor 469 to individual workplace Completes quality review and ensures standards are followed Is...condition 31, 37, 81? Complete evaluation Present 469 within 5 days of positive pregnancy test Is condition duty/fitness? NO End Process YES Send to...duty or mobility Document visit and restrictions in AHLTA YES 81 Signs off on the paperwork Tailor 469 to individual workplace Completes

  4. Understanding implementation processes of clinical pathways and clinical practice guidelines in pediatric contexts: a study protocol

    Directory of Open Access Journals (Sweden)

    Scott Shannon D

    2011-12-01

    Full Text Available Abstract Background Canada is among the most prosperous nations in the world, yet the health and wellness outcomes of Canadian children are surprisingly poor. There is some evidence to suggest that these poor health outcomes are partly due to clinical practice variation, which can stem from failure to apply the best available research evidence in clinical practice, otherwise known as knowledge translation (KT. Surprisingly, clinical practice variation, even for common acute paediatric conditions, is pervasive. Clinical practice variation results in unnecessary medical treatments, increased suffering, and increased healthcare costs. This study focuses on improving health outcomes for common paediatric acute health concerns by evaluating strategies that improve KT and reduce clinical practice variation. Design/Methods Using a multiple case study design, qualitative and quantitative data will be collected from four emergency departments in western Canada. Data sources will include: pre- and post-implementation focus group data from multidisciplinary healthcare professionals; individual interviews with the local champions, KT intervention providers, and unit/site leaders/managers; Alberta Context Tool (ACT survey data; and aggregated patient outcome data. Qualitative and quantitative data will be systematically triangulated, and matrices will be built to do cross-case comparison. Explanations will be built about the success or lack of success of the clinical practice guidelines (CPG and clinical pathways (CPs uptake based upon the cross-case comparisons. Significance This study will generate new knowledge about the potential causal mechanisms and factors which shape implementation. Future studies will track the impact of the CPG/CPs implementation on children's health outcome, and healthcare costs.

  5. Evaluation of global continental hydrology as simulated by the Land-surface Processes and eXchanges Dynamic Global Vegetation Model

    Directory of Open Access Journals (Sweden)

    S. J. Murray

    2011-01-01

    Full Text Available Global freshwater resources are sensitive to changes in climate, land cover and population density and distribution. The Land-surface Processes and eXchanges Dynamic Global Vegetation Model is a recent development of the Lund-Potsdam-Jena model with improved representation of fire-vegetation interactions. It allows simultaneous consideration of the effects of changes in climate, CO2 concentration, natural vegetation and fire regime shifts on the continental hydrological cycle. Here the model is assessed for its ability to simulate large-scale spatial and temporal runoff patterns, in order to test its suitability for modelling future global water resources. Comparisons are made against observations of streamflow and a composite dataset of modelled and observed runoff (1986–1995 and are also evaluated against soil moisture data and the Palmer Drought Severity Index. The model captures the main features of the geographical distribution of global runoff, but tends to overestimate runoff in much of the Northern Hemisphere (where this can be somewhat accounted for by freshwater consumption and the unrealistic accumulation of the simulated winter snowpack in permafrost regions and the southern tropics. Interannual variability is represented reasonably well at the large catchment scale, as are seasonal flow timings and monthly high and low flow events. Further improvements to the simulation of intra-annual runoff might be achieved via the addition of river flow routing. Overestimates of runoff in some basins could likely be corrected by the inclusion of transmission losses and direct-channel evaporation.

  6. Medical students' perception of objective structured clinical examination: a feedback for process improvement.

    Science.gov (United States)

    Nasir, Abdulrasheed A; Yusuf, Ayodeji S; Abdur-Rahman, Lukman O; Babalola, Olasunkanmi M; Adeyeye, Ademola A; Popoola, Ademola A; Adeniran, James O

    2014-01-01

    Medical educators have always been desirous of the best methods for formative and summative evaluation of trainees. The Objective Structured Clinical Examination (OSCE) is an approach for student assessment in which aspects of clinical competence are evaluated in a comprehensive, consistent, and structured manner with close attention to the objectivity of the process. Though popular in most medical schools globally, its use in Nigeria medical schools appears limited. This study was conceived to explore students' perception about the acceptability of OSCE process and to provide feedback to be used to improve the assessment technique. A cross-sectional survey was conducted on final-year medical students, who participated in the final MBBS surgery examination in June 2011. A 19-item self-administered structured questionnaire was employed to obtain relevant data on demographics of respondents and questions evaluating the OSCE stations in terms of the quality of instructions and organization, learning opportunities, authenticity and transparency of the process, and usefulness of the OSCE as an assessment instrument compared with other formats. Students' responses were based on a 5-point Likert scales ranging from strongly disagree to strongly agree. The data were analyzed using SPSS, version 15 (SPSS, Inc, Chicago, IL). The study took place at the University of Ilorin, College of Health Science. A total of 187 final-year medical students were enrolled in to the survey. Of 187 eligible students, 151 completed the self-administered questionnaire representing 80.7% response rate. A total of 61 (40.4%) students felt that it was easy to understand written instructions at the OSCE stations. In total, 106 (70.2%) students felt that the time allocated to each station was adequate. A total of 89 (58.9%) students agreed that the OSCE accurately measured their knowledge and skill, and 85 (56.3%) reported that OSCE enhanced their communication skill. Of the respondents, 80 (53

  7. Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

    Science.gov (United States)

    Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

    2016-03-01

    This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers.

  8. Utilization of a Clinical Trial Management System for the Whole Clinical Trial Process as an Integrated Database: System Development.

    Science.gov (United States)

    Park, Yu Rang; Yoon, Young Jo; Koo, HaYeong; Yoo, Soyoung; Choi, Chang-Min; Beck, Sung-Ho; Kim, Tae Won

    2018-04-24

    Clinical trials pose potential risks in both communications and management due to the various stakeholders involved when performing clinical trials. The academic medical center has a responsibility and obligation to conduct and manage clinical trials while maintaining a sufficiently high level of quality, therefore it is necessary to build an information technology system to support standardized clinical trial processes and comply with relevant regulations. The objective of the study was to address the challenges identified while performing clinical trials at an academic medical center, Asan Medical Center (AMC) in Korea, by developing and utilizing a clinical trial management system (CTMS) that complies with standardized processes from multiple departments or units, controlled vocabularies, security, and privacy regulations. This study describes the methods, considerations, and recommendations for the development and utilization of the CTMS as a consolidated research database in an academic medical center. A task force was formed to define and standardize the clinical trial performance process at the site level. On the basis of the agreed standardized process, the CTMS was designed and developed as an all-in-one system complying with privacy and security regulations. In this study, the processes and standard mapped vocabularies of a clinical trial were established at the academic medical center. On the basis of these processes and vocabularies, a CTMS was built which interfaces with the existing trial systems such as the electronic institutional review board health information system, enterprise resource planning, and the barcode system. To protect patient data, the CTMS implements data governance and access rules, and excludes 21 personal health identifiers according to the Health Insurance Portability and Accountability Act (HIPAA) privacy rule and Korean privacy laws. Since December 2014, the CTMS has been successfully implemented and used by 881 internal and

  9. Effects of early focal brain injury on memory for visuospatial patterns: selective deficits of global-local processing.

    Science.gov (United States)

    Stiles, Joan; Stern, Catherine; Appelbaum, Mark; Nass, Ruth; Trauner, Doris; Hesselink, John

    2008-01-01

    Selective deficits in visuospatial processing are present early in development among children with perinatal focal brain lesions (PL). Children with right hemisphere PL (RPL) are impaired in configural processing, while children with left hemisphere PL (LPL) are impaired in featural processing. Deficits associated with LPL are less pervasive than those observed with RPL, but this difference may reflect the structure of the tasks used for assessment. Many of the tasks used to date may place greater demands on configural processing, thus highlighting this deficit in the RPL group. This study employed a task designed to place comparable demands on configural and featural processing, providing the opportunity to obtain within-task evidence of differential deficit. Sixty-two 5- to 14-year-old children (19 RPL, 19 LPL, and 24 matched controls) reproduced from memory a series of hierarchical forms (large forms composed of small forms). Global- and local-level reproduction accuracy was scored. Controls were equally accurate on global- and local-level reproduction. Children with RPL were selectively impaired on global accuracy, and children with LPL on local accuracy, thus documenting a double dissociation in global-local processing.

  10. Using Unified Modelling Language (UML) as a process-modelling technique for clinical-research process improvement.

    Science.gov (United States)

    Kumarapeli, P; De Lusignan, S; Ellis, T; Jones, B

    2007-03-01

    The Primary Care Data Quality programme (PCDQ) is a quality-improvement programme which processes routinely collected general practice computer data. Patient data collected from a wide range of different brands of clinical computer systems are aggregated, processed, and fed back to practices in an educational context to improve the quality of care. Process modelling is a well-established approach used to gain understanding and systematic appraisal, and identify areas of improvement of a business process. Unified modelling language (UML) is a general purpose modelling technique used for this purpose. We used UML to appraise the PCDQ process to see if the efficiency and predictability of the process could be improved. Activity analysis and thinking-aloud sessions were used to collect data to generate UML diagrams. The UML model highlighted the sequential nature of the current process as a barrier for efficiency gains. It also identified the uneven distribution of process controls, lack of symmetric communication channels, critical dependencies among processing stages, and failure to implement all the lessons learned in the piloting phase. It also suggested that improved structured reporting at each stage - especially from the pilot phase, parallel processing of data and correctly positioned process controls - should improve the efficiency and predictability of research projects. Process modelling provided a rational basis for the critical appraisal of a clinical data processing system; its potential maybe underutilized within health care.

  11. Ecosystem services and biogeochemical cycles on a global scale: valuation of water, carbon and nitrogen processes

    International Nuclear Information System (INIS)

    Watanabe, Marcos D.B.; Ortega, Enrique

    2011-01-01

    Ecosystem services (ES) are provided by healthy ecosystems and are fundamental to support human life. However, natural systems have been degraded all over the world and the process of degradation is partially attributed to the lack of knowledge regarding the economic benefits associated with ES, which usually are not captured in the market. To valuate ES without using conventional approaches, such as the human's willingness-to-pay for ecosystem goods and services, this paper uses a different method based on Energy Systems Theory to estimate prices for biogeochemical flows that affect ecosystem services by considering their emergy content converted to equivalent monetary terms. Ecosystem services related to water, carbon and nitrogen biogeochemical flows were assessed since they are connected to a range of final ecosystem services including climate regulation, hydrological regulation, food production, soil formation and others. Results in this paper indicate that aquifer recharge, groundwater flow, carbon dioxide sequestration, methane emission, biological nitrogen fixation, nitrous oxide emission and nitrogen leaching/runoff are the most critical biogeochemical flows in terrestrial systems. Moreover, monetary values related to biogeochemical flows on a global scale could provide important information for policymakers concerned with payment mechanisms for ecosystem services and costs of greenhouse gas emissions.

  12. Automated global structure extraction for effective local building block processing in XCS.

    Science.gov (United States)

    Butz, Martin V; Pelikan, Martin; Llorà, Xavier; Goldberg, David E

    2006-01-01

    Learning Classifier Systems (LCSs), such as the accuracy-based XCS, evolve distributed problem solutions represented by a population of rules. During evolution, features are specialized, propagated, and recombined to provide increasingly accurate subsolutions. Recently, it was shown that, as in conventional genetic algorithms (GAs), some problems require efficient processing of subsets of features to find problem solutions efficiently. In such problems, standard variation operators of genetic and evolutionary algorithms used in LCSs suffer from potential disruption of groups of interacting features, resulting in poor performance. This paper introduces efficient crossover operators to XCS by incorporating techniques derived from competent GAs: the extended compact GA (ECGA) and the Bayesian optimization algorithm (BOA). Instead of simple crossover operators such as uniform crossover or one-point crossover, ECGA or BOA-derived mechanisms are used to build a probabilistic model of the global population and to generate offspring classifiers locally using the model. Several offspring generation variations are introduced and evaluated. The results show that it is possible to achieve performance similar to runs with an informed crossover operator that is specifically designed to yield ideal problem-dependent exploration, exploiting provided problem structure information. Thus, we create the first competent LCSs, XCS/ECGA and XCS/BOA, that detect dependency structures online and propagate corresponding lower-level dependency structures effectively without any information about these structures given in advance.

  13. Issues Related to University Education in Ukraine in the Context of Globalization, European Integration and Bologna Process

    Directory of Open Access Journals (Sweden)

    Maryna V. Bosenko

    2014-03-01

    Full Text Available The article deals with the analysis of issued linked to the development of Ukrainian education in the contexts of globalization, European integration and Bologna Process. The needs for reforms related to the university education in Ukraine is linked with job market and social services, including educational services, globalization of economics and IT technologies: enhancing of socio-economical and pedagogical processes, informatization in society, transition to ‘knowledge societies’, changing the system f values, expanding the core of university education, emergence and distribution of innovative technologies, freedom of choice in electing the university curriculum, fundamentalization and humanization of education etc.

  14. Interactions between global processes and local health problems. A human ecology approach to health among indigenous groups in the Amazon

    Directory of Open Access Journals (Sweden)

    Maj-Lis Follér

    Full Text Available This article deals with methodological issues and how to link global processes - social and ecological - with environmental changes and human health in local communities. The discussion concerns how interdisciplinary approaches can help us find tools to develop new knowledge. Scientific knowledge and local knowledge are not seen as opposite epistemological forms, but as socially and culturally constructed. Power and social legitimacy have to be included when analyzing how to deal with the interaction between global processes and local environmental change and the health/disease interface.

  15. Data processing for registered multimodal images and its clinical application

    International Nuclear Information System (INIS)

    Toyama, Hinako; Kobayashi, Akio; Uemura, Kouji

    1998-01-01

    We have developed two kinds of data processing methods for co-registered PET and MR images. The 3D-brain surface, representing the cortical rim in the transaxial images, was projected on a 2D-plane by utilizing Mollweide projection, which is an area-conserving method of displaying the globe as a world map. A quantitative ROI analysis on the brain surface and 3D superimposed surface display were performed by means of the 2D projection image. A clustered brain image was created by referring to the clustered 3D correlation map of resting CBF, the acetazolamide response and the hyperventilatory response, where each pixel in the brain was labeled with the color representing its cluster number. With this method, the stage of hemodynamic deficiency was evaluated in a patient with the occlusion of internal carotid artery. The differences in the brain images obtained before and after revascularized surgery was also evaluated. (author)

  16. Forest Soil Bacteria: Diversity, Involvement in Ecosystem Processes, and Response to Global Change.

    Science.gov (United States)

    Lladó, Salvador; López-Mondéjar, Rubén; Baldrian, Petr

    2017-06-01

    The ecology of forest soils is an important field of research due to the role of forests as carbon sinks. Consequently, a significant amount of information has been accumulated concerning their ecology, especially for temperate and boreal forests. Although most studies have focused on fungi, forest soil bacteria also play important roles in this environment. In forest soils, bacteria inhabit multiple habitats with specific properties, including bulk soil, rhizosphere, litter, and deadwood habitats, where their communities are shaped by nutrient availability and biotic interactions. Bacteria contribute to a range of essential soil processes involved in the cycling of carbon, nitrogen, and phosphorus. They take part in the decomposition of dead plant biomass and are highly important for the decomposition of dead fungal mycelia. In rhizospheres of forest trees, bacteria interact with plant roots and mycorrhizal fungi as commensalists or mycorrhiza helpers. Bacteria also mediate multiple critical steps in the nitrogen cycle, including N fixation. Bacterial communities in forest soils respond to the effects of global change, such as climate warming, increased levels of carbon dioxide, or anthropogenic nitrogen deposition. This response, however, often reflects the specificities of each studied forest ecosystem, and it is still impossible to fully incorporate bacteria into predictive models. The understanding of bacterial ecology in forest soils has advanced dramatically in recent years, but it is still incomplete. The exact extent of the contribution of bacteria to forest ecosystem processes will be recognized only in the future, when the activities of all soil community members are studied simultaneously. Copyright © 2017 American Society for Microbiology.

  17. The Leicester AATSR Global Analyser (LAGA) - Giving Young Students the Opportunity to Examine Space Observations of Global Climate-Related Processes

    Science.gov (United States)

    Llewellyn-Jones, David; Good, Simon; Corlett, Gary

    A pc-based analysis package has been developed, for the dual purposes of, firstly, providing ‘quick-look' capability to research workers inspecting long time-series of global satellite datasets of Sea-surface Temperature (SST); and, secondly, providing an introduction for students, either undergraduates, or advanced high-school students to the characteristics of commonly used analysis techniques for large geophysical data-sets from satellites. Students can also gain insight into the behaviour of some basic climate-related large-scale or global processes. The package gives students immediate access to up to 16 years of continuous global SST data, mainly from the Advanced Along-Track Scanning Radiometer, currently flying on ESA's Envisat satellite. The data are available and are presented in the form of monthly averages and spatial averaged to half-degree or one-sixth degree longitude-latitude grids. There are simple button-operated facilities for defining and calculating box-averages; producing time-series of such averages; defining and displaying transects and their evolution over time; and the examination anomalous behaviour by displaying the difference between observed values and values derived from climatological means. By using these facilities a student rapidly gains familiarity with such processes as annual variability, the El Nĩo effect, as well as major current systems n such as the Gulf Stream and other climatically important phenomena. In fact, the student is given immediate insights into the basic methods of examining geophysical data in a research context, without needing to acquire special analysis skills are go trough lengthy data retrieval and preparation procedures which are more generally required, as precursors to serious investigation, in the research laboratory. This software package, called the Leicester AAATSR Global Analyser (LAGA), is written in a well-known and widely used analysis language and the package can be run by using software

  18. Global Education as a Way of Reinforcing the Process by Which a Solidaritous and Just World is Built

    Science.gov (United States)

    Kaniewska, Małgorzata; Klimski, Marcin

    2017-12-01

    Global education is a part of civic education and upbringing that contributes to their scope through the better understanding of various phenomena and global interdependencies that it affords. It thus represents a response to globalisation processes that has as its goal the development of critical thinking skills in schoolchildren from an early age, with a view to stereotypes and prejudices being combated, human life and human dignity being shown values, and emphasis placed on equality, peace, tolerance, solidarity and equity. The paper considers the reasons for including axiological reflection in school education programmes encompassing matters that are global in nature. Also presented are methods by which to achieve postulates of global education at the primary-school teaching level, as well as the results of research into the level of knowledge on key aspects of this education that are present among primary-school teachers.

  19. Understanding One Institutions' Process in Preparing Civil Engineering Students to Be Globally Competent

    Science.gov (United States)

    Mavroudhis, Vasiliki Goudanas

    2017-01-01

    Civil engineering is an increasingly dynamic and global industry experiencing expansion cross borders, resulting in new required competencies sought out by employers and reflected in updated undergraduate program outcomes. These new competencies include attributes that result in global competence. Institutions of higher learning need to…

  20. Global and Local Processing of Incidental Information and Memory Retrieval at 6 Months.

    Science.gov (United States)

    Bhatt, Ramesh S.; And Others

    1994-01-01

    Five experiments examined the role of global and local cues in memory retrieval in infancy. Results showed that infants encode and remember for substantial periods of time not only the shape of figures displayed in their periphery but also the global organization of these figures. They also adapt this information when responding to new events.…

  1. The process of developing policy based on global environmental risk assessment

    International Nuclear Information System (INIS)

    Fisk, D.J.

    1995-01-01

    A brief presentation is given on developing policy based on a global environmental risk assessment. The author looks at the global warming issue as if it were a formal problem in risk assessment. He uses that framework to make one or two suggestions as to how the interaction of policy and research might evolve as the climate convention progresses

  2. Natural Language Processing Technologies in Radiology Research and Clinical Applications

    Science.gov (United States)

    Cai, Tianrun; Giannopoulos, Andreas A.; Yu, Sheng; Kelil, Tatiana; Ripley, Beth; Kumamaru, Kanako K.; Rybicki, Frank J.

    2016-01-01

    The migration of imaging reports to electronic medical record systems holds great potential in terms of advancing radiology research and practice by leveraging the large volume of data continuously being updated, integrated, and shared. However, there are significant challenges as well, largely due to the heterogeneity of how these data are formatted. Indeed, although there is movement toward structured reporting in radiology (ie, hierarchically itemized reporting with use of standardized terminology), the majority of radiology reports remain unstructured and use free-form language. To effectively “mine” these large datasets for hypothesis testing, a robust strategy for extracting the necessary information is needed. Manual extraction of information is a time-consuming and often unmanageable task. “Intelligent” search engines that instead rely on natural language processing (NLP), a computer-based approach to analyzing free-form text or speech, can be used to automate this data mining task. The overall goal of NLP is to translate natural human language into a structured format (ie, a fixed collection of elements), each with a standardized set of choices for its value, that is easily manipulated by computer programs to (among other things) order into subcategories or query for the presence or absence of a finding. The authors review the fundamentals of NLP and describe various techniques that constitute NLP in radiology, along with some key applications. ©RSNA, 2016 PMID:26761536

  3. Natural Language Processing Technologies in Radiology Research and Clinical Applications.

    Science.gov (United States)

    Cai, Tianrun; Giannopoulos, Andreas A; Yu, Sheng; Kelil, Tatiana; Ripley, Beth; Kumamaru, Kanako K; Rybicki, Frank J; Mitsouras, Dimitrios

    2016-01-01

    The migration of imaging reports to electronic medical record systems holds great potential in terms of advancing radiology research and practice by leveraging the large volume of data continuously being updated, integrated, and shared. However, there are significant challenges as well, largely due to the heterogeneity of how these data are formatted. Indeed, although there is movement toward structured reporting in radiology (ie, hierarchically itemized reporting with use of standardized terminology), the majority of radiology reports remain unstructured and use free-form language. To effectively "mine" these large datasets for hypothesis testing, a robust strategy for extracting the necessary information is needed. Manual extraction of information is a time-consuming and often unmanageable task. "Intelligent" search engines that instead rely on natural language processing (NLP), a computer-based approach to analyzing free-form text or speech, can be used to automate this data mining task. The overall goal of NLP is to translate natural human language into a structured format (ie, a fixed collection of elements), each with a standardized set of choices for its value, that is easily manipulated by computer programs to (among other things) order into subcategories or query for the presence or absence of a finding. The authors review the fundamentals of NLP and describe various techniques that constitute NLP in radiology, along with some key applications. ©RSNA, 2016.

  4. Global vibrations in the wetwell condensation process caused by LOCA in BWR plants

    International Nuclear Information System (INIS)

    Bjoerndahl, O.; Andersson, Magnus

    1998-12-01

    basis the GE methodology has been evaluated. The conclusion of this evaluation is that the GE methodology my lead to non-conservative and/or non-unique results when predictions of global vibration loading in secondary systems supported by the building structure. For the CO-case the assumption is made by GE that a conservative loading is established if an acoustic source is applied in the system model at the locations of all the vent pipe exits which is identical in magnitude and in time dependence in all vents. The source is derived from the one pipe experiments. This evaluation shows that the correlation between the time signals of the different vent pipe sources is a very significant parameter. This parameter is not possible to identify from one pipe experiment. The estimates of this parameter will strongly effect the calculated structural response both concerning the magnitude and the spatial characteristics. The assumption made by GE may lead to non-conservative responses in main parts of the building. The method developed by GE to predict responses for the CH-loading is by itself a random process. The responses computed by this method can be shown to be non-unique. The variance of predicted response spectra are significant. This effect is a direct result of the technique used to simulate the random behaviour of the start times of individual chuggs at the location of the vent pipe exits, the so called desyncronisation technique

  5. Effects of the Wegener-Bergeron-Findeisen process on global black carbon distribution

    Science.gov (United States)

    Qi, Ling; Li, Qinbin; He, Cenlin; Wang, Xin; Huang, Jianping

    2017-06-01

    We systematically investigate the effects of Wegener-Bergeron-Findeisen process (hereafter WBF) on black carbon (BC) scavenging efficiency, surface BCair, deposition flux, concentration in snow (BCsnow, ng g-1), and washout ratio using a global 3-D chemical transport model (GEOS-Chem). We differentiate riming- versus WBF-dominated in-cloud scavenging based on liquid water content (LWC) and temperature. Specifically, we implement an implied WBF parameterization using either temperature or ice mass fraction (IMF) in mixed-phase clouds based on field measurements. We find that at Jungfraujoch, Switzerland, and Abisko, Sweden, where WBF dominates in-cloud scavenging, including the WBF effect strongly reduces the discrepancies of simulated BC scavenging efficiency and washout ratio against observations (from a factor of 3 to 10 % and from a factor of 4-5 to a factor of 2). However, at Zeppelin, Norway, where riming dominates, simulation of BC scavenging efficiency, BCair, and washout ratio become worse (relative to observations) when WBF is included. There is thus an urgent need for extensive observations to distinguish and characterize riming- versus WBF-dominated aerosol scavenging in mixed-phase clouds and the associated BC scavenging efficiency. Our model results show that including the WBF effect lowers global BC scavenging efficiency, with a higher reduction at higher latitudes (8 % in the tropics and up to 76 % in the Arctic). The resulting annual mean BCair increases by up to 156 % at high altitudes and at northern high latitudes because of lower temperature and higher IMF. Overall, WBF halves the model-observation discrepancy (from -65 to -30 %) of BCair across North America, Europe, China and the Arctic. Globally WBF increases BC burden from 0.22 to 0.29-0.35 mg m-2 yr-1, which partially explains the gap between observed and previous model-simulated BC burdens over land. In addition, WBF significantly increases BC lifetime from 5.7 to ˜ 8 days. Additionally

  6. Effects of the Wegener–Bergeron–Findeisen process on global black carbon distribution

    Directory of Open Access Journals (Sweden)

    L. Qi

    2017-06-01

    Full Text Available We systematically investigate the effects of Wegener–Bergeron–Findeisen process (hereafter WBF on black carbon (BC scavenging efficiency, surface BCair, deposition flux, concentration in snow (BCsnow, ng g−1, and washout ratio using a global 3-D chemical transport model (GEOS-Chem. We differentiate riming- versus WBF-dominated in-cloud scavenging based on liquid water content (LWC and temperature. Specifically, we implement an implied WBF parameterization using either temperature or ice mass fraction (IMF in mixed-phase clouds based on field measurements. We find that at Jungfraujoch, Switzerland, and Abisko, Sweden, where WBF dominates in-cloud scavenging, including the WBF effect strongly reduces the discrepancies of simulated BC scavenging efficiency and washout ratio against observations (from a factor of 3 to 10 % and from a factor of 4–5 to a factor of 2. However, at Zeppelin, Norway, where riming dominates, simulation of BC scavenging efficiency, BCair, and washout ratio become worse (relative to observations when WBF is included. There is thus an urgent need for extensive observations to distinguish and characterize riming- versus WBF-dominated aerosol scavenging in mixed-phase clouds and the associated BC scavenging efficiency. Our model results show that including the WBF effect lowers global BC scavenging efficiency, with a higher reduction at higher latitudes (8 % in the tropics and up to 76 % in the Arctic. The resulting annual mean BCair increases by up to 156 % at high altitudes and at northern high latitudes because of lower temperature and higher IMF. Overall, WBF halves the model–observation discrepancy (from −65 to −30 % of BCair across North America, Europe, China and the Arctic. Globally WBF increases BC burden from 0.22 to 0.29–0.35 mg m−2 yr−1, which partially explains the gap between observed and previous model-simulated BC burdens over land. In addition, WBF significantly increases

  7. Optimizing Clinical Operations as part of a Global Emergency Medicine Initiative in Kumasi, Ghana: Application of Lean Manufacturing Principals to Low Resource Health Systems

    Science.gov (United States)

    Carter, Patrick M.; Desmond, Jeffery S.; Akanbobnaab, Christopher; Oteng, Rockefeller A.; Rominski, Sarah; Barsan, William G.; Cunningham, Rebecca

    2012-01-01

    Background Although many global health programs focus on providing clinical care or medical education, improving clinical operations can have a significant effect on patient care delivery, especially in developing health systems without high-level operations management. Lean manufacturing techniques have been effective in decreasing emergency department (ED) length of stay, patient waiting times, numbers of patients leaving without being seen, and door-to-balloon times for ST-elevation myocardial infarction in developed health systems; but use of Lean in low to middle income countries with developing emergency medicine systems has not been well characterized. Objectives To describe the application of Lean manufacturing techniques to improve clinical operations at Komfo Anokye Teaching Hospital in Ghana and to identify key lessons learned to aid future global EM initiatives. Methods A three-week Lean improvement program focused on the hospital admissions process at Komfo Anokye Teaching Hospital was completed by a 14-person team in six stages: problem definition, scope of project planning, value stream mapping, root cause analysis, future state planning, and implementation planning. Results The authors identified eight lessons learned during our use of Lean to optimize the operations of an ED in a global health setting: 1) the Lean process aided in building a partnership with Ghanaian colleagues; 2) obtaining and maintaining senior institutional support is necessary and challenging; 3) addressing power differences among the team to obtain feedback from all team members is critical to successful Lean analysis; 4) choosing a manageable initial project is critical to influence long-term Lean use in a new environment; 5) data intensive Lean tools can be adapted and are effective in a less resourced health system; 6) several Lean tools focused on team problem solving techniques worked well in a low resource system without modification; 7) using Lean highlighted that

  8. Optimizing clinical operations as part of a global emergency medicine initiative in Kumasi, Ghana: application of Lean manufacturing principals to low-resource health systems.

    Science.gov (United States)

    Carter, Patrick M; Desmond, Jeffery S; Akanbobnaab, Christopher; Oteng, Rockefeller A; Rominski, Sarah D; Barsan, William G; Cunningham, Rebecca M

    2012-03-01

    Although many global health programs focus on providing clinical care or medical education, improving clinical operations can have a significant effect on patient care delivery, especially in developing health systems without high-level operations management. Lean manufacturing techniques have been effective in decreasing emergency department (ED) length of stay, patient waiting times, numbers of patients leaving without being seen, and door-to-balloon times for ST-elevation myocardial infarction in developed health systems, but use of Lean in low to middle income countries with developing emergency medicine (EM) systems has not been well characterized. To describe the application of Lean manufacturing techniques to improve clinical operations at Komfo Anokye Teaching Hospital (KATH) in Ghana and to identify key lessons learned to aid future global EM initiatives. A 3-week Lean improvement program focused on the hospital admissions process at KATH was completed by a 14-person team in six stages: problem definition, scope of project planning, value stream mapping, root cause analysis, future state planning, and implementation planning. The authors identified eight lessons learned during our use of Lean to optimize the operations of an ED in a global health setting: 1) the Lean process aided in building a partnership with Ghanaian colleagues; 2) obtaining and maintaining senior institutional support is necessary and challenging; 3) addressing power differences among the team to obtain feedback from all team members is critical to successful Lean analysis; 4) choosing a manageable initial project is critical to influence long-term Lean use in a new environment; 5) data intensive Lean tools can be adapted and are effective in a less resourced health system; 6) several Lean tools focused on team problem-solving techniques worked well in a low-resource system without modification; 7) using Lean highlighted that important changes do not require an influx of resources; and

  9. Clinical Processes - The Killer Application for Constraint-Based Process Interactions

    DEFF Research Database (Denmark)

    Jiménez-Ramírez, Andrés; Barba, Irene; Reichert, Manfred

    2018-01-01

    . The scenario is subject to complex temporal constraints and entails the need for coordinating the constraint-based interactions among the processes related to a patient treatment process. As demonstrated in this work, the selected real process scenario can be suitably modeled through a declarative approach....... examples. However, to the best of our knowledge, they have not been used to model complex, real-world scenarios that comprise constraints going beyond control-flow. In this paper, we propose the use of a declarative language for modeling a sophisticated healthcare process scenario from the real world......For more than a decade, the interest in aligning information systems in a process-oriented way has been increasing. To enable operational support for business processes, the latter are usually specified in an imperative way. The resulting process models, however, tend to be too rigid to meet...

  10. Supine Versus Prone Position During Percutaneous Nephrolithotomy: A Report from the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study

    DEFF Research Database (Denmark)

    G. Vadivia, José; M. Scarpa, Roberto; Duvdevani, Mordechai

    2011-01-01

    To determine differences in patients' characteristics, operative time and procedures, and perioperative outcomes between prone and supine positioning in percutaneous nephrolithotomy (PCNL) using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database....

  11. Percutaneous nephrolithotomy among patients with renal anomalies: patient characteristics and outcomes; a subgroup analysis of the clinical research office of the endourological society global percutaneous nephrolithotomy study

    NARCIS (Netherlands)

    Osther, Palle Jörn; Razvi, Hassan; Liatsikos, Evangelos; Averch, Timothy; Crisci, Alfonso; Garcia, Juan Lòpez; Mandal, Arup; de la Rosette, Jean

    2011-01-01

    This study compared the characteristics and outcomes of percutaneous nephrolithotomy (PCNL) in patients with and without renal malformations using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database. The CROES PCNL Global Study collected prospective data for

  12. Validity and reliability problems with patient global as a component of the ACR/EULAR remission criteria as used in clinical practice.

    Science.gov (United States)

    Masri, Karim R; Shaver, Timothy S; Shahouri, Shadi H; Wang, Shirley; Anderson, James D; Busch, Ruth E; Michaud, Kaleb; Mikuls, Ted R; Caplan, Liron; Wolfe, Frederick

    2012-06-01

    To investigate what factors influence patient global health assessment (PtGlobal), and how those factors and the reliability of PtGlobal affect the rate, reliability, and validity of recently published American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) rheumatoid arthritis (RA) remission criteria when used in clinical practice. We examined consecutive patients with RA in clinical practice and identified 77 who met ACR/EULAR joint criteria for remission (≤ 1 swollen joint and ≤ 1 tender joint). We evaluated factors associated with a PtGlobal > 1, because a PtGlobal ≤ 1 defined ACR/EULAR remission in this group of patients who had already met ACR/EULAR joint criteria. Of the 77 patients examined, only 17 (22.1%) had PtGlobal ≤ 1 and thus fully satisfied ACR/EULAR criteria. A large proportion of patients not in remission by ACR/EULAR criteria had high PtGlobal related to noninflammatory issues, including low back pain, fatigue, and functional limitations, and a number of patients clustered in the range of PtGlobal > 1 and ≤ 2. However, the minimal detectable difference for PtGlobal was 2.3. In addition, compared with a PtGlobal severity score, a PtGlobal activity score was 3.3% less likely to be abnormal (> 1). Noninflammatory factors contribute to the level of PtGlobal and result in the exclusion of many patients who would otherwise be in "true" remission according to the ACR/EULAR definition. Reliability problems associated with PtGlobal can also result in misclassification, and may explain the observation of low longterm remission rates in RA. As currently constituted, the use of the ACR/EULAR remission criteria in clinical practice appears to be problematic.

  13. The Global Health Service Partnership: An Academic–Clinical Partnership to Build Nursing and Medical Capacity in Africa

    Directory of Open Access Journals (Sweden)

    Eileen M. Stuart-Shor

    2017-07-01

    Full Text Available The World Health Organization estimates a global deficit of about 12.9 million skilled health professionals (midwives, nurses, and physicians by 2035. These shortages limit the ability of countries, particularly resource-constrained countries, to deliver basic health care, to respond to emerging and more complex needs, and to teach, graduate, and retain their future health professionals—a vicious cycle that is perpetuated and has profound implications for health security. The Global Health Service Partnership (GHSP is a unique collaboration between the Peace Corps, President’s Emergency Plan for AIDS Relief, Seed and host-country institutions, which aims to strengthen the breadth and quality of medical and nursing education and care delivery in places with dire shortages of health professionals. Nurse and physician educators are seconded to host institutions to serve as visiting faculty alongside their local colleagues. They serve for 1 year with many staying longer. Educational and clinical best practices are shared, emphasis is placed on integration of theory and practice across the academic–clinical domains and the teaching and learning environment is expanded to include implementation science and dissemination of locally tailored and sustainable practice innovations. In the first 3 years (2013–2016 GHSP placed 97 nurse and physician educators in three countries (Malawi, Tanzania, and Uganda. These educators have taught 454 courses and workshops to 8,321 trainees, faculty members, and practicing health professionals across the curriculum and in myriad specialties. Mixed-methods evaluation included key stakeholder interviews with host institution faculty and students who indicate that the addition of GHSP enhanced clinical teaching (quality and breadth resulting in improved clinical skills, confidence, and ability to connect theory to practice and critical thinking. The outputs and outcomes from four exemplars which focus on the

  14. Globalization processes of value chains in clothing industry in Portugal: implication in the working structures

    OpenAIRE

    Moniz, António Brandão; V. Silva, Ana; Woll, Tobias; J. Sampaio, José

    2007-01-01

    International audience; Some of the phenomena where the “globalization” concept is applied include the internationalization of markets, globalization of culture, polítical hegemony of world by some states, or groups of states, the increasing power of supranational institutions, and the development of a global division of labour. A starting point to understand the global division of work is the study of how companies are re-structuring, once they are the key-actors in the decision on which wor...

  15. Kyoto global consensus report on Helicobacter pylori gastritis and its impact on Chinese clinical practice.

    Science.gov (United States)

    Chen, Qi; Lu, Hong

    2016-06-01

    The Kyoto global consensus report on Helicobacter pylori (H. pylori) gastritis has had a great effect on the field of H. pylori studies worldwide. For the first time H. pylori gastritis was defined entirely as an infectious disease and H. pylori-associated dyspepsia as a new category of organic dyspepsia apart from functional dyspepsia, together with a proposed diagnostic algorithm. Accordingly, the report states that the eradication of H. pylori should be regarded as the first-line treatment for dyspepsia. Moreover, H. pylori eradication before the development of pre-neoplastic changes is recommended to reduce the risk of more serious complications of H. pylori gastritis. Despite the recommendations of this new global consensus, the task of transforming them into feasible and practical recommendations for individual countries will require them to become region-specific, which requires further discussion. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  16. Managing two cultural identities: the malleability of bicultural identity integration as a function of induced global or local processing.

    Science.gov (United States)

    Mok, Aurelia; Morris, Michael W

    2012-02-01

    Increasingly, individuals identify with two or more cultures. Prior research has found the degree to which individuals chronically integrate these identities (bicultural identity integration; BII) moderates responses to cultural cues: High BII individuals assimilate (adopting biases that are congruent with norms of the cued culture), whereas low BII individuals contrast (adopting biases that are incongruent with these norms). The authors propose BII can also be a psychological state and modulated by shifts in processing styles. In four experiments, the authors induced a global or local processing style using physical posture (Experiment 1) and cognitive manipulations (Experiments 2-4) and found that BII is enhanced in contexts facilitating a more global processing style (i.e., smiling, high-level construal, and similarity focus). The authors also found that contrastive responses to cultural cues are diminished when BII is situationally enhanced. Implications for research on processing style, identity integration, and performance in culture-based situations are discussed.

  17. Theorizing Learning Process: An Experiential, Constructivist Approach to Young People's Learning about Global Poverty and Development

    Science.gov (United States)

    Brown, Kate

    2015-01-01

    Learning processes in global education have not been significantly theorized, with the notable exception of the application of transformative learning theory. No theory of learning is complete, and to understand the complexity of learning, multiple theoretical lenses must be applied. This article looks at Jarvis's (2006) model of lifelong learning…

  18. Percutaneous nephrolithotomy among patients with renal anomalies: patient characteristics and outcomes; a subgroup analysis of the clinical research office of the endourological society global percutaneous nephrolithotomy study

    DEFF Research Database (Denmark)

    Osther, Palle Jörn; Razvi, Hassan; Liatsikos, Evangelos

    2011-01-01

    This study compared the characteristics and outcomes of percutaneous nephrolithotomy (PCNL) in patients with and without renal malformations using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database.......This study compared the characteristics and outcomes of percutaneous nephrolithotomy (PCNL) in patients with and without renal malformations using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database....

  19. The clinical research office of the endourological society percutaneous nephrolithotomy global study

    DEFF Research Database (Denmark)

    Fuller, Andrew; Razvi, Hassan; Denstedt, John D

    2014-01-01

    in morbidly obese patients was assessed using a prospective database administered by the Clinical Research Office of the Endourological Society (CROES). A multidimensional match of 97 morbidly obese patients with those of normal weight was created using propensity score matching. Student's t-test and Chi...

  20. Setting global standards for stem cell research and clinical translation : The 2016 ISSCR guidelines

    NARCIS (Netherlands)

    Daley, George Q.; Hyun, Insoo; Apperley, Jane F.; Barker, Roger A.; Benvenisty, Nissim; Bredenoord, Annelien L.; Breuer, Christopher K.; Caulfield, Timothy; Cedars, Marcelle I.; Frey-Vasconcells, Joyce; Heslop, Helen E.; Jin, Ying; Lee, Richard T.; McCabe, Christopher; Munsie, Megan; Murry, Charles E.; Piantadosi, Steven; Rao, Mahendra; Rooke, Heather M.; Sipp, Douglas; Studer, Lorenz; Sugarman, Jeremy; Takahashi, Masayo; Zimmerman, Mark; Kimmelman, Jonathan

    2016-01-01

    The International Society for Stem Cell Research (ISSCR) presents its 2016 Guidelines for Stem Cell Research and Clinical Translation (ISSCR, 2016). The 2016 guidelines reflect the revision and extension of two past sets of guidelines (ISSCR, 2006; ISSCR, 2008) to address new and emerging areas of

  1. Addressing Clinical Faculty Need: Creating a Process and Evaluation for Peer Review of Practice

    Directory of Open Access Journals (Sweden)

    Jean Y. Moon

    2014-01-01

    Full Text Available Objectives: To describe the evolving process and evaluate the perceived value of peer review for clinical faculty. Methods: Using a 5-point Likert scale, clinical faculty rated the value of an electronic peer review process by completing an electronic 30 item survey across six areas of clinical faculty practice-related activity. Based on feedback, modifications were made and faculty were re-surveyed the following year. Results: Initially, 78% of faculty found peer review to be beneficial, mostly in the area of practice development and portions of practice dissemination. After modifications, 45% found peer review to be beneficial. Conclusions: Clinical faculty are challenged to leverage their practice into teaching and scholarly activities; however, clinical faculty often need feedback to accomplish this. Although the peer review process was designed to address perceived needs of clinical faculty, the process is dynamic and needs further refinement. Overall, clinical faculty find value in a peer review process. This evaluation of peer review illustrates the challenges to provide feedback across six key areas of clinical faculty activity.   Type: Original Research

  2. Latin American Identity and The Contradictory Processes Involved in its Construction-Deconstruction-Reconfiguration in Global Contexts

    OpenAIRE

    Víctor Hugo Ramos

    2012-01-01

    This paper addresses the difficult and contradictory formation, consolidation and change processes of Latin American identity from an anthropological and holistic perspective and in the context of the emergence of the world-system from the conquest, colonization and independence struggles to its current reconfiguration in the midst of transnational globalization and the alternatives to it. This approach, which we could call dynamicsynthetic, sees identity as a constantly changing open process...

  3. Intentional Modelling: A Process for Clinical Leadership Development in Mental Health Nursing.

    Science.gov (United States)

    Ennis, Gary; Happell, Brenda; Reid-Searl, Kerry

    2016-05-01

    Clinical leadership is becoming more relevant for nurses, as the positive impact that it can have on the quality of care and outcomes for consumers is better understood and more clearly articulated in the literature. As clinical leadership continues to become more relevant, the need to gain an understanding of how clinical leaders in nursing develop will become increasingly important. While the attributes associated with effective clinical leadership are recognized in current literature there remains a paucity of research on how clinical leaders develop these attributes. This study utilized a grounded theory methodology to generate new insights into the experiences of peer identified clinical leaders in mental health nursing and the process of developing clinical leadership skills. Participants in this study were nurses working in a mental health setting who were identified as clinical leaders by their peers as opposed to identifying them by their role or organizational position. A process of intentional modeling emerged as the substantive theory identified in this study. Intentional modeling was described by participants in this study as a process that enabled them to purposefully identify models that assisted them in developing the characteristics of effective clinical leaders as well as allowing them to model these characteristics to others. Reflection on practice is an important contributor to intentional modelling. Intentional modelling could be developed as a framework for promoting knowledge and skill development in the area of clinical leadership.

  4. NASA/MSFC FY90 Global Scale Atmospheric Processes Research Program Review

    Science.gov (United States)

    Leslie, Fred W. (Editor)

    1990-01-01

    Research supported by the Global Atmospheric Research Program at the Marshall Space Flight Center on atmospheric remote sensing, meteorology, numerical weather forecasting, satellite data analysis, cloud precipitation, atmospheric circulation, atmospheric models and related topics is discussed.

  5. A combination of process of care and clinical target among type 2 diabetes mellitus patients in general medical clinics and specialist diabetes clinics at hospital levels.

    Science.gov (United States)

    Sieng, Sokha; Hurst, Cameron

    2017-08-07

    This study compares a combination of processes of care and clinical targets among patients with type 2 diabetes mellitus (T2DM) between specialist diabetes clinics (SDCs) and general medical clinics (GMCs), and how differences between these two types of clinics differ with hospital type (community, provincial and regional). Type 2 diabetes mellitus patient medical records were collected from 595 hospitals (499 community, 70 provincial, 26 regional) in Thailand between April 1 to June 30, 2012 resulting in a cross-sectional sample of 26,860 patients. Generalized linear mixed modeling was conducted to examine associations between clinic type and quality of care. The outcome variables of interest were split into clinical targets and process of care. A subsequent subgroup analysis was conducted to examine if the nature of clinical target and process of care differences between GMCs and SDCs varied with hospital type (regional, provincial, community). Regardless of the types of hospitals (regional, provincial, or community) patients attending SDCs were considerably more likely to have eye and foot exam. In terms of larger hospitals (regional and provincial) patients attending SDCs were more likely to achieve HbA1c exam, All FACE exam, BP target, and the Num7Q. Interestingly, SDCs performed better than GMCs at only provincial hospitals for LDL-C target and the All7Q. Finally, patients with T2DM who attended community hospital-GMCs had a better chance of achieving the blood pressure target than patients who attended community hospital-SDCs. Specialized diabetes clinics outperform general medical clinics for both regional and provincial hospitals for all quality of care indicators and the number of quality of care indicators achieved was never lower. However, this better performance of SDC was not observed in community hospital. Indeed, GMCs outperformed SDCs for some quality of care indicators in the community level setting.

  6. Clinical laboratory markers of inflammation as determinants of chronic graft-versus-host disease activity and NIH global severity.

    Science.gov (United States)

    Grkovic, L; Baird, K; Steinberg, S M; Williams, K M; Pulanic, D; Cowen, E W; Mitchell, S A; Hakim, F T; Martires, K J; Avila, D N; Taylor, T N; Salit, R B; Rowley, S D; Zhang, D; Fowler, D H; Bishop, M R; Gress, R E; Pavletic, S Z

    2012-04-01

    Chronic graft-versus-host disease (cGVHD) remains a major cause of non-relapse morbidity and mortality after allogeneic hematopoietic stem cell transplantation. Currently there are no accepted measures of cGVHD activity to aid in clinical management and disease staging. We analyzed clinical markers of inflammation in the sera of patients with established cGVHD and correlated those with definitions of disease activity. In all, 189 adults with cGVHD (33% moderate and 66% severe according to National Institutes of Health (NIH) global scoring) were consecutively enrolled onto a cross-sectional prospective cGVHD natural history study. At the time of evaluation, 80% were receiving systemic immunosuppression and failed a median of four prior systemic therapies (PST) for their cGVHD. Lower albumin (P<0.0001), higher C-reactive protein (P = 0.043), higher platelets (P = 0.030) and higher number of PST (P<0.0001) were associated with active disease defined as clinician's intention to intensify or alter systemic therapy due to the lack of response. Higher platelet count (P = 0.021) and higher number of PST (P<0.0001) were associated with more severe diseased defined by NIH global score. This study identified common laboratory indicators of inflammation that can serve as markers of cGVHD activity and severity.

  7. Power and Politics in the Global Health Landscape: Beliefs, Competition and Negotiation Among Global Advocacy Coalitions in the Policy-Making Process.

    Science.gov (United States)

    McDougall, Lori

    2016-01-30

    Advocacy coalitions play an increasingly prominent role within the global health landscape, linking actors and institutions to attract political attention and resources. This paper examines how coalitions negotiate among themselves and exercise hidden forms of power to produce policy on the basis of their beliefs and strategic interests. This paper examines the beliefs and behaviours of health advocacy coalitions using Sabatier's Advocacy Coalition Framework (ACF) as an informal theoretical lens. Coalitions are further explored in relation to the concept of transnational advocacy networks (Keck and Sikkink) and of productive power (Shiffman). The ACF focuses on explaining how policy change takes place when there is conflict concerning goals and technical approaches among different actors. This study uses participant observation methods, self-reported survey results and semi-structured qualitative interviews to trace how a major policy project of the Millennium Development Goal (MDG) era, the Global Strategy for Women's and Children's Health, was constructed through negotiations among maternal, newborn, and child health (MNCH) and sexual and reproductive health and rights (SRHR) advocacy coalitions. The Global Strategy represented a new opportunity for high-level political attention. Despite differing policy beliefs, MNCH and SRHR actors collaborated to produce this strategy because of anticipated gains in political attention. While core beliefs did not shift fundamentally and collaboration was primarily a short-term tactical response to a time-bound opportunity, MNCH actors began to focus more on human rights perspectives and SRHR actors adopted greater use of quantifiable indicators and economic argumentation. This shift emphasises the inherent importance of SRHR to maternal and child health survival. As opportunities arise, coalitions respond based on principles and policy beliefs, as well as to perceptions of advantage. Global health policy-making is an arena of

  8. Power and Politics in the Global Health Landscape: Beliefs, Competition and Negotiation Among Global Advocacy Coalitions in the Policy-Making Process

    Science.gov (United States)

    McDougall, Lori

    2016-01-01

    advantage. Global health policy-making is an arena of contested interests, power and ideas, shaped by the interaction of coalitions. Although policy-making is often seen as a process that should be guided by evidence rather than interest-based politics, this study concludes that a participatory process of debate among different actor-coalitions is vital to progress and can lend greater legitimacy, accountability and transparency to the policy process. PMID:27239880

  9. Power and Politics in the Global Health Landscape: Beliefs, Competition and Negotiation Among Global Advocacy Coalitions in the Policy-Making Process

    Directory of Open Access Journals (Sweden)

    Lori McDougall

    2016-05-01

    of advantage. Global health policy-making is an arena of contested interests, power and ideas, shaped by the interaction of coalitions. Although policy-making is often seen as a process that should be guided by evidence rather than interest-based politics, this study concludes that a participatory process of debate among different actorcoalitions is vital to progress and can lend greater legitimacy, accountability and transparency to the policy process.

  10. Setting Global Standards for Stem Cell Research and Clinical Translation: The 2016 ISSCR Guidelines

    Directory of Open Access Journals (Sweden)

    George Q. Daley

    2016-06-01

    Full Text Available The International Society for Stem Cell Research (ISSCR presents its 2016 Guidelines for Stem Cell Research and Clinical Translation (ISSCR, 2016. The 2016 guidelines reflect the revision and extension of two past sets of guidelines (ISSCR, 2006; ISSCR, 2008 to address new and emerging areas of stem cell discovery and application and evolving ethical, social, and policy challenges. These guidelines provide an integrated set of principles and best practices to drive progress in basic, translational, and clinical research. The guidelines demand rigor, oversight, and transparency in all aspects of practice, providing confidence to practitioners and public alike that stem cell science can proceed efficiently and remain responsive to public and patient interests. Here, we highlight key elements and recommendations in the guidelines and summarize the recommendations and deliberations behind them.

  11. Glocal clinical registries: pacemaker registry design and implementation for global and local integration--methodology and case study.

    Directory of Open Access Journals (Sweden)

    Kátia Regina da Silva

    Full Text Available The ability to apply standard and interoperable solutions for implementing and managing medical registries as well as aggregate, reproduce, and access data sets from legacy formats and platforms to advanced standard formats and operating systems are crucial for both clinical healthcare and biomedical research settings.Our study describes a reproducible, highly scalable, standard framework for a device registry implementation addressing both local data quality components and global linking problems.We developed a device registry framework involving the following steps: (1 Data standards definition and representation of the research workflow, (2 Development of electronic case report forms using REDCap (Research Electronic Data Capture, (3 Data collection according to the clinical research workflow and, (4 Data augmentation by enriching the registry database with local electronic health records, governmental database and linked open data collections, (5 Data quality control and (6 Data dissemination through the registry Web site. Our registry adopted all applicable standardized data elements proposed by American College Cardiology / American Heart Association Clinical Data Standards, as well as variables derived from cardiac devices randomized trials and Clinical Data Interchange Standards Consortium. Local interoperability was performed between REDCap and data derived from Electronic Health Record system. The original data set was also augmented by incorporating the reimbursed values paid by the Brazilian government during a hospitalization for pacemaker implantation. By linking our registry to the open data collection repository Linked Clinical Trials (LinkedCT we found 130 clinical trials which are potentially correlated with our pacemaker registry.This study demonstrates how standard and reproducible solutions can be applied in the implementation of medical registries to constitute a re-usable framework. Such approach has the potential to

  12. Glocal Clinical Registries: Pacemaker Registry Design and Implementation for Global and Local Integration – Methodology and Case Study

    Science.gov (United States)

    da Silva, Kátia Regina; Costa, Roberto; Crevelari, Elizabeth Sartori; Lacerda, Marianna Sobral; de Moraes Albertini, Caio Marcos; Filho, Martino Martinelli; Santana, José Eduardo; Vissoci, João Ricardo Nickenig; Pietrobon, Ricardo; Barros, Jacson V.

    2013-01-01

    Background The ability to apply standard and interoperable solutions for implementing and managing medical registries as well as aggregate, reproduce, and access data sets from legacy formats and platforms to advanced standard formats and operating systems are crucial for both clinical healthcare and biomedical research settings. Purpose Our study describes a reproducible, highly scalable, standard framework for a device registry implementation addressing both local data quality components and global linking problems. Methods and Results We developed a device registry framework involving the following steps: (1) Data standards definition and representation of the research workflow, (2) Development of electronic case report forms using REDCap (Research Electronic Data Capture), (3) Data collection according to the clinical research workflow and, (4) Data augmentation by enriching the registry database with local electronic health records, governmental database and linked open data collections, (5) Data quality control and (6) Data dissemination through the registry Web site. Our registry adopted all applicable standardized data elements proposed by American College Cardiology / American Heart Association Clinical Data Standards, as well as variables derived from cardiac devices randomized trials and Clinical Data Interchange Standards Consortium. Local interoperability was performed between REDCap and data derived from Electronic Health Record system. The original data set was also augmented by incorporating the reimbursed values paid by the Brazilian government during a hospitalization for pacemaker implantation. By linking our registry to the open data collection repository Linked Clinical Trials (LinkedCT) we found 130 clinical trials which are potentially correlated with our pacemaker registry. Conclusion This study demonstrates how standard and reproducible solutions can be applied in the implementation of medical registries to constitute a re-usable framework

  13. Development and clinical implementation of a global software use and analysis of radiochromic s films

    International Nuclear Information System (INIS)

    Gimeno Olmos, J.; Martinez Fernandez, J. M.; Pastor Sanchis, V.; Gonzalez Perez, V.; Guardino de la Flor, C.; Dolores Alemany, V. de los; Crispin Contreras, V.

    2011-01-01

    The aim of this study was to gather information in one solution the different processes that occur with the use of radiochromic films: calibration, reading, corrections, step-absorbed dose, dose distribution analysis and comparison with reference distributions.

  14. Short-Term Memory and Auditory Processing Disorders: Concurrent Validity and Clinical Diagnostic Markers

    Science.gov (United States)

    Maerlender, Arthur

    2010-01-01

    Auditory processing disorders (APDs) are of interest to educators and clinicians, as they impact school functioning. Little work has been completed to demonstrate how children with APDs perform on clinical tests. In a series of studies, standard clinical (psychometric) tests from the Wechsler Intelligence Scale for Children, Fourth Edition…

  15. Seeing the Forest "and" the Trees: Default Local Processing in Individuals with High Autistic Traits Does Not Come at the Expense of Global Attention

    Science.gov (United States)

    Stevenson, Ryan A.; Sun, Sol Z.; Hazlett, Naomi; Cant, Jonathan S.; Barense, Morgan D.; Ferber, Susanne

    2018-01-01

    Atypical sensory perception is one of the most ubiquitous symptoms of autism, including a tendency towards a local-processing bias. We investigated whether local-processing biases were associated with global-processing impairments on a global/local attentional-scope paradigm in conjunction with a composite-face task. Behavioural results were…

  16. Clinical Natural Language Processing in languages other than English: opportunities and challenges.

    Science.gov (United States)

    Névéol, Aurélie; Dalianis, Hercules; Velupillai, Sumithra; Savova, Guergana; Zweigenbaum, Pierre

    2018-03-30

    Natural language processing applied to clinical text or aimed at a clinical outcome has been thriving in recent years. This paper offers the first broad overview of clinical Natural Language Processing (NLP) for languages other than English. Recent studies are summarized to offer insights and outline opportunities in this area. We envision three groups of intended readers: (1) NLP researchers leveraging experience gained in other languages, (2) NLP researchers faced with establishing clinical text processing in a language other than English, and (3) clinical informatics researchers and practitioners looking for resources in their languages in order to apply NLP techniques and tools to clinical practice and/or investigation. We review work in clinical NLP in languages other than English. We classify these studies into three groups: (i) studies describing the development of new NLP systems or components de novo, (ii) studies describing the adaptation of NLP architectures developed for English to another language, and (iii) studies focusing on a particular clinical application. We show the advantages and drawbacks of each method, and highlight the appropriate application context. Finally, we identify major challenges and opportunities that will affect the impact of NLP on clinical practice and public health studies in a context that encompasses English as well as other languages.

  17. Global Strategy

    DEFF Research Database (Denmark)

    Li, Peter Ping

    2013-01-01

    Global strategy differs from domestic strategy in terms of content and process as well as context and structure. The content of global strategy can contain five key elements, while the process of global strategy can have six major stages. These are expounded below. Global strategy is influenced...... by rich and complementary local contexts with diverse resource pools and game rules at the national level to form a broad ecosystem at the global level. Further, global strategy dictates the interaction or balance between different entry strategies at the levels of internal and external networks....

  18. The integration of object levels and their content: a theory of global/local processing and related hemispheric differences.

    Science.gov (United States)

    Hübner, Ronald; Volberg, Gregor

    2005-06-01

    This article presents and tests the authors' integration hypothesis of global/local processing, which proposes that at early stages of processing, the identities of global and local units of a hierarchical stimulus are represented separately from information about their respective levels and that, therefore, identity and level information have to be integrated at later stages. It further states that the cerebral hemispheres differ in their capacities for these binding processes. Three experiments are reported in which the integration hypothesis was tested. Participants had to identify a letter at a prespecified level with the viewing duration restricted by a mask. False reporting of the letter at the nontarget level was predicted to occur more often when the integration of identity and level could fail. This was the case. Moreover, visual-field effects occurred, as expected. Finally, a multinomial model was constructed and fitted to the data. ((c) 2005 APA, all rights reserved).

  19. Stochastic process of pragmatic information for 2D spiral wave turbulence in globally and locally coupled Alief-Panfilov oscillators

    Science.gov (United States)

    Kuwahara, Jun; Miyata, Hajime; Konno, Hidetoshi

    2017-09-01

    Recently, complex dynamics of globally coupled oscillators have been attracting many researcher's attentions. In spite of their numerous studies, their features of nonlinear oscillator systems with global and local couplings in two-dimension (2D) are not understood fully. The paper focuses on 2D states of coherent, clustered and chaotic oscillation especially under the effect of negative global coupling (NGC) in 2D Alief-Panfilov model. It is found that the tuning NGC can cause various new coupling-parameter dependency on the features of oscillations. Then quantitative characterization of various states of oscillations (so called spiral wave turbulence) is examined by using the pragmatic information (PI) which have been utilized in analyzing multimode laser, solar activity and neuronal systems. It is demonstrated that the dynamics of the PI for various oscillations can be characterized successfully by the Hyper-Gamma stochastic process.

  20. Scaling ethics up and down: moral craft in clinical genetics and in global health research.

    Science.gov (United States)

    Parker, Michael

    2015-01-01

    This paper engages with the question of what it is to 'do good medical ethics' in two ways. It begins with an exploration of what it might mean to say that health professionals practise good medical ethics as part of practising good ethical medicine. Using the example of the Genethics Club, a well-established national ethics forum for genetics professionals in the UK, the paper develops an account of moral craftsmanship grounded in the concepts of shared moral commitments and practices, moral work, ethics and living morality. In the light of this discussion, the paper goes on to consider what it might mean for a specialist in medical ethics, a bioethicist, to do good medical ethics. Finally, a research agenda focusing on the challenges of thinking about good medical ethics in a global context and a proposal for an innovative approach to bioethics methodology is outlined. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Developing global citizenship online: an authentic alternative to overseas clinical placement.

    Science.gov (United States)

    Strickland, Karen; Adamson, Elizabeth; McInally, Wendy; Tiittanen, Hannele; Metcalfe, Sharon

    2013-10-01

    This paper presents the findings of a pilot project to develop and evaluate an international nursing module delivered using a collaborative online platform between nursing programmes in Scotland, USA and Finland. The purpose of the project was to provide an authentic international nursing experience for nursing students, allowing them to explore and contrast the nursing and health care issues in an international context. The pilot cohort ran in September 2011 with a total of 22 students with a mix of students from both undergraduate and postgraduate programmes. A mixed methods research design was used to evaluate the students' experience using an anonymous online questionnaire and the collection of testimonials from students based on their experience. The results demonstrated high levels of satisfaction with the learning experience. Four key themes-learning together, widening horizons, developing autonomy and learning beyond frontiers-emerged from the qualitative data. Developing confidence from the shared learning experience has real implications for the global mobility of the nursing workforce as it helps to prepare nurses for a career beyond their own country's borders. The pilot module has clearly demonstrated that the use of Web 2.0 technology in the forms of a wiki may effectively be employed to provide an online learning environment to allow cross institutional learning. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  2. Modelling and performance analysis of clinical pathways using the stochastic process algebra PEPA.

    Science.gov (United States)

    Yang, Xian; Han, Rui; Guo, Yike; Bradley, Jeremy; Cox, Benita; Dickinson, Robert; Kitney, Richard

    2012-01-01

    Hospitals nowadays have to serve numerous patients with limited medical staff and equipment while maintaining healthcare quality. Clinical pathway informatics is regarded as an efficient way to solve a series of hospital challenges. To date, conventional research lacks a mathematical model to describe clinical pathways. Existing vague descriptions cannot fully capture the complexities accurately in clinical pathways and hinders the effective management and further optimization of clinical pathways. Given this motivation, this paper presents a clinical pathway management platform, the Imperial Clinical Pathway Analyzer (ICPA). By extending the stochastic model performance evaluation process algebra (PEPA), ICPA introduces a clinical-pathway-specific model: clinical pathway PEPA (CPP). ICPA can simulate stochastic behaviours of a clinical pathway by extracting information from public clinical databases and other related documents using CPP. Thus, the performance of this clinical pathway, including its throughput, resource utilisation and passage time can be quantitatively analysed. A typical clinical pathway on stroke extracted from a UK hospital is used to illustrate the effectiveness of ICPA. Three application scenarios are tested using ICPA: 1) redundant resources are identified and removed, thus the number of patients being served is maintained with less cost; 2) the patient passage time is estimated, providing the likelihood that patients can leave hospital within a specific period; 3) the maximum number of input patients are found, helping hospitals to decide whether they can serve more patients with the existing resource allocation. ICPA is an effective platform for clinical pathway management: 1) ICPA can describe a variety of components (state, activity, resource and constraints) in a clinical pathway, thus facilitating the proper understanding of complexities involved in it; 2) ICPA supports the performance analysis of clinical pathway, thereby assisting

  3. Integrating complex business processes for knowledge-driven clinical decision support systems.

    Science.gov (United States)

    Kamaleswaran, Rishikesan; McGregor, Carolyn

    2012-01-01

    This paper presents in detail the component of the Complex Business Process for Stream Processing framework that is responsible for integrating complex business processes to enable knowledge-driven Clinical Decision Support System (CDSS) recommendations. CDSSs aid the clinician in supporting the care of patients by providing accurate data analysis and evidence-based recommendations. However, the incorporation of a dynamic knowledge-management system that supports the definition and enactment of complex business processes and real-time data streams has not been researched. In this paper we discuss the process web service as an innovative method of providing contextual information to a real-time data stream processing CDSS.

  4. Global industrial impact coefficient based on random walk process and inter-country input-output table

    Science.gov (United States)

    Xing, Lizhi; Dong, Xianlei; Guan, Jun

    2017-04-01

    Input-output table is very comprehensive and detailed in describing the national economic system with lots of economic relationships, which contains supply and demand information among industrial sectors. The complex network, a theory and method for measuring the structure of complex system, can describe the structural characteristics of the internal structure of the research object by measuring the structural indicators of the social and economic system, revealing the complex relationship between the inner hierarchy and the external economic function. This paper builds up GIVCN-WIOT models based on World Input-Output Database in order to depict the topological structure of Global Value Chain (GVC), and assumes the competitive advantage of nations is equal to the overall performance of its domestic sectors' impact on the GVC. Under the perspective of econophysics, Global Industrial Impact Coefficient (GIIC) is proposed to measure the national competitiveness in gaining information superiority and intermediate interests. Analysis of GIVCN-WIOT models yields several insights including the following: (1) sectors with higher Random Walk Centrality contribute more to transmitting value streams within the global economic system; (2) Half-Value Ratio can be used to measure robustness of open-economy macroeconomics in the process of globalization; (3) the positive correlation between GIIC and GDP indicates that one country's global industrial impact could reveal its international competitive advantage.

  5. Effect of brief training on reliability and applicability of Global Assessment of functioning scale by Psychiatric clinical officers in Uganda.

    Science.gov (United States)

    Abbo, C; Okello, E S; Nakku, J

    2013-03-01

    The Global Assessment of Functioning (GAF) is the standard method and an essential tool for representing a clinician's judgment of a patient's overall level of psychological, social and occupational functioning. As such, it is probably the single most widely used method for assessing impairment among the patients with psychiatric illnesses. To assess the effects of one-hour training on application of the GAF by Psychiatric Clinical Officers' in a Ugandan setting. Five Psychiatrists and five Psychiatric Clinical Officers (PCOs) or Assistant Medical Officers who hold a 2 year diploma in Clinical Psychiatry were randomly selected to independently rate a video-recorded psychiatric interview according to the DSM IV-TR. The PCOs were then offered a one-hour training on how to rate the GAF scale and asked to rate the video case interview again. All ratings were assigned on the basis of past one year, at admission and current functioning. Interclass correlations (ICC) were computed using two-way mixed models. The ICC between the psychiatrists and the PCOs before training in the past one year, at admission and current functioning were +0.48, +0.51 and +0.59 respectively. After training, the ICC coefficients were +0.60, +0.82 and +0.83. Brief training given to PCOs improved the applications of their ratings of GAF scale to acceptable levels. There is need for formal training to this cadre of psychiatric practitioners in the use of the GAF.

  6. Clinical global assessment of nutritional status as predictor of mortality in chronic kidney disease patients.

    Science.gov (United States)

    Dai, Lu; Mukai, Hideyuki; Lindholm, Bengt; Heimbürger, Olof; Barany, Peter; Stenvinkel, Peter; Qureshi, Abdul Rashid

    2017-01-01

    The value of subjective global assessment (SGA) as nutritional assessor of protein-energy wasting (PEWSGA) in chronic kidney disease (CKD) patients depends on its mortality predictive capacity. We investigated associations of PEWSGA with markers of nutritional status and all-cause mortality in CKD patients. In 1031 (732 CKD1-5 non-dialysis and 299 dialysis) patients, SGA and body (BMI), lean (LBMI) and fat (FBMI) body mass indices, % handgrip strength (% HGS), serum albumin, and high sensitivity C-reactive protein (hsCRP) were examined at baseline. The five-year all-cause mortality predictive strength of baseline PEWSGA and during follow-up were investigated. PEWSGA was present in 2% of CKD1-2, 16% of CKD3-4, 31% of CKD5 non-dialysis and 44% of dialysis patients. Patients with PEWSGA (n = 320; 31%) had higher hsCRP and lower BMI, LBMI, FBMI, %HGS and serum albumin. But, using receiver operating characteristics-derived cutoffs, these markers could not classify (by kappa statistic) or explain variations of (by multinomial logistic regression analysis) presence of PEWSGA. In generalized linear models, SGA independently predicted mortality after adjustments of multiple confounders (RR: 1.17; 95% CI: 1.11-1.23). Among 323 CKD5 patients who were re-assessed after median 12.6 months, 222 (69%) remained well-nourished, 37 (11%) developed PEWSGA de novo, 40 (12%) improved while 24 (8%) remained with PEWSGA. The latter independently predicted mortality (RR: 1.29; 95% CI: 1.13-1.46). SGA, a valid assessor of nutritional status, is an independent predictor of all-cause mortality both in CKD non-dialysis and dialysis patients that outperforms non-composite nutritional markers as prognosticator.

  7. [Modeling a clinical process for differentiated thyroid cancer health care in Hospital Base Valdivia, Chile].

    Science.gov (United States)

    Ávila-Schwerter, C; Torres-Andrade, M C; Méndez, C A; Márquez-Manzano, M

    2016-01-01

    To design a clinical process model in the management of differentiated thyroid cancer in order to improve accessibility to this treatment. Based on modified Participatory Action Research, a model design process was conducted using a literature review and meetings with organisations committed to the redesigning process, and to agree an improved and feasible process. The process map was constructed by participatory action including, characterisation of the value chain, fault detection in the flow of the process, relevant documents and process for proposing modifications and approvals necessary for this purpose. Links were established between the main process and the support and strategic processes. The participatory model helped to cut the waiting times for diagnosis and treatment of this disease from 12 to 4 months. For each unit to be able to fully visualise the map of the process and understand their contribution as a set of integrated contributions and not fragmented, helps in the comprehensive management of patients and operation processes based on the hierarchical and dominant organisational model in Chilean hospitals. To analyse and remodel clinical processes by participatory action helps to limit failures in the fluidity of care of the patients, by presenting each participating unit with a general view of the process, the problems, and the possible solutions. Furthermore, this approach helps to clarify the process in order to make it more efficient, to harmonise relationships, and to improve coordination in order to optimise patient care. Copyright © 2015 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Validating and Determining the Weight of Items Used for Evaluating Clinical Governance Implementation Based on Analytic Hierarchy Process Model

    Directory of Open Access Journals (Sweden)

    Elaheh Hooshmand

    2015-10-01

    Full Text Available Background The purpose of implementing a system such as Clinical Governance (CG is to integrate, establish and globalize distinct policies in order to improve quality through increasing professional knowledge and the accountability of healthcare professional toward providing clinical excellence. Since CG is related to change, and change requires money and time, CG implementation has to be focused on priority areas that are in more dire need of change. The purpose of the present study was to validate and determine the significance of items used for evaluating CG implementation. Methods The present study was descriptive-quantitative in method and design. Items used for evaluating CG implementation were first validated by the Delphi method and then compared with one another and ranked based on the Analytical Hierarchy Process (AHP model. Results The items that were validated for evaluating CG implementation in Iran include performance evaluation, training and development, personnel motivation, clinical audit, clinical effectiveness, risk management, resource allocation, policies and strategies, external audit, information system management, research and development, CG structure, implementation prerequisites, the management of patients’ non-medical needs, complaints and patients’ participation in the treatment process. The most important items based on their degree of significance were training and development, performance evaluation, and risk management. The least important items included the management of patients’ non-medical needs, patients’ participation in the treatment process and research and development. Conclusion The fundamental requirements of CG implementation included having an effective policy at national level, avoiding perfectionism, using the expertise and potentials of the entire country and the coordination of this model with other models of quality improvement such as accreditation and patient safety.

  9. Validating and determining the weight of items used for evaluating clinical governance implementation based on analytic hierarchy process model.

    Science.gov (United States)

    Hooshmand, Elaheh; Tourani, Sogand; Ravaghi, Hamid; Vafaee Najar, Ali; Meraji, Marziye; Ebrahimipour, Hossein

    2015-04-08

    The purpose of implementing a system such as Clinical Governance (CG) is to integrate, establish and globalize distinct policies in order to improve quality through increasing professional knowledge and the accountability of healthcare professional toward providing clinical excellence. Since CG is related to change, and change requires money and time, CG implementation has to be focused on priority areas that are in more dire need of change. The purpose of the present study was to validate and determine the significance of items used for evaluating CG implementation. The present study was descriptive-quantitative in method and design. Items used for evaluating CG implementation were first validated by the Delphi method and then compared with one another and ranked based on the Analytical Hierarchy Process (AHP) model. The items that were validated for evaluating CG implementation in Iran include performance evaluation, training and development, personnel motivation, clinical audit, clinical effectiveness, risk management, resource allocation, policies and strategies, external audit, information system management, research and development, CG structure, implementation prerequisites, the management of patients' non-medical needs, complaints and patients' participation in the treatment process. The most important items based on their degree of significance were training and development, performance evaluation, and risk management. The least important items included the management of patients' non-medical needs, patients' participation in the treatment process and research and development. The fundamental requirements of CG implementation included having an effective policy at national level, avoiding perfectionism, using the expertise and potentials of the entire country and the coordination of this model with other models of quality improvement such as accreditation and patient safety. © 2015 by Kerman University of Medical Sciences.

  10. The economic impact of poor sample quality in clinical chemistry laboratories: results from a global survey.

    Science.gov (United States)

    Erdal, Erik P; Mitra, Debanjali; Khangulov, Victor S; Church, Stephen; Plokhoy, Elizabeth

    2017-03-01

    Background Despite advances in clinical chemistry testing, poor blood sample quality continues to impact laboratory operations and the quality of results. While previous studies have identified the preanalytical causes of lower sample quality, few studies have examined the economic impact of poor sample quality on the laboratory. Specifically, the costs associated with workarounds related to fibrin and gel contaminants remain largely unexplored. Methods A quantitative survey of clinical chemistry laboratory stakeholders across 10 international regions, including countries in North America, Europe and Oceania, was conducted to examine current blood sample testing practices, sample quality issues and practices to remediate poor sample quality. Survey data were used to estimate costs incurred by laboratories to mitigate sample quality issues. Results Responses from 164 participants were included in the analysis, which was focused on three specific issues: fibrin strands, fibrin masses and gel globules. Fibrin strands were the most commonly reported issue, with an overall incidence rate of ∼3%. Further, 65% of respondents indicated that these issues contribute to analyzer probe clogging, and the majority of laboratories had visual inspection and manual remediation practices in place to address fibrin- and gel-related quality problems (55% and 70%, respectively). Probe maintenance/replacement, visual inspection and manual remediation were estimated to carry significant costs for the laboratories surveyed. Annual cost associated with lower sample quality and remediation related to fibrin and/or gel globules for an average US laboratory was estimated to be $100,247. Conclusions Measures to improve blood sample quality present an important step towards improved laboratory operations.

  11. Global women's health: current clinical trials in low- and middle-income countries.

    Science.gov (United States)

    Merriel, A; Harb, H M; Williams, H; Lilford, R; Coomarasamy, A

    2015-01-01

    Clinical trials in low- and middle-income countries (LMICs) are necessary to develop evidence-based approaches to improve women's health. Understanding what research is currently being conducted will allow the identification of research gaps, avoidance of duplication, planning of future studies, collaboration amongst research groups, and geographical targeting for research investments. To provide an overview of active women's health trials in LMICs. The World Health Organization's International Clinical Trials Registry Platform was searched for trials registered between 1 April 2012 and 31 March 2014. Selected trials were randomised, conducted in LMICs, active, and with a women's health intervention or a significant outcome for the woman. Two reviewers extracted data. Analysis included geographical spread, speciality areas, pre-enrolment registration, study size, and funders. Of the 8966 records, 509 were eligible for inclusion. Gynaecology trials made up 57% of the research, whereas the remaining 43% of trials were in obstetrics. Research activity focused on fertility (17%), the antenatal period (15%), benign gynaecology (14%), intrapartum care (9%), and pre-invasive disease and cancers (8%). The majority of trials (84%) took place in middle-income countries (MICs). In low-income countries (LICs) 83% of research investigated obstetrics, and in MICs 60% of research investigated gynaecology. Most trials (80%) had a sample size of 500 or fewer participants. The median size of trials in LICs was 815 compared with 128 in MICs. Pre-enrolment registration occurred in 54% of trials. The majority (62%) of trials were funded locally. Many LMICs are active in women's health research. The majority of registered trials are located in MICs; however, the trials in LICs are often larger. The focus of research in MICs may be driven by local priorities and funding, with fertility being highly researched. In LICs, pregnancy is the focus, perhaps reflecting the international

  12. A review of global environmental mercury processes in response to human and natural perturbations: Changes of emissions, climate, and land use

    OpenAIRE

    Obrist, Daniel; Zhang, Lei; Jiskra, Martin; Kirk, Jane L.; Sunderland, Elsie M.; Selin, Noelle E

    2018-01-01

    We review recent progress in our understanding of the global cycling of mercury (Hg), including best estimates of Hg concentrations and pool sizes in major environmental compartments and exchange processes within and between these reservoirs. Recent advances include the availability of new global datasets covering areas of the world where environmental Hg data were previously lacking; integration of these data into global and regional models is continually improving estimates of global Hg cyc...

  13. Formation of global energy minimim structures in the growth process of Lennard-Jones clusters

    DEFF Research Database (Denmark)

    Solov'yov, Ilia; Koshelev, Andrey; Shutovich, Andrey

    2003-01-01

    that in this way all known global minimum structures of the Lennard-Jones (LJ) clusters can be found. Our method provides an efficient tool for the calculation and analysis of atomic cluster structure. With its use we justify the magic numbers sequence for the clusters of noble gases atoms and compare...

  14. Reproducing Life and Labor: Global Processes and Working Children in Tijuana, Mexico

    Science.gov (United States)

    Aitken, Stuart; Estrada, Silvia Lopez; Jennings, Joel; Aguirre, Lina Maria

    2006-01-01

    The issue of child labor continues to challenge thinking on the nature of work, play, schooling and apprenticeship. New wisdom from some contemporary academic writing places children closer to the center of our understanding of consumption, production and reproduction, and at the heart of inequities generated by globalization. Child labor comes in…

  15. Stepping back to see the big picture: when obstacles elicit global processing

    NARCIS (Netherlands)

    Marguc, J.; Förster, J.; van Kleef, G.A.

    2011-01-01

    Can obstacles prompt people to look at the "big picture" and open up their minds? Do the cognitive effects of obstacles extend beyond the tasks with which they interfere? These questions were addressed in 6 studies involving both physical and nonphysical obstacles and different measures of global

  16. Clinical Global Impression of Improvement (CGI-I) as a valid proxy measure for remission in schizophrenia: analyses of ziprasidone clinical study data.

    Science.gov (United States)

    Masand, Prakash; O'Gorman, Cedric; Mandel, Francine S

    2011-03-01

    To determine the degree to which a proxy measure of remission in schizophrenia correlates with the criteria identified by the Remission in Schizophrenia Working Group, and how well early treatment response to ziprasidone predicts remission. Data from 10 ziprasidone studies were analyzed to determine rates of remission achieved with ziprasidone using a remission definition of Clinical Global Impression of Improvement (CGI-I) of 1, and compared with rates of remission achieved using the remission working group criteria. Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) scores were then investigated as predictors of remission. A CGI-I score of 1 correlated with the remission criteria developed by the remission working group. In the combined ziprasidone arms, BPRS scores at Weeks 1, 3, and 4 successfully predicted PANSS remission (pproxy measure for the assessment of remission should be easy to apply in a clinical setting and facilitates the prediction of remission in schizophrenia. Copyright © 2010 Elsevier B.V. All rights reserved.

  17. Analysis of Existing Guidelines for the Systematic Planning Process of Clinical Registries.

    Science.gov (United States)

    Löpprich, Martin; Knaup, Petra

    2016-01-01

    Clinical registries are a powerful method to observe the clinical practice and natural disease history. In contrast to clinical trials, where guidelines and standardized methods exist and are mandatory, only a few initiatives have published methodological guidelines for clinical registries. The objective of this paper was to review these guidelines and systematically assess their completeness, usability and feasibility according to a SWOT analysis. The results show that each guideline has its own strengths and weaknesses. While one supports the systematic planning process, the other discusses clinical registries in great detail. However, the feasibility was mostly limited and the special requirements of clinical registries, their flexible, expandable and adaptable technological structure was not addressed consistently.

  18. The Children's Global Assessment Scale (CGAS) and Global Assessment of Psychosocial Disability (GAPD) in clinical practice--substance and reliability as judged by intraclass correlations

    DEFF Research Database (Denmark)

    Dyrborg, J; Larsen, F W; Nielsen, S

    2000-01-01

    Studies on the inter-rater reliability on the Children's Global Assessment Scale (CGAS) and the Global Assessment of Psychosocial Disability (GAPD) involving different subgroups of 145 outpatients from 4 to 16 years of age showed fair to substantial intraclass correlations of 0.59 to 0.90. Raters...

  19. Modification of the Clinical Global Impressions (CGI) Scale for use in bipolar illness (BP): the CGI-BP.

    Science.gov (United States)

    Spearing, M K; Post, R M; Leverich, G S; Brandt, D; Nolen, W

    1997-12-05

    The Clinical Global Impressions Scale (CGI) was modified specifically for use in assessing global illness severity and change in patients with bipolar disorder. Criticisms of the original CGI were addressed by correcting inconsistencies in scaling, identifying time frames for comparison, clarifying definitions of illness severity and change, and separating out assessment of treatment side effects from illness improvement during treatment. A Detailed User's Guide was developed to train clinicians in the use of the new CGI-Bipolar Version (CGI-BP) for rating severity of manic and depressive episodes and the degree of change from the immediately preceding phase and from the worst phase of illness. The revised scale and manual provide a focused set of instructions to facilitate the reliability of these ratings of mania, depression, and overall bipolar illness during treatment of an acute episode or in longer-term illness prophylaxis. Interrater reliability of the scale was demonstrated in preliminary analyses. Thus, the modified CGI-BP is anticipated to be more useful than the original CGI in studies of bipolar disorder.

  20. An analysis of clinical reasoning through a recent and comprehensive approach: the dual-process theory.

    Science.gov (United States)

    Pelaccia, Thierry; Tardif, Jacques; Triby, Emmanuel; Charlin, Bernard

    2011-03-14

    Clinical reasoning plays a major role in the ability of doctors to make diagnoses and decisions. It is considered as the physician's most critical competence, and has been widely studied by physicians, educationalists, psychologists and sociologists. Since the 1970s, many theories about clinical reasoning in medicine have been put forward. This paper aims at exploring a comprehensive approach: the "dual-process theory", a model developed by cognitive psychologists over the last few years. After 40 years of sometimes contradictory studies on clinical reasoning, the dual-process theory gives us many answers on how doctors think while making diagnoses and decisions. It highlights the importance of physicians' intuition and the high level of interaction between analytical and non-analytical processes. However, it has not received much attention in the medical education literature. The implications of dual-process models of reasoning in terms of medical education will be discussed.

  1. An analysis of clinical reasoning through a recent and comprehensive approach: the dual-process theory

    Directory of Open Access Journals (Sweden)

    Thierry Pelaccia

    2011-03-01

    Full Text Available Context. Clinical reasoning plays a major role in the ability of doctors to make diagnoses and decisions. It is considered as the physician's most critical competence, and has been widely studied by physicians, educationalists, psychologists and sociologists. Since the 1970s, many theories about clinical reasoning in medicine have been put forward.Purpose. This paper aims at exploring a comprehensive approach: the “dual-process theory”, a model developed by cognitive psychologists over the last few years.Discussion. After 40 years of sometimes contradictory studies on clinical reasoning, the dual-process theory gives us many answers on how doctors think while making diagnoses and decisions. It highlights the importance of physicians’ intuition and the high level of interaction between analytical and non-analytical processes. However, it has not received much attention in the medical education literature. The implications of dual-process models of reasoning in terms of medical education will be discussed.

  2. Utilization of the Nursing Process to Foster Clinical Reasoning During a Simulation Experience

    Directory of Open Access Journals (Sweden)

    Amanda Lambie

    2015-11-01

    Full Text Available Nursing practice includes complex reasoning and multifaceted decision making with minimal standardized guidance in how to evaluate this phenomenon among nursing students. Learning outcomes related to the clinical reasoning process among novice baccalaureate nursing students during a simulation experience were evaluated. Nursing process records were utilized to evaluate and foster the development of clinical reasoning in a high-fidelity medical-surgical simulation experience. Students were unable to describe and process pertinent patient information appropriately prior to the simulation experience. Students’ ability to identify pertinent patient cues and plan appropriate patient care improved following the simulation. The learning activity afforded a structured opportunity to identify cues, prioritize the proper course of nursing interventions, and engage in collaboration among peers. The simulation experience provides faculty insight into the students’ clinical reasoning processes, while providing students with a clear framework for successfully accomplishing learning outcomes.

  3. Essential processes for cognitive behavioral clinical supervision: Agenda setting, problem-solving, and formative feedback.

    Science.gov (United States)

    Cummings, Jorden A; Ballantyne, Elena C; Scallion, Laura M

    2015-06-01

    Clinical supervision should be a proactive and considered endeavor, not a reactive one. To that end, supervisors should choose supervision processes that are driven by theory, best available research, and clinical experience. These processes should be aimed at helping trainees develop as clinicians. We highlight 3 supervision processes we believe should be used at each supervision meeting: agenda setting, encouraging trainee problem-solving, and formative feedback. Although these are primarily cognitive-behavioral skills, they can be helpful in combination with other supervision models. We provide example dialogue from supervision exchanges, and discuss theoretical and research support for these processes. Using these processes not only encourages trainee development but also models for them how to use the same processes and approaches with clients. (c) 2015 APA, all rights reserved).

  4. Registered nurses' clinical reasoning skills and reasoning process: A think-aloud study.

    Science.gov (United States)

    Lee, JuHee; Lee, Young Joo; Bae, JuYeon; Seo, Minjeong

    2016-11-01

    As complex chronic diseases are increasing, nurses' prompt and accurate clinical reasoning skills are essential. However, little is known about the reasoning skills of registered nurses. This study aimed to determine how registered nurses use their clinical reasoning skills and to identify how the reasoning process proceeds in the complex clinical situation of hospital setting. A qualitative exploratory design was used with a think-aloud method. A total of 13 registered nurses (mean years of experience=11.4) participated in the study, solving an ill-structured clinical problem based on complex chronic patients cases in a hospital setting. Data were analyzed using deductive content analysis. Findings showed that the registered nurses used a variety of clinical reasoning skills. The most commonly used skill was 'checking accuracy and reliability.' The reasoning process of registered nurses covered assessment, analysis, diagnosis, planning/implementation, and evaluation phase. It is critical that registered nurses apply appropriate clinical reasoning skills in complex clinical practice. The main focus of registered nurses' reasoning in this study was assessing a patient's health problem, and their reasoning process was cyclic, rather than linear. There is a need for educational strategy development to enhance registered nurses' competency in determining appropriate interventions in a timely and accurate fashion. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. The process and organizational characteristics of memory clinics in Israel in 2007.

    Science.gov (United States)

    Werner, Perla; Goldstein, Dovrat; Heinik, Jeremia

    2009-01-01

    We previously described the characteristics and activities of 25 memory clinics in Israel in 1998 using a mail survey. Questionnaires assessing the administrative structure of the clinics, patient characteristics, processes and methods used, and outcomes of the assessment were mailed again in 2007 to 35 memory clinics. Overall, the general operating characteristics of the clinics in 2007 were found to be similar to those reported in the previous survey conducted in 1998. The assessment process in 2007 was shorter than in 1998 (mean time=1.92 and 3.12 h, respectively), although both surveys were based on an interdisciplinary team, including a physician, a nurse and a social worker. However, in 2007 the teams were more wide-ranging. A wider variety of instruments were reported in the more recent survey. Most of the clinics in both surveys reported that family members were involved at all stages of the assessment. Medication treatment was the main outcome reported by the clinics in both surveys. There has been a development in the process and organizational characteristics of memory clinics in Israel over the years, probably as a consequence of the development of knowledge in the area of cognitive deterioration.

  6. [The balanced scorecard used as a management tool in a clinical laboratory: internal business processes indicators].

    Science.gov (United States)

    Salinas La Casta, Maria; Flores Pardo, Emilio; Uris Selles, Joaquín

    2009-01-01

    to propose a set of indicators as a management tool for a clinical laboratory, by using the balanced scorecard internal business processes perspective. indicators proposed are obtained from different sources; external proficiency testing of the Valencia Community Government, by means of internal surveys and laboratory information system registers. One year testing process proportion indicators results are showed. internal management indicators are proposed (process, appropriateness and proficiency testing). The process indicators results show gradual improvement since its establishment. after one years of using a conceptually solid Balanced Scorecard Internal business processes perspective indicators, the obtained results validate the usefulness as a laboratory management tool.

  7. Relations between perceptual and conceptual scope: how global versus local processing fits a focus on similarity versus dissimilarity.

    Science.gov (United States)

    Förster, Jens

    2009-02-01

    Nine studies showed a bidirectional link (a) between a global processing style and generation of similarities and (b) between a local processing style and generation of dissimilarities. In Experiments 1-4, participants were primed with global versus local perception styles and then asked to work on an allegedly unrelated generation task. Across materials, participants generated more similarities than dissimilarities after global priming, whereas for participants with local priming, the opposite was true. Experiments 5-6 demonstrated a bidirectional link whereby participants who were first instructed to search for similarities attended more to the gestalt of a stimulus than to its details, whereas the reverse was true for those who were initially instructed to search for dissimilarities. Because important psychological variables are correlated with processing styles, in Experiments 7-9, temporal distance, a promotion focus, and high power were predicted and shown to enhance the search for similarities, whereas temporal proximity, a prevention focus, and low power enhanced the search for dissimilarities. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

  8. Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice Guidelines and Quality Certification Do Not Avert Variability in Clinical Practice.

    Science.gov (United States)

    Torras, M G; Canals, E; Jurado-Bruggeman, D; Marín-Borras, S; Macià, M; Jové, J; Boladeras, A M; Muñoz-Montplet, C; Molero, J; Picón, C; Puigdemont, M; Aliste, L; Torrents, A; Guedea, F; Borras, J M

    2018-06-01

    The therapeutic approach to cancer is complex and multidisciplinary. Radiotherapy is among the essential treatments, whether used alone or in conjunction with other therapies. This study reports a clinical audit of the radiotherapy process to assess the process of care, evaluate adherence to agreed protocols and measure the variability to improve therapeutic quality for rectal cancer. Multicentre retrospective cohort study in a representative sample of patients diagnosed with rectal cancer in the Institut Català d'Oncologia, a comprehensive cancer centre with three different settings. We developed a set of indicators to assess the key areas of the radiotherapy process. The clinical audit consisted of a review of a random sample of 40 clinical histories for each centre. The demographic profile, histology and staging of patients were similar between centres. The MRI reports did not include the distance from tumour to mesorectal fascia (rCRM) in 38.3% of the cases. 96.7% of patients received the planned dose, and 57.4% received it at the planned time. Surgery followed neoadjuvant treatment in 96.7% of the patients. Among this group, postoperative CRM was recorded in 65.5% of the cases and was negative in 93.4% of these. With regard to the 34.5% (n = 40) of cases where no CRM value was stated, there were differences between the centres. Mean follow-up was 3.4 (SD 0.6) years, and overall survival at four years was 81.7%. The audit revealed a suboptimal degree of adherence to clinical practice guidelines. Significant variability between centres exists from a clinical perspective but especially with regard to organization and process. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  9. PROCESS OF GLOBAL SHOCKS TRANSMISSION TO DOMESTIC FOOD PRICE LEVEL: CASE OF BANGLADESH

    Directory of Open Access Journals (Sweden)

    Fakir Azmal Huda

    2014-04-01

    Full Text Available The world experienced in dramatic price surge of food commodities since mid of 2007 to 2008. It was claimed that the crisis were being mainly for backdrop of global shocks in food and energy price. But how the shocks come to domestic market from external sources is a researchable phenomenon. Surprisingly few attempts have been made to systematically analysis of shock transmission from international to domestic market. The study analyzed the effect of global commodity market factors and domestic exchange rate development on domestic food price in Bangladesh. A bi-variants co-integration approach was applied for the analysis of shock transmission. Finally an error correction model was developed. The overall magnitudes of the pass through suggest that only 46 per cent of the total world shock pass-through in domestic economy.

  10. Global restructuring of the CPM-2 transport algorithm for vector and parallel processing

    International Nuclear Information System (INIS)

    Vujic, J.L.; Martin, W.R.

    1989-01-01

    The CPM-2 code is an assembly transport code based on the collision probability (CP) method. It can in principle be applied to global reactor problems, but its excessive computational demands prevent this application. Therefore, a new transport algorithm for CPM-2 has been developed for vector-parallel architectures, which has resulted in an overall factor of 20 speedup (wall clock) on the IBM 3090-600E. This paper presents the detailed results of this effort as well as a brief description of ongoing effort to remove some of the modeling limitations in CPM-2 that inhibit its use for global applications, such as the use of the pure CP treatment and the assumption of isotropic scattering

  11. Global weak solutions for coupled transport processes in concrete walls at high temperatures

    OpenAIRE

    Beneš, Michal; Štefan, Radek

    2012-01-01

    We consider an initial-boundary value problem for a fully nonlinear coupled parabolic system with nonlinear boundary conditions modelling hygro-thermal behavior of concrete at high temperatures. We prove a global existence of a weak solution to this system on an arbitrary time interval. The main result is proved by an approximation procedure. This consists in proving the existence of solutions to mollified problems using the Leray-Schauder theorem, for which a priori estimates are obtained. T...

  12. COMPETITION AMONG FOREIGN AND CHINESE AGRO-FOOD ENTERPRISES IN THE PROCESS OF GLOBALIZATION

    OpenAIRE

    Wei, Anning; Cacho, Joyce A.

    1999-01-01

    Based on various case studies, this article examines the interaction of foreign investors and local operators in globalization in the agro-food market in China. The study found that to break the limitation of the high-end market and to position mainly in the middle market were critical for international brands to succeed. Asian companies approached the China market as an insider because of cultural proximity. The latter, plus focused management and effective technology, made their operations ...

  13. Development of clinical process measures for pediatric burn care: Understanding variation in practice patterns.

    Science.gov (United States)

    Kazis, Lewis E; Sheridan, Robert L; Shapiro, Gabriel D; Lee, Austin F; Liang, Matthew H; Ryan, Colleen M; Schneider, Jeffrey C; Lydon, Martha; Soley-Bori, Marina; Sonis, Lily A; Dore, Emily C; Palmieri, Tina; Herndon, David; Meyer, Walter; Warner, Petra; Kagan, Richard; Stoddard, Frederick J; Murphy, Michael; Tompkins, Ronald G

    2018-04-01

    There has been little systematic examination of variation in pediatric burn care clinical practices and its effect on outcomes. As a first step, current clinical care processes need to be operationally defined. The highly specialized burn care units of the Shriners Hospitals for Children system present an opportunity to describe the processes of care. The aim of this study was to develop a set of process-based measures for pediatric burn care and examine adherence to them by providers in a cohort of pediatric burn patients. We conducted a systematic literature review to compile a set of process-based indicators. These measures were refined by an expert panel of burn care providers, yielding 36 process-based indicators in four clinical areas: initial evaluation and resuscitation, acute excisional surgery and critical care, psychosocial and pain control, and reconstruction and aftercare. We assessed variability in adherence to the indicators in a cohort of 1,076 children with burns at four regional pediatric burn programs in the Shriners Hospital system. The percentages of the cohort at each of the four sites were as follows: Boston, 20.8%; Cincinnati, 21.1%; Galveston, 36.0%; and Sacramento, 22.1%. The cohort included children who received care between 2006 and 2010. Adherence to the process indicators varied both across sites and by clinical area. Adherence was lowest for the clinical areas of acute excisional surgery and critical care, with a range of 35% to 48% across sites, followed by initial evaluation and resuscitation (range, 34%-60%). In contrast, the clinical areas of psychosocial and pain control and reconstruction and aftercare had relatively high adherence across sites, with ranges of 62% to 93% and 71% to 87%, respectively. Of the 36 process indicators, 89% differed significantly in adherence between clinical sites (p measures represents an important step in the assessment of clinical practice in pediatric burn care. Substantial variation was observed

  14. Applying Process Improvement Methods to Clinical and Translational Research: Conceptual Framework and Case Examples.

    Science.gov (United States)

    Daudelin, Denise H; Selker, Harry P; Leslie, Laurel K

    2015-12-01

    There is growing appreciation that process improvement holds promise for improving quality and efficiency across the translational research continuum but frameworks for such programs are not often described. The purpose of this paper is to present a framework and case examples of a Research Process Improvement Program implemented at Tufts CTSI. To promote research process improvement, we developed online training seminars, workshops, and in-person consultation models to describe core process improvement principles and methods, demonstrate the use of improvement tools, and illustrate the application of these methods in case examples. We implemented these methods, as well as relational coordination theory, with junior researchers, pilot funding awardees, our CTRC, and CTSI resource and service providers. The program focuses on capacity building to address common process problems and quality gaps that threaten the efficient, timely and successful completion of clinical and translational studies. © 2015 The Authors. Clinical and Translational Science published by Wiley Periodicals, Inc.

  15. Seeing the Forest and the Trees: Default Local Processing in Individuals with High Autistic Traits Does Not Come at the Expense of Global Attention.

    Science.gov (United States)

    Stevenson, Ryan A; Sun, Sol Z; Hazlett, Naomi; Cant, Jonathan S; Barense, Morgan D; Ferber, Susanne

    2018-04-01

    Atypical sensory perception is one of the most ubiquitous symptoms of autism, including a tendency towards a local-processing bias. We investigated whether local-processing biases were associated with global-processing impairments on a global/local attentional-scope paradigm in conjunction with a composite-face task. Behavioural results were related to individuals' levels of autistic traits, specifically the Attention to Detail subscale of the Autism Quotient, and the Sensory Profile Questionnaire. Individuals showing high rates of Attention to Detail were more susceptible to global attentional-scope manipulations, suggesting that local-processing biases associated with Attention to Detail do not come at the cost of a global-processing deficit, but reflect a difference in default global versus local bias. This relationship operated at the attentional/perceptual level, but not response criterion.

  16. An analysis of clinical reasoning through a recent and comprehensive approach: the dual-process theory

    OpenAIRE

    Pelaccia, Thierry; Tardif, Jacques; Triby, Emmanuel; Charlin, Bernard

    2011-01-01

    Context: Clinical reasoning plays a major role in the ability of doctors to make diagnoses and decisions. It is considered as the physician’s most critical competence, and has been widely studied by physicians, educationalists, psychologists and sociologists. Since the 1970s, many theories about clinical reasoning in medicine have been put forward. Purpose: This paper aims at exploring a comprehensive approach: the ‘‘dual-process theory’’, a model developed by co...

  17. Medical subdomain classification of clinical notes using a machine learning-based natural language processing approach

    OpenAIRE

    Weng, Wei-Hung; Wagholikar, Kavishwar B.; McCray, Alexa T.; Szolovits, Peter; Chueh, Henry C.

    2017-01-01

    Background The medical subdomain of a clinical note, such as cardiology or neurology, is useful content-derived metadata for developing machine learning downstream applications. To classify the medical subdomain of a note accurately, we have constructed a machine learning-based natural language processing (NLP) pipeline and developed medical subdomain classifiers based on the content of the note. Methods We constructed the pipeline using the clinical ...

  18. Designing a clinical audit tool to measure processes of pregnancy care

    Directory of Open Access Journals (Sweden)

    Wallace EM

    2011-12-01

    Full Text Available Suzanne V Sinni1, Wendy M Cross2, Euan M Wallace1,31Department of Obstetrics and Gynaecology, Monash University and Southern Health, Monash Medical Centre, Clayton, Victoria, 2School of Nursing and Midwifery, Monash University, Clayton, Victoria, 3The Ritchie Centre, Monash Institute of Medical Research, Monash University, Clayton, Victoria, AustraliaAbstract: This paper reports the development of a clinical audit tool as part of a larger project to evaluate a new maternity service, underpinned by a patient safety framework.Aim: The aim of this work is to describe the development of a clinical audit tool that measures the process of pregnancy care, and its application.Background: There are many reports about outcomes of healthcare provision, however there are limited studies examining the process of care. There is also limited evidence linking clinical audit with improvements in care delivery. Pregnancy care was chosen because there are well defined and agreed clinical standards against which to measure the delivery of pregnancy care. A clinical audit using these standards addresses both gaps in the literature.Methods: Standard methodological processes were used to develop the audit tool. Literature informed the processes. Data were collected in 2009–2010 using the tool described in the paper. Reliability testing was completed in September 2011.Results: An audit tool to measure pregnancy care was developed and applied to 354 health records to enable analysis of adherence to organizational expectations of care. Reliability testing of the tool achieved an overall kappa of 0.896.Conclusion: Developing an audit tool based on processes described in the literature is labor intensive and resource dependent, however it results in a robust, reliable, valid tool that can be used in diverse maternity services. Stakeholder participation from the outset ensures ongoing engagement for the duration of a clinically based project spanning several years

  19. Natural language processing systems for capturing and standardizing unstructured clinical information: A systematic review.

    Science.gov (United States)

    Kreimeyer, Kory; Foster, Matthew; Pandey, Abhishek; Arya, Nina; Halford, Gwendolyn; Jones, Sandra F; Forshee, Richard; Walderhaug, Mark; Botsis, Taxiarchis

    2017-09-01

    We followed a systematic approach based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify existing clinical natural language processing (NLP) systems that generate structured information from unstructured free text. Seven literature databases were searched with a query combining the concepts of natural language processing and structured data capture. Two reviewers screened all records for relevance during two screening phases, and information about clinical NLP systems was collected from the final set of papers. A total of 7149 records (after removing duplicates) were retrieved and screened, and 86 were determined to fit the review criteria. These papers contained information about 71 different clinical NLP systems, which were then analyzed. The NLP systems address a wide variety of important clinical and research tasks. Certain tasks are well addressed by the existing systems, while others remain as open challenges that only a small number of systems attempt, such as extraction of temporal information or normalization of concepts to standard terminologies. This review has identified many NLP systems capable of processing clinical free text and generating structured output, and the information collected and evaluated here will be important for prioritizing development of new approaches for clinical NLP. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Reading out neural populations: shared variability, global fluctuations and information processing

    OpenAIRE

    Romero Arandia, Iñigo

    2017-01-01

    Entendre l'origen i la funció de l'activitat de poblacions neuronals, i com aquesta activitat es relaciona amb els estímuls sensorials, les decisions o les accions motores és un gran repte per les neurociències. En aquest treball hem analitzat l'activitat de desenes de neurones enregistrades a l'escorça visual primària de micos mentre se'ls presentaven escletxes sinusoïdals en diferents orientacions. Hem trobat que les fluctuacions globals de la xarxa mesurades mitjançant l'...

  1. Processes of globalization, economic policy and the role of state in raw materials and energy complex

    Directory of Open Access Journals (Sweden)

    Vladimír Vodzinský

    2009-09-01

    Full Text Available Authors dedicate this article to impacts of constrains in paradigm of potentials forming our society.As entire societies are assembled in certain pattern, this article is dedicated to reasoning why economical growth builton influence and a use of knowledge of the reasons would accelerate consumer orientation of reproduction cycle on the levelof ownership.Both of these, causes and reasons, result in aggravation of social order and ecological crises.End products of globalization and concomitant state economic policies do not lead to crisis solution nor do they lead to effectivedisappearance of their consequences.

  2. System of automated processing of radionuclide investigations (SAPRI-01) in clinical practice

    International Nuclear Information System (INIS)

    Sivachenko, T.P.; Mechev, D.S.; Krupka, I.N.

    1988-01-01

    The author described the results of clinical testing of a system SAPRI-01 designed for automated collection, storage and processing of data on radionuclide investigations. He gave examples of automated processing of RCG and the results of positive scintigraphy of tumors of different sites using 67 Ga-citrate and 99m Tc pertechnetate in statistical and dynamic investigations. Short-comings and ways for updating 4 the system during its serial production were pointed out. The introduction of the system into clinical practice on a wide scale was shown to hold promise

  3. Strategy for 90% autoverification of clinical chemistry and immunoassay test results using six sigma process improvement.

    Science.gov (United States)

    Randell, Edward W; Short, Garry; Lee, Natasha; Beresford, Allison; Spencer, Margaret; Kennell, Marina; Moores, Zoë; Parry, David

    2018-06-01

    Six Sigma involves a structured process improvement strategy that places processes on a pathway to continued improvement. The data presented here summarizes a project that took three clinical laboratories from autoverification processes that allowed between about 40% to 60% of tests being auto-verified to more than 90% of tests and samples auto-verified. The project schedule, metrics and targets, a description of the previous system and detailed information on the changes made to achieve greater than 90% auto-verification is presented for this Six Sigma DMAIC (Design, Measure, Analyze, Improve, Control) process improvement project.

  4. A simulation framework for mapping risks in clinical processes: the case of in-patient transfers.

    Science.gov (United States)

    Dunn, Adam G; Ong, Mei-Sing; Westbrook, Johanna I; Magrabi, Farah; Coiera, Enrico; Wobcke, Wayne

    2011-05-01

    To model how individual violations in routine clinical processes cumulatively contribute to the risk of adverse events in hospital using an agent-based simulation framework. An agent-based simulation was designed to model the cascade of common violations that contribute to the risk of adverse events in routine clinical processes. Clinicians and the information systems that support them were represented as a group of interacting agents using data from direct observations. The model was calibrated using data from 101 patient transfers observed in a hospital and results were validated for one of two scenarios (a misidentification scenario and an infection control scenario). Repeated simulations using the calibrated model were undertaken to create a distribution of possible process outcomes. The likelihood of end-of-chain risk is the main outcome measure, reported for each of the two scenarios. The simulations demonstrate end-of-chain risks of 8% and 24% for the misidentification and infection control scenarios, respectively. Over 95% of the simulations in both scenarios are unique, indicating that the in-patient transfer process diverges from prescribed work practices in a variety of ways. The simulation allowed us to model the risk of adverse events in a clinical process, by generating the variety of possible work subject to violations, a novel prospective risk analysis method. The in-patient transfer process has a high proportion of unique trajectories, implying that risk mitigation may benefit from focusing on reducing complexity rather than augmenting the process with further rule-based protocols.

  5. Global change and modern coral reefs: New opportunities to understand shallow-water carbonate depositional processes

    Science.gov (United States)

    Hallock, Pamela

    2005-04-01

    Human activities are impacting coral reefs physically, biologically, and chemically. Nutrification, sedimentation, chemical pollution, and overfishing are significant local threats that are occurring worldwide. Ozone depletion and global warming are triggering mass coral-bleaching events; corals under temperature stress lose the ability to synthesize protective sunscreens and become more sensitive to sunlight. Photo-oxidative stress also reduces fitness, rendering reef-building organisms more susceptible to emerging diseases. Increasing concentration of atmospheric CO 2 has already reduced CaCO 3 saturation in surface waters by more than 10%. Doubling of atmospheric CO 2 concentration over pre-industrial concentration in the 21st century may reduce carbonate production in tropical shallow marine environments by as much as 80%. As shallow-water reefs decline worldwide, opportunities abound for researchers to expand understanding of carbonate depositional systems. Coordinated studies of carbonate geochemistry with photozoan physiology and calcification, particularly in cool subtropical-transition zones between photozoan-reef and heterotrophic carbonate-ramp communities, will contribute to understanding of carbonate sedimentation under environmental change, both in the future and in the geologic record. Cyanobacteria are becoming increasingly prominent on declining reefs, as these microbes can tolerate strong solar radiation, higher temperatures, and abundant nutrients. The responses of reef-dwelling cyanobacteria to environmental parameters associated with global change are prime topics for further research, with both ecological and geological implications.

  6. Changes in residential, occupational and gender structure of the greater Bangkok in the globalization process

    Directory of Open Access Journals (Sweden)

    Satoshi Nakagawa

    2004-01-01

    Full Text Available This study investigated recent changes in migration and population structure of the GreaterBangkok considering the impact of economic globalization. The spatial policy of the Thaigovernment has lead newer investments for manufacturing to locate away from BangkokMetropolis and thereby the industrial structure of Bangkok Metropolis has gradually turnedinto service-dominated, while the region surrounding Bangkok Metropolis has attractedfactories mainly owned by foreign capital. Light industry and electronics industry are concentratedin the adjacent provinces to Bangkok Metropolis and the heavy and petrochemicalindustry tends to be located in the outer zone of the surrounding region. The service sectorand light industry as well as electronics industry prefer female workers and Bangkok metropolisand the adjoining provinces have become female-dominated population structurewhile male workers tend to gather in the outer zone attracted by heavy and petrochemicalindustry. It is possible to mention accordingly that the unbalanced spatial distribution of sexstructure of population which might cause changes in the norm to the family formation infuture is one of the consequences of economic globalization of Thailand, which the investmentpromotion policy of the government did not assume.

  7. Changes in residential, occupational and gender structure of the greater Bangkok in the globalization process

    Directory of Open Access Journals (Sweden)

    Satoshi Nakagawa

    2004-12-01

    Full Text Available This study investigated recent changes in migration and population structure of the Greater Bangkok considering the impact of economic globalization. The spatial policy of the Thai government has lead newer investments for manufacturing to locate away from Bangkok Metropolis and thereby the industrial structure of Bangkok Metropolis has gradually turned into service-dominated, while the region surrounding Bangkok Metropolis has attracted factories mainly owned by foreign capital. Light industry and electronics industry are con-centrated in the adjacent provinces to Bangkok Metropolis and the heavy and petrochemical industry tends to be located in the outer zone of the surrounding region. The service sector and light industry as well as electronics industry prefer female workers and Bangkok met-ropolis and the adjoining provinces have become female-dominated population structure while male workers tend to gather in the outer zone attracted by heavy and petrochemical industry. It is possible to mention accordingly that the unbalanced spatial distribution of sex structure of population which might cause changes in the norm to the family formation in future is one of the consequences of economic globalization of Thailand, which the inves-tment promotion policy of the government did not assume.

  8. Parameter extraction using global particle swarm optimization approach and the influence of polymer processing temperature on the solar cell parameters

    Science.gov (United States)

    Kumar, S.; Singh, A.; Dhar, A.

    2017-08-01

    The accurate estimation of the photovoltaic parameters is fundamental to gain an insight of the physical processes occurring inside a photovoltaic device and thereby to optimize its design, fabrication processes, and quality. A simulative approach of accurately determining the device parameters is crucial for cell array and module simulation when applied in practical on-field applications. In this work, we have developed a global particle swarm optimization (GPSO) approach to estimate the different solar cell parameters viz., ideality factor (η), short circuit current (Isc), open circuit voltage (Voc), shunt resistant (Rsh), and series resistance (Rs) with wide a search range of over ±100 % for each model parameter. After validating the accurateness and global search power of the proposed approach with synthetic and noisy data, we applied the technique to the extract the PV parameters of ZnO/PCDTBT based hybrid solar cells (HSCs) prepared under different annealing conditions. Further, we examine the variation of extracted model parameters to unveil the physical processes occurring when different annealing temperatures are employed during the device fabrication and establish the role of improved charge transport in polymer films from independent FET measurements. The evolution of surface morphology, optical absorption, and chemical compositional behaviour of PCDTBT co-polymer films as a function of processing temperature has also been captured in the study and correlated with the findings from the PV parameters extracted using GPSO approach.

  9. [Narrative Pedagogy in Nursing Education: The Essence of Clinical Nursing Process Recording].

    Science.gov (United States)

    Chao, Yu-Mei Y; Chiang, Hsien-Hsien

    2017-02-01

    Clinical nursing process recording (CNPR) has been shown to be an effective tool for facilitating student-centered teaching and learning in nursing education. Yet, the essence and process of this tool have yet to be sufficiently explored and clarified. To explore the essence of CNPR in the contexts of clinical teaching and learning. Reflective analysis was used as the phenomenological approach to analyze the qualitative data, which were transcribed from the oral responses of the six participants who were attending the Clinical Nursing Education Forum. A total of five sessions of the Clinical Nursing Education Forums were conducted. The content of the Clinical Nursing Education Forums consisted of a series of 12 narrative writings of CNPR that were written by a senior student and read and commented on by the student's clinical instructor. Three groups of the essence and process of clinical teaching and learning were inductively identified as: (a) mobilizing autonomous, self-directed learning behavior from self-writing and re-storying; (b) establishing the student-instructor dialogical relationship from mutual localization; and (c) co-creating a learning environment in education and in clinical practice. When used as an interactive teaching and learning tool, CNPR promotes mutual understanding by re-locating the self in the coexisting roles of student nurse, instructor, and patient in a series of nursing care situations. This re-location facilitates students' self-directed learning, enhances the abilities of asking question, waiting for and accompany with the instructor; and promotes the self-care capabilities of patients.

  10. Using global positioning systems in health research a practical approach to data collection and processing

    DEFF Research Database (Denmark)

    Kerr, Jacqueline; Duncan, Scott; Schipperijn, Jasper

    2011-01-01

    The use of GPS devices in health research is increasingly popular. There are currently no best-practice guidelines for collecting, processing, and analyzing GPS data. The standardization of data collection and processing procedures will improve data quality, allow more-meaningful comparisons acro...

  11. Informing Hospital Change Processes through Visualization and Simulation: A Case Study at a Children's Emergency Clinic.

    Science.gov (United States)

    Persson, Johanna; Dalholm, Elisabeth Hornyánszky; Johansson, Gerd

    2014-01-01

    To demonstrate the use of visualization and simulation tools in order to involve stakeholders and inform the process in hospital change processes, illustrated by an empirical study from a children's emergency clinic. Reorganization and redevelopment of a hospital is a complex activity that involves many stakeholders and demands. Visualization and simulation tools have proven useful for involving practitioners and eliciting relevant knowledge. More knowledge is desired about how these tools can be implemented in practice for hospital planning processes. A participatory planning process including practitioners and researchers was executed over a 3-year period to evaluate a combination of visualization and simulation tools to involve stakeholders in the planning process and to elicit knowledge about needs and requirements. The initial clinic proposal from the architect was discarded as a result of the empirical study. Much general knowledge about the needs of the organization was extracted by means of the adopted tools. Some of the tools proved to be more accessible than others for the practitioners participating in the study. The combination of tools added value to the process by presenting information in alternative ways and eliciting questions from different angles. Visualization and simulation tools inform a planning process (or other types of change processes) by providing the means to see beyond present demands and current work structures. Long-term involvement in combination with accessible tools is central for creating a participatory setting where the practitioners' knowledge guides the process. © 2014 Vendome Group, LLC.

  12. Classification of processes involved in sharing individual participant data from clinical trials.

    Science.gov (United States)

    Ohmann, Christian; Canham, Steve; Banzi, Rita; Kuchinke, Wolfgang; Battaglia, Serena

    2018-01-01

    Background: In recent years, a cultural change in the handling of data from research has resulted in the strong promotion of a culture of openness and increased sharing of data. In the area of clinical trials, sharing of individual participant data involves a complex set of processes and the interaction of many actors and actions. Individual services/tools to support data sharing are available, but what is missing is a detailed, structured and comprehensive list of processes/subprocesses involved and tools/services needed. Methods : Principles and recommendations from a published data sharing consensus document are analysed in detail by a small expert group. Processes/subprocesses involved in data sharing are identified and linked to actors and possible services/tools. Definitions are adapted from the business process model and notation (BPMN) and applied in the analysis. Results: A detailed and comprehensive list of individual processes/subprocesses involved in data sharing, structured according to 9 main processes, is provided. Possible tools/services to support these processes/subprocesses are identified and grouped according to major type of support. Conclusions: The list of individual processes/subprocesses and tools/services identified is a first step towards development of a generic framework or architecture for sharing of data from clinical trials. Such a framework is strongly needed to give an overview of how various actors, research processes and services could form an interoperable system for data sharing.

  13. An application of business process method to the clinical efficiency of hospital.

    Science.gov (United States)

    Leu, Jun-Der; Huang, Yu-Tsung

    2011-06-01

    The concept of Total Quality Management (TQM) has come to be applied in healthcare over the last few years. The process management category in the Baldrige Health Care Criteria for Performance Excellence model is designed to evaluate the quality of medical services. However, a systematic approach for implementation support is necessary to achieve excellence in the healthcare business process. The Architecture of Integrated Information Systems (ARIS) is a business process architecture developed by IDS Scheer AG and has been applied in a variety of industrial application. It starts with a business strategy to identify the core and support processes, and encompasses the whole life-cycle range, from business process design to information system deployment, which is compatible with the concept of healthcare performance excellence criteria. In this research, we apply the basic ARIS framework to optimize the clinical processes of an emergency department in a mid-size hospital with 300 clinical beds while considering the characteristics of the healthcare organization. Implementation of the case is described, and 16 months of clinical data are then collected, which are used to study the performance and feasibility of the method. The experience gleaned in this case study can be used a reference for mid-size hospitals with similar business models.

  14. Brand as a challenge to corporate governance in the globalization process

    Directory of Open Access Journals (Sweden)

    Milojević Sonja

    2016-01-01

    Full Text Available The increasing expansion of globalization, largely changes and the current economic strategy and policy of companies. The aim of this paper is to show to the alarming the need to accede to the seriousness of the implementation of adequate marketing strategies, among which is dominant brand strategy and thus the strategic brand management. The pace of technological innovation and information technologies contribute to the intensity of communication and have an impact on competitiveness. Networking overcomes time and space and leads almost to the equalization consumer demands set by companies, or to brand loyalty. Modern conditions of market economy, changing business conditions and intense competition, dictate the lower limit of efficiency of business entities to survive in the market. Creation and development of the brand is the company's long-term investment because brand loyalty of consumers means focusing on achieving their satisfaction, which directly leads to strengthening competitiveness and thus improve financial results.

  15. CLAMP - a toolkit for efficiently building customized clinical natural language processing pipelines.

    Science.gov (United States)

    Soysal, Ergin; Wang, Jingqi; Jiang, Min; Wu, Yonghui; Pakhomov, Serguei; Liu, Hongfang; Xu, Hua

    2017-11-24

    Existing general clinical natural language processing (NLP) systems such as MetaMap and Clinical Text Analysis and Knowledge Extraction System have been successfully applied to information extraction from clinical text. However, end users often have to customize existing systems for their individual tasks, which can require substantial NLP skills. Here we present CLAMP (Clinical Language Annotation, Modeling, and Processing), a newly developed clinical NLP toolkit that provides not only state-of-the-art NLP components, but also a user-friendly graphic user interface that can help users quickly build customized NLP pipelines for their individual applications. Our evaluation shows that the CLAMP default pipeline achieved good performance on named entity recognition and concept encoding. We also demonstrate the efficiency of the CLAMP graphic user interface in building customized, high-performance NLP pipelines with 2 use cases, extracting smoking status and lab test values. CLAMP is publicly available for research use, and we believe it is a unique asset for the clinical NLP community. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Global direct radiative forcing by process-parameterized aerosol optical properties

    Science.gov (United States)

    KirkevâG, Alf; Iversen, Trond

    2002-10-01

    A parameterization of aerosol optical parameters is developed and implemented in an extended version of the community climate model version 3.2 (CCM3) of the U.S. National Center for Atmospheric Research. Direct radiative forcing (DRF) by monthly averaged calculated concentrations of non-sea-salt sulfate and black carbon (BC) is estimated. Inputs are production-specific BC and sulfate from [2002] and background aerosol size distribution and composition. The scheme interpolates between tabulated values to obtain the aerosol single scattering albedo, asymmetry factor, extinction coefficient, and specific extinction coefficient. The tables are constructed by full calculations of optical properties for an array of aerosol input values, for which size-distributed aerosol properties are estimated from theory for condensation and Brownian coagulation, assumed distribution of cloud-droplet residuals from aqueous phase oxidation, and prescribed properties of the background aerosols. Humidity swelling is estimated from the Köhler equation, and Mie calculations finally yield spectrally resolved aerosol optical parameters for 13 solar bands. The scheme is shown to give excellent agreement with nonparameterized DRF calculations for a wide range of situations. Using IPCC emission scenarios for the years 2000 and 2100, calculations with an atmospheric global cliamte model (AFCM) yield a global net anthropogenic DRF of -0.11 and 0.11 W m-2, respectively, when 90% of BC from biomass burning is assumed anthropogenic. In the 2000 scenario, the individual DRF due to sulfate and BC has separately been estimated to -0.29 and 0.19 W m-2, respectively. Our estimates of DRF by BC per BC mass burden are lower than earlier published estimates. Some sensitivity tests are included to investigate to what extent uncertain assumptions may influence these results.

  17. Roles of transport and chemistry processes in global ozone change on interannual and multidecadal time scales

    Science.gov (United States)

    Sekiya, T.; Sudo, K.

    2014-04-01

    This study investigates ozone changes and the individual impacts of transport and chemistry on those changes. We specifically examine (1) variation related to El Niño Southern Oscillation, which is a dominant mode of interannual variation of tropospheric ozone, and (2) long-term change between the 2000s and 2100s. During El Niño, the simulated ozone shows an increase (1 ppbv/K) over Indonesia, a decrease (2-10 ppbv/K) over the eastern Pacific in the tropical troposphere, and an increase (50 ppbv/K) over the eastern Pacific in the midlatitude lower stratosphere. These variations fundamentally agree with those observed by Microwave Limb Sounder/Tropospheric Emission Spectrometer instruments. The model demonstrates that tropospheric chemistry has a strong impact on the variation over the eastern Pacific in the tropical lower troposphere and that transport dominates the variation in the midlatitude lower stratosphere. Between the 2000s and 2100s, the model predicts an increase in the global burden of stratospheric ozone (0.24%/decade) and a decrease in the global burden of tropospheric ozone (0.82%/decade). The increase in the stratospheric burden is controlled by stratospheric chemistry. Tropospheric chemistry reduces the tropospheric burden by 1.07%/decade. However, transport (i.e., stratosphere-troposphere exchange and tropospheric circulation) causes an increase in the burden (0.25%/decade). Additionally, we test the sensitivity of ozone changes to increased horizontal resolution of the representation of atmospheric circulation and advection apart from any aspects of the nonlinearity of chemistry sensitivity to horizontal resolution. No marked difference is found in medium-resolution or high-resolution simulations, suggesting that the increased horizontal resolution of transport has a minor impact.

  18. Disciplined Decision Making in an Interdisciplinary Environment: Some Implications for Clinical Applications of Statistical Process Control.

    Science.gov (United States)

    Hantula, Donald A.

    1995-01-01

    Clinical applications of statistical process control (SPC) in human service organizations are considered. SPC is seen as providing a standard set of criteria that serves as a common interface for data-based decision making, which may bring decision making under the control of established contingencies rather than the immediate contingencies of…

  19. Validating the extract, transform, load process used to populate a large clinical research database.

    Science.gov (United States)

    Denney, Michael J; Long, Dustin M; Armistead, Matthew G; Anderson, Jamie L; Conway, Baqiyyah N

    2016-10-01

    Informaticians at any institution that are developing clinical research support infrastructure are tasked with populating research databases with data extracted and transformed from their institution's operational databases, such as electronic health records (EHRs). These data must be properly extracted from these source systems, transformed into a standard data structure, and then loaded into the data warehouse while maintaining the integrity of these data. We validated the correctness of the extract, load, and transform (ETL) process of the extracted data of West Virginia Clinical and Translational Science Institute's Integrated Data Repository, a clinical data warehouse that includes data extracted from two EHR systems. Four hundred ninety-eight observations were randomly selected from the integrated data repository and compared with the two source EHR systems. Of the 498 observations, there were 479 concordant and 19 discordant observations. The discordant observations fell into three general categories: a) design decision differences between the IDR and source EHRs, b) timing differences, and c) user interface settings. After resolving apparent discordances, our integrated data repository was found to be 100% accurate relative to its source EHR systems. Any institution that uses a clinical data warehouse that is developed based on extraction processes from operational databases, such as EHRs, employs some form of an ETL process. As secondary use of EHR data begins to transform the research landscape, the importance of the basic validation of the extracted EHR data cannot be underestimated and should start with the validation of the extraction process itself. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Setting up a randomized clinical trial in the UK: approvals and process.

    Science.gov (United States)

    Greene, Louise Eleanor; Bearn, David R

    2013-06-01

    Randomized clinical trials are considered the 'gold standard' in primary research for healthcare interventions. However, they can be expensive and time-consuming to set up and require many approvals to be in place before they can begin. This paper outlines how to determine what approvals are required for a trial, the background of each approval and the process for obtaining them.

  1. Physiological differences and changes in global DNA methylation levels in Agave angustifolia Haw. albino variant somaclones during the micropropagation process.

    Science.gov (United States)

    Duarte-Aké, Fátima; Castillo-Castro, Eduardo; Pool, Felipe Barredo; Espadas, Francisco; Santamaría, Jorge M; Robert, Manuel L; De-la-Peña, Clelia

    2016-12-01

    Global DNA methylation changes caused by in vitro conditions are associated with the subculturing and phenotypic variation in Agave angustifolia Haw. While the relationship between the development of albinism and in vitro culture is well documented, the role of epigenetic processes in this development leaves some important questions unanswered. During the micropropagation of Agave angustifolia Haw., we found three different phenotypes, green (G), variegated (V) and albino (A). To understand the physiological and epigenetic differences among the somaclones, we analyzed several morphophysiological parameters and changes in the DNA methylation patterns in the three phenotypes during their in vitro development. We found that under in vitro conditions, the V plantlets maintained their CAM photosynthetic capacity, while the A variant showed no pigments and lost its CAM photosynthetic ability. Epigenetic analysis revealed that global DNA methylation increased in the G phenotype during the first two subcultures. However, after that time, DNA methylation levels declined. This hypomethylation correlated with the appearance of V shoots in the G plantlets. A similar correlation occurred in the V phenotype, where an increase of 2 % in the global DNA methylation levels was correlated with the generation of A shoots in the V plantlets. This suggests that an "epigenetic stress memory" during in vitro conditions causes a chromatin shift that favors the generation of variegated and albino shoots.

  2. Abnormal global processing along the dorsal visual pathway in autism: a possible mechanism for weak visuospatial coherence?

    Science.gov (United States)

    Pellicano, Elizabeth; Gibson, Lisa; Maybery, Murray; Durkin, Kevin; Badcock, David R

    2005-01-01

    Frith and Happe (Frith, U., & Happe, F. (1994). Autism: Beyond theory of mind. Cognition, 50, 115-132) argue that individuals with autism exhibit 'weak central coherence': an inability to integrate elements of information into coherent wholes. Some authors have speculated that a high-level impairment might be present in the dorsal visual pathway in autism, and furthermore, that this might account for weak central coherence, at least at the visuospatial level. We assessed the integrity of the dorsal visual pathway in children diagnosed with an autism spectrum disorder (ASD), and in typically developing children, using two visual tasks, one examining functioning at higher levels of the dorsal cortical stream (Global Dot Motion (GDM)), and the other assessing lower-level dorsal stream functioning (Flicker Contrast Sensitivity (FCS)). Central coherence was tested using the Children's Embedded Figures Test (CEFT). Relative to the typically developing children, the children with ASD had shorter CEFT latencies and higher GDM thresholds but equivalent FCS thresholds. Additionally, CEFT latencies were inversely related to GDM thresholds in the ASD group. These outcomes indicate that the elevated global motion thresholds in autism are the result of high-level impairments in dorsal cortical regions. Weak visuospatial coherence in autism may be in the form of abnormal cooperative mechanisms in extra-striate cortical areas, which might contribute to differential performance when processing stimuli as Gestalts, including both dynamic (i.e., global motion perception) and static (i.e., disembedding performance) stimuli.

  3. AN ANALYSIS OF THE ORGANIZATIONAL STRUCTURE AND THE PROCESS TO ADOPT GLOBAL SOURCING

    Directory of Open Access Journals (Sweden)

    Moema Pereira Nunes

    2016-03-01

    Full Text Available This study analyze the adoption of GS by Brazilian companies in terms of organizational structure and process of GS in order to identify what is differencing the experience of these companies and the previously knowledge related with GS. A case-based qualitative research was developed. Four Brazilian companies were investigated. Data were collect interviews and a content analysis was made. Regarding the organizational structure, it was identified that the firm’s industry sector influence in the adoption of GS. It confirms the assumption that the environment plays an important role in emerging countries. The need of innovation and the geographic concentration in an industry sector were identified as influences in the organizational structure to adopt GS. The need of scale in the purchasing process was perceived as an influence in the process of GS. The investigated companies presented a non-structure process of GS, what reduce the opportunity to learn with GS as part of the process may not be monitored.

  4. On Fast Post-Processing of Global Positioning System Simulator Truth Data and Receiver Measurements and Solutions Data

    Science.gov (United States)

    Kizhner, Semion; Day, John H. (Technical Monitor)

    2000-01-01

    Post-Processing of data related to a Global Positioning System (GPS) simulation is an important activity in qualification of a GPS receiver for space flight. Because a GPS simulator is a critical resource it is desirable to move off the pertinent simulation data from the simulator as soon as a test is completed. The simulator data files are usually moved to a Personal Computer (PC), where the post-processing of the receiver logged measurements and solutions data and simulated data is performed. Typically post-processing is accomplished using PC-based commercial software languages and tools. Because of commercial software systems generality their general-purpose functions are notoriously slow and more than often are the bottleneck problem even for short duration experiments. For example, it may take 8 hours to post-process data from a 6-hour simulation. There is a need to do post-processing faster, especially in order to use the previous test results as feedback for a next simulation setup. This paper demonstrates that a fast software linear interpolation algorithm is applicable to a large class of engineering problems, like GPS simulation data post-processing, where computational time is a critical resource and is one of the most important considerations. An approach is developed that allows to speed-up post-processing by an order of magnitude. It is based on improving the post-processing bottleneck interpolation algorithm using apriori information that is specific to the GPS simulation application. The presented post-processing scheme was used in support of a few successful space flight missions carrying GPS receivers. A future approach to solving the post-processing performance problem using Field Programmable Gate Array (FPGA) technology is described.

  5. Monitoring Crohn's disease during anti-TNF-α therapy: validation of the magnetic resonance enterography global score (MEGS) against a combined clinical reference standard

    International Nuclear Information System (INIS)

    Prezzi, Davide; Bhatnagar, Gauraang; Makanyanga, Jesica; Halligan, Steve; Taylor, Stuart Andrew; Vega, Roser

    2016-01-01

    To assess the ability of magnetic resonance enterography global score (MEGS) to characterise Crohn's disease (CD) response to anti-TNF-α therapy. Thirty-six CD patients (median age 26 years, 20 males) commencing anti-TNF-α therapy with concomitant baseline MRI enterography (MRE) were identified retrospectively. Patients' clinical course was followed and correlated with subsequent MREs. Scan order was randomised and MEGS (a global activity score) was applied by two blinded radiologists. A physician's global assessment of the disease activity (remission, mild, moderate or severe) at the time of MRE was assigned. The cohort was divided into clinical responders and non-responders and MEGS compared according to activity status and treatment response. Interobserver agreement was assessed. Median MEGS decreased significantly between baseline and first follow-up in responders (28 versus 6, P < 0.001) but was unchanged in non-responders (26 versus 18, P = 0.28). The median MEGS was significantly lower in clinical remission (9) than in moderate (14) or severe (29) activity (P < 0.001). MEGS correlated significantly with clinical activity (r = 0.53; P < 0.001). Interobserver Bland-Altman limits of agreement (BA LoA) were -19.7 to 18.5. MEGS decreases significantly in clinical responders to anti-TNF-α therapy but not in non-responders, demonstrates good interobserver agreement and moderate correlation with clinical disease activity. (orig.)

  6. Clinical, information and business process modeling to promote development of safe and flexible software.

    Science.gov (United States)

    Liaw, Siaw-Teng; Deveny, Elizabeth; Morrison, Iain; Lewis, Bryn

    2006-09-01

    Using a factorial vignette survey and modeling methodology, we developed clinical and information models - incorporating evidence base, key concepts, relevant terms, decision-making and workflow needed to practice safely and effectively - to guide the development of an integrated rule-based knowledge module to support prescribing decisions in asthma. We identified workflows, decision-making factors, factor use, and clinician information requirements. The Unified Modeling Language (UML) and public domain software and knowledge engineering tools (e.g. Protégé) were used, with the Australian GP Data Model as the starting point for expressing information needs. A Web Services service-oriented architecture approach was adopted within which to express functional needs, and clinical processes and workflows were expressed in the Business Process Execution Language (BPEL). This formal analysis and modeling methodology to define and capture the process and logic of prescribing best practice in a reference implementation is fundamental to tackling deficiencies in prescribing decision support software.

  7. New methods for clinical pathways-Business Process Modeling Notation (BPMN) and Tangible Business Process Modeling (t.BPM).

    Science.gov (United States)

    Scheuerlein, Hubert; Rauchfuss, Falk; Dittmar, Yves; Molle, Rüdiger; Lehmann, Torsten; Pienkos, Nicole; Settmacher, Utz

    2012-06-01

    Clinical pathways (CP) are nowadays used in numerous institutions, but their real impact is still a matter of debate. The optimal design of a clinical pathway remains unclear and is mainly determined by the expectations of the individual institution. The purpose of the here described pilot project was the development of two CP (colon and rectum carcinoma) according to Business Process Modeling Notation (BPMN) and Tangible Business Process Modeling (t.BPM). BPMN is an established standard for business process modelling in industry and economy. It is, in the broadest sense, a computer programme which enables the description and a relatively easy graphical imaging of complex processes. t.BPM is a modular construction system of the BPMN symbols which enables the creation of an outline or raw model, e.g. by placing the symbols on a spread-out paper sheet. The thus created outline can then be transferred to the computer and further modified as required. CP for the treatment of colon and rectal cancer have been developed with support of an external IT coach. The pathway was developed in an interdisciplinary and interprofessional manner (55 man-days over 15 working days). During this time, necessary interviews with medical, nursing and administrative staffs were conducted as well. Both pathways were developed parallel. Subsequent analysis was focussed on feasibility, expenditure, clarity and suitability for daily clinical practice. The familiarization with BPMN was relatively quick and intuitive. The use of t.BPM enabled the pragmatic, effective and results-directed creation of outlines for the CP. The development of both CP was finished from the diagnostic evaluation to the adjuvant/neoadjuvant therapy and rehabilitation phase. The integration of checklists, guidelines and important medical or other documents is easily accomplished. A direct integration into the hospital computer system is currently not possible for technical reasons. BPMN and t.BPM are sufficiently

  8. Sensitivity of sequestration efficiency to mixing processes in the global ocean

    International Nuclear Information System (INIS)

    Mignone, B.K.

    2004-01-01

    A number of large-scale sequestration strategies have been considered to help mitigate rising levels of atmospheric carbon dioxide (CO 2 ). Here, we use an ocean general circulation model (OGCM) to evaluate the efficiency of one such strategy currently receiving much attention, the direct injection of liquid CO 2 into selected regions of the abyssal ocean. We find that currents typically transport the injected plumes quite far before they are able to return to the surface and release CO 2 through air-sea gas exchange. When injected at sufficient depth (well within or below the main thermocline), most of the injected CO 2 outgasses in high latitudes (mainly in the Southern Ocean) where vertical exchange is most favored. Virtually all OGCMs that have performed similar simulations confirm these global patterns, but regional differences are significant, leading efficiency estimates to vary widely among models even when identical protocols are followed. In this paper, we make a first attempt at reconciling some of these differences by performing a sensitivity analysis in one OGCM, the Princeton Modular Ocean Model. Using techniques we have developed to maintain both the modeled density structure and the absolute magnitude of the overturning circulation while varying important mixing parameters, we estimate the sensitivity of sequestration efficiency to the magnitude of vertical exchange within the low-latitude pycnocline. Combining these model results with available tracer data permits us to narrow the range of model behavior, which in turn places important constraints on sequestration efficiency. (author)

  9. Cross-species global proteomics reveals conserved and unique processes in Phytophthora sojae and P. ramorum

    Energy Technology Data Exchange (ETDEWEB)

    Savidor, Alon [ORNL; Donahoo, Ryan S [ORNL; Hurtado-Gonzales, Oscar [University of Tennessee, Knoxville (UTK); Land, Miriam L [ORNL; Shah, Manesh B [ORNL; Lamour, Kurt H [ORNL; McDonald, W Hayes [ORNL

    2008-08-01

    Phytophthora ramorum and Phytophthora sojae are destructive plant pathogens. Phytophthora sojae has a narrow host range whereas P. ramorum has a wide host range. A global proteomic comparison of the vegetative (mycelium) and infective (germinating-cyst) life-stages of P. sojae and P. ramorum was conducted to identify candidate proteins involved in host range, early infection and vegetative growth. Sixty-two candidates for early infection, 26 candidates for vegetative growth, and numerous proteins that may be involved in defining host specificity were identified. In addition, common life stage proteomic trends between the organisms were observed. In mycelia, proteins involved in transport and metabolism of amino acids, carbohydrates and other small molecules were up-regulated. In the germinating cysts, up-regulated proteins associated with lipid transport and metabolism, cytoskeleton and protein synthesis were observed. It appears that the germinating cyst catabolizes lipid reserves through the -oxidation pathway to drive the extensive protein synthesis necessary to produce the germ tube and initiate infection. Once inside the host, the pathogen switches to vegetative growth, where energy is derived from glycolysis and utilized for synthesis of amino acids and other molecules that assist survival in the plant tissue.

  10. Analysis of International Monetary Fund under conditions of globalization of economic processes

    Directory of Open Access Journals (Sweden)

    V.V. Ksendzuk

    2016-06-01

    Full Text Available Globalization in the economy requires proper management of countries' financial resources as the regulation of international financial market is one of the most important tasks of the successful development of the world economy and individual national economies. The International Monetary Fund since the beginning of its creation was intended to regulate the financial situation in the post-war period in world space. In present conditions of information development of the world economic system the role and importance of international financial institutions are changing. Thus, the policies and activities of the IMF are increasingly criticized, that is substantiated and requires some restructuring and reforming areas of the Fund activity. During the research the basic aspects of IMF activities in 2015 have been analyzed and the suggestions for its further effective development have been presented. In particular, it is advisable to use the specific individual approach to the problems of particular economies and to view the sizes of quotas and their functional purposes that will allow to develop new funding mechanisms that are based on social and ecological needs of society. This, in turn, will reduce the impact of developed countries on the activities of the financial institution

  11. Drug pricing and reimbursement information management: processes and decision making in the global economy.

    Science.gov (United States)

    Tsourougiannis, Dimitrios

    2017-01-01

    Background : Cost-containment initiatives are re-shaping the pharmaceutical business environment and affecting market access as well as pricing and reimbursement decisions. Effective price management procedures are too complex to accomplish manually. Prior to February 2013, price management within Astellas Pharma Europe Ltd was done manually using an Excel database. The system was labour intensive, slow to update, and prone to error. An innovative web-based pricing information management system was developed to address the shortcomings of the previous system. Development : A secure web-based system for submitting, reviewing and approving pricing requests was designed to: track all pricing applications and approval status; update approved pricing information automatically; provide fixed and customizable reports of pricing information; collect pricing and reimbursement rules from each country; validate pricing and reimbursement rules monthly. Several sequential phases of development emphasized planning, time schedules, target dates, budgets and implementation of the entire system. A test system was used to pilot the electronic (e)-pricing system with three affiliates (four users) in February 2013. Outcomes : The web-based system was introduced in March 2013, currently has about 227 active users globally and comprises more than 1000 presentations of 150 products. The overall benefits of switching from a manual to an e-pricing system were immediate and highly visible in terms of efficiency, transparency, reliability and compliance. Conclusions : The e-pricing system has improved the efficiency, reliability, compliance, transparency and ease of access to multinational drug pricing and approval information.

  12. Fusion process of Lennard-Jones clusters: global minima and magic numbers formation

    DEFF Research Database (Denmark)

    Solov'yov, Ilia; Solov'yov, Andrey V.; Greiner, Walter

    2004-01-01

    We present a new theoretical framework for modeling the fusion process of Lennard–Jones (LJ) clusters. Starting from the initial tetrahedral cluster configuration, adding new atoms to the system and absorbing its energy at each step, we find cluster growing paths up to the cluster size of 150 atoms...

  13. Proceedings of INC 02. International Nuclear Conference 2002: Global Trends and Perspectives, Seminar V: Radiation Processing

    International Nuclear Information System (INIS)

    2002-01-01

    The papers discuss the folowing areas: radiation processing using low, medium and high energy electron beam, gamma and ultraviolet radiation; polymers blend; electron beam uses in wire, cables and polymers industry; studies of mechanical and tensile properties of elastomers / polymers blend

  14. Global optimization for integrated design and control of computationally expensive process models

    NARCIS (Netherlands)

    Egea, J.A.; Vries, D.; Alonso, A.A.; Banga, J.R.

    2007-01-01

    The problem of integrated design and control optimization of process plants is discussed in this paper. We consider it as a nonlinear programming problem subject to differential-algebraic constraints. This class of problems is frequently multimodal and "costly" (i.e., computationally expensive to

  15. Mergers and acquisitions in the global food processing industry in 1986–2006

    NARCIS (Netherlands)

    Muehlfeld, K.; Weitzel, G.U.; Witteloostuijn, A. van

    2011-01-01

    Food systems around the world experienced increased merger and acquisition (M&A) activity over the past decades. Based on a sample of 13,911M&A attempts worldwide during 1986–2006, this study provides an analysis of major determinants of M&A completion in the food processing industry. Friendly

  16. A clinical data warehouse-based process for refining medication orders alerts.

    Science.gov (United States)

    Boussadi, Abdelali; Caruba, Thibaut; Zapletal, Eric; Sabatier, Brigitte; Durieux, Pierre; Degoulet, Patrice

    2012-01-01

    The objective of this case report is to evaluate the use of a clinical data warehouse coupled with a clinical information system to test and refine alerts for medication orders control before they were fully implemented. A clinical decision rule refinement process was used to assess alerts. The criteria assessed were the frequencies of alerts for initial prescriptions of 10 medications whose dosage levels depend on renal function thresholds. In the first iteration of the process, the frequency of the 'exceeds maximum daily dose' alerts was 7.10% (617/8692), while that of the 'under dose' alerts was 3.14% (273/8692). Indicators were presented to the experts. During the different iterations of the process, 45 (16.07%) decision rules were removed, 105 (37.5%) were changed and 136 new rules were introduced. Extensive retrospective analysis of physicians' medication orders stored in a clinical data warehouse facilitates alert optimization toward the goal of maximizing the safety of the patient and minimizing overridden alerts.

  17. Investigation of the causes of clinical symptom aggravation in process of intravenous thrombolysis with alteplase

    Directory of Open Access Journals (Sweden)

    LI Chen-hua

    2013-04-01

    Full Text Available Objective To explore the causes of aggravation of microcirculation disorders in the process of intravenous thrombolysis with alteplase and the clinical outcomes. Methods The clinical data of the aggravated signs and symptoms of 13 cases treated by alteplase were reported, and the onset characteristics and clinical outcomes were analysed to summarize emergency experiences. Results There were 13 patients with stenosis of intracranial large arteries occurred perforating branch infarctions caused by the blocking of carried arteries (8 cases in internal carotid system, 5 cases in vertebral-basilar system. In the process of thrombolytic therapy, main aggravated presentations including cortical ischemic symptom, quadriplegia, exacerbated disturbance of consciousness were seen. Imaging examinations showed multiple new petechial ischemic foci in cortex and watershed region or increasing of infarct foci in cerebellum and brain stem. The prognosis was favorable after expectant treatment. NIHSS score was 8.69 ± 3.42 at 24 h after treatment, and mRS score was 0.94 ±0.37 at 3 month-follow-up. Neurologic deficit and quality of life were evidently improved. Conclusion In the course of intravenous thrombolytic therapy with alteplase. Aggravated clinical signs and symptoms may be related to various factors. Emboli disintegration inducing microcirculation disorder is inferred to be the main cause. For patients presenting aggravated signs and symptoms in thrombolysis process, favorable outcomes may occur as long as intensive care and timely treatment are performed.

  18. Attending to global versus local stimulus features modulates neural processing of low versus high spatial frequencies: An analysis with event-related brain potentials.

    Directory of Open Access Journals (Sweden)

    Anastasia V Flevaris

    2014-04-01

    Full Text Available Spatial frequency (SF selection has long been recognized to play a role in global and local processing, though the nature of the relationship between SF processing and global/local perception is debated. Previous studies have shown that attention to relatively lower SFs facilitates global perception, and that attention to relatively higher SFs facilitates local perception. Here we recorded event-related brain potentials (ERPs to investigate whether processing of low versus high SFs is modulated automatically during global and local perception, and to examine the time course of any such effects. Participants compared bilaterally presented hierarchical letter stimuli and attended to either the global or local levels. Irrelevant SF grating probes flashed at the center of the display 200 ms after the onset of the hierarchical letter stimuli could either be low or high in SF. It was found that ERPs elicited by the SF grating probes differed as a function of attended level (global vs. local. ERPs elicited by low SF grating probes were more positive in the interval 196-236 ms during global than local attention, and this difference was greater over the right occipital scalp. In contrast, ERPs elicited by the high SF gratings were more positive in the interval 250-290 ms during local than global attention, and this difference was bilaterally distributed over the occipital scalp. These results indicate that directing attention to global versus local levels of a hierarchical display facilitates automatic perceptual processing of low versus high SFs, respectively, and this facilitation is not limited to the locations occupied by the hierarchical display. The relatively long latency of these attention-related ERP modulations suggests that initial (early SF processing is not affected by attention to hierarchical level, lending support to theories positing a higher level mechanism to underlie the relationship between SF processing and global versus local

  19. Sensitivity of sequestration efficiency to mixing processes in the global ocean

    Energy Technology Data Exchange (ETDEWEB)

    B.K. Mignone; J.L. Sarmiento; R.D. Slater; A. Gnanadesikan [Princeton University, Princeton, NJ (United States). Department of Geosciences

    2003-07-01

    A number of large-scale sequestration strategies have been considered to help mitigate rising levels of atmospheric carbon dioxide (CO{sub 2}). Here an ocean general circulation model (OGCM) is used to evaluate the efficiency of one such strategy currently receiving much attention, the direct injection of liquid CO{sub 2} into selected regions of the abyssal ocean. It was found that currents typically transport the injected plumes quite far before they are able to return to the surface and release CO{sub 2} through air-sea gas exchange. When injected at sufficient depth (well within or below the main thermocline), most of the injected CO{sub 2} outgases in high latitudes (mainly in the Southern Ocean) where vertical exchange is most favored. Virtually all OGCMs that have performed similar simulations confirm these global patterns, but regional differences are significant, leading efficiency estimates to vary widely among models even when identical protocols are followed. In this paper, a first attempt is made at reconciling some of these differences by performing a sensitivity analysis in one OGCM, the Princeton Modular Ocean Model. Using techniques developed to maintain both the modeled density structure and the absolute magnitude of the overturning circulation while varying important mixing parameters, the sensitivity of sequestration efficiency to the magnitude of vertical exchange within the low-latitude pycnoclineis is estimated. Combining these model results with available tracer data allows a narrowing of the range of allowable mixing in the model, which in turn places important constraints on sequestration efficiency. 35 refs., 1 fig.

  20. Sensitivity of sequestration efficiency to mixing processes in the global ocean

    Energy Technology Data Exchange (ETDEWEB)

    Mignone, B.K. [Princeton Univ., NJ (United States). Dept. of Geosciences; Sarmiento, J.L.; Slater, R.D. [Princeton Univ., NJ (United States). Program in Atmospheric and Oceanic Sciences; Gnanadesikan, A. [Princeton Univ., NJ (United States). Program in Atmospheric and Oceanic Sciences; Geophysical Fluid Dynamics Lab., NOAA, Princeton, NJ (United States)

    2004-08-01

    A number of large-scale sequestration strategies have been considered to help mitigate rising levels of atmospheric carbon dioxide (CO{sub 2}). Here, we use an ocean general circulation model (OGCM) to evaluate the efficiency of one such strategy currently receiving much attention, the direct injection of liquid CO{sub 2} into selected regions of the abyssal ocean. We find that currents typically transport the injected plumes quite far before they are able to return to the surface and release CO{sub 2} through air-sea gas exchange. When injected at sufficient depth (well within or below the main thermocline), most of the injected CO{sub 2} outgasses in high latitudes (mainly in the Southern Ocean) where vertical exchange is most favored. Virtually all OGCMs that have performed similar simulations confirm these global patterns, but regional differences are significant, leading efficiency estimates to vary widely among models even when identical protocols are followed. In this paper, we make a first attempt at reconciling some of these differences by performing a sensitivity analysis in one OGCM, the Princeton Modular Ocean Model. Using techniques we have developed to maintain both the modeled density structure and the absolute magnitude of the overturning circulation while varying important mixing parameters, we estimate the sensitivity of sequestration efficiency to the magnitude of vertical exchange within the low-latitude pycnocline. Combining these model results with available tracer data permits us to narrow the range of model behavior, which in turn places important constraints on sequestration efficiency. (author)

  1. Crustal Structure of Active Deformation Zones in Africa: Implications for Global Crustal Processes

    Science.gov (United States)

    Ebinger, C. J.; Keir, D.; Bastow, I. D.; Whaler, K.; Hammond, J. O. S.; Ayele, A.; Miller, M. S.; Tiberi, C.; Hautot, S.

    2017-12-01

    The Cenozoic East African rift (EAR), Cameroon Volcanic Line (CVL), and Atlas Mountains formed on the slow-moving African continent, which last experienced orogeny during the Pan-African. We synthesize primarily geophysical data to evaluate the role of magmatism in shaping Africa's crust. In young magmatic rift zones, melt and volatiles migrate from the asthenosphere to gas-rich magma reservoirs at the Moho, altering crustal composition and reducing strength. Within the southernmost Eastern rift, the crust comprises 20% new magmatic material ponded in the lower crust and intruded as sills and dikes at shallower depths. In the Main Ethiopian Rift, intrusions comprise 30% of the crust below axial zones of dike-dominated extension. In the incipient rupture zones of the Afar rift, magma intrusions fed from crustal magma chambers beneath segment centers create new columns of mafic crust, as along slow-spreading ridges. Our comparisons suggest that transitional crust, including seaward dipping sequences, is created as progressively smaller screens of continental crust are heated and weakened by magma intrusion into 15-20 km thick crust. In the 30 Ma Recent CVL, which lacks a hot spot age progression, extensional forces are small, inhibiting the creation and rise of magma into the crust. In the Atlas orogen, localized magmatism follows the strike of the Atlas Mountains from the Canary Islands hot spot toward the Alboran Sea. CVL and Atlas magmatism has had minimal impact on crustal structure. Our syntheses show that magma and volatiles are migrating from the asthenosphere through the plates, modifying rheology, and contributing significantly to global carbon and water fluxes.

  2. Evaluating the Credibility of Transport Processes in Simulations of Ozone Recovery using the Global Modeling Initiative Three-dimensional Model

    Science.gov (United States)

    Strahan, Susan E.; Douglass, Anne R.

    2004-01-01

    The Global Modeling Initiative (GMI) has integrated two 36-year simulations of an ozone recovery scenario with an offline chemistry and tra nsport model using two different meteorological inputs. Physically ba sed diagnostics, derived from satellite and aircraft data sets, are d escribed and then used to evaluate the realism of temperature and transport processes in the simulations. Processes evaluated include barri er formation in the subtropics and polar regions, and extratropical w ave-driven transport. Some diagnostics are especially relevant to sim ulation of lower stratospheric ozone, but most are applicable to any stratospheric simulation. The global temperature evaluation, which is relevant to gas phase chemical reactions, showed that both sets of me teorological fields have near climatological values at all latitudes and seasons at 30 hPa and below. Both simulations showed weakness in upper stratospheric wave driving. The simulation using input from a g eneral circulation model (GMI(GCM)) showed a very good residual circulation in the tropics and Northern Hemisphere. The simulation with inp ut from a data assimilation system (GMI(DAS)) performed better in the midlatitudes than it did at high latitudes. Neither simulation forms a realistic barrier at the vortex edge, leading to uncertainty in the fate of ozone-depleted vortex air. Overall, tracer transport in the offline GML(GCM) has greater fidelity throughout the stratosphere tha n it does in the GMI(DAS)

  3. Constant-scale natural boundary mapping to reveal global and cosmic processes

    CERN Document Server

    Clark, Pamela Elizabeth

    2013-01-01

    Whereas conventional maps can be expressed as outward-expanding formulae with well-defined central features and relatively poorly defined edges, Constant Scale Natural Boundary (CSNB) maps have well-defined boundaries that result from natural processes and thus allow spatial and dynamic relationships to be observed in a new way useful to understanding these processes. CSNB mapping presents a new approach to visualization that produces maps markedly different from those produced by conventional cartographic methods. In this approach, any body can be represented by a 3D coordinate system. For a regular body, with its surface relatively smooth on the scale of its size, locations of features can be represented by definite geographic grid (latitude and longitude) and elevation, or deviation from the triaxial ellipsoid defined surface. A continuous surface on this body can be segmented, its distinctive regional terranes enclosed, and their inter-relationships defined, by using selected morphologically identifiable ...

  4. Peer production on the Internet as an example of global disintegration of production process

    OpenAIRE

    Slawomir Czetwertynski

    2012-01-01

    The article is an attempt to explain the reason for participation in peer production in the context of decentralization of production process. There are two maintheses. The first is that the motivations of participants in production are the same as motivation for gainful employment. Although in the case of the partnership production model bypasses the medium of money, because the participants do not receive payment for manufactured products. The second argument indicates the need for the disi...

  5. LACAN Code for global simulation of SILVA laser isotope separation process

    International Nuclear Information System (INIS)

    Quaegebeur, J.P.; Goldstein, S.

    1991-01-01

    Functions used for the definition of a SILVA separator require quite a lot of dimensional and operating parameters. Sizing a laser isotope separation plant needs the determination of these parameters for optimization. In the LACAN simulation code, each elementary physical process is described by simplified models. An example is given for a uranium isotope separation plant whose separation power is optimized with 6 parameters [fr

  6. Forest Soil Bacteria: Diversity, Involvement in Ecosystem Processes, and Response to Global Change

    Czech Academy of Sciences Publication Activity Database

    Lladó, Salvador; López-Mondéjar, Rubén; Baldrian, Petr

    2017-01-01

    Roč. 81, č. 2 (2017), s. 1-27, č. článku e00063. ISSN 1092-2172 R&D Projects: GA ČR(CZ) GP14-09040P; GA MŠk(CZ) LD15086 Institutional support: RVO:61388971 Keywords : bacteria * decomposition * ecosystem processes Subject RIV: EE - Microbiology, Virology OBOR OECD: Microbiology Impact factor: 14.533, year: 2016

  7. A simulation framework for mapping risks in clinical processes: the case of in-patient transfers

    Science.gov (United States)

    Ong, Mei-Sing; Westbrook, Johanna I; Magrabi, Farah; Coiera, Enrico; Wobcke, Wayne

    2011-01-01

    Objective To model how individual violations in routine clinical processes cumulatively contribute to the risk of adverse events in hospital using an agent-based simulation framework. Design An agent-based simulation was designed to model the cascade of common violations that contribute to the risk of adverse events in routine clinical processes. Clinicians and the information systems that support them were represented as a group of interacting agents using data from direct observations. The model was calibrated using data from 101 patient transfers observed in a hospital and results were validated for one of two scenarios (a misidentification scenario and an infection control scenario). Repeated simulations using the calibrated model were undertaken to create a distribution of possible process outcomes. The likelihood of end-of-chain risk is the main outcome measure, reported for each of the two scenarios. Results The simulations demonstrate end-of-chain risks of 8% and 24% for the misidentification and infection control scenarios, respectively. Over 95% of the simulations in both scenarios are unique, indicating that the in-patient transfer process diverges from prescribed work practices in a variety of ways. Conclusions The simulation allowed us to model the risk of adverse events in a clinical process, by generating the variety of possible work subject to violations, a novel prospective risk analysis method. The in-patient transfer process has a high proportion of unique trajectories, implying that risk mitigation may benefit from focusing on reducing complexity rather than augmenting the process with further rule-based protocols. PMID:21486883

  8. Delivering Value In A Global Aerospace Manufacturer Through The Effective Use Of Numerical Process Simulation

    Science.gov (United States)

    Ward, M. J.; Walløe, S. J.

    2004-06-01

    Numerical models are used extensively in the aerospace sector to identify appropriate manufacturing parameters, and to minimize the risk associated with new product introduction and manufacturing change. This usage is equally prevalent in original equipment manufacturers (OEMs), and in their supply chains. The wide range of manufacturing processes and production environments involved, coupled with the varying degrees of technology maturity associated with numerical models of different processes leads to a situation of significant complexity from the OEM perspective. In addition, the intended use of simulation technology can vary considerably between applications, from simple geometric assessment of die shape at one extreme, to full process design or development at the other. Consequently there is an increasing trend towards multi-scale modelling, i.e. the use of several different model types, with differing attributes in terms of accuracy and speed to support a range of different new product introduction decisions. This makes the allocation of appropriate levels of activity to the research and implementation of new capabilities a difficult problem. This paper uses a number of industrial cases studies to illustrate a framework for making such allocation decisions such that value to the OEM is maximized, and investigates how such a framework is likely to shift over the next few years based on technological developments.

  9. Using global positioning systems in health research: a practical approach to data collection and processing.

    Science.gov (United States)

    Kerr, Jacqueline; Duncan, Scott; Schipperijn, Jasper; Schipperjin, Jasper

    2011-11-01

    The use of GPS devices in health research is increasingly popular. There are currently no best-practice guidelines for collecting, processing, and analyzing GPS data. The standardization of data collection and processing procedures will improve data quality, allow more-meaningful comparisons across studies and populations, and advance this field more rapidly. This paper aims to take researchers, who are considering using GPS devices in their research, through device-selection criteria, device settings, participant data collection, data cleaning, data processing, and integration of data into GIS. Recommendations are outlined for each stage of data collection and analysis and indicates challenges that should be considered. This paper highlights the benefits of collecting GPS data over traditional self-report or estimated exposure measures. Information presented here will allow researchers to make an informed decision about incorporating this readily available technology into their studies. This work reflects the state of the art in 2011. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Global ergonomics strategy in Volkswagen: from the product construction, over the planning until the serial process.

    Science.gov (United States)

    Toledo, Begoña

    2012-01-01

    The Volkswagen Group operates and coordinates the activities of ergonomics from Wolfsburg in Germany and works with its contact persons of every plant and brand of the group towards an integrated proceeding relating to ergonomics. For the ergonomic process it is very important to consider the ergonomics in the whole production process, still from the beginning the conception and construction of the vehicle in the early phases. In these phases there is a big potential to work in the preventive ergonomics and avoid correcting the workstations after start of production. Therefore, it is important to have fluently information in all this phases and identify the potential in each of them. In order to attend these items, Volkswagen has defined different activity fields: coordination of ergonomic standards and the roll-out into all the plants, introducing the ergonomic items in the product development process (PEP), considering the constant improvement of the workplaces in the Volkswagen-Way (KVP and 3P Workshops), taking care of an adequate qualification concept in ergonomics and the intern and extern information exchange within the committees. This topic is established in the industrial engineering of the production area of the group. We are working interdisciplinary with the medical services, human resources, work council and the protection of labor.

  11. People-, Process- and Goal-Focused Leadership Behaviour: An Empirical Study in a Global Company

    Directory of Open Access Journals (Sweden)

    Thanh Ha-Vikstrom

    2017-03-01

    Full Text Available This study explores the focus of leadership behaviours that perceived and experienced by leaders in a multinational company. By using triangulation method including questionnaires, in-depth interviews and observations, we analyse the data collected from twenty managers across organisational levels. The results reveal the patterns of managerial behaviour in three key focus areas for success: people, process and goal. Directors and general managers are more people-focused than line managers, who in turn tend to be more process-focused. The research findings bridge the gap in the field and initiate a new normative leadership behaviour model (people-, process and goal-focused, which can be used to directly support leaders in enhancing their leadership skills as well as for recruitment or promotion purposes. The model can be utilized as an aid to organisations when developing training programs to support leaders in different types of organisations (for-profit or non-profit to focus their development efforts on organizational success.

  12. Clinical intuition in the nursing process and decision-making-A mixed-studies review.

    Science.gov (United States)

    Melin-Johansson, Christina; Palmqvist, Rebecca; Rönnberg, Linda

    2017-12-01

    To review what is characteristic of registered nurses' intuition in clinical settings, in relationships and in the nursing process. Intuition is a controversial concept and nurses believe that there are difficulties in how they should explain their nursing actions or decisions based on intuition. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. More information on how nurses integrate intuition as a core element in daily clinical work would contribute to an improved understanding on how they go about this. Intuition deserves a place in evidence-based activities, where intuition is an important component associated with the nursing process. An integrative review strengthened with a mixed-studies review. Literature searches were conducted in the databases CINAHL, PubMed and PsycINFO, and literature published 1985-2016 were included. The findings in the studies were analysed with content analysis, and the synthesis process entailed a reasoning between the authors. After a quality assessment, 16 studies were included. The analysis and synthesis resulted in three categories. The characteristics of intuition in the nurse's daily clinical activities include application, assertiveness and experiences; in the relationships with patients' intuition include unique connections, mental and bodily responses, and personal qualities; and in the nursing process include support and guidance, component and clues in decision-making, and validating decisions. Intuition is more than simply a "gut feeling," and it is a process based on knowledge and care experience and has a place beside research-based evidence. Nurses integrate both analysis and synthesis of intuition alongside objective data when making decisions. They should rely on their intuition and use this knowledge in clinical practice as a support in decision-making, which increases the quality and safety of patient care. We find that intuition plays a

  13. Bernard Lerer: recipient of the 2014 inaugural Werner Kalow Responsible Innovation Prize in Global Omics and Personalized Medicine (Pacific Rim Association for Clinical Pharmacogenetics).

    Science.gov (United States)

    Ozdemir, Vural; Endrenyi, Laszlo; Aynacıoğlu, Sükrü; Bragazzi, Nicola Luigi; Dandara, Collet; Dove, Edward S; Ferguson, Lynnette R; Geraci, Christy Jo; Hafen, Ernst; Kesim, Belgin Eroğlu; Kolker, Eugene; Lee, Edmund J D; Llerena, Adrian; Nacak, Muradiye; Shimoda, Kazutaka; Someya, Toshiyuki; Srivastava, Sanjeeva; Tomlinson, Brian; Vayena, Effy; Warnich, Louise; Yaşar, Umit

    2014-04-01

    This article announces the recipient of the 2014 inaugural Werner Kalow Responsible Innovation Prize in Global Omics and Personalized Medicine by the Pacific Rim Association for Clinical Pharmacogenetics (PRACP): Bernard Lerer, professor of psychiatry and director of the Biological Psychiatry Laboratory, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. The Werner Kalow Responsible Innovation Prize is given to an exceptional interdisciplinary scholar who has made highly innovative and enduring contributions to global omics science and personalized medicine, with both vertical and horizontal (transdisciplinary) impacts. The prize is established in memory of a beloved colleague, mentor, and friend, the late Professor Werner Kalow, who cultivated the idea and practice of pharmacogenetics in modern therapeutics commencing in the 1950s. PRACP, the prize's sponsor, is one of the longest standing learned societies in the Asia-Pacific region, and was founded by Kalow and colleagues more than two decades ago in the then-emerging field of pharmacogenetics. In announcing this inaugural prize and its winner, we seek to highlight the works of prize winner, Professor Lerer. Additionally, we contextualize the significance of the prize by recalling the life and works of Professor Kalow and providing a brief socio-technical history of the rise of pharmacogenetics and personalized medicine as a veritable form of 21(st) century scientific practice. The article also fills a void in previous social science analyses of pharmacogenetics, by bringing to the fore the works of Kalow from 1995 to 2008, when he presciently noted the rise of yet another field of postgenomics inquiry--pharmacoepigenetics--that railed against genetic determinism and underscored the temporal and spatial plasticity of genetic components of drug response, with invention of the repeated drug administration (RDA) method that estimates the dynamic heritabilities of drug response. The prize goes a long way

  14. The world as the new local clinic: a critical analysis of three discourses of global medical competency.

    Science.gov (United States)

    Martimianakis, Maria Athina Tina; Hafferty, Frederic W

    2013-06-01

    The effects of globalization on health are the focus of administrators, educators, policy makers and researchers as they work to consider how best to train and regulate health professionals to practice in a globalized world. This study explores what happens to constructs such as medical competence when the context of medical practice is discursively expanded to include the whole world. An archive of texts was assembled (1970-2011) totaling 1100 items and analyzed using a governmentality approach. Texts were included that articulated rationales for pursuing global education activities, and/or that implicitly or explicitly took a position on medical competencies in relation to practicing medicine in international or culturally diverse contexts, or in dealing with health issues as global concerns. The analysis revealed three distinct visions, representative of a primarily western mentality, for preparing physicians to practice in a globalized world: the universal global physician, the culturally versed global physician and the global physician advocate. Each has its own epistemological relationship to globalization and is supported by an evidence base. All three discourses are active and productive, sometimes within the same context. However, the discourse of the universal global physician is currently the most established. The challenge to policy makers and educators in evolving regulatory frameworks and curricula that are current and relevant necessitates a better understanding of the socio-political effects of globalization on medical education, and the ethical, political, cultural and scientific issues underlying efforts to prepare students to practice competently in a globalized world. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Restructuring of privatisation? - state petroleum enterprises and the global economic adjustment process

    International Nuclear Information System (INIS)

    Ndi, G.K.; Moller, L.E.

    1994-01-01

    The restructuring, and to a lesser extent the privatisation, of state petroleum enterprises in many oil-producing countries has been seen as a means of addressing the shortcomings of previous state regulation. Recent developments in the petroleum industry within the general context of the current privatisation process are examined in this chapter. Political, economic and social reasons are sought for restructuring being the preferred alternative to the privatisation of state petroleum enterprises in developing countries. The benefits, problems and obstacles to privatisation are analysed. (UK)

  16. Risk-evaluation of Hi-tech Enterprise in the Process of Approaching Global Market

    Institute of Scientific and Technical Information of China (English)

    Xiang Laisheng; Guo Yajun; Li Zhanfang

    2007-01-01

    In the high technology industry, small and medium sized technology enterprises (SMSTEs) play a pivotal role in advancing the whole industry. To achieve sustainable development, they need to extend their scope of business activities beyond a national view and exploit international market actively to meet international competitions that increase quickly in the form of allocating resources within the scope of the world. However, the SMSTEs are also facing risks associated with themselves during the process of exploiting international market owing to their own restrictions, so what they should do is to consider risk evaluations in exploiting the international market.

  17. A global, incremental development method for a web-based prostate cancer treatment decision aid and usability testing in a Dutch clinical setting.

    Science.gov (United States)

    Cuypers, Maarten; Lamers, Romy Ed; Kil, Paul Jm; The, Regina; Karssen, Klemens; van de Poll-Franse, Lonneke V; de Vries, Marieke

    2017-07-01

    Many new decision aids are developed while aspects of existing decision aids could also be useful, leading to a sub-optimal use of resources. To support treatment decision-making in prostate cancer patients, a pre-existing evidence-based Canadian decision aid was adjusted to Dutch clinical setting. After analyses of the original decision aid and routines in Dutch prostate cancer care, adjustments to the decision aid structure and content were made. Subsequent usability testing (N = 11) resulted in 212 comments. Care providers mainly provided feedback on medical content, and patients commented most on usability and summary layout. All participants reported that the decision aid was comprehensible and well-structured and would recommend decision aid use. After usability testing, final adjustments to the decision aid were made. The presented methods could be useful for cultural adaptation of pre-existing tools into other languages and settings, ensuring optimal usage of previous scientific and practical efforts and allowing for a global, incremental decision aid development process.

  18. Evaluate transport processes in MERRA driven chemical transport models using updated 222Rn emission inventories and global observations

    Science.gov (United States)

    Zhang, B.; Liu, H.; Crawford, J. H.; Fairlie, T. D.; Chen, G.; Chambers, S. D.; Kang, C. H.; Williams, A. G.; Zhang, K.; Considine, D. B.; Payer Sulprizio, M.; Yantosca, R.

    2015-12-01

    Convective and synoptic processes play a major role in determining the transport and distribution of trace gases and aerosols in the troposphere. The representation of these processes in global models (at ~100-1000 km horizontal resolution) is challenging, because convection is a sub-grid process and needs to be parameterized, while synoptic processes are close to the grid scale. Depending on the parameterization schemes used in climate models, the role of convection in transporting trace gases and aerosols may vary from model to model. 222Rn is a chemically inert and radioactive gas constantly emitted from soil and has a half-life (3.8 days) comparable to synoptic timescale, which makes it an effective tracer for convective and synoptic transport. In this study, we evaluate the convective and synoptic transport in two chemical transport models (GMI and GEOS-Chem), both driven by the NASA's MERRA reanalysis. Considering the uncertainties in 222Rn emissions, we incorporate two more recent scenarios with regionally varying 222Rn emissions into GEOS-Chem/MERRA and compare the simulation results with those using the relatively uniform 222Rn emissions in the standard model. We evaluate the global distribution and seasonality of 222Rn concentrations simulated by the two models against an extended collection of 222Rn observations from 1970s to 2010s. The intercomparison will improve our understanding of the spatial variability in global 222Rn emissions, including the suspected excessive 222Rn emissions in East Asia, and provide useful feedbacks on 222Rn emission models. We will assess 222Rn vertical distributions at different latitudes in the models using observations at surface sites and in the upper troposphere and lower stratosphere. Results will be compared with previous models driven by other meteorological fields (e.g., fvGCM and GEOS4). Since the decay of 222Rn is the source of 210Pb, a useful radionuclide tracer attached to submicron aerosols, improved

  19. Describing the clinical reasoning process: application of a model of enablement to a pediatric case.

    Science.gov (United States)

    Furze, Jennifer; Nelson, Kelly; O'Hare, Megan; Ortner, Amanda; Threlkeld, A Joseph; Jensen, Gail M

    2013-04-01

    Clinical reasoning is a core tenet of physical therapy practice leading to optimal patient care. The purpose of this case was to describe the outcomes, subjective experience, and reflective clinical reasoning process for a child with cerebral palsy using the International Classification of Functioning, Disability, and Health (ICF) model. Application of the ICF framework to a 9-year-old boy with spastic triplegic cerebral palsy was utilized to capture the interwoven factors present in this case. Interventions in the pool occurred twice weekly for 1 h over a 10-week period. Immediately post and 4 months post-intervention, the child made functional and meaningful gains. The family unit also developed an enjoyment of exercising together. Each individual family member described psychological, emotional, or physical health improvements. Reflection using the ICF model as a framework to discuss clinical reasoning can highlight important factors contributing to effective patient management.

  20. Workshop on using natural language processing applications for enhancing clinical decision making: an executive summary.

    Science.gov (United States)

    Pai, Vinay M; Rodgers, Mary; Conroy, Richard; Luo, James; Zhou, Ruixia; Seto, Belinda

    2014-02-01

    In April 2012, the National Institutes of Health organized a two-day workshop entitled 'Natural Language Processing: State of the Art, Future Directions and Applications for Enhancing Clinical Decision-Making' (NLP-CDS). This report is a summary of the discussions during the second day of the workshop. Collectively, the workshop presenters and participants emphasized the need for unstructured clinical notes to be included in the decision making workflow and the need for individualized longitudinal data tracking. The workshop also discussed the need to: (1) combine evidence-based literature and patient records with machine-learning and prediction models; (2) provide trusted and reproducible clinical advice; (3) prioritize evidence and test results; and (4) engage healthcare professionals, caregivers, and patients. The overall consensus of the NLP-CDS workshop was that there are promising opportunities for NLP and CDS to deliver cognitive support for healthcare professionals, caregivers, and patients.

  1. The clinical reasoning process in randomized clinical trials with patients with non-specific neck pain is incomplete: A systematic review.

    Science.gov (United States)

    Maissan, Francois; Pool, Jan; de Raaij, Edwin; Mollema, Jürgen; Ostelo, Raymond; Wittink, Harriet

    2018-06-01

    Primarily to evaluate the completeness of the description of the clinical reasoning process in RCTs with patients with non-specific neck pain with an argued or diagnosed cause i.e. an impairment or activity limitation. Secondly, to determine the association between the completeness of the clinical reasoning process and the degree of risk of bias. Pubmed, Cinahl and PEDro were systematically searched from inception to July 2016. RCTs (n = 122) with patients with non-specific neck pain receiving physiotherapy treatment published in English were included. Data extraction included study characteristics and important features of the clinical reasoning process based on the Hypothesis-Oriented Algorithm for Clinicians II (HOAC II)]. Thirty-seven studies (30%) had a complete clinical reasoning process of which 8 (6%) had a 'diagnosed cause' and 29 (24%) had an 'argued cause'. The Spearmans rho association between the extent of the clinical reasoning process and the risk of bias was -0.2. In the majority of studies (70%) the described clinical reasoning process was incomplete. A very small proportion (6%) had a 'diagnosed cause'. Therefore, a better methodological quality does not necessarily imply a better described clinical reasoning process. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Metaassesment of the Global Instititucional Evaluation Process in Ecuador with the “V” Model

    Directory of Open Access Journals (Sweden)

    María Verónica Peña

    2015-12-01

    Full Text Available This article presents the results of an evaluation research developed with the use of the methodological strategy of the “V” Model for integrative structural analysis of higher education institutions, which is a meta-model of assessment that allows comprehensive assessment of the problem undergoing analysis from different points of view so as to posit improvement proposals. The overall objective set for this project was to evaluate the model used for the process of institutional assessment in Ecuador regarding compliance with the quality standards that have been established within the Organic Law on Higher Education (LOES. An increase of meaning vis-à-vis the intent of this study was achieved through the use of the “V” Model analysis and synthesis tools. The main findings helped outline the need to take account of indicators to assess sections of the Law that were not covered within the model, provide more information within the assessment guidelines, introduce qualitative data collection techniques, specify the theoretical foundations and information for the methodological procedure of information substantiation, and strengthen the training process of external peer reviewers. The aforesaid will allow the structuring of a plan to improve the Ecuadorian institutional assessment model.

  3. Digital image processing techniques for the analysis of fuel sprays global pattern

    Science.gov (United States)

    Zakaria, Rami; Bryanston-Cross, Peter; Timmerman, Brenda

    2017-12-01

    We studied the fuel atomization process of two fuel injectors to be fitted in a new small rotary engine design. The aim was to improve the efficiency of the engine by optimizing the fuel injection system. Fuel sprays were visualised by an optical diagnostic system. Images of fuel sprays were produced under various testing conditions, by changing the line pressure, nozzle size, injection frequency, etc. The atomisers were a high-frequency microfluidic dispensing system and a standard low flow-rate fuel injector. A series of image processing procedures were developed in order to acquire information from the laser-scattering images. This paper presents the macroscopic characterisation of Jet fuel (JP8) sprays. We observed the droplet density distribution, tip velocity, and spray-cone angle against line-pressure and nozzle-size. The analysis was performed for low line-pressure (up to 10 bar) and short injection period (1-2 ms). Local velocity components were measured by applying particle image velocimetry (PIV) on double-exposure images. The discharge velocity was lower in the micro dispensing nozzle sprays and the tip penetration slowed down at higher rates compared to the gasoline injector. The PIV test confirmed that the gasoline injector produced sprays with higher velocity elements at the centre and the tip regions.

  4. Visualizing complex processes using a cognitive-mapping tool to support the learning of clinical reasoning.

    Science.gov (United States)

    Wu, Bian; Wang, Minhong; Grotzer, Tina A; Liu, Jun; Johnson, Janice M

    2016-08-22

    Practical experience with clinical cases has played an important role in supporting the learning of clinical reasoning. However, learning through practical experience involves complex processes difficult to be captured by students. This study aimed to examine the effects of a computer-based cognitive-mapping approach that helps students to externalize the reasoning process and the knowledge underlying the reasoning process when they work with clinical cases. A comparison between the cognitive-mapping approach and the verbal-text approach was made by analyzing their effects on learning outcomes. Fifty-two third-year or higher students from two medical schools participated in the study. Students in the experimental group used the computer-base cognitive-mapping approach, while the control group used the verbal-text approach, to make sense of their thinking and actions when they worked with four simulated cases over 4 weeks. For each case, students in both groups reported their reasoning process (involving data capture, hypotheses formulation, and reasoning with justifications) and the underlying knowledge (involving identified concepts and the relationships between the concepts) using the given approach. The learning products (cognitive maps or verbal text) revealed that students in the cognitive-mapping group outperformed those in the verbal-text group in the reasoning process, but not in making sense of the knowledge underlying the reasoning process. No significant differences were found in a knowledge posttest between the two groups. The computer-based cognitive-mapping approach has shown a promising advantage over the verbal-text approach in improving students' reasoning performance. Further studies are needed to examine the effects of the cognitive-mapping approach in improving the construction of subject-matter knowledge on the basis of practical experience.

  5. When to trust our learners? Clinical teachers' perceptions of decision variables in the entrustment process.

    Science.gov (United States)

    Duijn, Chantal C M A; Welink, Lisanne S; Bok, Harold G J; Ten Cate, Olle T J

    2018-06-01

    Clinical training programs increasingly use entrustable professional activities (EPAs) as focus of assessment. However, questions remain about which information should ground decisions to trust learners. This qualitative study aimed to identify decision variables in the workplace that clinical teachers find relevant in the elaboration of the entrustment decision processes. The findings can substantiate entrustment decision-making in the clinical workplace. Focus groups were conducted with medical and veterinary clinical teachers, using the structured consensus method of the Nominal Group Technique to generate decision variables. A ranking was made based on a relevance score assigned by the clinical teachers to the different decision variables. Field notes, audio recordings and flip chart lists were analyzed and subsequently translated and, as a form of axial coding, merged into one list, combining the decision variables that were similar in their meaning. A list of 11 and 17 decision variables were acknowledged as relevant by the medical and veterinary teacher groups, respectively. The focus groups yielded 21 unique decision variables that were considered relevant to inform readiness to perform a clinical task on a designated level of supervision. The decision variables consisted of skills, generic qualities, characteristics, previous performance or other information. We were able to group the decision variables into five categories: ability, humility, integrity, reliability and adequate exposure. To entrust a learner to perform a task at a specific level of supervision, a supervisor needs information to support such a judgement. This trust cannot be credited on a single case at a single moment of assessment, but requires different variables and multiple sources of information. This study provides an overview of decision variables giving evidence to justify the multifactorial process of making an entrustment decision.

  6. Remote Digital Preoperative Assessments for Cleft Lip and Palate May Improve Clinical and Economic Impact in Global Plastic Surgery.

    Science.gov (United States)

    Hughes, Christopher; Campbell, Jacob; Mukhopadhyay, Swagoto; McCormack, Susan; Silverman, Richard; Lalikos, Janice; Babigian, Alan; Castiglione, Charles

    2017-09-01

    Reconstructive surgical care can play a vital role in the resource-poor settings of low- and middle-income countries. Telemedicine platforms can improve the efficiency and effectiveness of surgical care. The purpose of this study is to determine whether remote digital video evaluations are reliable in the context of a short-term plastic surgical intervention. The setting for this study was a district hospital located in Latacunga, Ecuador. Participants were 27 consecutive patients who presented for operative repair of cleft lip and palate. We calculated kappa coefficients for reliability between in-person and remote digital video assessments for the classification of cleft lip and palate between two separate craniofacial surgeons. We hypothesized that the technology would be a reliable method of preoperative assessment for cleft disease. Of the 27 (81.4%) participants, 22 received operative treatment for their cleft disorder. Mean age was 11.1 ± 8.3 years. Patients presented with a spectrum of disorders, including cleft lip (24 of 27, 88.9%), cleft palate (19 of 27, 70.4%), and alveolar cleft (19 of 27, 70.4%). We found a 95.7% agreement between observers for cleft lip with substantial reliability (κ = .78, P cleft palate, with a moderate interrater reliability (κ = .55, P = .01). We found only a 47.8% agreement between observers for alveolar cleft with a nonsignificant, weak kappa agreement (κ = .06, P = .74). Remote digital assessments are a reliable way to preoperatively diagnose cleft lip and palate in the context of short-term plastic surgical interventions in low- and middle-income countries. Future work will evaluate the potential for real-time, telemedicine assessments to reduce cost and improve clinical effectiveness in global plastic surgery.

  7. B-Type Natriuretic Peptide: From Posttranslational Processing to Clinical Measurement

    DEFF Research Database (Denmark)

    Goetze, Jens P

    2012-01-01

    BACKGROUND:Plasma cardiac natriuretic peptides and peptide fragments from their molecular precursors are markers of heart disease. Clinical studies have defined the current diagnostic utility of these markers, whereas biochemical elucidation of peptide structure and posttranslational processing has...... revealed new plasma peptide forms of potential clinical use.CONTENT:Natriuretic propeptide structures undergo variable degrees of endo- and exoproteolytic cleavages as well as amino acid modifications, which leave the plasma phase of the peptides highly heterogeneous and dependent on cardiac......-atrial natriuretic peptide and pro-B-type natriuretic peptide are useful plasma markers in heart failure. New data have defined cardiac myocytes as competent endocrine cells in posttranslational processing and cellular secretion....

  8. Processes influencing the development of graduate nurse capabilities in clinical risk management: an Australian study.

    Science.gov (United States)

    Johnstone, Megan-Jane; Kanitsaki, Olga

    2006-01-01

    To explore and describe key processes influencing the development of graduate nurse capabilities in clinical risk management (CRM). This study was undertaken using an exploratory descriptive case study method. Four sample units of analysis were used, notably: 2 cohorts of graduate nurses (n = 11) undertaking a 12-month graduate nurse transition program; key stakeholders (n = 34), that is, nurse unit managers, clinical teachers, preceptors, a quality manager, a librarian, and senior nurse administrators employed by the participating health service; patient outcome data; and pertinent literature. Data strongly suggested that graduate nurse capabilities in CRM were most influenced not by their supposed lack of clinical knowledge and skills but by their lack of corporate knowledge. The failure to provide new graduate nurses with pertinent information on CRM at the beginning of their employment and thereafter at pertinent intervals during the graduate nurse year program aslo hindered the development of their capabilities to manage clinical risk. Management and educational processes pertinent to informing and involving new graduate nurses in a hospital's local CRM program (including information about the organization's local policies and procedures) need to be implemented systematically at the very beginning of a new graduate's employment and thereafter throughout the remainder of the graduate nurse year.

  9. The role of clinician emotion in clinical reasoning: Balancing the analytical process.

    Science.gov (United States)

    Langridge, Neil; Roberts, Lisa; Pope, Catherine

    2016-02-01

    This review paper identifies and describes the role of clinicians' memory, emotions and physical responses in clinical reasoning processes. Clinical reasoning is complex and multi-factorial and key models of clinical reasoning within musculoskeletal physiotherapy are discussed, highlighting the omission of emotion and subsequent physical responses and how these can impact upon a clinician when making a decision. It is proposed that clinicians should consider the emotions associated with decision-making, especially when there is concern surrounding a presentation. Reflecting on practice in the clinical environment and subsequently applying this to a patient presentation should involve some acknowledgement of clinicians' physical responses, emotions and how they may play a part in any decision made. Presenting intuition and gut-feeling as separate reasoning methods and how these processes co-exist with other more accepted reasoning such as hypothetico-deductive is also discussed. Musculoskeletal physiotherapy should consider the elements of feelings, emotions and physical responses when applying reflective practice principles. Furthermore, clinicians dealing with difficult and challenging presentations should look at the emotional as well as the analytical experience when justifying decisions and learning from practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. [Informed consent process in clinical trials: Insights of researchers, patients and general practitioners].

    Science.gov (United States)

    Giménez, Nuria; Pedrazas, David; Redondo, Susana; Quintana, Salvador

    2016-10-01

    Adequate information for patients and respect for their autonomy are mandatory in research. This article examined insights of researchers, patients and general practitioners (GPs) on the informed consent process in clinical trials, and the role of the GP. A cross-sectional study using three questionnaires, informed consent reviews, medical records, and hospital discharge reports. GPs, researchers and patients involved in clinical trials. Included, 504 GPs, 108 researchers, and 71 patients. Consulting the GP was recommended in 50% of the informed consents. Participation in clinical trials was shown in 33% of the medical records and 3% of the hospital discharge reports. GPs scored 3.54 points (on a 1-10 scale) on the assessment of the information received by the principal investigator. The readability of the informed consent sheet was rated 8.03 points by researchers, and the understanding was rated 7.68 points by patients. Patient satisfaction was positively associated with more time for reflection. GPs were not satisfied with the information received on the participation of patients under their in clinical trials. Researchers were satisfied with the information they offered to patients, and were aware of the need to improve the information GPs received. Patients collaborated greatly towards biomedical research, expressed satisfaction with the overall process, and minimised the difficulties associated with participation. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  11. Increasing clinical, satisfaction, and financial performance through nurse-driven process improvement.

    Science.gov (United States)

    Sims, Caroline E

    2003-02-01

    Providers and regulatory agencies are increasing their demands for hospitals to document clinical quality and customer satisfaction at a decreased cost. Nurse leaders search for ways to meet these requirements while retaining their most valuable resource: healthcare workers (especially nurses). First-line leadership struggles with balancing quality, cost-effectiveness, and staff retention. The author discusses the planning, methodology, implementation, and outcomes of a staff driven process improvement initiative.

  12. Global identification of new substrates for the yeast endoribonuclease, RNase mitochondrial RNA processing (MRP).

    Science.gov (United States)

    Aulds, Jason; Wierzbicki, Sara; McNairn, Adrian; Schmitt, Mark E

    2012-10-26

    RNase mitochondrial RNA processing (MRP) is an essential, evolutionarily conserved endoribonuclease composed of 10 different protein subunits and a single RNA. RNase MRP has established roles in multiple pathways including ribosome biogenesis, cell cycle regulation, and mitochondrial DNA replication. Although each of these functions is important to cell growth, additional functions may exist given the essential nature of the complex. To identify novel RNase MRP substrates, we utilized RNA immunoprecipitation and microarray chip analysis to identify RNA that physically associates with RNase MRP. We identified several new potential substrates for RNase MRP including a cell cycle-regulated transcript, CTS1; the yeast homolog of the mammalian p27(Kip1), SIC1; and the U2 RNA component of the spliceosome. In addition, we found RNase MRP to be involved in the regulation of the Ty1 transposon RNA. These results reinforce and broaden the role of RNase MRP in cell cycle regulation and help to identify new roles of this endoribonuclease.

  13. Global investigation of RNA 3'end processing and transcription termination pathways

    DEFF Research Database (Denmark)

    Molska, Ewa

    2018-01-01

    . For example, contrary to prediction, a subset of protein-coding genes utilise the machinery used by genes encoding U snRNAs. This same machinery is predominantly used by a class of lncRNA genes, encoding so-called PROMPTs, despite the presence of sequence elements predicted to guide the usage of the pathway......RNA polymerases transcribe diverse classes of genes and the produced RNAs need to be targeted to their appropriate cognate biochemical maturation pathways. The vast majority of the human transcriptome consists of long non-coding RNAs (lncRNAs), which is a heterogeneous group of RNAs...... that is inadequately divided into classes based e.g. on length, stability and association with protein-coding genes. We reasoned that further classification based on biochemical properties, in this case transcription termination and the mechanistically coupled RNA 3’-end processing, would enable a better understanding...

  14. Toward a Process Framework of Business Model Innovation in the Global Context

    DEFF Research Database (Denmark)

    Cao, Yangfeng; Li, Peter Ping; Skat-Rørdam, Peter

    2014-01-01

    Primarily due to the large gaps in economic and institutional contexts between the developed and emerging economies, effective business models in the two distinctive contexts tend to differ. In particular, the business model innovation (BMI) at the subsidiary level plays an important role...... in the success of multinational enterprises (MNE) from the developed economies operating in the emerging economies as top-down ventures. While some studies claim that direct involvement of headquarters (HQ) in the operations of subsidiaries is critical, surprisingly little is known about how HQ specifically...... enable BMI at the subsidiary level, especially for medium-sized MNE. Adopting the method of comparative and longitudinal case study, we tracked the BMI processes of six Danish medium-sized MNE operating in China. The emergent framework indicates that entrepreneurial aspiration and flexibility at the HQ...

  15. Evaluation of climate-related carbon turnover processes in global vegetation models for boreal and temperate forests.

    Science.gov (United States)

    Thurner, Martin; Beer, Christian; Ciais, Philippe; Friend, Andrew D; Ito, Akihiko; Kleidon, Axel; Lomas, Mark R; Quegan, Shaun; Rademacher, Tim T; Schaphoff, Sibyll; Tum, Markus; Wiltshire, Andy; Carvalhais, Nuno

    2017-08-01

    Turnover concepts in state-of-the-art global vegetation models (GVMs) account for various processes, but are often highly simplified and may not include an adequate representation of the dominant processes that shape vegetation carbon turnover rates in real forest ecosystems at a large spatial scale. Here, we evaluate vegetation carbon turnover processes in GVMs participating in the Inter-Sectoral Impact Model Intercomparison Project (ISI-MIP, including HYBRID4, JeDi, JULES, LPJml, ORCHIDEE, SDGVM, and VISIT) using estimates of vegetation carbon turnover rate (k) derived from a combination of remote sensing based products of biomass and net primary production (NPP). We find that current model limitations lead to considerable biases in the simulated biomass and in k (severe underestimations by all models except JeDi and VISIT compared to observation-based average k), likely contributing to underestimation of positive feedbacks of the northern forest carbon balance to climate change caused by changes in forest mortality. A need for improved turnover concepts related to frost damage, drought, and insect outbreaks to better reproduce observation-based spatial patterns in k is identified. As direct frost damage effects on mortality are usually not accounted for in these GVMs, simulated relationships between k and winter length in boreal forests are not consistent between different regions and strongly biased compared to the observation-based relationships. Some models show a response of k to drought in temperate forests as a result of impacts of water availability on NPP, growth efficiency or carbon balance dependent mortality as well as soil or litter moisture effects on leaf turnover or fire. However, further direct drought effects such as carbon starvation (only in HYBRID4) or hydraulic failure are usually not taken into account by the investigated GVMs. While they are considered dominant large-scale mortality agents, mortality mechanisms related to insects and

  16. An improved hindcast approach for evaluation and diagnosis of physical processes in global climate models

    Science.gov (United States)

    Ma, H.-Y.; Chuang, C. C.; Klein, S. A.; Lo, M.-H.; Zhang, Y.; Xie, S.; Zheng, X.; Ma, P.-L.; Zhang, Y.; Phillips, T. J.

    2015-12-01

    We present an improved procedure of generating initial conditions (ICs) for climate model hindcast experiments with specified sea surface temperature and sea ice. The motivation is to minimize errors in the ICs and lead to a better evaluation of atmospheric parameterizations' performance in the hindcast mode. We apply state variables (horizontal velocities, temperature, and specific humidity) from the operational analysis/reanalysis for the atmospheric initial states. Without a data assimilation system, we apply a two-step process to obtain other necessary variables to initialize both the atmospheric (e.g., aerosols and clouds) and land models (e.g., soil moisture). First, we nudge only the model horizontal velocities toward operational analysis/reanalysis values, given a 6 h relaxation time scale, to obtain all necessary variables. Compared to the original strategy in which horizontal velocities, temperature, and specific humidity are nudged, the revised approach produces a better representation of initial aerosols and cloud fields which are more consistent and closer to observations and model's preferred climatology. Second, we obtain land ICs from an off-line land model simulation forced with observed precipitation, winds, and surface fluxes. This approach produces more realistic soil moisture in the land ICs. With this refined procedure, the simulated precipitation, clouds, radiation, and surface air temperature over land are improved in the Day 2 mean hindcasts. Following this procedure, we propose a "Core" integration suite which provides an easily repeatable test allowing model developers to rapidly assess the impacts of various parameterization changes on the fidelity of modeled cloud-associated processes relative to observations.

  17. Global site-specific analysis of glycoprotein N-glycan processing.

    Science.gov (United States)

    Cao, Liwei; Diedrich, Jolene K; Ma, Yuanhui; Wang, Nianshuang; Pauthner, Matthias; Park, Sung-Kyu Robin; Delahunty, Claire M; McLellan, Jason S; Burton, Dennis R; Yates, John R; Paulson, James C

    2018-06-01

    N-glycans contribute to the folding, stability and functions of the proteins they decorate. They are produced by transfer of the glycan precursor to the sequon Asn-X-Thr/Ser, followed by enzymatic trimming to a high-mannose-type core and sequential addition of monosaccharides to generate complex-type and hybrid glycans. This process, mediated by the concerted action of multiple enzymes, produces a mixture of related glycoforms at each glycosite, making analysis of glycosylation difficult. To address this analytical challenge, we developed a robust semiquantitative mass spectrometry (MS)-based method that determines the degree of glycan occupancy at each glycosite and the proportion of N-glycans processed from high-mannose type to complex type. It is applicable to virtually any glycoprotein, and a complete analysis can be conducted with 30 μg of protein. Here, we provide a detailed description of the method that includes procedures for (i) proteolytic digestion of glycoprotein(s) with specific and nonspecific proteases; (ii) denaturation of proteases by heating; (iii) sequential treatment of the glycopeptide mixture with two endoglycosidases, Endo H and PNGase F, to create unique mass signatures for the three glycosylation states; (iv) LC-MS/MS analysis; and (v) data analysis for identification and quantitation of peptides for the three glycosylation states. Full coverage of site-specific glycosylation of glycoproteins is achieved, with up to thousands of high-confidence spectra hits for each glycosite. The protocol can be performed by an experienced technician or student/postdoc with basic skills for proteomics experiments and takes ∼7 d to complete.